Psychology Health & Medicine最新文献

{"title":"Mental health trajectories among Malaysian university students: A repeated cross-sectional study.","authors":"Pei Nee Mah, Shin Ling Wu, Jia Yuin Fam, Soon Aun Tan, Chin Choo Yap","doi":"10.1080/13548506.2026.2659692","DOIUrl":"https://doi.org/10.1080/13548506.2026.2659692","url":null,"abstract":"<p><p>The COVID-19 pandemic had a profound effect on university students' mental health worldwide. As debates continue about whether these negative impacts will persist or gradually diminish over time, this study examined changes in mental health indicators and protective factors among Malaysian university students between the late-pandemic period (2023) and the post-pandemic recovery phase (2025). Using a repeated cross-sectional design, two independent samples of full-time Malaysian university students aged 18-24 years were surveyed (2023: <i>n</i> = 547; 2025: <i>n</i> = 551). Participants completed validated measures of depression, anxiety, stress, suicidality, perceived social support, emotional intelligence, and hope. Results indicated significant reductions in depressive symptoms, stress, and suicidality from 2023 to 2025, accompanied by significant increases in perceived social support, emotional intelligence, and hope, all with small effect sizes. Perceived social support across family, friends, and significant others shifted from the moderate range in 2023 to the high range in 2025. In contrast, anxiety levels did not differ significantly between the two time points. These findings suggest partial psychological recovery among Malaysian university students in the post-pandemic period, characterised by improvements in several mental health indicators and protective psychosocial resources. However, the persistence of elevated anxiety underscores the need for continued institutional support, targeted interventions, and longitudinal research to address ongoing mental health challenges among university students.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-16"},"PeriodicalIF":1.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion visibility and localization as predictors of social appearance anxiety in Pemphigus vulgaris: a case-control study.","authors":"Faruk Kurhan, İbrahim Halil Yavuz","doi":"10.1080/13548506.2026.2653105","DOIUrl":"https://doi.org/10.1080/13548506.2026.2653105","url":null,"abstract":"<p><p>Pemphigus vulgaris (PV), a chronic autoimmune blistering disorder, frequently affects highly visible regions such as the face, scalp, and upper body, potentially altering body image and increasing social appearance anxiety (SAA). The psychosocial pathways linking lesion visibility and localization to SAA, however, remain insufficiently examined. This analytical cross-sectional case�control study compared SAA levels between 150 PV patients with visible lesions and 150 age- and sex-matched controls, and explored associations between SAA and illness perception, anxiety, depression, self-esteem, and dermatology-specific quality of life. Participants completed the Social Appearance Anxiety Scale (SAAS), Hospital Anxiety and Depression Scale (HADS), Dermatology Life Quality Index (DLQI), Brief Illness Perception Questionnaire (B-IPQ), Rosenberg Self-Esteem Scale (RSES), and a Visual Analog Scale (VAS) for perceived severity. Group comparisons, Pearson correlations, one-way ANOVA by lesion visibility and location, and moderation analysis (PROCESS Model 1: HADS-A � VAS ? SAAS) were performed. PV patients demonstrated significantly higher SAA than controls (55.8?�?10.2 vs. 21.3?�?8.8; p?0.001). Within patients, SAA correlated positively with HADS-A, DLQI, and B-IPQ, and negatively with self-esteem. General anxiety moderated the relationship between perceived severity and SAA (interaction 0.18, p=0.006), indicating greater distress among highly anxious individuals. Lesion visibility showed a clear gradient, with face, scalp, and neck lesions producing the highest SAA (ANOVA F(3,146) = 8.02, p?0.001). Findings highlight lesion visibility and localization as key determinants of SAA in PV and suggest that integrating psychological screening into dermatologic care may help address elevated appearance-related distress.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-16"},"PeriodicalIF":1.