Mindfulness-, compassion-, and acceptance-based (i.e., “third wave”) psychotherapies are effective for treating chronic pain conditions. Many of these programs require that patients engage in the systematic home practice of meditation experiences so they can develop meditation skills. This systematic review aimed at evaluating the frequency, duration, and effects of home practice in patients with chronic pain undergoing a “third wave” psychotherapy. A comprehensive database search for quantitative studies was conducted in PubMed, Embase, and Web of Sciences Core Collection; 31 studies fulfilled the inclusion criteria. The reviewed studies tended to indicate a pattern of moderately frequent practice (around four days/week), with very high variability in terms of time invested; most studies observed significant associations between the amount of practice and positive health outcomes. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy were the most common interventions and presented low levels of adherence to home practice (39.6% of the recommended time). Some studies were conducted on samples of adolescents, who practiced very few minutes, and a few tested eHealth interventions with heterogeneous adherence levels. In conclusion, some adaptations may be required so that patients with chronic pain can engage more easily and, thus, effectively in home meditation practices.

The lack of highly effective treatments for fibromyalgia (FM) represents a great challenge for public health. The objective of this parallel, pilot randomized controlled trial (RCT) was two-fold: (1) to analyze the clinical effects of mindfulness plus amygdala and insula retraining (MAIR) compared to a structurally equivalent active control group of relaxation therapy (RT) in the treatment of FM; and (2) to evaluate its impact on immune-inflammatory markers and brain-derived neurotrophic factor (BDNF) in serum. A total of 41 FM patients were randomized into two study arms: MAIR (intervention group) and RT (active control group), both as add-ons of treatment as usual. MAIR demonstrated significantly greater reductions in functional impairment, anxiety, and depression, as well as higher improvements in mindfulness, and self-compassion at post-treatment and follow-up, with moderate to large effect sizes. Significant decreases in pain catastrophizing and psychological inflexibility and improvements in clinical severity and health-related quality of life were found at follow-up, but not at post-treatment, showing large effect sizes. The number needed to treat was three based on the criteria of ≥50% Fibromyalgia Impact Questionnaire (FIQ) reduction post-treatment. Compared to RT, the MAIR showed significant decreases in BDNF. No effect of MAIR was observed in immune-inflammatory biomarkers (i.e., TNF-α, IL-6, IL-10, and hs-CRP). In conclusion, these results suggest that MAIR, as an adjuvant of treatment-as-usual (TAU), appears to be effective for the management of FM symptoms and for reducing BDNF levels in serum.

Background/Objectives: Adolescent levels of psychological distress are strongly influenced by community, individual, social, and family factors. Family functioning, social media use, and community disorder have shown high predictive value for psychological distress during this critical stage of development. However, these relationships are not always direct and are often mediated by individual-level variables, such as intolerance of uncertainty. Adolescent psychological well-being is not solely determined by contextual factors; the coping skills developed during this critical stage also play a significant role. Our study aims to analyze how these factors are directly and indirectly related by developing a predictive model of psychological distress in adolescents. Methods: The study included 908 adolescents (46.9% female) aged between 14 and 21 years (M = 16.29, SD = 1.5). Participants completed self-administered questionnaires in a school setting. Structural equation modeling was used to estimate total, direct, and indirect effects. Results: The model showed a good fit to the data. Social media disorder and family functioning showed statistically significant direct and indirect effects on psychological distress. Social media disorder was associated with higher psychological distress, while positive family functioning was protective. Community social disorder was only indirectly linked to higher psychological distress through the increase of intolerance of uncertainty. Conclusions: Intolerance of uncertainty is a critical predictor of adolescent distress, often overlooked despite its significant mediating role. Direct effects of family functioning and social media use also strongly influence distress levels. Impaired family functioning and community disorder interact bidirectionally, creating a cycle that exacerbates distress. Adolescents in these contexts face compounded negative effects from these reinforcing environments.

