• Impulsivity mediates the effect of childhood adversity on addictive behaviors. • Mediation part of impulsivity is higher with exposure to intra-familial violence. • Great mediation part of impulsivity (37.5%) for cyberaddiction. • Screening addictive behaviors among impulsive youth is needed.

Background and Aim: The COVID‐19 is a stigmatizing infectious disease even after healing. Until now, no COVID‐19 stigma scale validated in Tunisian Arabic language among the general population is available. Developing such tools is necessary to detect COVID‐19 stigma and reduce it effectively. Indeed, stigmatization of COVID‐19 patients could increase the spread of this disease and its related mental health issues. We aimed at testing the validity of a translated and modified version of the 12‐item HIV stigma scale among Tunisian COVID‐19 patients.Methods: A cross‐sectional study was conducted between November and December 2020 among a representative sample of COVID‐19 patients in the governorate of Sousse, Tunisia, after quarantine. The 12‐item HIV stigma scale was translated in Tunisian Arabic and then modified to be adapted to the Tunisian context. The preliminary modified version was administrated to the participants by pretrained medical doctors during phone calls. It consisted on 20 items covering the four stigma dimensions (personalized stigma, disclosure concerns, concerns with public attitudes, and negative self‐image). The psychometric evaluation of this version included internal consistency as well as principal component analysis (PCA).Results: The responses of 346 COVID‐19 patients were obtained. Their median age was 40 years (interquartile range: 30‐54.5). Females represented 60.4% of them. The PCA resulted in a three factor solution with 14 items. This 14‐item scale demonstrated good internal consistency with a global Cronbach's α of 0.91 and values of 0.94, 0.93, and 0.98 for social stigma, negative self‐image, and disclosure concerns, respectively.Conclusion: This study provides a reliable and valid instrument for stigma measuring among Tunisian COVID‐19 patients. The use of this scale would contribute in reducing the spread of this new infectious disease and its related mental health issues.

Background: Several studies revealed that medical students have low performance levels of hand hygiene (HH) and biomedical waste management (BMWM). However, there have been limited interventions directed at young students targeting HH and BMWM enhancement. Given these data, we aimed at assessing HH and BMWM among medical students after two training methods.Methods: We performed a quasi-experimental study from September 2021 to May 2022, which included fifth-year medical students enrolled in the faculty of Medicine of Monastir (Tunisia). We relied on a conventional training based on presentations and simulations guided by the teacher and a student-centred training method based on courses and simulated exercises prepared by students. We used the WHO HH Knowledge Questionnaire and the “BMWM audit” validated by The Nosocomial Infection Control Committee in France.Results: A total of 203 medical students were included (105 in the control group and 98 in the experimental group) with a mean age of 23 ± 0.7 years. Regarding HH, we found a statistically significant increase in post-test scores for both training methods. A higher post-test mean score was noted for student-centred method (14.1 ± 1.9 vs. 13.9 ± 2.3). The overall improvement in good HH knowledge rates was greater after student-centred method compared to conventional training (40.5% vs. 25%). Concerning infectious waste, mean scores were higher after student-centred learning in all hazardous waste management steps (25 ± 3.3 vs. 23.6 ± 5.5).Results: Coupling student-centred teaching and continuous supervision could improve HH and BMWM knowledge and practices among medical students.

We sought to investigate the impact of recent violence exposure on the relationship between extrafamilial adverse childhood experiences (ACEs) and self-inflicted violence in male Tunisian prisoners. We performed a cross-sectional study among adult male prisoners during April 2023. We used the validated Arabic versions of the World Health Organization ACE questionnaire and the Hospital Anxiety and Depression Scale. We assessed exposure to violence during the incarceration. Self-directed violence was subdivided into suicidal behaviors and self-harm. The participation was anonymous and voluntary, and the questionnaire was self-administered. A total of 540 prisoners were recruited with a response rate of 74.6%. Exposure to at least one extrafamilial ACE was reported by 96.8% of them. Anxiety and depression were screened in 83.2% and 79.6% of cases, respectively. Approximately the half (51.5%) reported recent violence exposure mainly psychological (45.8%). About 35% of prisoners had suicidal thoughts and 45.9% reported self-harming. We found that the risk of self-directed violence was significantly higher when the number of extrafamilial ACEs increased. After adjusting for anxiety and depression, our study revealed that childhood collective and peer violence predict self-directed violence through recent exposure to violence (%mediated = 41.6 and %mediated = 30.8, respectively). This survey underscores the urgent need for targeted interventions to break the vicious cycle of violence in jails. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Given that resilience is the ability to cope with adversities, and impulsivity is characterized with rapid reactions without foresight, we aimed to explore the pathways between intra-familial childhood adversities, resilience, impulsivity and suicidal behaviors among adolescents in Mahdia and Gafsa cities (Tunisia). We conducted a cross-sectional study in secondary schools from January to February 2020. Exposure to intra-familial early life experiences was evaluated by the Adverse Childhood Experiences (ACEs)-International Questionnaire. Resilience and impulsivity were assessed via the Adolescent Psychological Resilience and the Barratt Impulsivity Scale. A total of 3170 students were recruited with a response rate of 74%. About 81.1% of them reported being emotionally abused. The resilience mean score was 86.10 ± 9.85. Impulsivity was screened among 42.2% of them. About 38% of students presented suicidal thoughts, 16.4% had a suicide plan, and 10.8% have made a suicide attempt. We found that exposure to intra-familial ACEs predicts suicidal behaviors through impulsiveness (% mediated = 18% for emotional violence) and interpersonal resilience (% mediated = 24% for emotional violence; % mediated = 20.4% for physical violence). Our results emphasize the need to prevent ACEs, and to seek out a way to promote ACE protective factors among adolescents such as resilience.