American Journal of Forensic Psychology (ISSN: 0733-1290) Official Website: https://americanforensicpsychology.org/ is a peer-reviewed academic journal dedicated to research and professional practice in the field of forensic psychology, which explores the relationship between psychology and the legal system. The journal publishes original research, case studies, and theoretical papers related to criminal behavior, psychological assessment, legal decision-making, and mental health issues in legal contexts. Founded in 1983 and published by the American College of Forensic Psychology (ACFP), United States, the journal serves as a platform for psychologists, criminologists, legal scholars, and researchers working in applied and forensic psychology. It is indexed in international databases and is classified under Medicine (Pathology and Forensic Medicine) and Psychology (Applied Psychology). According to SCImago Journal Rank (SJR) 2024, the journal has an SJR score of 0.103, is placed in Q4, and has an H-Index of 20.
American College of Forensic Psychology (ACFP),
Histopathological Changes in Sudden Cardiac Death: A Prospective Autopsy-Based Study at Bhopal Region
Background: Cases of sudden cardiac death (SCD) and autopsy-revealed coronary artery lesions in central India have been reported in the literature. Aim: The purpose of this study was to assess cardiac histopathological lesions in sudden cardiac death and their correlation with age and sex. Methods: In this prospective autopsy study (01 March 2025–28 February 2026), a total of hundred sudden, non-traumatic deaths suspected to be cardiac were studied at Gandhi Medical College Bhopal. The heart and coronaries were examined grossly and histopathologically using standard parameters. Results: 73% of cases were males and half of cases aged 40-59 years. Among the participants, a significant 62% showed signs of coronary atherosclerosis, with a notable increase observed as age progressed. 46% had a myocardial infarction acute and/or healed and 35% had left ventricular hypertrophy. Myocarditis and cardiomyopathies together accounted for around 16% of cases, especially in youth. Conclusion: The major cause of SCD in this setting is coronary atherosclerosis which can or cannot have a myocardial infarction. Importantly, this is the case in middle-aged men. Myocarditis and cardiomyopathies are important minorities in younger victims. Carrying out systematic autopsy and histopathology is very important for establishing the cause of SCD. Thereby allowing an opportunity for implementing preventive measures.
sudden cardiac death, autopsy, histopathology, coronary atherosclerosis, myocarditis
Copyright (c) 2026 American Journal of Forensic Psychology
Local Infiltration Analgesia Versus Transversus Abdominis Plane (Tap) Block For Postoperative Pain Control In Paediatric Laparoscopic Surgery: A Randomized Controlled Trial
Background and Objective: Paediatric laparoscopic surgery, while minimally invasive, is associated with significant postoperative somatic and visceral pain. Effective pain management is crucial for early mobilization and recovery. This study aims to compare the postoperative analgesic efficacy of local infiltration analgesia at port sites versus ultrasound-guided Transversus Abdominis Plane (TAP) block in children undergoing elective laparoscopic procedures. Methodology: A randomized controlled trial was conducted at the Department of Paediatric Surgery. One hundred twenty children aged 2–12 years, scheduled for elective laparoscopy, were enrolled using consecutive sampling and randomized into two equal groups (n=60). Group A received local surgical site infiltration of 0.25% Bupivacaine (2 mg/kg total), while Group B received an ultrasound-guided bilateral TAP block utilizing 0.25% Bupivacaine (0.5 mL/kg per side). Postoperative pain was assessed using the FLACC scale (for children <4 years) or Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours. The primary outcome was the mean pain score, and the secondary outcome was the time to first rescue analgesia. Results: Both groups exhibited comparable baseline demographics. Group B (TAP Block) demonstrated significantly lower mean pain scores at 6 hours (2.1 ± 0.8 vs 4.3 ± 1.1, p < 0.001) and 12 hours (2.5 ± 0.9 vs 4.8 ± 1.2, p < 0.001) compared to Group A. The mean time to first rescue analgesia was significantly prolonged in Group B (540 ± 85 minutes) compared to Group A (310 ± 60 minutes) (p < 0.001). Conclusion: Ultrasound-guided TAP block provides superior, longer-lasting postoperative analgesia and delays the need for rescue analgesics compared to local port-site infiltration in paediatric laparoscopic surgery.
