Paramedicine students experience disproportionately high rates of anxiety, depression, stress, and insomnia compared to the general population, placing them at risk of post-traumatic stress disorder and long-term psychological distress. Breathwork has emerged as a promising self-regulation intervention that may enhance resilience and wellbeing while reducing symptoms of mental illness. This randomised controlled trial (RCT) evaluated the effectiveness of the A52 Breath Method, a structured breathwork protocol, in improving mental health and resilience among student paramedics. A single-blind parallel-group mixed-methods RCT was conducted with 98 student paramedics from two Australian universities, randomised to either a 12-week breathwork intervention or control, with results interpreted in light of differential attrition. The intervention involved twice-daily practice of slow, diaphragmatic breathing (5-s inhale, 5-s exhale, 2-s hold) with video and guided audio instruction. Outcomes included changes in anxiety, depression, stress (DASS-21), insomnia (ISI), resilience (RS-14), and psychological wellbeing (RPWB-18), between baseline and post-intervention. Analyses included 2 × 2 mixed factorial ANOVA, ANCOVA for baseline differences, and correlation analyses. At post-intervention, participants in the breathwork group reported significantly lower stress, anxiety, and depression scores, and higher resilience compared to controls (all p < 0.05), with medium to large effect sizes. Insomnia and psychological wellbeing showed non-significant changes. Qualitative feedback highlighted perceived benefits for self-regulation, including emotional regulation and perceived psychological safety and control-although challenges to practice engagement was noted. The A52 Breath Method significantly reduced reported symptoms of psychological distress and enhanced resilience in student paramedics, even during exam stress. Breathwork shows promise as a scalable, upstream intervention to support mental health in paramedic student training. TRIAL REGISTRATION: Registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12625000101482 on 30/01/2025. Available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=388884&showOriginal=true&isReview=true.

ABSTRACTSelf‐reflection is central to adaptive stress regulation, yet little is known about when immersed versus distanced reflection optimises learning from stressful events. Drawing on Perceptual Control Theory, we propose that matching reflective stance to the emotional salience of stressors—adopting immersion for mild events and distancing for highly significant ones—optimises control‐system reorganisation. This triple‐blind, parallel‐group randomised controlled trial will compare event‐informed reflection against fixed self‐immersed and self‐distanced conditions using ecological momentary assessment. Two hundred and fifty emerging adults (aged 18–25) in the United Kingdom will complete three daily assessments over 14 days. Primary outcomes include stress reactivity (within‐person stressor–negative affect slopes) and coping self‐insight. We hypothesise that event‐informed reflection will attenuate stress reactivity and enhance coping self‐insight relative to fixed stances, with coping self‐insight mediating effects on reactivity. Dynamic structural equation modelling with Bayesian estimation will test these predictions.

ABSTRACTAssociations between stress, emotions and unhealthy eating have been reported, yet findings remain inconsistent. Stress eating and emotional eating have frequently been used interchangeably despite potential differences regarding physiological and psychological explanations. To aid in disentangling the shared and unique effects of stressors and emotions, we examined their associations with distinct aspects of eating behaviour (food craving, quantity, healthiness and snacking) in daily life in an experience‐sampling study. Participants (N = 64) responded to six daily smartphone prompts over 4 weeks, reporting stressors, multidimensional emotional states (valence, arousal, calmness) and eating behaviour. Bayesian multilevel models revealed that general stressors were unrelated to snacking (OR = 1.07, 90% CI = [0.87, 1.32]), but episodes of time pressure increased snacking likelihood (OR = 1.34, 90% CI = [1.01, 1.75]) while being associated with lower food quantity (B = −2.45, 90% CI = [−4.07, −0.82]). Arousal was associated with more food intake (B = 0.04, 90% CI = [0.001, 0.087]), while there was no other emotional state—eating association. Together, these results indicate that changes in snacking behaviour are more strongly linked to specific situational constraints, such as time pressure, than to momentary emotional fluctuations. Emotional eating, operationalised as emotion‐driven snacking independent of stressors, received little support in this sample. These findings suggest that interventions may benefit from targeting situational constraints, such as time pressure.

ABSTRACTThis study explored stress, anxiety, depression, sleep, and somatic ill‐health as predictors of burnout symptoms in a general population. The objectives were to identify underlying latent symptom categories of burnout as well as other aspects of mental and somatic health and to examine whether these symptom categories can predict burnout symptoms 3 years later. Longitudinal data with 3‐year follow‐up time using validated questionnaires from 1722 participants from a general population in northern Sweden were analysed using exploratory factor analysis (EFA) and structural equation modelling (SEM). The EFA showed overlap between instruments and 10 latent categories of symptoms were identified and used as predictors of burnout in SEM analyses. Two SEM models were tested: one unadjusted and the other adjusting for burnout symptoms at baseline. The symptom categories of anxious tension and gastrointestinal problems were the strongest predictors of burnout symptoms 3 years later, in both models. Sleep problems, depressive symptoms, and self‐efficacy for coping with stress were also important predictors in the unadjusted model. One important contribution of this study is the identification of the symptom category anxious tension which may well describe the experiential aspect of stress, incorporating feelings of anxiety, tension, and nervousness. The results indicate that anxious tension includes components that predict burnout symptoms. Gastrointestinal problems were also important predictors of burnout symptoms, and more research is needed to explain the mechanisms of these relationships, several possible mechanisms are proposed in this study. The study found burnout symptoms to be stable over time, potentially masking other symptoms. Anxious tension and gastrointestinal symptoms predicted burnout independently of baseline symptoms, whereas sleep problems, depressive symptoms, and low self‐efficacy emerged as predictors only when baseline burnout was not adjusted for.

