Mental Health and Prevention最新文献

{"title":"Effect of progressive muscle relaxation on breastfeeding self-efficacy and depression in mothers of preterm infants- a randomized controlled study","authors":"Kadriye ŞAHİN ,&nbsp;Birsen MUTLU","doi":"10.1016/j.mhp.2025.200458","DOIUrl":"10.1016/j.mhp.2025.200458","url":null,"abstract":"<div><h3>Background</h3><div>Mothers of preterm infants often experience increased depressive symptoms during their stay in the neonatal intensive care unit (NICU). This situation can negatively affect breastfeeding self-efficacy, necessitating effective supportive interventions. This randomized controlled trial aimed to investigated the impact of Progressive Muscle Relaxation (PMR) exercises on breastfeeding self-efficacy and postpartum depression in mothers of preterm infants.</div></div><div><h3>Methods</h3><div>The study was conducted in the NICU of a hospital in Istanbul between November 2018 and June 2019. The study included 70 mothers. Data were collected using a sociodemographic form, Breastfeeding Self-Efficacy Scale (BSES), Edinburgh Postpartum Depression Scale (EPDS), and mother follow-up forms. In the experimental group, mothers performed progressive muscle relaxation (PMR) exercises twice a day for two weeks, while the control group received routine care; data were analysed using the Kolmogorov–Smirnov test, independent samples <em>t</em>-test, chi-square test and repeated measures ANOVA, and the significance level was <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>At the two-week follow-up, mothers in the experimental group had significantly higher BSES scores and lower EPDS scores. In the 2nd-week assessment compared to baseline, the EPDS score for the experimental group mothers decreased by −3.46 ± 3.45, while the control group mothers, it decreased by −1.03 ± 2.15. This difference was statistically significant (<em>t</em> = −3.535, <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>PMR exercises effectively enhance breastfeeding self-efficacy and reduce postpartum depression in mothers of preterm infants. PMR is a safe, low-cost intervention that can be integrated into NICU nursing care to reduce depressive symptoms in mothers of preterm infants, increase breastfeeding success.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200458"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do reporting guidelines improve the quality of suicide coverage?: A case study of Indonesia","authors":"Eriyanto (Associate Professor)","doi":"10.1016/j.mhp.2025.200463","DOIUrl":"10.1016/j.mhp.2025.200463","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the effectiveness of adopting the World Health Organization (WHO) suicide reporting guidelines in Indonesian online media. Although the guidelines were officially adopted by the Indonesian Press Council in 2019, little is known about the extent of their implementation in everyday journalistic practice.</div></div><div><h3>Methods</h3><div>A quantitative content analysis was conducted on 2375 suicide-related news articles published by four of the largest Indonesian online media outlets between 2015 and 2024, retrieved via Google News. The analysis was carried out in two stages. First, descriptive statistics were used to assess compliance with the “Do’s” and violations of the “Don’ts.” Second, joinpoint regression analysis was employed to examine whether significant trend shifts occurred across the study period.</div></div><div><h3>Results</h3><div>Findings indicate that Indonesian online media tend to demonstrate only surface-level compliance. Formal practices such as including counseling hotline numbers or stating that suicide is preventable were adopted. However, widespread violations of the “Don’ts” persisted, including disclosure of victims’ identities, detailed descriptions of suicide methods and locations, and the use of sensational language.</div></div><div><h3>Conclusion</h3><div>The novelty of this study lies in its longitudinal design, which allows a comparison of reporting patterns before and after the adoption of the WHO guidelines. The results suggest that adoption of the guidelines in Indonesia has not yet translated into substantive ethical change in reporting culture. Stronger newsroom integration of guidelines (e.g., style sheets, templates), targeted journalist training, and periodic monitoring are needed to move beyond symbolic compliance toward meaningful implementation.