Paediatric Laparoscopy, Postoperative Pain, Transversus Abdominis Plane Block, Local Infiltration, Bupivacaine, FLACC Scale.
Sleep, Learning, and Academic Achievement in Medical Students: A Systematic Review of Observational Studies
Background: Sleep plays a fundamental role in cognitive functioning, memory consolidation, learning processes, and academic success. Medical students are particularly vulnerable to sleep disturbances due to demanding academic schedules, examination pressure, clinical responsibilities, and lifestyle factors. Although numerous observational studies have investigated the relationship between sleep and academic outcomes among medical students, the available evidence remains dispersed across different educational settings and geographical regions. Objective: To systematically review observational studies evaluating the association between sleep characteristics, learning outcomes, and academic achievement among medical students worldwide. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Electronic databases including PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched from January 2000 to December 2025. Observational studies involving undergraduate or graduate medical students that assessed sleep parameters and reported learning or academic achievement outcomes were included. Data regarding study characteristics, sleep measures, academic outcomes, and associated factors were extracted and narratively synthesized. Results: A total of 38 observational studies involving approximately 27,600 medical students from 24 countries met the inclusion criteria. Poor sleep quality, insufficient sleep duration, and excessive daytime sleepiness were highly prevalent across studies. Thirty-three studies (86.8%) reported a significant association between adverse sleep characteristics and poorer academic outcomes. Students experiencing poor sleep quality or short sleep duration consistently demonstrated lower grade point averages (GPAs), reduced examination performance, impaired concentration, poorer memory retention, and decreased learning efficiency. Academic workload, examination stress, excessive smartphone use, social media engagement, and poor sleep hygiene emerged as major determinants of sleep disturbances. Conclusion: Observational evidence consistently demonstrates that inadequate sleep is associated with impaired learning and poorer academic achievement among medical students. Promoting healthy sleep behaviors may represent an important strategy for improving educational outcomes and student well-being.
Sleep; Learning; Academic achievement; Medical students; Sleep quality; Academic performance; Systematic review; Observational studies.
Sleep Quality and Educational Performance in Undergraduate Medical Students: A Systematic Review and Narrative Synthesis
Background: Background: Sleep quality is a crucial determinant of cognitive functioning, memory consolidation, emotional regulation, and overall well-being. Undergraduate medical students frequently experience poor sleep quality due to demanding academic schedules, examination stress, clinical exposure, and lifestyle-related factors. Growing evidence suggests that inadequate sleep quality may adversely affect educational performance; however, findings across studies remain heterogeneous. Objective: To systematically review and narratively synthesize global evidence regarding sleep quality among undergraduate medical students and its association with educational performance. Methods: A systematic review and narrative synthesis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Electronic databases including PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched for studies published between January 2000 and December 2025. Observational studies assessing sleep quality among undergraduate medical students and reporting educational performance outcomes were included. Data regarding study characteristics, sleep quality measures, prevalence of poor sleep quality, educational outcomes, and associated factors were extracted and synthesized narratively. Results: A total of 34 studies involving approximately 23,400 undergraduate medical students from 20 countries met the inclusion criteria. Poor sleep quality was reported in 35.8% to 79.4% of participants, with an overall weighted prevalence of 59.8%. Most studies demonstrated a significant association between poor sleep quality and lower grade point averages (GPAs), poor examination scores, impaired concentration, reduced learning efficiency, and increased academic stress. Excessive daytime sleepiness, irregular sleep schedules, and insomnia symptoms were frequently associated with adverse educational outcomes. Academic workload, examination anxiety, smartphone use before bedtime, social media engagement, and poor sleep hygiene emerged as major determinants of poor sleep quality. Conclusion: Poor sleep quality is highly prevalent among undergraduate medical students and is consistently associated with poor educational performance. Interventions aimed at improving sleep hygiene and promoting healthy sleep behaviors may contribute to enhanced academic outcomes and student well-being.
