Our study aims to describe the status of workplace violence against medical students during clinical practice, which consists of its prevalence, types, perpetrators, students' responses and influences on them, reasons for workplace violence and to determine some relevant factors of this issue through both quantitative questionnaire and qualitative interview. A descriptive cross-sectional study with mixed methods was conducted on 320 students from the second-year to the sixth-year classes at Hanoi Medical University from August 2022 to February 2023. The questionnaire was based on the WHO questionnaire survey 'Workplace violence in the health sector - country case studies research instruments - Geneva 2003'. 10 students from quantitative research who completed the questionnaire, experienced at least one type of workplace violence and consented to continue taking part in the research were chosen for in-depth interviews. The prevalence of students witnessing and/or experiencing workplace violence was 35.6% and 19.4% of the sample population had experienced at least one kind of workplace violence. Medical staff were the most common perpetrators. 86.8% of students who were exposed to workplace violence did not report the incidents for a variety of reasons. The major reasons leading to workplace violence related to patients, patients' relatives and students, among which the first-ranked ones were the patients' education level and their unsatisfied expectations. Some relevant factors to workplace violence against medical students were determined by quantitative analysis such as students' grade (OR = 3.09) and region (OR = 3.31) and were explored additionally by qualitative interview such as the student management of the instructors, students' personality, attitude and appearance as well as hospital environment. Based on the research findings, establishing prevention methods, which require action from both individuals (students, medical staff) and organizations (universities, hospitals) is recommended.

This study investigates the predictors of consistent condom use among male construction workers in South Africa who reported concurrent sexual relationships with regular partners, casual partners, and sex workers over a 3-month period. A cross-sectional survey was used to collect data from a convenience sample of 450 male workers across 18 construction work sites in the Western Cape province. Of these, 245 (54%) indicated that they had engaged in sex with all three partner types during the 3-month study period. Hierarchical multiple linear regression was then used to assess consistent condom use as a function of demographic, experiential, behavioural and cognitive characteristics. Three statistically significant predictors of consistent condom use were identified: perceived control over condom use (β = 0.252,  < 0.001), positive attitude toward condom use (β = 0.154,  < 0.05) and fear of HIV infection (β = 0.121,  < 0.05). These findings highlight the high prevalence of sexual concurrency among study participants. It also suggests that amid declining condom use, interventions which focus on enhancing an individuals' condom application skills and efficacy, that foster positive attitudes toward condom use and that strategically incorporate fear-based messaging within a multilevel framework may potentially increase condom use among individuals in concurrent sexual relationships.

Several studies have shown high rates of mental health problems amongst doctors in training worldwide. Self-care has been shown to be protective against burnout and increases subjective wellbeing. This study aims to investigate the self-care practices of foundation year doctors (FYs) in Malta. All doctors enrolled in Foundation Programme Malta in 2022 were invited to participate in an online questionnaire containing the Mindful Self-Care Scale (MSCS). Confirmatory factor analysis confirmed the 6-factor model described in literature. The independent sample t-test and Mann-Whitney U-test were used to check for relationships between total scores and variables of interest and means and medians for each group were compared. A total of 122 doctors answered the questionnaire out of 264 (46%). The median score for our FY cohort was 68, indicating moderate levels of self-care. Almost 40% of participants rarely or never experienced a sense of meaning at work. Working for long hours under stressful conditions means that self-care must be one of the top priorities for new doctors. However, very few FYs working in Malta regularly care for their physical and mental health. Strategies to improve trainee wellbeing must first focus on systemic factors to allow the individual factors to be addressed.

Defined as the ability to adapt to adversity with a positive and stable mindset, resilience should be an important factor in coping with long-term evolving setbacks such as the COVID-19 pandemic. Although the negative mental health impacts of the pandemic are well-documented, the course of resilience during the pandemic and recovery periods remains understudied. This study examined resilience trajectories among respondents in the Canadian Personal Impacts of COVID-19 Survey (PICS) who provided data for at least two timepoints ( = 741). Resilience was measured using the Connor-Davidson Resilience Scale (CD-RISC), and linear mixed models assessed for variations in resilience over time. Sociodemographic factors were introduced as fixed-effects variables to ascertain impacts on baseline resilience scores and temporal trends. Overall, resilience levels were low throughout the course of the study. The study sample's median baseline resilience score was 26 (IQR 21-30), which is significantly lower than the 25 percentile CD-RISC score noted in a pre-pandemic American community survey. This remained relatively unchanged until month 20 of follow-up, when point resilience scores showed a subtle (under one point), yet significant uptick from baseline. Sociodemographic analysis showed that low income was consistently associated with lower resilience (1.8-point difference, SE = 0.5,  = 0.002) throughout the observational period. Participants with a psychiatric disorder history had lower baseline resilience compared to those without any psychiatric history (3.4-point difference, SE = .05,  < 0.001). This gap decreased to 2.0 points (SE = 0.6,  < 0.001) by 24 months post baseline, suggesting that this negative effect on resilience diminished over time.

