Attachment has a fundamental role in the development of empathy, which helps people interact with others and prevents aggressive behaviors. It is believed that having a secure attachment can promote empathy. However, there is no clear evidence about the relationship between insecure attachment styles and empathy. Therefore, a meta-analysis was performed to clarify the relation between different types of attachment and empathy from late children to adults (9-47 years). It was conducted using 14 studies (11542 participants) for the secure attachment, 7 studies (3115 participants) for the avoidant, and 8 studies (3479 participants) for the anxious-ambivalent. Results indicated that secure attachment was positively correlated with empathy, avoidant attachment was negatively correlated, and anxious-ambivalent attachment had an inconclusive relationship. Whereas the results obtained for the secure and avoidant attachment with empathy are consistent with literature, the inconsistencies in anxious-ambivalent style may be due to a duality of feelings experienced by these individuals, who go from high levels of empathy (to be accepted) to low levels of empathy (to avoid distressing emotions). We suggest broadening the limit in age, include the multidirectional nature of empathy, as well as the effect of gender and different sorts of affiliations (parents, couples) for future studies.
El apego tiene un papel fundamental en el desarrollo de la empatía, la cual ayuda a las personas a interactuar y previene conductas agresivas. Aunque se cree que tener un apego seguro puede promover la empatía, no existe evidencia clara sobre la relación entre los apegos inseguros y la empatía. Consecuentemente, se realizó un metaanálisis para aclarar la relación entre los diferentes tipos de apego y la empatía desde infantes tardíos hasta adultos (9-47 años). Se incluyeron 14 estudios (11542 participantes) para el apego seguro, 7 estudios (3115 participantes) para el evitativo y 8 estudios (3479 participantes) para el ansioso-ambivalente.Los resultados indicaron que el apego seguro se correlacionó positivamente con la empatía, el apego evitativo se correlacionó negativamente y el apego ansioso-ambivalente tuvo una relación no concluyente. Mientras que los resultados obtenidos para el apego seguro y evitativo con empatía concuerdan con la literatura, las inconsistencias en el ansioso-ambivalente pueden deberse a una dualidad de sentimientos experimentados por estos individuos, experimentando desde altos niveles de empatía (buscando aceptación) a bajos niveles de empatía (evitando emociones estresantes).Sugerimos ampliar el límite de edad, incluir la multidireccionalidad de la empatía, el efecto del género y diferentes afiliaciones (padres, parejas) para futuros estudios.

More positive pre- or early therapy patient outcome expectation (OE) has consistently correlated with better treatment outcomes. Thus, it is important to identify factors that contribute to patients\' OE, which can inform therapist responsivity to such risk or facilitative markers. With growing research on OE correlates-centered primarily on patient characteristics/treatment factors and, to a lesser extent, therapist factors-a comprehensive synthesis is warranted to elucidate replicated and mixed associations and stimulate further research. Accordingly, we set a pragmatic cutoff of k ≥ 5 for meaningful empirical aggregation of participant factor-OE associations; otherwise, we conducted box counts.
We searched for articles published through March 2022 that included a clinical sample, a measure of patient\'s pre- or early treatment OE, and an explicit test of the factor-OE association.
Patient problem severity, problem chronicity, education, age, and quality of life were meta-analyzed. Greater severity correlated with lower/less optimistic OE (r = -0.13, p < .001) and higher QOL correlated with higher/more optimistic OE (r = 0.18, p < .001). Box counts revealed that few variables had consistent associations with OE.
Some factors can help forecast patient OE, though additional research is needed to enhance confidence and clinical meaning.

Theoretical and empirical evidence has suggested that child maltreatment victimization is associated with rejection sensitivity. However, empirical evidence on this association is inconsistent. Therefore, this meta-analysis aimed to examine the overall association between child maltreatment and rejection sensitivity, and to investigate variables that may affect the strength of this association. Studies eligible for inclusion were searched in the databases: Web of Science, Science Direct, PubMed, MEDLINE, and China National Knowledge Infrastructure after which relevant studies were coded. Studies were synthesized in advanced three-level meta-analytic models in R. A total of 16 studies (N = 5,335 participants) yielding 41 effect sizes were included. Results showed that child maltreatment is significantly and positively related to rejection sensitivity (mean r = 0.230; p < .001), and to a small extent. Furthermore, this association is stronger for emotional abuse (r = 0.275) than for physical abuse (r = 0.157). It is not affected by the mean age and gender distribution of primary study samples nor by sample type (community sample versus clinical sample). It is concluded that child maltreatment is a risk factor for developing rejection sensitivity later in life. Therefore, interventions for rejection sensitivity should consider potential trauma resulting from prior child maltreatment experiences.