Sleep quality; Educational performance; Undergraduate medical students; Academic achievement; Sleep hygiene; Systematic review; Narrative synthesis.
Sleep Deprivation and Academic Achievement Among Medical Students: A Systematic Review of Global Evidence
Background: Sleep deprivation is increasingly recognized as a major public health concern among university students, particularly those pursuing medical education. Medical students frequently experience inadequate sleep due to demanding academic schedules, clinical responsibilities, examination stress, and lifestyle-related factors. Emerging evidence suggests that chronic sleep deprivation adversely affects cognitive function, learning capacity, memory consolidation, and academic achievement. Objective: To systematically review the global evidence regarding the prevalence of sleep deprivation among medical students and examine its association with academic achievement. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Electronic databases including PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched for studies published between January 2000 and December 2025. Observational studies evaluating sleep deprivation and academic outcomes among undergraduate or postgraduate medical students were included. Data regarding study characteristics, prevalence of sleep deprivation, sleep duration, academic performance indicators, and associated risk factors were extracted and narratively synthesized. Results: A total of 36 studies comprising approximately 24,800 medical students from 22 countries met the inclusion criteria. The prevalence of sleep deprivation, commonly defined as sleeping less than 7 hours per night, ranged from 41.2% to 88.5%, with an overall weighted prevalence of 65.9%. Most studies reported a significant negative association between sleep deprivation and academic achievement. Students experiencing sleep deprivation demonstrated lower grade point averages (GPAs), poorer examination performance, reduced concentration, impaired memory retention, increased daytime sleepiness, and higher levels of academic stress. Several studies identified academic workload, examination anxiety, excessive screen time, social media use, and caffeine consumption as major contributors to sleep deprivation. Conclusion: Sleep deprivation is highly prevalent among medical students worldwide and is consistently associated with poorer academic achievement. Interventions promoting adequate sleep duration and healthy sleep practices may improve both academic performance and overall well-being among medical students.
Sleep deprivation; Academic achievement; Medical students; Sleep duration; Academic performance; Systematic review.
Sleep Disturbances and Their Association With Academic Performance Among Medical Students: A Systematic Review
Background: Sleep is a fundamental physiological process essential for cognitive functioning, memory consolidation, emotional regulation, and overall health. Medical students are particularly vulnerable to sleep disturbances because of demanding academic schedules, prolonged study hours, clinical responsibilities, examination stress, and lifestyle factors. Increasing evidence suggests that inadequate sleep quality and quantity may adversely affect academic performance; however, the magnitude and consistency of this association remain unclear. Objective: To systematically review and synthesize the available evidence regarding the prevalence of sleep disturbances among medical students and their association with academic performance. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar were searched for studies published between January 2000 and December 2025. Observational studies assessing sleep quality, sleep duration, insomnia, daytime sleepiness, or other sleep-related parameters among undergraduate or postgraduate medical students and reporting academic performance outcomes were included. Data on study characteristics, sleep assessment tools, prevalence of sleep disturbances, and academic outcomes were extracted and narratively synthesized. Results: A total of 32 studies involving approximately 21,500 medical students across multiple countries met the inclusion criteria. The prevalence of poor sleep quality ranged from 32% to 78%, while insufficient sleep duration (<7 hours per night) was reported in 40–85% of participants. Most studies demonstrated a significant association between poor sleep quality and lower academic achievement. Students experiencing sleep disturbances were more likely to report reduced grade point averages, impaired concentration, decreased examination performance, increased absenteeism, and poorer cognitive functioning. Excessive daytime sleepiness and insomnia symptoms were also consistently associated with adverse academic outcomes. Several studies identified stress, electronic device use before bedtime, caffeine consumption, and irregular sleep schedules as major contributing factors. Conclusion: Sleep disturbances are highly prevalent among medical students and are consistently associated with poorer academic performance. Interventions aimed at improving sleep hygiene, stress management, and mental well-being may contribute to enhanced academic outcomes and overall student health. Medical institutions should prioritize sleep health promotion as part of student wellness programs.