This study examined a model of the associations among self-esteem, body dissatisfaction, and the drive for muscularity among Jamaican male weight lifters, and compared model relationships between weight lifters from rural and urban areas of residence. Using a purposive sampling approach, cross-sectional data were collected from 225 male weight lifters, ages 18-67 years ( = 28.16,  = 9.52), from gyms in rural and urban areas of Jamaica. Participants completed the Rosenberg Self-esteem Scale (RSE), the Body Areas Satisfaction Scale (BASS), and the Drive for Muscularity Scale (DMS). Results from path analysis indicated that self-esteem exerted a negative direct effect on body dissatisfaction (β = -0.32,  < .001). The direct effect of self-esteem on the drive for muscularity was negative and non-significant (β= -0.10,  = .172), however, body dissatisfaction exerted a positive direct effect on the drive for muscularity (β = 0.27,  = .001). Self-esteem exerted a negative indirect effect on the drive for muscularity through body dissatisfaction (β = -0.09, 95% CI [-0.16, -0.03]). Model relationships remained similar across both rural and urban weight lifting subgroups. These results highlight self-esteem and body dissatisfaction as contributors to the drive for muscularity among Jamaican male weight lifters, with the role of self-esteem being primarily indirect by way of body dissatisfaction.

Subjective Social Status (SSS) reflects one's perceived rank within a given social structure and has been shown to be a unique correlate of physical and mental health. However, no research has been conducted to address populations of (recovering) critically ill patients. To shed light on the relationship between SSS and health in critically ill patients, we focus on survivors of acute respiratory distress syndrome (ARDS). A cohort study with  = 877 ARDS survivors was conducted in 61 intensive care units (ICUs) in Germany between 2014 and 2019. Health-related quality of life (HRQoL, Physical and Mental Component Scale: PCS, MCS of the SF-12) and SSS (MacArthur Scale) were assessed at 12, 24, and 36 months after discharge from ICU. Objective social status (Socioeconomic status [SES]) was assessed once at ICU baseline. Bivariate correlations between SSS and HRQoL (PCS and MCS) remain significant throughout the study period ( = .29 - .50, all p-values < .05). Subsequent hierarchical regression shows that SSS remains predictive for PCS and MCS even after controlling for SES (β = .335 - .486, all values < .001). The results indicate the importance (and unique contribution) of the subjective localization within the status hierarchy for long-term HRQoL after critical illness.

The aim of this cross-sectional study was to compare women who are not experiencing infertility, women who have experienced infertility in the past, and women who are currently experiencing infertility on illness representations of infertility. Participants were 668 women recruited via social media discussion forums and divided into three groups: not experiencing infertility ( = 299), experienced infertility in the past ( = 229), and currently experiencing infertility ( = 140). Their illness representations (cognitive and emotional) of infertility were measured with the Brief Illness Perception Questionnaire. Comparisons between the three groups showed that women who had not experienced infertility perceived fewer symptoms to be associated with infertility than the other two groups did and attributed infertility more to biological and psychological causes. Women who were currently experiencing infertility reported less negative emotions than the other two groups and attributed their infertility more to contraception, the medical profession, and their weight. Finally, women who experienced infertility in the past perceived more consequences of infertility, considered it to be more long-lasting and attributed it more to substances and environmental causes than the two other groups. Results revealed several differences between the illness representations of infertility in women. These findings highlight the need for information campaigns about infertility, with messages that are more closely tailored to the target population.

