Gordon J. G. Asmundson

Narcissism is defined by an inflated sense of self-importance and entitlement and can be characterized into two subtypes: grandiose narcissism and vulnerable narcissism. Both subtypes share overlapping core features of disregard for others, self-centredness and entitlement. Entitlement can lead to unrealistic expectations from others, leading people with higher narcissism to engage in maladaptive strategies (e.g., attacking others) to re-establish their desired sense of superiority and protect themselves from vulnerability. People with higher narcissism also show minimal to no concern regarding others’ well-being in various health-related situations. During the COVID-19 pandemic, individuals higher in narcissism were less likely to follow government-mandated public health interventions (e.g., mask-wearing, social distancing, isolation) and more likely to hold anti-vaccination attitudes. Sex differences indicated that males showed greater levels of non-adherence in comparison to females. Non-adherence to these public health measures is a risk factor during global pandemics, as the likelihood of disease transmission is increased.

Objective. Public safety personnel (PSP; e.g., police, firefighters, paramedics, correctional workers, and communications officials) face elevated risks of mental health concerns, including suicidal ideation and behaviours. Well-validated cognitive and interpersonal theories of suicide emphasize the roles of hopelessness, belongingness, traumatic exposures, and burdensomeness; however, the integration with symptom-level processes of posttraumatic stress remains limited. This study examined the relationships between posttraumatic stress symptoms (PTSSs), hopelessness, and suicidal ideation in relation to suicidal contemplation in a large sample of PSP. Method. Data were collected between September 2016 and January 2017 from 1259 Canadian public safety personnel, including 623 who endorsed suicidal contemplation and 636 who did not. Participants completed validated self-report measures of posttraumatic stress symptoms (PCL-5), depression symptoms, including hopelessness and suicidal ideation (PHQ-9), and trauma exposure (LEC-5). Separate partial correlation networks were estimated for personnel with and without suicidal thoughts using regularized graphical models. Centrality was assessed with expected influence, networks were compared using the Network Comparison Test, and a directed acyclic graph was constructed to examine conditional dependency patterns. Results. Networks for personnel with suicidal contemplation showed greater overall connectivity. Comparison tests indicated that network structure and centrality differences were not statistically significant between groups. Descriptively, several trauma-related symptoms appeared somewhat more central in the contemplation network, although centrality differences were not statistically significant. Directed acyclic graph modelling identified conditional dependence patterns linking hopelessness and suicidal ideation, with PTSSs such as upsetting reminders and detachment also appearing in the model. Conclusions. Findings align with elements of cognitive and interpersonal theories of suicide while extending them to posttraumatic stress processes in PSP. The results provide exploratory hypotheses concerning hopelessness and trauma-related symptoms for future longitudinal and intervention research, while recognizing that the findings reflect cross-sectional, pre-pandemic associations.

Background: The COVID-19 pandemic intensified health anxiety, a common and costly condition marked by excessive fear of illness and functional impairment. Despite growing prevalence and impact, health anxiety remains under-recognized in clinical practice. Scalable, accessible interventions such as internet-based cognitive behavioral therapy (iCBT) are needed to address this gap.Methods: A three-arm randomized controlled trial with waitlist control group was conducted to evaluate two self-guided digital interventions for health anxiety: THIS WAY UP iCBT and 90SecondHealth Anxiety compared to a control group. Canadian adults (N=278) meeting eligibility criteria were randomized (1:1:1). Assessments occurred at baseline, post-intervention, and at one- and three-month follow-ups. Primary outcomes were health anxiety, depression, and generalized anxiety. Data were analyzed using mixed-effects regression models under both intention-to-treat and per-protocol frameworks. Non-inferiority was tested using a predefined margin.Results: Both interventions led to improvements in health anxiety relative to waitlist control, though effect magnitude and timing varied. THIS WAY UP iCBT demonstrated significant reductions at all time points, whereas 90SecondHealth Anxiety showed a delayed effect, achieving statistical significance only at the 3-month follow-up. Non-inferiority analysis indicated that the two interventions were comparable at the 3-month follow-up. Both interventions yielded modest improvements in depressive symptoms, while generalized anxiety reductions were observed only in the THIS WAY UP iCBT group. Sex-based analyses revealed stronger and more consistent effects among female participants.Conclusions: Findings support the effectiveness of digital interventions for health anxiety and highlight the potential of brief, low-intensity programs as scalable alternatives to clinical CBT. Integration of such interventions into stepped-care models may optimize resource allocation and improve access. Future research should examine mechanisms of change, personalization strategies, and long-term outcomes.