The research team, led by Başak Çağla Arslan of Lokman Hekim University in Ankara, Türkiye, together with colleagues from Hacettepe University, Lokman Hekim University, and Yüksek İhtisas University, set out to examine how coping styles and perceived social support relate to psychiatric symptoms in parents of children with DMD. Rather than treating caregiver distress as an inevitable consequence of the disease, the authors investigated the psychological machinery that shapes it: the habitual strategies people use when facing stress, and the subjective sense that others are there for them when things fall apart.

Methodologically, the study took the form of a descriptive, exploratory, cross-sectional survey distributed online. Parents completed a demographic information form along with three validated instruments: the Stress Coping Styles Scale, which distinguishes adaptive patterns such as optimistic and self-confident coping from maladaptive ones such as helpless and submissive approaches; the Multidimensional Scale of Perceived Social Support, which measures perceived support separately from family, friends, and significant others; and the Brief Symptom Inventory, a screening tool capturing dimensions including anxiety, depression, somatization, hostility, and negative self-concept. In total, 139 parents participated, comprising 105 mothers and 34 fathers, with a mean age of 37.8 years and a standard deviation of 7.05. The imbalance between mothers and fathers is itself telling, reflecting the reality that caregiving burdens in many families fall disproportionately on women.

The correlational results paint a consistent picture. Optimistic coping, the tendency to approach stress with a hopeful, constructive outlook, was negatively correlated with anxiety (r = −.427), depression (r = −.370), negative self-concept (r = −.410), somatization (r = −.339), and hostility (r = −.428). In other words, parents who characteristically sought out positive ways of managing strain reported systematically fewer symptoms across the psychiatric spectrum. Helpless coping, by contrast, showed positive correlations with anxiety (r = .313), depression (r = .388), and negative self-concept (r = .327), suggesting that resignation in the face of a relentless illness goes hand in hand with internalizing distress.

Social support emerged as a second, complementary pillar. Higher perceived support from friends and significant others was associated with lower anxiety scores, while optimistic coping was itself positively associated with perceived support from family, friends, and significant others. This interconnection is not accidental, the authors suggest. Parents who face adversity with optimism may find it easier to maintain relationships, ask for help, and sustain the social networks that then buffer them against psychological deterioration. Support and coping style may thus form a mutually reinforcing loop, or alternatively a downward spiral when maladaptive coping isolates caregivers from the very people who could help them.

The most statistically rigorous evidence came from the multiple linear regression analyses. After adjusting for the contributions of other variables, optimistic coping was independently associated with lower depression scores (β = −0.368, p < .001), whereas helpless coping predicted higher depression scores (β = 0.304, p < .001). Taken together, coping styles and perceived social support explained 25.9 percent of the variance in depression scores among the parents. In behavioral science, where predicting even a tenth of the variance in mental health outcomes can be considered meaningful, a quarter of the variance explained by modifiable psychosocial factors is a substantial and clinically encouraging finding.

Why does this matter? Depression and anxiety in caregivers are not merely private suffering. Parental psychiatric symptoms can affect the quality of care a child with DMD receives, the consistency of adherence to complex treatment regimens including corticosteroids and cardiac surveillance, and the emotional environment in which the child develops. Newborn screening and molecular therapies are gradually extending the lifespan and improving the outlook for boys with DMD, which means caregiving durations are lengthening. Protecting the mental health of parents is therefore becoming an integral, rather than peripheral, component of comprehensive DMD care.

The Turkish research team is careful to frame its conclusions appropriately. Because the study is cross-sectional, it captures a single moment in time and cannot establish causation. It remains possible that psychiatric symptoms themselves push parents toward helpless coping, or that unknown third factors, such as disease severity, socioeconomic strain, or personality traits, drive both coping style and distress. The authors explicitly call for longitudinal and intervention studies to clarify the direction of these associations and to evaluate whether, for example, teaching optimistic coping skills or strengthening support networks actually reduces symptoms over time. They also note that the sample, while valuable, was recruited online and may not represent all families affected by DMD in Türkiye or elsewhere.