In Parkinson's disease (PD), a large number of individuals are confronted with pain. This issue has been receiving increasing attention in literature in recent years, as the complexity of pain in this disease makes its evaluation and treatment challenging. However, psychological variables related to the pain experience have received limited attention, especially when it comes to the exploration of beliefs regarding pain which, to our knowledge, remains unexplored in PD. Pain beliefs are defined as a subset of a patient's belief system which represents a personal understanding of the pain experience. Four dimensions of pain beliefs have been isolated in literature: mystery, pain permanence, pain constancy and self-blame. Thus, the goal of this study was first to describe pain beliefs in individuals with PD and second, to explore the relationships between pain beliefs and clinical and psychological variables. One hundred and sixty-nine international individuals with PD completed an online survey with socio-demographic and medical data. Participants completed self-report instruments to assess their pain (King's Parkinson's Disease Pain Questionnaire, McGill Pain Questionnaire and Brief Pain Inventory), psychological distress (Beck Depression Inventory, short-form and Parkinson Anxiety Scale), pain catastrophizing (Pain Catastrophizing Scale) and pain beliefs catastrophizing (Pain Beliefs and Perception Inventory). The study's findings revealed that most participants' beliefs are marked by the dimension of , suggesting that individuals with PD perceive the pain experience as chronic and enduring. Meanwhile, pain is minimally perceived as , , or a source of . Our finding concerning the permanence dimension deserves specific attention: even though this belief is prevalent in our population, it is not, or only weakly, associated with an impact on mood or pain catastrophizing. These results bring forth several hypotheses for understanding, highlighting the role of acceptance, and offer new perspectives toward improving clinical practices in terms of assessing and managing pain in PD.

This study was carried out to examine the spiritual well-being and depression levels of postpartum women following the two major earthquakes that occurred in 2023 with the epicenter Kahramanmaraş in Turkey. This cross-sectional analytical study was conducted with the participation of 345 postpartum women admitted to the maternity ward of a medical faculty hospital in the provincial center of Kahramanmaraş in Turkey between June and September 2023. Data were collected using the Spiritual Well-Being Scale (SWBS) and the Edinburgh Postnatal Depression Scale (EPDS). Independent-samples t-tests, Pearson's correlation tests, and simple linear regression analysis were used in the analyses. It was determined that 48.7% of the participants were at risk of postpartum depression. The participants whose relatives were lost/injured in the earthquakes and those who experienced financial losses had significantly lower total SWBS scores and significantly higher total EPDS scores ( < 0.05). A negative and statistically significant relationship was found between the total SWBS and total EPDS scores of the participants ( < 0.001). In this study, it was determined that after the Kahramanmaraş earthquakes in 2023, almost one in every two postpartum women was at risk of depression, and their earthquake experience affected their mental health and spiritual well-being negatively. Moreover, as the spiritual well-being of the postpartum women increased, their risk of postpartum depression decreased.

Breast cancer is the leading cancer type among women globally, and its chemotherapy often results in multiple side effects, compromising the patient's quality of life. Our study aimed to analyze the impact of neoadjuvant chemotherapy on the quality of life in Brazilian women with breast cancer within the public health system. This research was a one-year, observational, longitudinal study, conducted at a charitable health facility, examining the effect of neoadjuvant chemotherapy on these women's quality of life. Sociodemographic and clinical data were extracted from medical records. Quality of life parameters were gauged using Portuguese-validated questionnaires: EORTC.QLQ - C30 version 3.0, EORTC.BR-23, Body Image Scale (BIS), BPI-SF pain scale, and Beck Depression Inventory (BDI). These tools were utilized at three intervals: before the start of systemic treatment, after three months (before initiating paclitaxel), and upon concluding neoadjuvant therapy. Qualitative variables were tested for normality using the Kolmogorov-Smirnov test. As the continuous variables referring to the questionnaires did not show normal distribution, non-parametric tests were used: Friedman tests for paired pairs, and Wilcoxon and Mann-Whitney tests for multiple comparisons. In all tests, the significance level adopted was 5%. The software used for the analysis was SPSS. Our findings revealed a decline in quality of life, observing deterioration in the role, social, and cognitive functioning domains. Additionally, symptoms like fatigue, hyporexia, constipation, and diarrhea became more pronounced during the treatment. The presence of minimal depressive symptoms, associated with systemic therapy side effects also contributed to this worsening. Notably, there were no improvements in any quality of life-related parameters, and no discernible differences were observed in pain levels or body image across the evaluated periods.

