BackgroundThe widespread adoption of digital media has reshaped young people’s aesthetic experiences. The abundance of idealized and digitally enhanced appearance-related content on social media has made appearance anxiety increasingly prevalent among university students. However, the psychological pathways linking social media use to appearance anxiety require systematic examination. This study examined the relationship between social media use and appearance anxiety among university students and tested the chain mediating roles of upward social comparison and envy.MethodsUsing convenience sampling, 1,640 university students in China completed the Social Media Use Intensity Scale, Appearance Anxiety Scale, Upward Social Comparison Scale, and Envy Scale. Confirmatory factor analysis, correlation analysis, and PROCESS Model 6 analysis with 5,000 percentile bootstrap samples were used to examine the relationship between social media use and appearance anxiety and the chain mediating effects of upward social comparison and envy. All regression equations controlled for gender, educational level, and average daily social media use time.Results(1) Social media use was significantly and positively associated with appearance anxiety among university students. (2) Upward social comparison mediated the relationship between social media use and appearance anxiety. (3) Envy mediated the relationship between social media use and appearance anxiety. (4) Upward social comparison and envy showed a significant chain mediating effect in the relationship between social media use and appearance anxiety.ConclusionThis study provided preliminary cross-sectional evidence for an appearance-anxiety-specific comparison–envy pattern linking social media use to appearance anxiety among university students. The findings provide theoretical and practical implications for aesthetic education and media literacy education in higher education within the digital media environment. They may also help guide university students toward more rational aesthetic perceptions, reduced appearance anxiety, and improved physical and mental well-being.
Feasibility and Preliminary Outcomes of Compassion-Focused Group Therapy for Depression and Anxiety
Conditions: Depression / Major Depressive Disorder; Anxiety Disorder (Panic Disorder or GAD)
Interventions: Behavioral: Compassion-Focused Group Therapy (CFT)
Sponsors: Karolinska Institutet
Completed
Interventions: Behavioral: Compassion-Focused Group Therapy (CFT)
Sponsors: Karolinska Institutet
Completed
Network analysis of trauma-related mental health comorbidities under continuous traumatic stress: a comparative study of South African and Ukrainian adolescents
BackgroundAdolescents living under conditions of continuous traumatic stress (CTS) are exposed to ongoing, persistent, unpredictable threats that differ from past discrete traumatic events and are associated with high levels of CTS symptoms, posttraumatic stress disorder (PTSD), depression, and anxiety. Despite growing evidence that CTS functions as a risk factor for trauma-related disorders, little is known about how specific CTS symptoms are embedded within broader psychopathology networks across diverse contexts of chronic violence.AimThis study applied item-level network analysis to examine the structural role of individual CTS symptoms within PTSD, depression, and anxiety symptom networks among adolescents exposed to CTS in South Africa (n = 600) and Ukraine (n = 485).MethodAdolescents (aged 12 to 18 years) completed standardised measures of CTS, PTSD, depression, and anxiety symptoms. Item-level network models were used to examine within- and cross-domain symptom associations, identify central and bridging CTS symptoms, assess their predictive value for overall symptom severity, and test network invariance across countries.ResultsIn both samples, strong within-domain clustering was observed alongside robust cross-domain connections linking CTS symptoms with PTSD, depression, and anxiety symptoms. In Ukraine, CTS symptoms were represented by symptoms reflecting loss of meaning, intense fear or horror, and episodes of rage, while in South Africa, CTS symptoms were represented by difficulty controlling emotions, feelings of betrayal, and perceived life threat. The findings also suggest that CTS symptoms were more tightly interconnected and more evenly distributed across PTSD, depression, and anxiety symptoms in the Ukrainian sample, whereas the South African sample demonstrated a broader and more diffuse symptom pattern, with anxiety-related symptoms appearing to be more prominently expressed.ConclusionFindings suggest that CTS symptoms may potentially operate as a transdiagnostic process – cutting across, and contributing to shared variance in PTSD, depression, and anxiety symptoms – among adolescents exposed to ongoing violence. Interventions targeting core CTS bridge symptoms may reduce comorbidity and improve mental health outcomes in chronically threatened youth across diverse conflict settings.