Sleep quality; Sleep disturbances; Academic performance; Medical students; Insomnia; Daytime sleepiness; Systematic review
Psychiatric Comorbidity in Patients with Migraine: A Cross-Sectional Hospital-Based Study
Background: Migraine is a prevalent, highly disabling chronic neurological disorder. Clinical and population observations suggest an elevated prevalence of mental health disorders among these patients. This study aims to quantify psychiatric comorbidities in migraineurs using standardised clinical assessment metrics. Methods: A cross-sectional observational study was conducted with 120 migraine patients diagnosed under the International Classification of Headache Disorders (ICHD-3) guidelines. Psychiatric conditions were evaluated using the Hospital Anxiety and Depression Scale (HADS) alongside structured clinical psychiatric diagnostic interviews. Results: Among the 120 recruited participants, 71.7% met the criteria for at least one psychiatric comorbidity. Generalized Anxiety Disorder (GAD) was the most common condition (38.3%), closely followed by Major Depressive Disorder (MDD, 24.2%). Significantly higher rates of psychiatric pathology were observed in patients suffering from migraine with aura compared to those without aura (81.6% vs. 67.1%, p = 0.038). Chronic migraineurs also demonstrated significantly higher anxiety and depression scores compared to episodic sufferers (p < 0.001). Conclusions: Psychiatric comorbidities, specifically anxiety and depressive disorders, are exceptionally prevalent in the migraine population. Integrating routine mental health screenings into standard neurological care is critical to optimizing therapeutic outcomes.
Psychiatric Comorbidity; Generalized Anxiety Disorder; Major Depressive Disorder; Hospital Anxiety and Depression Scale (HADS); Bidirectional Relationship.
Copyright (c) 2023 American Journal of Forensic Psychology
Quality of life and caregiver burden in schizophrenia
Background: Family caregivers serve as the primary support ecosystem for individuals diagnosed with schizophrenia, facing severe subjective and objective strains. Schizophrenia is a chronic psychiatric disorder that significantly impairs patients’ quality of life (QoL) and imposes a considerable burden on caregivers. This study aimed to assess QoL among patients with schizophrenia and evaluate caregiver burden using standardized instruments. A cross sectional design was employed with 90 patients and their primary caregivers. Aims: This study evaluates the quantitative relationship between caregiving burden and multifaceted quality of life (QoL) metrics among home caregivers (\(N=90\)), while examining the modifying role of modern healthcare delivery options like long-acting therapeutics. Methods: A cross-sectional analytic design was employed. Primary caregiver burden was measured via the validated Zarit Burden Interview (ZBI-22), and caregiver life quality was quantified via the World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument. Results: Heavy or severe clinical burden was documented in 51.1% of the cohort. Linear regression models confirmed that higher baseline ZBI scores predicted dramatic reductions across all four major WHOQOL domains (\(p < 0.001\)). Caregivers utilizing long-acting injectable (LAI) regimens experienced lower overall subjective burden profiles compared to those managing daily oral regimens. Conclusion: Chronic caregiver strain operates as a key predictor of depleted family health. Strategic structural interventions, including psychoeducation, community respite care, and advanced drug delivery mechanisms, are essential to preserve the domestic care network.
Schizophrenia 2. Caregiver-Burden 3. Quality-of-Life 4. Mental-Illness 5. Chronic-Care.