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects from job stress on self-rated health transitions over time: the ELSA-Brasil cohort study.","authors":"Thaís Lopes de Oliveira, Raquel de Vasconcellos Carvalhaes de Oliveira, Rosane Harter Griep, Arlinda B Moreno, Maria da Conceição Chagas de Almeida, Maria de Jesus Mendes da Fonseca","doi":"10.1080/13548506.2026.2645960","DOIUrl":"https://doi.org/10.1080/13548506.2026.2645960","url":null,"abstract":"<p><p>This study aimed to analyze the effects of job stressors on self-rated health transitions in more than ten years of follow-up of participants of The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Longitudinal design, including individuals from ELSA-Brasil, aged 35-74 years at baseline. Our outcome was transition intensities between self-rated health states, a time-varying variable, categorized into three states (good, fair, and poor). Our exposure, measured at the baseline, was job stressors assessed by the Demand-Control-Support Questionnaire. The effects of job stressors on changes in self-rated health were analyzed using longitudinal models adjusted for age, sex, and education. In total, we analyzed information from 9776 individuals. Participants with active jobs (Hazard Ratio - HR = 0.81, 95% Confidence Interval - CI = 0.72 - 0.91), passive jobs (HR = 0.78, CI = 0.70 - 0.86), and high job strain (HR = 0.75, CI = 0.68 - 0.84) had a lower risk of transitioning from fair to good self-rated health. Participants with low social support had a higher risk of transitioning from good to fair self-rated health (HR = 1.12, CI = 1.04 - 1.21) and a lower risk of transitioning from poor to good self-rated health (HR = 0.10, CI = 0.02 - 0.50). Job stressors were associated with a decline in self-rated health within our population. The risks varied depending on the participants' current state of self-rated health. It is essential to improve job control and social support to prevent the negative consequences of poor health states.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping and benefit seeking as determinants of health-related quality of life in multiple sclerosis: a cross-sectional study.","authors":"Verónica Sarabia Montaño, Silvia Ubillos Landa, José Luis González Castro","doi":"10.1080/13548506.2026.2653103","DOIUrl":"https://doi.org/10.1080/13548506.2026.2653103","url":null,"abstract":"<p><p>In the absence of a cure for multiple sclerosis (MS), improving the quality of life of those affected becomes a vital priority, especially for those in advanced stages of the disease. The quality of life of people with MS depends not only on medical treatments but also on the ability to adapt to the disease and seek out the positive aspects of the situation. This cross-sectional study presents a model that analyzes whether in people with MS benefit-finding will have a positive direct effect on health-related quality of life (HRQoL), and an indirect effect through the use of coping strategies, depending on whether or not the individual has a recognized disability. The sample consisted of 250 MS Spanish patients (mean age = 41.74 ± 10.34 years, 70.8% female). Correlations, hierarchical multiple linear regression, and multiple mediation analysis were used to analyze the data. Benefit-finding was found to have no significant direct effect on HRQoL. Only in participants whose disability was officially recognized the mediating effect of planning (B = -3.79, SE = 1.68, 95% CI: -7.58/-1.05) and self-distraction (B = -2.53, SE = 1.35, 95% CI: -5.55/-.34) between benefit-finding and HRQoL was negative, while that of emotional support (B = 9.81, SE = 2.58, 95% CI: 5.23/15.39) and acceptance (B = 3.87, SE = 2.22, 95% CI: .10/8.89) was positive. In conclusion, benefit-finding exerts a beneficial effect on HRQoL in people with advanced MS only through acceptance and emotional support. The unpredictable nature of MS likely demands a well-developed and sophisticated repertoire of coping strategies that can respond flexibly to the complex and variable stressors that arise throughout the disease trajectory.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiles of posttraumatic stress disorder and posttraumatic growth among breast cancer patients: role of caregiver burden.","authors":"Leyi Cao, Ziwei Wang, Shu Da, Yuanyuan An","doi":"10.1080/13548506.2026.2653102","DOIUrl":"https://doi.org/10.1080/13548506.2026.2653102","url":null,"abstract":"<p><p>Using a person-centered approach, this study examined the heterogeneity of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) co-occurrence among breast cancer patients and identified factors associated with distinct latent profiles. A total of 600 breast cancer patients undergoing chemotherapy at a tertiary hospital were recruited. Latent