Which classroom anxiety experience should teachers target first? A network-simulation study of foreign language classroom anxiety and enjoyment
BackgroundForeign language classroom anxiety and enjoyment are moderately negatively related, but this relationship has been examined almost entirely at the total score level, and to our knowledge, no published study has asked which specific anxiety experiences are most closely coupled to enjoyment.MethodsUsing item-level psychological network analysis and the GGMNIRA simulated node-manipulation framework, we estimated the joint network of eight anxiety items and nine enjoyment items in 3,957 Chinese non-English-major college students and simulated the alleviation of each anxiety node in turn.ResultsRank-based stability was high (case-dropping correlation stability coefficient ≥ 0.75 for EI, BEI, and the KL rankings). The highest expected influence nodes were shared jokes and topics and teacher support; among anxiety items, panic without preparation speaking ranked highest. The simulations applied two complementary criteria that answer different questions: panic without preparation produced the largest distributional reconfiguration of the enjoyment construct, whereas alleviating nervousness when speaking predicted the largest signed enjoyment gain, the largest model-implied gain among the eight anxiety items. The highest bridge-centrality anxiety node showed negligible simulated effects.ConclusionsSpeaking-related anxiety, particularly the fear of speaking without preparation, is the anxiety experience most closely coupled to enjoyment. Simulated conditioning offers a principled, model-implied complement to centrality when researchers generate hypotheses about which anxiety experiences classroom practice might target first.
Group Transdiagnostic Cognitive Behavioural Therapy for Intolerance of Uncertainty Versus Applied Relaxation
Conditions: Mental Disorders; Mood Disorders; Anxiety Disorders; Generalized Anxiety Disorder
Interventions: Behavioral: Group Transdiagnostic Cognitive Behavioural Therapy for Intolerance of Uncertainty (CBT-IU); Behavioral: Group Transdiagnostic Applied Relaxation (AR)
Sponsors: Medical Research Council Cognition and Brain Sciences Unit; University of Cambridge
Not yet recruiting
Interventions: Behavioral: Group Transdiagnostic Cognitive Behavioural Therapy for Intolerance of Uncertainty (CBT-IU); Behavioral: Group Transdiagnostic Applied Relaxation (AR)
Sponsors: Medical Research Council Cognition and Brain Sciences Unit; University of Cambridge
Not yet recruiting
Efficacy of artificial intelligence-driven conversational agents (chatbots) for mental health promotion among university students: a systematic review and meta-analysis
BackgroundUniversity students experience substantial mental-health burdens, while access to timely support remains uneven. AI conversational agents may provide low-threshold support, but the evidence base has expanded rapidly and prior reviews have often combined different age groups, intervention types, outcome domains, and comparator conditions.ObjectiveTo evaluate the effects of AI-mediated conversational interventions on depressive and anxiety symptoms in university students, while distinguishing outcome domains, comparator intensity, intervention architecture, and the evidential requirements for standardized post-intervention effect estimation.MethodsWe updated the search in PubMed, Embase, PsycINFO, CENTRAL, and Web of Science to the revised search date and rebuilt an auditable cross-database record ledger. The updated workflow included 3,786 exported records, 451 DOI/PMID duplicates, 41 confirmed title/author duplicates, and 3,294 unique records screened. All title/abstract records completed a two-reviewer screening and consensus chain. Forty-six update-search records entered research-level/full-text assessment. Randomized controlled trials were eligible for causal quantitative synthesis; relevant feasibility, acceptability, usability, and non-comparable controlled studies were retained narratively. Standard post-intervention analyses used Hedges g, REML random-effects models, and Hartung-Knapp adjustment, and were restricted to attributable two-group post-intervention data.ResultsIn the final locked non-active/low-intensity comparator analysis, three depression comparisons favored conversational interventions (k=3; Hedges g=-0.413, 95% CI -0.557 to -0.268; I2 = 0.0%) and four anxiety comparisons also favored them (k=4; Hedges g=-0.435, 95% CI -0.603 to -0.268; I2 = 2.1%). In the separate active conversational-control analysis, two MYLO comparisons did not show a reliable incremental effect for depression (k=2; g=0.165, 95% CI -0.580 to 0.911) or anxiety (k=2; g=0.190, 95% CI -0.556 to 0.937). The evidence base remained small, clinically heterogeneous, and limited by attrition, self-reported outcomes, and uncertainty regarding generalizability.ConclusionsAI conversational interventions may improve depressive and anxiety symptoms relative to non-active or low-intensity comparators in university students, but the certainty of evidence is low and estimates are based on few comparisons. Evidence against active conversational controls is very uncertain. Outcome-domain differences and architecture-related claims should be treated as hypothesis-generating. Secure, consent-based, human-supervised implementation and objective outcome assessment are priorities for future research.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261323382, identifier CRD420261323382.