Copyright (c) 2022 American Journal of Forensic Psychology
Knowledge, Attitude, and Practice of Dental Professionals Regarding Cross Infection in the Dental Teaching Hospital of Karachi
Background: Oral dental care infection management is of primary concern in combating the spread of bloodborne pathologic agents and protecting the patient and provider alike. Although there are set guidelines, the level of adherence to the guidelines on infection control is still low among dental practitioners. The aim of this study was to assess the knowledge, attitudes and practices of dental practitioners in a teaching hospital in Karachi, Pakistan in respect to cross-infection control. Methods: The study was a cross-sectional study that was carried out in February 2025 in Fatima Jinnah Dental College and Hospital and involved 330 dental professionals including undergraduate students, house officers, post-graduate residents, lecturers, and senior faculty. The information has been obtained with the help of a validated self-administered questionnaire that is filled in via a Google Forms and face-to-face interaction. The questionnaire measured demographic factors, awareness of the infection control measures, views on infection prevention, self-reported practices, perceived obstacles, vaccination, and suggestions on how they can promote the same. Findings: Most of the respondents were aged 2030 (82.4%), female (59.4%), and house officers (52.1%). The level of knowledge was high as 98.2% were able to identify autoclaving as the most efficient sterilization technique and 88.5% displayed knowledge in sharps disposal. Favourable attitudes were found, with 96.4% of people regarding infection control as very important and 98.2% recognizing the importance of lifelong learning. Adherence was self-reported (sterilization 83.0%, PPE use, 78.8%, hand hygiene, 74.5%, waste disposal, 71.5%, and aerosol management, 50.9%). The vaccination coverage of hepatitis B was 88.5. Among the significant barriers, there were resource shortage (61.8%), time (52.1%), and insufficient training (45.5%). Markedly, although 98.2% agreed with the need to engage in constant learning, 62.4 per cent had not attended any training related to infection control over the last year. Ordinary training workshops (80.6% recommendation) and more rigid adherence of guidelines (73.3% of 72.7%) and greater PPE supplies were highly suggested by participants. Conclusion: Dental professionals have shown great awareness and favourable attitudes towards infection control; still, there are numerous gaps in the practical application, especially in regards to aerosol management and involvement in continuing education. Systemic obstacles such as resource constraints and institutional hindrances are the major irregularities to ideal infection control. An organizational intervention, better training opportunities, and additional mechanisms to enforce the distance between knowledge and regular practice are necessary to bridge the gap.
Control of the infection in dental professionals, measures of cross-infection prevention, sterilization in dentistry, hand hygiene, and personal protective equipment (PPE).
Behavioral Problems Associated with Excessive Social Media Use: A Systematic Review and Meta-Analysis.
Background: Excessive social media use has emerged as a major public health concern, particularly among adolescents and young adults. Increasing evidence suggests that problematic social media engagement is associated with behavioral disturbances including aggression, impulsivity, attention deficits, anxiety, depression, sleep disturbances, and social dysfunction. Objective: This systematic review and meta-analysis aimed to evaluate the association between excessive social media use and behavioral problems across different age groups. Methods: A systematic search of PubMed, Scopus, Web of Science, Google Scholar, and PsycINFO databases was conducted for studies published between 2010 and 2025. Observational studies assessing behavioral outcomes associated with excessive social media use were included. Data extraction and quality assessment were performed independently by two reviewers. Meta-analysis was conducted using a random-effects model. Results: A total of 38 studies involving 74,562 participants were included. Excessive social media use demonstrated significant associations with behavioral problems including attention deficit symptoms, aggression, emotional instability, impulsive behavior, poor academic performance, sleep disorders, and social withdrawal. The pooled odds ratio for behavioral disturbances among excessive users was significantly elevated. Adolescents demonstrated stronger associations compared to adults. Conclusion: Excessive social media use is significantly associated with a wide spectrum of behavioral problems, particularly among adolescents and young adults. Early intervention strategies, digital literacy programs, parental monitoring, and mental health screening may help mitigate adverse behavioral outcomes associated with problematic social media engagement.