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200463"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The co-design of a children’s health and wellbeing Local model of care to embed early mental health intervention and prevention within community ecosystems","authors":"Jennifer Bibb ,&nbsp;Tara Dimopoulos-Bick ,&nbsp;Kate McMahon ,&nbsp;Caroline Tjung ,&nbsp;Phillip Orcher (Muruwori | Gumbaynggirr) ,&nbsp;Victoria J Palmer","doi":"10.1016/j.mhp.2025.200457","DOIUrl":"10.1016/j.mhp.2025.200457","url":null,"abstract":"<div><div><em>Objective:</em> The aim of this paper is to present the co-design processes for a conceptual design of a model of care for the Southern Melbourne Children’s Health and Wellbeing Local in Victoria, Australia – one of three pilot sites established under the National Children’s Mental Health and Wellbeing Strategy and recommendations of the Victorian Royal Commission into Mental Health, targeting children’s mental health and wellbeing. <em>Methods:</em> Using an experience co-design approach, the concepts for the model of care were developed in partnership with over 235 children, families, carers, kin, service providers, and intersectoral partners across culturally and linguistically diverse and First Nations (Aboriginal and Torres Strait Islander peoples) communities. Co-design used creative arts approaches, journey mapping and Lego serious play to establish experiential goals. The co-design also enabled identification of systemic barriers, including racism, stigma, distrust, and fragmented service pathways. <em>Results:</em> Systemic inequities that emerged through co-design included that carers, family and kin described deep-seated barriers shaped by past institutional harm, trauma and distrust towards health and mental health services and the government. This has created barriers to people engaging with and accessing new services. Five core elements to the model were outlined in the conceptual design: finding our way, feeling recognised and respected, open, playful, and connected. These elements reflect the priorities of community members for trauma violence-informed, culturally safe, and accessible care. <em>Conclusion:</em> The project highlights how co-design can identify inequities that are systemically caused which can further inform early intervention and prevention approaches within community ecosystems.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200457"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the positive expectancy of enjoyment towards gambling with adolescents: Preliminary evaluation of efficacy of a video-based intervention","authors":"Maria Anna Donati ,&nbsp;Elisa Borace ,&nbsp;Daniela Capitanucci ,&nbsp;Roberta Smaniotto ,&nbsp;Angela Bizangoli ,&nbsp;Caterina Primi","doi":"10.1016/j.mhp.2025.200461","DOIUrl":"10.1016/j.mhp.2025.200461","url":null,"abstract":"<div><div>Harmful gambling in adolescents seems to be characterized by both cognitive and affective factors. To date, prevention interventions focused only on the first ones. Objectives: The aim of this study was to conduct a preliminary evaluation of the short- and long-term efficacy of an intervention based on a video focused on enjoyment, excitement and arousal expectancies about gambling. Methods: Participants were 203 Italian high school students (63 % boys, mean age = 16.9, <em>SD</em> = 0.89). They were randomly assigned to two groups (Experimental and Control group). The Experimental group watched a video with an emotional impact regarding gambling, while the Control group watched a video on the bystander effect. Results: The intervention had an effect on decreasing enjoyment, excitement and arousal expectancies about gambling, but not upon gambling frequency. The intervention effects were stable over time and the frequency of gambling increased only in the Control group. Conclusion: Despite limitations, this intervention is the first to modify enjoyment, excitement and arousal expectancies about gambling among adolescents.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200461"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of stress and burnout in trainee and qualified NHS psychological professionals: A systematic review and narrative synthesis","authors":"Annabel Harding,&nbsp;Jinnie Ooi,&nbsp;Megan Stinton,&nbsp;Rachel Russell,&nbsp;Sheryl Parke","doi":"10.1016/j.mhp.2025.200453","DOIUrl":"10.1016/j.mhp.2025.200453","url":null,"abstract":"<div><div>Background: Stress and burnout are widespread among NHS staff, with NHS psychological professionals particularly at risk. Despite ongoing investments into the expansion of this workforce, the extent to which these conditions are experienced remains unclear.