profile analysis (LPA) and multinomial logistic regression were conducted to identify PTSD - PTG profiles and to examine the predictive roles of caregiver burden and demographic variables. LPA identified three distinct profiles: (1) <i>Low Symptom Group</i>, characterized by low PTSD and PTG; (2) <i>Positive Growth Group</i>, exhibiting low PTSD and high PTG; and (3) <i>Distressed Growth Group</i>, marked by high levels of both PTSD and PTG. Multinomial logistic regression indicated that type of surgery, residential location, and caregiver burden were significant predictors of profile membership. Patients living in cities were more likely to belong to the low symptom group relative to the distressed growth group (OR = 0.27). In addition, residence in cities (OR = 3.22) and towns (OR = 2.17) was associated with a higher probability of belonging to the positive growth group compared with the distressed growth group. Patients who underwent breast-conserving surgery were more likely to belong to the low symptom profile rather than the positive growth group (OR = 3.22). Higher caregiver burden significantly increased the odds of membership in the distressed growth group relative to the low symptom group (OR = 1.11), whereas it was associated with lower odds of belonging to the positive growth group compared with the distressed growth group (OR = 0.88). These findings highlight the heterogeneity of posttraumatic psychological responses among breast cancer patients, demonstrating distinct co-occurring profiles of PTSD and PTG, and emphasizing the relevance of caregiver burden and contextual factors in shaping patterns of posttraumatic adaptation.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity is associated with depression and depressive symptoms in US adults with diabetes: a cross-sectional study.","authors":"Damián Pereira-Payo, Carmen Galán-Arroyo, Jorge Pérez-Gómez, Marco Batista","doi":"10.1080/13548506.2026.2645951","DOIUrl":"10.1080/13548506.2026.2645951","url":null,"abstract":"<p><p>Physical Activity (PA) is crucial for the management of diabetes. Since PA participation has a positive effect on mental health, it was hypothesized that PA and depression could be associated in individuals with diabetes. The aim of this research was to study whether there are associations of PA with depression and depressive symptoms in diabetics. Additionally, a potential dose-response relationship of PA with depression and depressive symptoms and the risk of suffering depression and depressive symptoms according to PA group were explored. This cross-sectional study is based on data from the NHANES 2011-2020, the study sample was formed by 3017 (1585 males and 1432 females) US adults with diabetes. Associations were studied through the Chi-squared test. The Kruskal Wallis test was used to study differences in depression scores. Correlations were studied through Spearman´s rho, and the odds ratios were calculated using a binary logistic regression model. Associations of PA with depression prevalence (<i>p</i> < 0.001) and the frequency of depressive symptoms (<i>p</i> < 0.05) were found. Greater incidence of major depression, depressive symptoms and greater depression scores in the PHQ-9 were found for inactive diabetes patients. Correlations of PA group and METs with PHQ-9 scores and the frequency of depressive symptoms for each item of the PHQ-9 were found, except for the 7th item (concentration problems). Increased odds of suffering major depression (OR = 1.957 (CI95% = 1.310-2.923)) and all the depressive symptoms studied were found for physically inactive diabetes patients compared to those from the moderate PA group. The association of PA with depression and the frequency of suffering depressive symptoms in US adults with diabetes were confirmed. Greater prevalence of depression and greater frequency of depressive symptoms were found for physically inactive diabetes sufferers. A dose-response relationship between PA and frequency of depressive symptoms is suggested.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-20"},"PeriodicalIF":1.