Social media addiction; Behavioral problems; Adolescents; Internet addiction; Mental health; Systematic review; Meta-analysis.
WHO ARE THEY? A CLOSER LOOK AT ACCUSED IN POCSO CASES.
Background: The Protection of Children from Sexual Offences (POCSO) Act, 2012 was enacted to safeguard children from sexual abuse and exploitation. While considerable attention has been directed toward victims, limited research has focused on the characteristics of individuals accused under the Act. Understanding the socio-demographic, behavioral, psychological, and legal awareness profiles of accused persons is essential for developing preventive and rehabilitative strategies. Aim: To study the socio-demographic profile, behavioral characteristics, mental health status, and legal awareness among individuals accused under the POCSO Act. Materials and Methods: A hospital-based observational analytical cross-sectional study was conducted in the Department of Forensic Medicine, Bidar Institute of Medical Sciences, Bidar, Karnataka, from January 2024 to December 2025. A total of 60 accused individuals fulfilling the inclusion criteria were enrolled. Data were collected using a structured proforma, interviews, medico-legal records, police documents, and psychiatric assessments. Variables included socio-demographic characteristics, substance use, criminal history, personality traits, mental health status, victim-offender relationship, and awareness regarding the POCSO Act. Data were analyzed using SPSS software. Descriptive statistics, Chi-square test, and Student’s t-test were applied, with p<0.05 considered statistically significant. Results: The mean age of accused persons was 28.7 ± 8.6 years. Most accused were males (96.7%), from rural areas (61.7%), unmarried (56.7%), and belonged to low socioeconomic class (68.3%). Education up to secondary level or below was observed in 65.0% of participants. The victim was known to the accused in 78.3% of cases. Substance use was present in 51.7% of accused, while psychiatric abnormalities were identified in 28.3%. Previous criminal history was present in 21.7% and antisocial personality traits in 25.0% of participants. Poor awareness regarding the POCSO Act was observed in 70.0% of accused, and only 13.3% reported prior exposure to legal awareness programs. Conclusion: Individuals accused under the POCSO Act were predominantly young adult males from socioeconomically disadvantaged backgrounds with limited education and poor legal awareness. A substantial proportion demonstrated behavioral and psychological risk factors, including substance use, psychiatric illness, and antisocial traits. The findings highlight the importance of legal literacy initiatives, community awareness programs, behavioral interventions, and mental health assessment in efforts to prevent child sexual abuse and strengthen child protection mechanisms
POCSO Act; Child Sexual Abuse; Accused Profile; Legal Awareness; Psychiatric Assessment
Study of Ligature Mark Patterns in Cases of Hanging: An Autopsy-Based Observational Study
Introduction: Hanging is one of the most common methods of suicide worldwide and constitutes a significant proportion of medicolegal autopsies. The ligature mark on the neck is the principal external finding and serves as the cornerstone of postmortem diagnosis in hanging deaths. The morphological characteristics of the ligature mark, including its position, direction, continuity, depth, and associated peri-ligature injuries, provide crucial information regarding the type of hanging, ligature material used, and mechanism of death. This study aimed to evaluate the patterns of ligature marks in autopsy-confirmed cases of death by hanging and to correlate these patterns with the type of ligature material, type of hanging, and position of the knot. Material and Methods: This cross-sectional observational study was conducted at the PRM Medical College & Hospital, Baripada and SJ Medical College & Hospital, Puri from January 2022 to December 2025. A total of 200 autopsy-confirmed cases of death by hanging were included. Cases were selected based on predefined inclusion and exclusion criteria. Data regarding demographic profiles, ligature material, type of hanging, knot position, and detailed ligature mark characteristics were recorded using a structured proforma and analyzed statistically using SPSS version 25.0. Results: Among the 200 cases studied, males constituted 74% (n=148) and females 26% (n=52). The majority of victims belonged to the 21–30 year age group (36.5%). Complete hanging was observed in 62% of cases and partial hanging in 38%. Rope was the most commonly used ligature material (38.5%), followed by dupatta/scarf (22%). The ligature mark was obliquely placed in 82% of cases and above the thyroid cartilage in 76.5%. A non-continuous mark was found in 72% of cases. Slip knots were used in 58% of cases. Imprint patterns corresponding to the ligature material were observed in 64% of cases. Hyoid bone fracture was noted in 8.5% and thyroid cartilage fracture in 12% of cases, with a statistically significant association with age above 40 years (p<0.05). Conclusion: The study demonstrated that the characteristics of ligature marks in hanging are significantly influenced by the type of ligature material, the type of hanging (complete vs. partial), and the position of the knot. A thorough and systematic examination of the ligature mark remains the most important component of postmortem examination in hanging deaths and is indispensable for accurate medicolegal diagnosis.