</div><div>Objectives: This systematic review sought to establish levels of stress and burnout within trainee and qualified NHS psychological professionals.</div><div>Methods: Systematic searches of nine electronic databases identified peer-reviewed papers meeting criteria for inclusion. Screening was conducted at all stages by the primary and secondary researchers, and quality assessed using the Newcastle-Ottowa Scale (Wells et al., 2000). A narrative synthesis was employed, conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (Moher et al., 2009) and Systematic and Synthesis Without Meta-Analysis (SWiM; Campbell et al., 2020) guidance.</div><div>Results: Eight studies were included in the review. Three studies explored stress in trainee NHS psychological professions, reporting moderate levels. No studies identified in this review reported stress in qualified psychological professionals, leaving levels unestablished. Two studies explored burnout in trainee NHS psychological professions, reporting low-to-moderate levels that were comparable between trainee professions. Three studies explored burnout in qualified NHS psychological professions, reporting low-to-moderate levels, with variability between qualified professions.</div><div>Conclusions: Given the limited number of included studies, their heterogeneity, and the focus on few NHS psychological professions, this review provides a tentative picture of an at-risk workforce. To ensure its sustainability, future research must examine all psychological professions, use consistent measures, and report all data to gain robust insights and draw meaningful conclusions.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200453"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring staff perspectives on mental health promotion and prevention in Flemish schools","authors":"Lies Sercu","doi":"10.1016/j.mhp.2025.200450","DOIUrl":"10.1016/j.mhp.2025.200450","url":null,"abstract":"<div><div>Background Mental disorders like anxiety and depression often emerge for the first time during adolescence. It is increasingly recognized that schools play an influential role in promoting adolescents’ mental health and well-being. Several theoretical frameworks have been proposed to classify school-based and healthcare-based interventions aimed at promoting well-being in adolescents. Against this theoretical background, this study aims to investigate Flemish staff’s descriptions and perspectives on schools’ approaches to preventing mental health problems and promoting well-being in 12–18-year-old students.</div><div>This study is an exploratory qualitative investigation among school staff from 12 Flemish schools, examining their views on school-based interventions.</div><div>Forty-eight interviewees participated in the study. For data analysis, an a priori approach was employed, utilizing one classification scheme’s categories to describe the schools’ activities <span><span>https://elsevier.proofcentral.com/en-us/landing-page.html?token=bad096ee90775280ce8bb5b44ab825(1)</span><svg><path></path></svg></span> and code staff perspectives thematically, developing a coding scheme that reflected the main topics and attitudes addressed for each classification.</div><div>Results demonstrate that staff perceive the schools as deploying very similar care activities, of which school-wide and individual approaches are constitutive parts. Promotion and prevention are necessary complementary components of a comprehensive school approach. While schools offer similar types of prevention and promotion activities, they differ significantly in who delivers them, ranging from teachers and psychologists to student counsellors and Student Guidance Centers. Teachers often feel that they lack the appropriate training to address students’ emotional, behavioral, or psychological difficulties, and they expect individual support from the school counselor or the external Center for Student Guidance.</div><div>Even if (ad hoc) promotion and prevention activities are in place, and school-external student guidance centers serve as hubs for students who need specialized mental health care, there is room for the development of more strategic proactive initiatives, and for the training of a future workforce that can deploy such school-based initiatives. While schools collect valuable data that could inform initiatives, there is a lack of designated staff trained to use this data to develop evidence-based, school-wide strategies. Strengthening collaboration between schools and Student Guidance Centers is essential to addressing these challenges effectively.