Even with those caveats, the practical implications are clear. Health professionals working with DMD families, including neurologists, physiotherapists, occupational therapists, nurses, and psychologists, could routinely screen parents for psychiatric symptoms rather than focusing exclusively on the affected child. Screening for coping style may be equally informative: a parent leaning heavily on helpless strategies could be flagged for early psychological intervention, such as cognitive-behavioral therapy, problem-solving training, or peer support programs that connect caregivers with others who understand their daily realities. The finding that support from friends and significant others, not only family, was linked to lower anxiety suggests that support interventions should look beyond the household to the wider social circle.

Ultimately, the study reframes caregiver distress in DMD not as an unavoidable toll but as a partially modifiable outcome. If optimistic coping and robust social support genuinely shield parents from depression and anxiety, then psychosocial care can move from reactive crisis management to proactive prevention. For the mothers and fathers who wake every day to muscle biopsies, wheelchair fittings, and the quiet grief of watching a progressive disease unfold, that shift could make an enormous difference, both for their own wellbeing and for the children who depend on them most.

Subject of Research: Coping styles, perceived social support, and psychiatric symptoms in parents of children with Duchenne muscular dystrophy

Article Title: Coping styles, social support, and psychiatric symptoms in parents of children with duchenne muscular dystrophy

Article References: Arslan, B. Ç., Öz, F., Tunç, A. R., Öztürk, D., Sönmez, F. M., & Karaduman, A. A. (2026). Coping styles, social support, and psychiatric symptoms in parents of children with duchenne muscular dystrophy. BMC Psychology. https://doi.org/10.1186/s40359-026-05593-0

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DOI: 10.1186/s40359-026-05593-0

Keywords: Duchenne muscular dystrophy, coping styles, social support, psychiatric symptoms, caregivers, mental health, depression, anxiety, BMC Psychology, parents, rare disease, psychosocial support

The study was grounded in the Research Domain Criteria, or RDoC, an approach developed by the U.S. National Institute of Mental Health to investigate psychological functioning through interacting biological, behavioral, and social systems rather than through diagnostic categories alone. The researchers focused on two RDoC-informed areas. Religious beliefs and spirituality were treated as a construct related to the positive valence system, which involves motivation, reward, meaning, and the evaluation of future outcomes. Perceived social support was examined as part of the social processes system, which includes affiliation, attachment, and interpersonal communication. The researchers proposed that adversity might be associated with lower flourishing partly because it disrupts meaning-making and spiritual confidence, while strong social relationships might weaken the relationship between early adversity and later well-being.

Participants completed an online survey between November 2022 and January 2023. They were recruited from universities in the Midwest, Southeast, and South of the United States. The final sample was predominantly female and White: 339 participants identified as female and 136 as male, while 304 participants identified as White. Approximately 70.5 percent identified as heterosexual, and 29.5 percent identified as sexual minorities. The average age was 21.32 years. Although the sample was not designed to represent every emerging adult in the country, it offered a view of college students navigating a developmental stage marked by increasing independence, relationship changes, educational pressure, and decisions about work and identity.

Childhood adversity was measured using the World Health Organization’s Adverse Childhood Experiences International Questionnaire. The instrument assessed 10 categories of adversity occurring before age 18, including physical, emotional, and sexual abuse; physical and emotional neglect; household violence; mental health problems in the household; incarceration; substance use; and parental separation. Researchers combined the responses into a cumulative score ranging from zero to 10. The results revealed a striking concentration of adversity in the sample. Forty-four percent of participants met the commonly used threshold of four or more adverse childhood experience categories. Emotional neglect was reported by 95 percent of participants, while emotional abuse was reported by 59 percent, household violence by 60 percent, physical abuse by 46 percent, and sexual abuse by 31 percent.

Flourishing was measured with the eight-item Flourishing Scale, which includes statements such as “I lead a purposeful and meaningful life,” “My social relationships are supportive and rewarding,” and “I am optimistic about my future.” Participants rated their agreement on a seven-point scale, with higher total scores representing stronger well-being and functioning. Religious beliefs and spirituality were assessed with three measures addressing the importance of religious or spiritual beliefs and practice, the belief that God cares about personal problems, and the belief that God has plans for one’s life. Perceived social support was measured through questions about family, friends, and significant others. All three measures showed high internal consistency in this sample, although the researchers noted that a short spirituality scale cannot capture the full diversity of religious experience or spiritual struggle.