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has the COVID-19 outbreak put more children and adolescents at risk for suicidality? A longitudinal insight of the phenomenon in psychiatrically hospitalized patients.","authors":"Valentina Ferro, Roberto Averna, Elena Bellelli, Eleonora Spinelli, Milena Labonia, Massimo Apicella, Umberto Raucci, Sebastian Cristaldi, Pasquale Parisi, Stefano Vicari, Massimiliano Raponi, Alberto Villani","doi":"10.1080/13548506.2026.2651910","DOIUrl":"https://doi.org/10.1080/13548506.2026.2651910","url":null,"abstract":"<p><p>As with previous pandemics, recent research hints that suicidality may have increased after the COVID-19 outbreak among younger people. This study aimed to better understand the trend of suicidality phenomenon in relation to pandemic and to determine whether the mental profile of children and adolescents with suicidality has changed following the COVID-19 outbreak. We retrospectively compared pediatric inpatients admitted to hospital for suicidality before and after the outbreak of COVID-19 during 2017-2022 period Suicidality demonstrated an upward trend, increasing from 44% in 2017 to 67% in 2022, with an interim decline in 2019; nevertheless, the overall trajectory showed significant growth. We reported a significant increase of depressive disorders (<i>p</i> < 0.001) and of eating disorders (<i>p</i> = 0.02) after the COVID-19 outbreak. By multivariable logistic regression, we analyzed factors independently associated with suicidality upon the hospital admission after the COVID-19 outbreak. The odds of a history of self-harm increased after the COVID-19 outbreak (<i>p</i> < 0.001), conversely, the likelihood of family history of suicidal behaviors, neuropsychiatric disorders, and personal history of ACEs decreased by 84% (OR 0.16, <i>p</i> < 0.001), 57% (OR 0.43, <i>p</i> < 0.001), and 73% (OR 0.27, <i>p</i> < 0.001), respectively. The COVID-19 pandemic period was associated with nullification of pre-pandemic prevention efforts to curb the uptrend of suicidality among children and adolescents and was associated with changes in the pattern of risk factors and the mental profile of patients hospitalized for suicidality.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyberchondria and pregnancy-related anxiety: multidimensional assessment of Health anxiety, sensitivity, uncertainty, and fear of childbirth in pregnant women.","authors":"Keziban Amanak, Fatma Şule Bilgiç","doi":"10.1080/13548506.2025.2524864","DOIUrl":"10.1080/13548506.2025.2524864","url":null,"abstract":"<p><p>This study was conducted to examine the effects of cyberchondria severity on intolerance of uncertainty, fear of childbirth, and anxiety related to health and pregnancy in pregnant women. The cross-sectional study was conducted between 1 August 2024 and 1 February 2025 (6 months) at the Gynecology and Obstetrics Clinic of Aydın Adnan Menderes University Hospital. 149 pregnant women who met the sample selection criteria were included in the study. Data were obtained using a face-to-face self-reporting technique using the Personal Information Form, Health Anxiety Inventory (HAI), Anxiety Sensitivity Index-3 (ASI-3), Intolerance of Uncertainty Scale (IUS), Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2, Cyberchondria Severity Scale (CSS-12) and Fear of Birth Scale (FBS). The mean age of the pregnant women participating in the study was 28.11 ± 4.78, the gestational week was 23.20 ± 7.66, and the number of pregnancies was 2.12 ± 0.84. The mean scores they received from the scales were; HAI 40.75 ± 3.40, ASI-3 59.44 ± 6.32, IUS 48.55 ± 3.57, PRAQ-R2 44.20 ± 3.70, CSS-12 50.36 ± 5.080 and FBS 54.49 ± 15.70. It was determined that there was a statistically significant difference between the working status and place of residence and HAI. In the study, it was determined that there was a weak positive relationship between the CSS-12 total score average and the ASI-3 and PRAQ-R2 total score, and a moderate positive relationship with FBS, HAI and IUS. According to the regression analysis result, it was found that the severity of cyberchondria in pregnant women increased pregnancy-related anxiety (β = 0.337), intolerance of uncertainty (β = 0.510) and fear of childbirth (β = 0.498). In the study, it was seen that the severity of cyberchondria use, health and pregnancy-related anxiety level, fear of childbirth and intolerance of uncertainty were high in pregnant women, and cyberchondria increased pregnancy-related anxiety, fear of childbirth and intolerance of uncertainty in pregnant women.