Novel and Conventional Interventions for Cognitive and Emotional Flexibility in Patient Trauma
Conditions: Depression; Anxiety; Trauma Patients
Interventions: Drug: D-Cycloserine (DCS); Device: Transcranial Magnetic Stimulation; Behavioral: Unified Protocol; Behavioral: Psychoeducation
Sponsors: Mclean Hospital
Active, not recruiting
Interventions: Drug: D-Cycloserine (DCS); Device: Transcranial Magnetic Stimulation; Behavioral: Unified Protocol; Behavioral: Psychoeducation
Sponsors: Mclean Hospital
Active, not recruiting
Using App Store Reviews to Explore User Experiences and Perceptions of Mental Health Mobile Apps: Qualitative Study
Background: With the rise of digital health, mental health apps (MHapps) have become an increasingly popular tool in the self-management of depression, anxiety, and stress. Star ratings are often used as indicators of app quality to guide selection. However, ratings do not fully capture if the MHapp’s features, usability, or design elements exhibit the heterogeneous real-life user experiences. Instead, examining the patterns of engagement and app usage can highlight whether high ratings reflect diverse user needs. Objective: This study aimed to examine user experience of top-rated depression and anxiety apps to assess if user perceptions, as reported in app reviews, align with star ratings. Methods: To identify relevant mobile apps, we used a systematic search strategy that mimicked a typical user’s journey and applied search terms related to depression, anxiety, and stress management. Apps were screened using a predefined inclusion criteria that guided the identification of the 5 most highly rated MHapps, yielding approximately 750 user reviews across all apps. Reviews were analyzed using hybrid inductive and deductive coding techniques, with codes generated iteratively to capture the spectrum of user perceptions and experiences. Codes were then clustered, leading to theme generation that provided a deeper understanding of user experiences. Results: User experiences demonstrated a complex interplay between perceived benefits and frustration. Users valued ease of navigation, convenience, accessibility, and low-effort features that allowed easier entry to self-management of mental health. Users expressed their affinity toward specific app features and desire for the addition of new features that could further support their mental wellness. However, limited or restrictive features due to paywall, in-app advertisement placement, and functionality issues resulting from technical issues or bugs garnered substantial criticism. Conclusions: This study highlights the complexity of user perceptions influencing experience with self-management MHapps. Despite high star ratings, app usability elicited paradoxical responses and showed multiple overlapping themes, showcasing features that may support some users but hinder others. The results emphasize that star ratings alone are insufficient to showcase if a MHapp meets user needs. Continued improvement in app design such as interface usability, feature development, and pricing transparency is needed to meet the diverse needs of users for better engagement and satisfaction.
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Elderly abuse and anxiety symptoms among older adults in China: the mechanism of physical frailty and social frailty
PurposeThis study aims to examine the association between elderly abuse and anxiety symptoms among older adults and explore the mechanisms of physical frailty and social frailty between them.MethodsA total of 1361 older adults were included in this study. Multiple linear regression and propensity score matching was conducted to confirm the association between elderly abuse and anxiety symptoms. Mediation and moderation analyses were performed to explore the mechanisms of physical frailty and social frailty between elderly abuse and anxiety symptoms.ResultsElderly abuse was significantly associated with higher levels of anxiety symptoms. Psychological abuse and neglect showed the strongest associations with anxiety symptoms. Social frailty played moderating roles between both psychological abuse, neglect and anxiety symptoms, while physical frailty played moderating roles between only psychological abuse and anxiety symptoms. Physical frailty and social frailty both partly mediated the relationship between psychological abuse, neglect and anxiety symptoms.ConclusionsThis study provides insight into the systematic relationship between elderly abuse and anxiety symptoms among older adults in Sichuan province. Preventive strategies should address abuse, physical health, and social support simultaneously of older adults.
Plant essential oils as a novel therapeutic strategy for depression and anxiety: emerging evidence and mechanisms
Depression and anxiety are major global mental health disorders that require safer and more accessible adjunctive interventions. This review uniquely integrates current evidence on plant essential oils in aromatherapy and identifies the cAMP–PKA–CREB pathway as a key mechanistic hub linking neurotransmitter regulation, HPA axis modulation, neuroinflammation, and neuroplasticity. Relevant animal, cell, and preliminary clinical studies were reviewed to summarize therapeutic effects, active constituents, and commonly used essential oils. The evidence indicates that essential oils may alleviate depression- and anxiety-like symptoms by increasing monoamine neurotransmitters, suppressing HPA axis hyperactivity, reducing pro-inflammatory cytokines, inhibiting NF-κB signaling, and restoring BDNF/CREB-related neuroplasticity. Representative active constituents include linalool, β-caryophyllene, and limonene, while lavender, bergamot, and chamomile are the most commonly studied essential oils. Overall, aromatherapy shows promise as a relatively safe and practical non-pharmacological adjunct for depression and anxiety, but its evidence base remains largely preclinical. More rigorous clinical studies are needed to confirm efficacy, standardize interventions, and clarify mechanisms in humans.