The relative effectiveness of altruistic and egocentric persuasion messages is an important research question when voluntary participation in medical research is the target behavior. In the US, most participants in Alzheimer's disease-focused research registries are White females, so increasing diversity in registry membership is a public health priority. We compared the association of two belief-based motivations - egocentric and altruistic - with intention to enroll in an Alzheimer's research registry using a nationally representative theory-based survey of US adults 50 years of age or older while oversampling Black and Hispanic respondents. With the exception of Hispanic females, there were few respondent differences between individual motivational belief items and the correlations between the altruistic and egocentric indices were similar with independent effects on intention: the effects of the two motivations on intention were not redundant. Further analysis demonstrated that a moderation model was not superior to an additive model when both altruistic and egocentric indices simultaneously predicted intention. Registry recruitment messages should use both altruistic and egocentric persuasive message components to increase enrollment into Alzheimer's research registries. Similar studies should determine if the additive effects of altruistic and egocentric motivations apply to other voluntary research participation contexts such as chronic diseases and mental illness.

This meta-analysis evaluated the association between the Val66Met polymorphism of brain-derived neurotrophic factor (BDNF) and the susceptibility to attention deficit hyperactivity disorder (ADHD) in the Chinese mainland population. Eligible documents were selected from online databases including PubMed, Embase, Cochrane Library, CNKI, Wanfang and CBM (updated to 15 October 2023). The evaluation of study quality was conducted according to guidelines of Newcastle-Ottawa Scale. Basic features of patients, OR and 95% CI were retrieved to assess the correlation between ADHD susceptibility and Val66Met polymorphism in four genetic models: allele genetic model (mutation (A) vs. wild-type (G)), additive genetic model (AA vs. GG and AG vs. GG), recessive genetic model (AA vs. AG+GG) and dominant genetic model (AA+AG vs. GG). This study included totally four studies for subsequent meta-analysis. The results indicated that the correlation between ADHD susceptibility and Val66Met polymorphism in A vs. G (OR = 0.8840, 95%CI: [0.6696-1.1672],  = 0.3846), AA vs. GG (OR = 0.8436, 95%CI: [0.5432-1.3102],  = 0.4490), AA+AG vs. GG (OR = 0.8602, 95%CI: [0.6497-1.1391],  = 0.2933), AG vs. GG (OR = 0.9132, 95%CI: [0.7810-1.0679],  = 0.2556) and AA vs. GG+AG (OR = 1.0315, 95%CI: [0.8789-1.2105],  = 0.7044) was not significant. Egger's test and sensitivity analysis demonstrating the reliability and stability our conclusions, respectively. BDNF Val66Met polymorphism did not contribute to the susceptibility of ADHD in Chinese mainland population.

This study aimed to investigate the prevalence of behavioral problems in children and adolescents in Chengdu, Sichuan, China and the associated risk factors. A questionnaire survey was conducted with the students and their parents or caregivers from five primary and middle schools to investigate the parent-child relationship, family financial situations, health risk behaviors, and behavioral problems. A total of 8157 questionnaires were distributed, and 7928 (97.19%) valid questionnaires were returned. Among the 7928 valid questionnaires, 3846 were completed by female students and their parents or caregivers, and 4082 were completed by male students and their parents or caregivers. The average age of the surveyed students was 10.62 years. The prevalence rate of behavioral problems in children and adolescents was 13.79%, and the prevalence rate of behavioral problems significantly varied by gender and age. The female students had a higher prevalence rate of behavioral problems than male students (14.6% versus 13.0%). The students aged 12-16 years had a higher prevalence rate of behavioral problems than those aged 6-11 years (16.4% versus 12.2%). A correlation between behavioral problems and weekly pocket money was detected in the children and adolescents. Poor parent-child relationships, excessive screen time for both parents and children, short duration of sleep, and excessive intake of sugar-sweetened beverages could lead to a significant increase to the risk of developing behavioral problems in children and adolescents. Health-risky behaviors in children and adolescents were closely correlated to their behavioral problems. More attention should be paid to encouraging children and adolescents to live healthy lifestyles and tackling their behavioral problems.