Hanging; Ligature mark; Autopsy; Forensic pathology; Asphyxia; Neck injuries; Medicolegal investigation.
Mapping the Mental Health Funnel: Unlocking the Hidden Power of DASS-21 for Suicidal Ideation Screening Through Structural Equation Modelling
Background: The rising prevalence of mental health morbidity among medical students necessitates a move from reactive crisis management to proactive population screening. This study aimed to map the "Mental Health Funnel" the epidemiological progression from generalized distress to suicidal ideation (SI) to identify the optimal window for institutional intervention. Methods: A cross-sectional community-based survey was conducted among 420 medical students. We employed a dual-stage analytical approach to bridge descriptive prevalence with structural causality. First, a Multiple Response Funnel was constructed to visualize the transition of risk. Second, Structural Equation Modelling (SEM) was used to identify the primary mediators of suicidal risk, applying robust estimation to ensure findings remained stable across the population distribution. Results: The study identified a clear cascading risk profile. Epidemiological mapping via the "Risk Funnel" showed that while 41% and 25% of the students reported anxiety and stress, 58% of these cases were comorbid. This distress "funnelled" into clinical depression (78% of comorbid cases), with 42% of the depressed cohort manifesting suicidal ideation. The structural analysis confirmed these findings, demonstrating that depression acts as a critical gateway (β = 0.87). Statistical fit indices confirmed the model was highly representative of the student population (CFI = 0.991, RMSEA = 0.036). Conclusion: Suicidal ideation in medical students is not an isolated event but the final stage of a predictable cascading pathway. These findings justify a Primary Prevention strategy: by screening for comorbid stress and anxiety using the DASS-21, institutions can interrupt the funnel before students’ progress into clinical depression and high-risk suicidal behaviour.
DASS-21, Suicidal Ideation, Screening, Funnel, CFA, SEM.
AN AUTOPSY BASED RETROSPECTIVE STUDY ABOUT PATTERN OF HEAD INJURY IN ROAD TRAFFIC ACCIDENT CASES
Road traffic accident (RTA) is one of the major causative factors of death among Indian population and also a major cause of burden over Autopsy surgeon due to rise in number of Autopsy cases. Among all the injuries caused by RTA, Head injuries are the most serious injuries in terms of both morbidity and mortality. Hence the aim of our present study is to understand the pattern of Head injuries in Road traffic accident cases. This study was conducted in the Department of Forensic Medicine & Toxicology, M.G.M. Medical College, Indore (M.P.) over the period of six months from 1st September 2023 to 29th February 2024. A total of 70 postmortem cases of road traffic accident were selected for our present study. Contusion/Ecchymosis is the major scalp injury present in 45.71% cases. Linear fracture is the most common type of skull fracture present over both skull vault as well as skull base. Subdural and Subarachnoid intracranial haemorrhage was present in majority of the cases of head injury due to RTA.