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200450"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of a brief masculine body image pilot program on college-aged men","authors":"Laci Whipple,&nbsp;Levi W. Smith,&nbsp;Katelyn Whitmer,&nbsp;Mary E. Pritchard","doi":"10.1016/j.mhp.2025.200451","DOIUrl":"10.1016/j.mhp.2025.200451","url":null,"abstract":"<div><h3>Objectives</h3><div>These two pilot studies aim to evaluate the effectiveness of a new body image curriculum for men. The program introduces men to body image programming that targets muscle-building behaviors and addresses unrealistic male appearance standards and masculine gender norms, aiming to improve men’s body satisfaction and eating attitudes.</div></div><div><h3>Method</h3><div>We recruited 84 U.S. men from a public university in the Rocky Mountain region of the United States to participate in one 90-minute-long body image intervention adapted for men from the Be Body Positive curriculum. The majority of participants were white/caucasian and heterosexual, ages 18–20. Participants completed measures assessing eating disorder attitudes and appearance comparison in Study 1, whereas in Study 2, participants completed measures assessing mood and body image states. Additionally, participants in both studies answered program satisfaction questions.</div></div><div><h3>Results</h3><div>While the pilot program showed no impact on eating disorder symptoms or appearance comparison in Study 1, participants reported satisfaction with the program, discovering messages that influenced their relationships with food, body, and exercise, and increased awareness of unrealistic appearance standards. In Study 2, participants reported improved negative mood states and body satisfaction following the intervention.</div></div><div><h3>Conclusion</h3><div>These findings suggest that targeted programming can effectively address key aspects of male body image concerns, highlight the promising impact of male-specific body image interventions, and underscore the importance of continued research and development in this area.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200451"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of mental health literacy research in young people beyond the school context","authors":"Elizabeth Toledo,&nbsp;Jason Skues,&nbsp;Roswitha Blasche,&nbsp;Jessica Sharp","doi":"10.1016/j.mhp.2025.200466","DOIUrl":"10.1016/j.mhp.2025.200466","url":null,"abstract":"<div><h3>Objective</h3><div>Mental health literacy (MHL) research in young people has expanded significantly, demonstrating its importance for prevention and early intervention. However, MHL research has primarily focused on school contexts, overlooking young people who may be disengaged from school, many of whom face heightened risk and structural disadvantage. This narrow focus creates a critical gap in understanding MHL across diverse cohorts of young people, some of whom may need MHL interventions but remain underrepresented in current research.</div></div><div><h3>Method</h3><div>This scoping review mapped the scope and characteristics of empirical research on MHL in young people beyond school-exclusive contexts to identify where, how, and with whom MHL has been studied outside school contexts. A comprehensive search of seven electronic databases and hand searching identified 31 empirical studies for inclusion.</div></div><div><h3>Results</h3><div>Several studies examined MHL among young people in non-school contexts and recruited young people from diverse settings. MHL levels and intervention outcomes varied across these contexts. Findings also highlighted a preference for informal support and the potential of digital tools to enhance MHL. While school-based research continues to dominate the field, these studies indicate progress toward broader inclusion of diverse cohorts of young people. Nevertheless, recruitment methods often relied heavily on gatekeepers, and several vulnerable cohorts remain underrepresented in existing research.</div></div><div><h3>Conclusion</h3><div>The review underscores the critical need for inclusive, context-sensitive, and equity-driven approaches to investigating MHL among young people. Future research should prioritise participatory methods and diverse settings beyond school context to ensure MHL initiatives effectively reach and support all young people.