Introduction: Teachers play a crucial role in fostering supportive environments for all students. However, research indicates that their knowledge and attitudes toward stuttering are often similar to those of the general population. The primary aim of this study is to examine the attitudes of teachers at different educational levels in Spain toward stuttering and to explore how these attitudes relate to specific sociodemographic variables. Method: A cross‐sectional, self‐report design was employed with a sample of 250 teachers from various educational levels and teaching roles across Spain. Participants completed the Public Opinion Survey on Human Attributes‐Stuttering (POSHA–S). Results: Overall, the attitudes of teachers in Spain toward stuttering were generally positive and exceeded those observed in other comparison groups, except for the Knowledge Source component. Positive attitudes toward stuttering were strongly associated with factors reflecting experience and knowledge, such as training in stuttering, teaching students who stutter, current teaching role, and self‐identification as a person who stutters. Conclusion: Our findings highlight the importance of providing teachers with targeted training and direct experience with students who stutter to foster supportive attitudes. WHAT THIS PAPER ADDS: What is already known on the subject Attitudes toward stuttering can significantly affect the wellbeing and development of people who stutter. While these attitudes have been studied internationally, no research has examined teachers’ attitudes in Spain toward students who stutter. What this paper adds to existing knowledge This study shows that teachers in Spain—including School‐Based Speech‐Language Pathologists (SLPs) and Special Education Teachers—generally hold more positive attitudes than those reported in previous studies. However, some harmful beliefs remain, such as underestimating genetic factors or perceiving students who stutter as shy, introverted or incapable of demanding tasks. What are the potential or actual clinical implications of this work? The lack of experience, training and information about stuttering, along with the better attitudes of specialized teachers, highlights the need to prioritize stuttering in the SEN agenda to address biased beliefs and reactions toward students who stutter.

Background: Suicide is a complex, global phenomenon linked to various intersecting vulnerability factors. Among these, sleep-related symptoms represent a significant yet understudied contributor to suicide risk. This study explored whether the concurrent relationship between sleep-related symptoms and suicide risk is statistically mediated by distinct coping strategies within an exploratory cross-sectional framework, addressing data non-normality through robust analytical methods. Methods: A total of 1014 participants (33.83% male, 66.17% female) aged 18 to 75 years (M = 33.00, SD = 15.15) participated in an online survey distributed through snowball recruitment. Participants completed the amplified Sleep Symptom Subscale (Su-a) of the Brief Symptom Checklist (LSB-50), the Coping with Stress Questionnaire (CSQ), and the Risk of Suicide Scale (RS). Multiple mediation analyses were conducted to evaluate the indirect effects of coping dimensions while adjusting for sex, age, educational attainment, and socioeconomic status. Results: Sleep-related symptoms were positively associated with suicide risk. Negative self-focus emerged as the strongest mediator (β = 0.112, 95% CI [0.083, 0.143]), whereas Positive Reappraisal (β = 0.018, 95% CI [0.007, 0.032]) and Seeking Social Support (β = 0.012, 95% CI [0.001, 0.024]) acted as protective mediators. Overt emotional expression also showed a small but significant indirect effect (β = 0.009, 95% CI [0.001, 0.018]). A significant direct effect of sleep-related symptoms on suicide risk remained, indicating partial mediation. Conclusions: The findings suggest that coping processes contribute to the connection between sleep difficulties and suicide risk. Interventions aimed at reducing maladaptive coping and strengthening adaptive coping skills may help diminish suicidal vulnerability among individuals experiencing sleep disturbances.

Many researchers note that mental disorders can be understood as maladaptive attempts to avoid aversive internal experiences, and propose that a functional approach is required to complement topographical classification. Approaches that are based on the function of behavior can identify basic processes for the development of interventions. From this perspective, communication difficulties can be seen as strategies that are based on avoidance that increase distress. Among these problems are problems understanding metaphors, humor, and irony. Relational Frame Theory (RFT) offers a functional framework from which to analyze these processes. All this is the basis of the interventions that are aimed at promoting more adaptive behavior patterns. Moreover, individuals with Social (Pragmatic) Communication Disorder (SPCD) often exhibit impairments in perspective-taking, which RFT interventions aim to address by developing relational framing skills and social cognition. This paper proposes a functional approach and a theoretical framework for understanding interventions in SPCD through RFT.