The first major finding involved religious beliefs and spirituality as a statistical mediator. Participants reporting more adverse childhood experiences tended to report lower levels of religious beliefs and spirituality. In turn, stronger religious or spiritual beliefs were associated with higher flourishing. The indirect association was statistically significant, with an estimated effect of –0.19 and a bootstrapped 95 percent confidence interval from –0.30 to –0.09. In technical terms, mediation does not prove that adversity directly destroys spirituality or that spirituality necessarily produces flourishing. Instead, the analysis indicates that differences in spirituality accounted for part of the statistical relationship between childhood adversity and flourishing after adjustment for age, sex, sexual identity, and racial or ethnic identity. The authors suggest that faith, sacred purpose, and meaning-making may help some students develop a coherent life narrative and maintain motivation while facing the demands of emerging adulthood.

The second major finding concerned social support. Overall, adverse childhood experiences were negatively associated with flourishing. However, the strength of that association depended on how much support participants believed they received from family, friends, or significant others. Among students with lower social support, each increase in adversity was associated with a substantial decline in flourishing, with a regression coefficient of –0.93. At moderate levels of support, the association remained significant, with a coefficient of –0.57. Among students with higher social support, the estimated association weakened to –0.21 and was no longer statistically significant because its confidence interval included zero. This pattern is consistent with a buffering effect: supportive relationships did not erase childhood adversity, but they appeared to reduce its observable connection with current well-being in this sample.

The researchers also tested whether social support strengthened the relationship between religious or spiritual beliefs and flourishing. It did not. The interaction between spirituality and social support was not statistically significant, with an estimated coefficient of –0.01 and a confidence interval extending from –0.02 to 0.00. This result contradicted the researchers’ third hypothesis. They had expected that spiritual beliefs might be especially beneficial when reinforced by strong interpersonal networks. Instead, the positive association between spirituality and flourishing appeared relatively consistent across different levels of perceived support. One possible explanation is that internal meaning and spiritual motivation may operate independently of external relationships. Another is that the broad measure of social support did not distinguish between general support and support from people who share a student’s religious or spiritual values.

The study’s findings were accompanied by several important demographic patterns. Older participants within the 18-to-29 age range reported somewhat greater exposure to adverse childhood experiences and lower levels of flourishing and religious or spiritual belief. Female participants reported more adversity than male participants, while Black participants reported higher religious or spiritual beliefs than other groups in the analyses. Heterosexual-identifying participants reported lower adversity and higher religious or spiritual beliefs and flourishing than sexual minority participants. These patterns do not establish why the groups differed, and they may reflect social conditions, identity-related stress, sampling characteristics, or other unmeasured influences. They do, however, underscore that emerging adulthood is not a uniform experience and that protective resources may be shaped by culture, identity, community, and access to safety.

The authors argue that universities could use the results to expand trauma-informed support beyond symptom reduction. Voluntary and inclusive programs might include counseling that allows students to explore meaning, faith, values, or existential questions without promoting any particular religion. Mentoring, peer-support groups, student organizations, community service, and faculty relationships could help strengthen social connection. The researchers also point to well-being programs, positive psychotherapy, well-being therapy, and courses focused on relationships, self-awareness, and personal growth as possible components of a broader campus strategy. Such interventions would need to respect students who are religious, spiritual but not religious, uncertain, or nonreligious. The findings support offering pathways to meaning and connection, not assuming that one form of belief or support is appropriate for everyone.

The evidence should nevertheless be interpreted cautiously. The study was cross-sectional, meaning all key variables were measured at one time, so the data cannot establish that adverse experiences caused lower spirituality, that spirituality caused flourishing, or that social support caused resilience. Childhood experiences were reported retrospectively and may have been affected by memory and current emotional state. The participants were recruited from universities and were mostly White and female, limiting generalization to emerging adults who are working, in vocational training, taking gap years, or living in other regions and cultures. The study also examined positive religious and spiritual beliefs but not spiritual struggles, such as anger at God, doubts, religious conflict, or feeling abandoned by a higher power. Future longitudinal studies could track students over time, include broader populations, test specific interventions, and examine additional protective factors such as self-control, caring adults, peer relationships, neighborhood safety, cognitive flexibility, and emotion regulation. Even with these limitations, the research highlights a potentially important shift in trauma science: early adversity may increase risk, but flourishing is influenced by the meanings people construct and the relationships that surround them.