ABSTRACTTransformative religious/spiritual experiences (RSE) represent a subset of extraordinary experiences that are both self‐destabilizing and relational in nature. This double‐edged quality positions transformative RSE as both a potential source of psychological vulnerability and a catalyst for enhanced social connectedness. This study investigates the antecedents and outcomes of transformative RSE using a nationally representative longitudinal sample of 10,529 young adults from the National Longitudinal Study of Adolescent to Adult Health T0 (1994–1995), T1 (2001–2002), and T2 (2008). We examined associations of reporting a transformative RSE at T1 (late adolescence) on a broad range of physical, mental, behavioural, and social health and wellbeing indicators assessed at T2 (early adulthood). Primary analyses controlled for an extensive set of covariates assessed at T0 (early adolescence), with sensitivity analyses employing both liberal (T0 sociodemographic characteristics only) and conservative (contemporaneous covariates taken from T1) adjustment strategies. Antecedents (T0 correlates) of transformative RSE included adverse childhood environments, negative parental dynamics, and heightened religious involvement. Consistent T2 outcomes of transformative RSE involved some markers of mental and social vulnerability (i.e., PTSD diagnosis and loneliness), as well as increased prosocial engagement (i.e., volunteering and voting). These findings support the theorized double‐edged sword effect of transformative RSE and suggest the potential role of meaning‐making and integration in shaping long‐term psychological and social outcomes.

ABSTRACTThe post‐pandemic era, coupled with the rising adoption of AI chatbots and robotics, introduces significant new challenges for employee work well‐being. Thus, it is important to investigate underlying mechanisms about how employees can develop mindsets to promote well‐being at work. This study examines how a dual‐focused growth mindset—comprising a growth mindset about the self (the belief in the ability to develop personal abilities) and a growth mindset about work (the belief in the capacity to optimise work conditions)—can enhance employee work well‐being through resilience. In a two‐wave survey involving 606 full‐time employees in China (Study 1), we found that both mindsets were associated with lower levels of mental ill‐health symptoms (one dimension of work well‐being) by increasing personal resilience. Notably, the effect of a growth mindset about the self (but not about work) on personal resilience was stronger when individuals perceived a high (vs. low) level of work stress. In Study 2, a quasi‐experimental design with 85 participants in an intervention group and 66 in a control group demonstrated that a growth mindset intervention effectively enhanced dual growth mindsets, leading to improved well‐being, including job satisfaction and individual flourishing. A serial mediation analysis confirmed that resilience mediated the relationship between the self‐growth mindset (not work‐growth mindset) and employee flourishing. Theoretical and practical implications were discussed.

ABSTRACTAdolescence is a critical developmental stage involving identity formation and increasing autonomy, both of which may be disrupted by acute external stressors. This qualitative study explored how adolescents coped with the psychological strain of war while undergoing normative developmental transitions during the 2023 Swords of Iron war in Israel. Semi‐structured interviews were conducted with 20 Israeli–Jewish adolescent–parent dyads, offering a dyadic perspective on adolescent coping as well as parental perceptions and expectations. Thematic analysis revealed two overarching themes: The first concerned the intensification of developmental demands under stress, including premature shifts toward adulthood, fluctuating autonomy shaped by parental anxiety and wartime constraints, future‐oriented identity reappraisal, as well as ambivalence toward military service as a civic responsibility. The second theme focused on coping strategies, which spanned a dynamic spectrum, ranging from emotional detachment through protective ‘bubbles’ to active civic engagement that fostered and sustained agency and personal meaning. Many adolescents oscillated between these modes, indicating adaptive responses to a rapidly changing reality. These findings highlight the interplay between developmental processes and stress regulation in adolescents facing an armed conflict. Rather than favouring a singular specific coping style, most adolescents benefited from fluid transitions between distancing and engagement. This study underscores the importance of flexible, developmentally sensitive interventions that support adolescents' psychological resilience during large‐scale crises and catastrophes. Implications are discussed for practitioners, researchers, and policymakers working in contexts of trauma and conflict, as well as youth mental health and social adjustment.

A file-matching error in SPSS misaligned a subset of cases across the two survey waves.Re-merging the data reduces the analytic sample from N = 247 to N 159-170.All findings remain unchanged except Hypothesis 8a, whose indirect effect is now nonsignificant (b = -0.02,p = 0.26).Corrected Tables 1 and2 are available at https://osf.io/2xqav/.These adjustments do not alter the article's conclusions.

ABSTRACTExam stress is one of the most influential factors for adolescent students' mental wellbeing (Brown et al. 2022). The typical response is to try and avoid, reduce or eliminate the stress, but it is possible to change the way individuals appraise stress. The present study aimed to investigate the effect of a 6‐week multi‐modal intervention on markers of performance and mental wellbeing in students that were soon to be completing their secondary and tertiary examination period (16–18 years). The intervention employed a multi‐modal approach of stress psychoeducation, self‐compassion and reappraisal of irrational beliefs. Content included helpful thinking techniques, badness scale and imagery to promote a more beneficial psychological response to exams. Eighty‐six young persons (49 males and 37 females) aged between 16 and 18 years old (M = 16.92, SD = 0.99) participated, 55 participants in the experimental group and 31 participants in the control group. All participants completed measures of stress‐mindset, perceived performance, irrational beliefs, anxiety, depression and proactive coping at baseline and post‐intervention. The separate ANCOVA's revealed there was greater significant levels of stress‐mindset, perceived performance and proactive coping in the experimental compared to the control at post. Furthermore, there was significantly lower levels of depression in the experimental compared to the control from at post. No significant changes were found in irrational beliefs and anxiety at post. Overall, the multi‐modal approach demonstrates to be efficacious in aiding a young person's mental wellbeing and performance.