This systematic review and meta-analysis examines similarities and differences in intrusive parenting between mothers and fathers and relations between intrusive parenting and early childhood development. The authors integrated 55 studies and differentiated cognitive skills and socio-emotional problems as developmental outcomes. The present study employs three-level meta-analyses to reliably estimate effect sizes and examine a range of moderators. It finds a moderate effect size of similarities in intrusive parenting within a family (r = 0.256, confidence interval [CI] = [0.180, 0.329]). No significant differences were observed in intrusiveness level between mothers and fathers (g = 0.035, CI = [-0.034, 0.103]). Intrusive parenting had a significant positive association with children\'s socio-emotional problems (rmother  = 0.098, CImother  = [0.051, 0.145]; rfather  = 0.094, CI father  = [0.032, 0.154]) but was not related to cognitive skills. Moderator analyses suggest that East Asian mothers exhibit higher intrusiveness levels than fathers, whereas Western parents display no significant differences. Overall, these results reveal more similarities than differences in intrusive parenting and that culture likely plays a role in shaping gender-specific parenting behaviors.

An increasing number of research has documented the positive associations between psychological inflexibility (PI) and mental health problems (i.e., depressive, anxiety, and stress symptoms) during the COVID-19 pandemic. However, the documented associations have been inconsistent. This review thus aimed to quantitatively summarize primary research to gain better estimates of these associations.
A systematic literature review was conducted in six databases and three-level meta-analytic models were used to statistically synthesize effect sizes and to examine moderators of the associations between PI and depressive, anxiety, and stress symptoms.
A total of 22 studies yielded 63 effect sizes on associations between PI and depressive, anxiety, or stress symptoms. The results of three separate meta-analyses revealed a large and significant association between PI and depressive (r = 0.580, 95 % CI [0.549; 0.775]), anxiety (r = 0.548, 95 % CI [0.468; 0.761]), and stress symptoms (r = 0.548, 95 % CI [0.506; 0.725]). The association between PI and depressive symptoms is stronger for males than for females, and the association between PI and stress symptoms varies by type of measure that primary studies use to assess PI and stress symptoms.
Temporal or causal conclusions are not allowed due to cross-sectional nature of the associations included in meta-analyses. Clinical samples with high levels of stress were underrepresented.
PI seems an important risk factor for symptoms of depression, anxiety, and stress, and should therefore be targeted in interventions addressing mental health problems during the COVID-19 pandemic and beyond.

Self-disgust is a negative self-conscious emotion that reflects disgust or revulsion directed toward oneself. A growing body of research has demonstrated a link between self-disgust, depression, and anxiety. However, the strength of these associations varied considerably across studies, suggesting the need to conduct a meta-analysis to produce a synthesized truer estimate. This review aimed to summarize the primary literature and improve our insight into these associations. The present study used three-level meta-analytic models to synthesize effect sizes and investigate potential moderators of the associations of self-disgust with depression and anxiety. The results revealed a significant association between self-disgust and depression (pooled r = 0.520, 95 % CI [0.485; 0.669], p < .001). The results also showed a significant and moderate association between self-disgust and anxiety (pooled r = 0.452, 95 % CI [0.419; 0.556], p < .001). These associations were held according to sex and age. In conclusion, this meta-analysis supports a moderate-to-large association between self-disgust, depression, and anxiety, suggesting that it is worthy of consideration in research and clinical practice.

Introduction: To use a quantitative approach to examine the effects of family interventions on physical activity (PA) and sedentary behavior (SB) in children aged 2. 5-12 years. Methods: PubMed, OVID, Web of Science, and others were searched from their inception to May 2020. Intervention studies that examined the effects of family interventions on PA among children aged 2.5-12 years were included in this meta-analysis. Lastly, subgroup analyses were conducted to examine the potential modifying effects of family intervention\'s characteristics and study quality. Results: Eleven articles met the inclusion criteria for this review. Studies investigated a range of PA outcomes, including moderate-to-vigorous PA (MVPA), total PA (TPA), daily steps, and SB levels. Meta-analysis showed that family intervention had a significant effect on PA [standardized mean difference (SMD) = 0.10; 95% CI = 0.01-0.19], especially for daily steps [weight means difference (WMD) = 1,006; 95% CI = 209-1,803], but not for SB (WMD = -0.38; 95% CI = -7.21-6.46). Subgroup analyses indicated the improvements in PA occurred when children were 6-12 years old, intervention focused on PA only, intervention duration ≤ 10 weeks, and \"low risk of bias\" study performed. Conclusions: Family intervention may be a promising way to promote children\'s PA levels, especially for daily steps. Trial Registration: Meta-analysis protocol was registered on PROSPERO: CRD42020193667.