HIV remains a significant public health concern, with an estimation of 39 million people infected. There is a lack of universally accepted benchmarks for prevalence of mental health problems among people living with HIV. We aimed to compute aggregate estimates of mental health problems among people living with HIV. We conducted a comprehensive literature search in PubMed, Web of Science, and Embase. Our inclusion criteria encompassed peer-reviewed cross-sectional or longitudinal studies conducted in any country that investigated people living with HIV and provided data allowing us to determine the prevalence of mental health problems. We conducted a meta-analysis to determine the combined prevalence of mental health problems among people living with HIV and consider predefined moderators by subgroup meta-analysis and meta-regression analysis. Our initial search identified 31 407 records. After removing the duplication and excluding ineligible records, 240 studies were included in our meta-analysis. Six commonly reported mental health problems were identified (depression, anxiety, suicidal ideation, post-traumatic stress disorder, stigma, and psychological distress). The pooled prevalence was 31% (95% CI 28-34) for depression, 29% (24-34) for anxiety, 20% (17-24) for suicidal ideation, 20% (13-28) for post-traumatic stress disorder, 47% (40-55) for stigma, 44% (31-56) for psychological distress. After considering predefined moderators, the heterogeneity was still observed. A high prevalence of mental health problems was observed among people living with HIV. Effective prevention and treatment programs can alleviate symptoms and promote mental health. This, in turn, can have a positive impact on all aspects of HIV management, leading to improved overall health outcomes for people living with HIV.

Fibromyalgia is characterized by widespread chronic pain and multiple additional symptoms which may result in significant disability. Recent studies have demonstrated disturbances in body image and body schema in people affected by this condition. Importantly, it affects a heterogenous population in which distinct profiles can be identified based on physiological and/or psychological characteristics. The objective of our study was to explore individual differences in experiencing one's own body in fibromyalgia. We applied a mixed methods design and included data from 28 women diagnosed with fibromyalgia. We measured symptom intensity (Fibromyalgia Impact Questionnaire, part 1), disturbances in body schema (adapted Fremantle Back Awareness Questionnaire) and body image (Body Esteem Scale, Multidimensional Assessment of Interoceptive Awareness). Additionally, participants drew their bodies and how they experienced them (Body Drawing task). Next, we asked five experts in chronic pain treatment to evaluate the drawings on a specially designed scale and indicate what kind of emotions these drawings expressed. We found evidence of disturbed body experiences and large individual differences in each of the measured variables which allowed for clustering participants into three groups, named 'Connected body', 'Conflicted body', and 'Disconnected body'. These preliminary results suggest patients with fibromyalgia may have both qualitatively and quantitatively distinct disrupted body experience.

Premenstrual syndrome is characterized by physical and psychological symptoms that negatively affect daily functioning. This study investigated the effect of a psychoeducation program based on cognitive-behavioral psychodrama techniques on premenstrual syndrome symptoms. This study utilized a 2 × 2 pretest-posttest, experimental-control group research design. The sample consisted of 32 participants randomized into experimental ( = 16) and control ( = 16) groups. The experimental group participated in a seven-session psychoeducation program based on cognitive-behavioral psychodrama techniques. Data were collected using a personal information questionnaire and the Premenstrual Syndrome Scale (PMSS). The experimental group demonstrated a significantly lower median posttest PMSS total and 'depressive affect', 'fatigue', 'irritability', 'depressive thoughts', 'changes in appetite' and 'changes in sleeping habits' subscale scores than the pretest score ( < .05). Moreover, the experimental group had a significantly lower median posttest 'anxiety' score than the control group ( = .021). A psychoeducational program based on cognitive-behavioral and psychodrama techniques can be used as an effective therapeutic intervention to relieve or managing premenstrual symptoms.

The aim of this randomized controlled experimental study is to determine the effect of singing or playing melodica activity applied to COPD patients on their symptoms, self-efficacy levels, and exercise capacities. The study was carried out in the chest diseases polyclinics of a hospital in Turkey between September 2020 and August 2021 with 30 patients: 15 in the control group and 15 in the song/melodica group. The data were collected with a patient information form and the scales examining disease symptoms, self-efficacy, and exercise capacity. The physical symptom, anxiety, Borg dyspnea, and fatigue scores of the disease in the post-test were significantly lower in the patients in the song/melodica group than those in the control group. In the post-test, the self-efficacy level, walking distance values were found to be significantly higher in the song/melodica group than in the control group. It is concluded that singing or playing melodica was an effective method in reducing the symptoms of the disease and enhancing the level of self-efficacy and exercise capacity in COPD patients.