Subject of Research: Adverse childhood experiences, flourishing, religious beliefs and spirituality, perceived social support, emerging adult college students, and RDoC-informed psychological mechanisms.

Article Title: Adverse Childhood Experiences and Flourishing Among Emerging Adult College Students: Religious Beliefs/Spirituality and Social Support as Research Domain Criteria (RDoC)-Informed Mechanisms

Article References: Kim, J.-Y., Lee, J. M., Park, Y., Lee, H., & Lee, J. Adverse Childhood Experiences and Flourishing Among Emerging Adult College Students: Religious Beliefs/Spirituality and Social Support as Research Domain Criteria (RDoC)-Informed Mechanisms. Journal of Adult Development (2026).

Image Credits: AI Generated

DOI: 10.1007/s10804-026-09560-2

Keywords: Adverse childhood experiences; flourishing; religious beliefs; spirituality; perceived social support; college students; emerging adulthood; resilience; Research Domain Criteria; positive valence system; social processes system.

Understanding the role of social support begins with recognizing its foundational importance in human psychological functioning. Social support, broadly defined as the perceived or actual assistance and comfort received from social networks, has long been acknowledged as a buffer against stress and an enhancer of overall mental health. However, moving beyond the mere presence of support, the novel focus here is on the act of appreciating that support—a cognitive-emotional process that may activate unique psychological mechanisms leading to positive affective states such as gratefulness. The study signals that this appreciation is not just a passive acknowledgment but an active appreciation that can initiate a cascade of beneficial behaviors.

One of the intermediary processes elucidated in this study is physical exercise, a behavioral variable that holds substantial evidence for its efficacy in improving mood and cognitive function. Physical exercise is not only a physiological activity that supports physical health but also an influential psychological tool that enhances emotional regulation and mitigates symptoms of anxiety and depression. The research posits that when college students appreciate their social support systems, they are more likely to engage in regular physical exercise, which in turn fosters heightened gratefulness. This exercise-related pathway underscores the symbiotic relationship between social interactions and one’s physical routine in cultivating emotional well-being.

Further mediating the relationship is the emergence of a sense of meaning in life, a construct referring to the extent to which individuals perceive their existence as purposeful and significant. The study identifies this sense of meaning as a critical psychological outcome influenced by both the appreciation of social support and the practice of physical exercise. Engaging consistently in physical activity may facilitate introspection and foster a deeper understanding of personal goals and values, thus enhancing meaning-making processes. The amplification of life’s meaningfulness subsequently reinforces feelings of gratefulness, suggesting a robust chain of psychological transformations triggered by appreciating social networks.

Delving into the methodological architecture of this research reveals an empirical rigor that bolsters the credibility of its findings. The study harnessed quantitative measures through validated psychometric scales administered to a diverse sample of college students. Social support appreciation was assessed via self-report instruments designed to capture both the cognitive recognition and affective gratitude toward support providers. Physical exercise frequency and intensity were recorded through standardized questionnaires, while the sense of meaning was evaluated using established existential and purpose-oriented scales. Gratefulness was measured as both a trait and state variable, providing a comprehensive portrait of participants’ grateful dispositions.

Statistical analyses employed in the study included structural equation modeling (SEM), a powerful technique apt for deciphering complex mediational relationships. SEM enabled the researchers to test the hypothesized chain mediation model, subsequently confirming that the route from appreciating social support to gratefulness was significantly mediated by physical exercise and sense of meaning. Notably, the direct effect remained significant even after accounting for the mediators, indicating that while physical activity and meaning-making are critical pathways, other factors might also contribute to this relationship, inviting further inquiry into additional psychological or social moderators.

The implications of these findings are manifold, especially within the context of higher education institutions striving to promote mental health resilience among students. The evidence suggests that fostering an environment where students are encouraged not only to lean on their social networks but also to consciously appreciate these supports can yield profound psychological benefits. Integrating physical exercise programs along with interventions aimed at existential meaning-making could form a holistic approach to enhancing gratefulness, potentially translating into improved academic performance, interpersonal relationships, and overall life satisfaction.