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200466"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145527746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Before Operational Stress on-demand asynchronous online training for public safety and healthcare personnel","authors":"Gabriela Ioachim ,&nbsp;Nicole Bolt ,&nbsp;Kathy Bélanger ,&nbsp;Andrii Shulhin ,&nbsp;Jilani Dabhoya ,&nbsp;Juliana M.B. Khoury ,&nbsp;Taylor A. Teckchandani ,&nbsp;Robyn E. Shields ,&nbsp;Kirby Maguire ,&nbsp;R. Nicholas Carleton","doi":"10.1016/j.mhp.2025.200459","DOIUrl":"10.1016/j.mhp.2025.200459","url":null,"abstract":"<div><h3>Background</h3><div>Public safety personnel (PSP) experience frequent exposures to potentially psychologically traumatic events, increasing their likelihood of developing several mental health disorders. The Before Operational Stress (BOS) program was designed as a proactive psychological intervention to build resilience and improve interpersonal relationships among Canadian PSP. Previous mixed-methods evaluations of the BOS program evidenced small but statistically significant improvements associated with BOS Intensive (in-person) training. A new delivery modality was developed to provide asynchronous online access to program content (i.e., BOS On-Demand) to improve accessibility.</div></div><div><h3>Objective</h3><div>The current study was designed to assess the impact of BOS On-Demand with data from a large sample of PSP (<em>n</em> = 9295; <em>n</em> = 636 [56.1% female] completed all surveys).</div></div><div><h3>Methods</h3><div>Participants were administered a self-report survey at pre-training, post-training, and at a 3-month follow-up. Multilevel modeling was used to assess differences in outcome measure changes across timepoints.</div></div><div><h3>Results</h3><div>BOS On Demand was associated with several small, but statistically significant, improvements sustained at follow-up, including decreased stress (post-training<em>, p</em> ≤ .001, Cohen’s <em>d</em> = -0.15; follow-up, <em>p</em> ≤ .01, Cohen’s <em>d</em> = -0.19), as well as increased mental health knowledge (pre-training, <em>p</em> ≤ .01, Cohen’s <em>d</em> = 0.13; follow-up, <em>p</em> ≤ .001, Cohen’s <em>d</em> = 0.34).</div></div><div><h3>Conclusion</h3><div>The current study provides the first evaluation of the BOS On-Demand program, evidencing encouraging improvements across several measures of mental health.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200459"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using network analysis to identify risk and protective factors for mental health in LGBTQ+ youth","authors":"Hana-May Eadeh ,&nbsp;G. Nic Rider ,&nbsp;Samantha E. Lawrence ,&nbsp;Amy L. Gower ,&nbsp;Ryan J. Watson ,&nbsp;Ka I Ip ,&nbsp;Marla E. Eisenberg","doi":"10.1016/j.mhp.2025.200449","DOIUrl":"10.1016/j.mhp.2025.200449","url":null,"abstract":"<div><h3>Objective</h3><div>Youth with marginalized gender and sexual identities, or lesbian, gay, bisexual, transgender, queer, and/or questioning youth (LGBTQ+) are at heightened risk for mental health concerns due to oppressive social contexts. To guide clinical practice and address health disparities for LGBTQ+ youth, researchers must identify central and influential risk and protective factors that have the greatest potential to affect mental health.</div></div><div><h3>Method</h3><div>Network analysis was used to model the complex relationships between risk factors, protective factors, mental health, and personal identities (gender, sexual, and racial and ethnic identities) among LGBTQ+ youth in a large statewide cross-sectional dataset from Minnesota (N = 24,400, <em>M</em>age = 14.77, <em>SD</em> = 1.30). Grade-stratified networks were analyzed using <em>qgraph</em> in RStudio with Graphical Least Absolute Shrinkage and Selection Operator model selection. Adjacency tables with correlations were used as the input data.</div></div><div><h3>Results</h3><div>The three grade networks were similar in density and overall pattern of centrality metrics. Bias-based bullying variables, regardless of grade, and three substance use variables were central nodes across networks. School safety and empowerment were the protective factor variables with the highest expected influence values.</div></div><div><h3>Conclusions</h3><div>Results indicate that bias-based bullying has a significant impact on mental health and other risk factors, replicating previous studies. Implications for prevention of mental health concerns include reducing bias-based bullying and substance use, the importance of early and accurate identification of mental health concerns, and increasing protective factors early on.</div></div>","PeriodicalId":55864,"journal":{"name":"Mental Health and Prevention","volume":"40 ","pages":"Article 200449"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}