Previous studies have confirmed a high prevalence of anxiety among medical students. The present study aimed to identify distinct medical student anxiety profiles to develop targeted interventions. A cross-sectional study was conducted with 735 medical students (346 males and 389 females) recruited voluntarily from mainland China. Latent profile analysis (LPA) was applied to explore profiles of various types of anxiety, including test anxiety, academic anxiety, social anxiety, career choice anxiety, general anxiety, and trait anxiety. The results showed that LPA yielded four profiles, comprising 17.14, 20.82, 21.50, and 40.54% of the sample respectively. Specifically, Class 1 (17.14%) showed the highest levels of multiple types of anxiety, particularly the highest level of general anxiety. Class 2 (20.82%) and Class 3 (21.50%) showed moderate levels of anxiety, but they displayed different patterns across various types of anxiety except for social anxiety. Class 4 (40.54%) displayed the lowest levels of anxiety across all types. These profiles differed in academic status and depression. Further, the multinomial logistic regression analysis showed that the high-anxiety group (Class 1) was more likely to be elder students, with lower sports frequency and a higher degree of self-handicapping. These results call for the need to move beyond linear relations among global constructs to address the complexity of anxiety coping and highlight the importance of customized intervention for these heterogeneous groups.

Since tuberculosis (TB) is an infectious disease, it affects patients not only physically but also socially and patients are reported to experience stigma. This study was conducted to determine the stigma levels of patients in a tuberculosis dispensary in the southeastern region of Turkey. The study was conducted between December 2020 and June 2021 with 79 patients who agreed to participate. 'Questionnaire' and 'Tuberculosis-Related Stigma Scale' (TSS) were used for data collection. The score obtained from the scale ranges between '33 and 132' and the higher the score, the higher the 'stigma level'. It was determined that 54.4% of the patients were male, 45.6% were primary school and the mean age was 44.98 ± 16.09 years. It was found that 60.8% of the patients had pulmonary TB, 40.5% had been on treatment for 3-6 months, 45.6% described the society's view of TB patients as 'bad, negative, and excluding', 64.8% had adverse effects on their communication with their family and close environment after being diagnosed with TB. The mean TSS score of the patients was 103.51 ± 10.65. TB patients were found to have 'very high' levels of stigma. The mean total stigma is higher in smokers, particularly in cases of pulmonary and extrapulmonary tuberculosis, as well as in those whose professional lives are affected.

Previous studies showed that loneliness and psychological distress are related. However, the potential mechanisms involved in this relationship are unknown. This study examined the mediating effect of mobile phone addiction and the moderating effect of core self-evaluation on the relationship between mobile phone addiction and psychological distress. A total of 826 college students were recruited. A cross-sectional study design and an online questionnaire survey were employed to measure loneliness, mobile phone addiction, core self-evaluation, and psychological distress in college students, and used the PROCESS macro program to conduct moderated mediation analysis. Loneliness was significantly and positively associated with psychological distress, mobile phone addiction partially mediated the relation between Loneliness and college students' psychological distress and this indirect path was moderated by core self-evaluations. Specifically, the effect of mobile phone addiction on psychological distress was stronger for college students with lower core self-evaluations than for those with higher core self-evaluations. The results are helpful to comprehend the producing mechanism of psychological distress and provide a theoretical basis for the intervention of psychological distress.

The benign dermatological hair condition Alopecia Areata (AA) is known to impair Quality of Life (QoL), especially mental and social health, due to the accompanying visible appearance changes. Previous studies have identified demographic, clinical, social, and psychological variables related to QoL. Yet, the novelty of this study lies in examining how QoL differences in AA relate to (combinations of) these variables. The aim of the current study is to identify and characterize subgroups of AA persons with less or more QoL impairment by means of (combinations of) demographic, clinical, psychological, and social factors, including both potential risk (perceived stigmatization, avoidant coping, physical identity definition) and protective factors (disclosure, social support, emotion-focused coping and non-physical identity definition). An online questionnaire was filled out by 322 persons with AA, including the Dermatology Life Quality Index (DLQI) as QoL measure, Perceived Stigmatization Questionnaire (FSQ), brief COPE, Social Support Survey, a newly developed identity-definition measure, clinical characteristics, and demographics. Classification and Regression Tree (CART) analysis identified subgroups based on QoL outcome. Lowest QoL impairment was found in persons with low feelings of being flawed combined with low secretiveness. Low QoL impairment was also found in persons feeling flawed combined with low avoidant coping, low sensitivity to others' opinions and older age. QoL impairment was intermediate in persons perceiving more social support in those with a younger age, and defining identity less on physical appearance in those sensitive to others' opinions. Highest QoL impairment was characterized by feeling flawed combined with an avoidant coping style. Current findings provide indications for the identification of risk and protective profiles for QoL impairment and which factors to address in interventions to improve QoL in AA.