On a theoretical front, this research contributes to the expanding literature on positive psychology by operationalizing gratitude not merely as an outcome but as a dynamic process intricately linked to behavioral and existential factors. It highlights the bidirectional nature of psychological well-being, where cognitive appraisals of social environments engender practical lifestyle choices such as exercise, which in turn scaffold deeper reflective capacities and emotional states. This triadic interplay adds a nuanced layer to existing models of how external and internal variables converge to shape mental health trajectories.

Beyond psychological theory, the physiological underpinnings implicit in this chain mediation merit attention. Physical exercise is associated with neurochemical changes, including increased endorphin release, enhanced brain-derived neurotrophic factor (BDNF) levels, and improved neural plasticity. These biological shifts likely create an optimal emotional milieu for cultivating gratitude and meaning. The recognition that social support appreciation indirectly impacts these neurobiological factors through exercise underscores the integrated framework of mind-body interactions critical to human flourishing.

It is also important to situate this study within the broader sociocultural matrices influencing college students today. The increasing prevalence of digital communication and social media platforms transforms how social support is given, received, and appreciated. While virtual interactions may lack some elements of face-to-face engagement, they nonetheless provide substantive emotional resources. Future research might explore how digital social support appreciation interfaces with physical exercise habits and existential meaning in digitally immersive environments, thus expanding the ecological validity of these findings.

Moreover, the temporal attributes of gratitude and its mediators are worthy of exploration. Longitudinal designs would be imperative to determine causality and the stability of these psychological processes over time. For instance, do intermittent bouts of appreciating social support have transient or cumulative effects when combined with sustained physical activity and meaning-making efforts? Understanding temporal dynamics could inform the timing and duration of interventions aimed at enhancing gratefulness.

In terms of practical application, universities and wellness programs could capitalize on these insights by designing integrative initiatives that promote social connectivity, appreciation exercises such as gratitude journaling, and accessible physical activity options. Workshops that encourage reflection on meaningful life themes could amplify the psychological benefits by reinforcing the chain mediation mechanism uncovered in this research. Tailoring such programs to diverse student populations would ensure inclusivity and maximize wellbeing outcomes.

This study also prompts a reevaluation of how gratitude is conceptualized in psychological assessment and intervention. Recognizing it as a multifactorial construct mediated by both behavioral engagement and existential reflection broadens its applicability. Clinical practitioners might incorporate physical exercise prescriptions and meaning-centered therapy as complementary approaches to traditional gratitude interventions, creating a multidisciplinary pathway toward enriched mental health.

As these findings disseminate within the scientific community and beyond, the potential for viral spread lies in their relatable and practical nature. College students and educators alike can resonate with the message that simple yet intentional appreciation of one’s support network can tangibly enhance emotional well-being through everyday behaviors and deeper psychological grounding. This alignment of research rigor with actionable advice positions the study as a compelling catalyst for widespread adoption.

Overall, the study by Jiang, Zhang, Zhao, and colleagues advances our comprehension of the psychological architecture underpinning gratefulness. By delineating a clear, empirically supported chain linking appreciation of social support to physical exercise and meaningful life engagement, culminating in enhanced gratefulness, it charts a path for future research and intervention development. The interplay among cognitive appraisal, behavioral activation, and existential meaning engrains gratitude as an attainable, sustainable state with benefits extending across multiple domains of health and flourishing.

In conclusion, appreciating social support stands out as a pivotal starting point in a complex psychological journey that traverses bodily activity and existential reflection to arrive at heightened gratefulness. This chain mediation model invites individuals and institutions to adopt integrative approaches that recognize the multiple layers contributing to psychological well-being. Through such multidimensional frameworks, the optimization of mental health and life satisfaction in college students—and potentially the wider population—may find new evidence-based avenues for advancement.

Subject of Research: The psychological impact of appreciating social support on college students’ gratefulness, focusing on the mediating roles of physical exercise and sense of meaning in life.

Article Title: The impact of appreciating social support on college students’ gratefulness: the chain mediating role of physical exercise and sense of meaning in life.

Article References:
Jiang, Y., Zhang, B., Zhao, H. et al. The impact of appreciating social support on college students’ gratefulness: the chain mediating role of physical exercise and sense of meaning in life. BMC Psychol 13, 575 (2025). https://doi.org/10.1186/s40359-025-02920-9

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