This study aimed to evaluate the effectiveness of physical activity (PA) interrupting prolonged sitting (PS) on postprandial glycemia and insulin responses among adults.
PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, PsycINFO, and the China National Knowledge Infrastructure databases were searched through September 30, 2020. Randomized controlled trials (RCTs) that examined the effect of all forms of PA interrupting PS on postprandial glycemia and/or insulin responses among adults without chronic diseases were included in this study. The risk of bias of included studies was evaluated based on the Cochrane tool. A network meta-analysis was performed to estimate the summary standardized mean differences (SMDs) with 95% confidence intervals (95%CIs) with random effects.
Thirty crossover RCTs were included in our review. These RCTs included 9 types of interventions that interrupted PS. When compared to PS by itself, light-intensity PA intermittent interrupting (LPA-INT) PS and moderate-intensity PA intermittent interrupting (MPA-INT) PS significantly lowered postprandial glycemia (SMD = -0.46, 95%CI: -0.70 to -0.21; SMD = -0.69, 95%CI: -1.00 to -0.37, respectively) and significantly reduced postprandial insulin response (SMD = -0.46, 95%CI: -0.66 to -0.26; SMD = -0.47, 95%CI: -0.77 to -0.17, respectively). Results of the clustered ranking plot indicated that MPA-INT was the most effective intervention in lowering postprandial glycemia and insulin responses.
Replacing PS with MPA-INT or LPA-INT has a positive effect in reducing postprandial glycemia and insulin responses, with MPA-INT being the optimal intervention strategy.

The extent to which walking pace is associated with a reduced risk for stroke remains unclear. This study examined the association between walking pace and stroke risk based on prospective cohort studies.
Databases of PubMed, EMBASE, Web of Science, Scopus, and China National Knowledge Internet were searched from the inception dates to January 31, 2019, for prospective cohort studies focusing on walking pace and risk of stroke in adults. Two reviewers independently extracted data and assessed the quality of the studies. The dependent measure was stroke incidence. Using random-effects models, a meta-analysis was performed to estimate the overall relative risks (RR) of stroke incidence and 95% confidence intervals (CIs) for the individuals with the fastest walking paces vs. individuals with the slowest walking paces. A dose-response relationship was also examined.
After screening 1294 titles/abstracts and 14 full-text studies identified in the search, 7 studies (from 8 cohorts) were included in the meta-analysis. The 7 studies included a total of 135,645 participants (95.2% women; mean age 63.6 years) and 2229 stroke events (median follow-up time = 8.0 years). Compared to individuals in the slowest walking-pace category (median = 1.6 km/h), individuals in the fastest walking-pace category (median = 5.6 km/h) had a 44% lower risk of stroke (pooled RR = 0.56, 95%CI: 0.48-0.65). There was also a linear dose-response relationship (RR = 0.87; 95%CI: 0.83-0.91), with the risk of stroke decreased by 13% for every 1 km/h increment in baseline walking pace. We observed similar results across walking-pace assessment, type of stroke ascertainment, stroke subtypes, sex, sample size, and duration of follow-up.
Findings from this meta-analysis indicate that walking pace is inversely associated with the risk of stroke.

BACKGROUND: Several studies have shown an association of acne vulgaris with depression and anxiety, but a quantitative review has not yet been conducted.
OBJECTIVE: We sought to conduct a systematic review and meta-analysis that elucidates the association of acne vulgaris with depression and anxiety.
METHODS: A systematic review and meta-analysis of literature published before October 1, 2019 from the PubMed, PsycINFO, MEDLINE, and Cochrane databases was conducted. We used a metaanalytic approach to perform a random effects analysis comparing individuals with and without acne. Subgroup analyses between studies included age, study setting, and geographic region.
RESULTS: Forty-two studies were included. We found a significant association of acne vulgaris with depression (r = 0.22 [95% confidence interval 0.17-0.26, P < .00001]) and anxiety (r = 0.25 [95% confidence interval 0.19-0.31, P < .00001]). Subgroup analyses and comparisons showed moderating influences based on factors including age, study setting, and geographic region.
CONCLUSIONS: Inconsistency between publications regarding acne and outcome ascertainment, data reporting, and studies with no control group posed considerable barriers to synthesizing all available published literature.
CONCLUSIONS: Because of an increased risk for depression and anxiety, clinicians should pursue aggressive treatment of acne and consider psychiatric screening or referrals.