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"844-858"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility patterns and influencing factors in Ethiopia.","authors":"Derbachew Asfaw, Bosena Adigo, Workineh Muluken","doi":"10.1080/13548506.2025.2486504","DOIUrl":"10.1080/13548506.2025.2486504","url":null,"abstract":"<p><p>Fertility level, indicating the number of births per woman of reproductive age, plays a pivotal role in population dynamics. In Ethiopia, grappling with a substantial population growth rate poses a significant hurdle in its journey toward attaining middle-income status. This study aims to pinpoint the key determinants influencing fertility levels in the country. Data from the 2019 mini Ethiopian Demographic Health Survey were utilized, encompassing a sample of 8,885 reproductive women selected through stratified random sampling. Various statistical models, including Poisson, Negative Binomial, Zero-Inflated Poisson, Zero-Inflated Negative Binomial, Hurdle Poisson, and Hurdle Negative Binomial, were employed for analysis. Among these, the Zero-Inflated Poisson model emerged as the most suitable for the dataset. The average fertility level among women was 2.59 births, with a variance of 7.852. Findings revealed several significant determinants of fertility levels in Ethiopia. Notably, residing in rural areas, attaining primary, secondary, or higher education, lack of utilization of modern family planning methods, limited knowledge about family planning, and geographic location, such as living in the Afar, Gambella, Addis Ababa, or Dire Dawa regions, were identified as influential factors. Furthermore, being a female household head, experiencing child deaths, widowhood, and divorced were also found to impact fertility rates. The study underscores the importance of addressing these determinants to curb high fertility rates. Recommendations include prioritizing initiatives to enhance women's education levels, ensuring widespread access to family planning services, and bolstering awareness regarding family planning methods. By implementing these measures, strides can be made towards stabilizing fertility rates in Ethiopia and promoting sustainable demographic growth.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"936-947"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can life skills-based interventions mitigate the impact of adverse childhood experiences on adolescent substance use prevention outcomes? A quasi-experimental study.","authors":"Chiao-Yu Yang, April Chiung-Tao Shen, Yu-An Lin, Deng-Min Chuang, Tai-Li Chou, Wen-Sung Lai","doi":"10.1080/13548506.2025.2594761","DOIUrl":"10.1080/13548506.2025.2594761","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) are associated with an increased risk of substance use during adolescence. However, most prevention efforts target youth with known childhood adversities who are receiving services in clinical or service programs, not in public settings such as schools. Moreover, research on the relationship between ACEs and substance use, as well as on the effectiveness of prevention strategies to mitigate the impact of ACEs on substance use, remains limited in East Asian countries, including Taiwan. This study aimed to address existing research gaps by examining the effects of a universal, school-based intervention on substance use outcomes among adolescents. Specifically, the study sought to examine the moderating effects that a life-skills intervention program, the Positive Interpersonal and Life Skills Training (PILOT), had on Taiwanese middle school adolescents with ACEs, assessing the program's impact on their level of substance use-related knowledge, attitudes, and skills. A total of 257 students from two middle schools in Taiwan participated in the study during the spring and fall of 2023. Of these, 139 students received the 8-module PILOT program integrated into their regular school curriculum, while 118 students received the standard curriculum. Participants completed pre-test and post-test questionnaires assessing ACEs and substance use prevention outcomes. The results indicate that ACEs were significantly associated with reduced substance-use-related knowledge among participants. The findings further confirmed the effectiveness of life skills-based interventions in enhancing substance use-related knowledge among Taiwanese middle school students. Notably, the PILOT program demonstrated a significant moderating effect, improving substance use-related knowledge among students with higher ACE exposure. In conclusion, life skills-based interventions can mitigate the negative impact of ACEs on adolescents' substance use prevention knowledge, which highlights the potential of universal, school-based life skills programs to serve as protective buffers for adolescents facing adversity.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1030-1048"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}