Road traffic accident, Scalp injury, Skull fracture, Intracranial haemorrhage.
A Study of Estimation of Stature from Forearm Length
Background: Estimation of stature from body parts is an essential component of forensic anthropology and medico-legal identification, particularly in cases involving mutilated, decomposed, or incomplete human remains. Among various anthropometric parameters, forearm length serves as a simple, reliable, and non-invasive predictor of stature. Population-specific regression models are necessary because anthropometric relationships vary according to ethnicity, sex, and geographical factors. Aim: To evaluate the correlation between forearm length and stature and to derive a regression formula for stature estimation among young adults. Methods: A cross-sectional observational study was conducted among 93 healthy MBBS students aged 18–25 years at Government Medical College, Dindigul. The study included 33 males and 60 females selected randomly. Forearm length was measured from the olecranon process to the styloid process using standard anthropometric techniques, while stature was measured using a stadiometer. Measurements were recorded at a fixed time to minimize diurnal variation. Statistical analysis included calculation of mean, standard deviation, Pearson’s correlation coefficient, and linear regression analysis. Results: The mean forearm length and stature were higher among males compared to females. Females showed a mean forearm length of 27.6 ± 1.5 cm and mean stature of 160.2 ± 5.8 cm, whereas males showed 29.6 ± 1.6 cm and 174.3 ± 6.5 cm respectively. A statistically significant moderate positive correlation (r = 0.67) was observed between forearm length and stature. The regression equation derived for stature estimation was: Height = 3.43 × Forearm Length + 67.56. Conclusion: Forearm length is a reliable anthropometric parameter for estimating stature in young adults. The derived regression equation can be useful in forensic identification and medico-legal investigations, particularly when only partial human remains are available.
Stature estimation, Forearm length, Anthropometry, Regression analysis, Forensic science
Retrospective Study of Road Traffic Accident Profile in Government Dindigul Tertiary Care Center During the Years 2022–2025
Background: Road traffic accidents (RTAs) are a major public health problem and constitute one of the leading causes of mortality and morbidity worldwide. India contributes significantly to global RTA-related deaths due to rapid urbanization, increasing motorization, poor road safety awareness, and inadequate trauma care. Aim: To study the epidemiological profile, injury pattern, cause of death, and survival period among fatal road traffic accident victims subjected to medico-legal autopsy at Government Dindigul Tertiary Care Center between January 2022 and December 2025. Materials and Methods: A retrospective descriptive autopsy-based study was conducted in the Department of Forensic Medicine, Government Dindigul Tertiary Care Center. All medico-legal autopsies performed from January 2022 to December 2025 were reviewed. Out of 3721 autopsies conducted during the study period, 888 fatal RTA cases were included in the study. Data regarding age, sex, position of victim, type of vehicle involved, pattern of injuries, cause of death, and survival period were collected from postmortem records and analyzed using descriptive statistics. Results: Among 888 fatal RTA cases, males constituted 84.57% and females 15.43%. The most commonly affected age group was 21–30 years (20.61%). Head injury was the leading cause of death accounting for 75% of cases. Pedestrians constituted the majority of victims (49%), followed by drivers (38%). Heavy vehicles (42%) and two-wheelers (41%) were the most commonly involved vehicles. Most victims (79%) were brought dead to the hospital. Conclusion: Young adult males were predominantly affected in fatal RTAs. Head injury remained the major cause of death. Pedestrians and two-wheeler users were highly vulnerable groups. Strengthening road safety measures, enforcement of helmet and seatbelt use, improvement in trauma care facilities, and public awareness programs are essential to reduce mortality.
Chronic suppurative otitis media, discharge, attic perforation, hearing loss and granulation tissue.
Systematic Review and Meta-Analysis on Stress, Anxiety, and Depression Prevalence Among Medical Students
Background: Medical students are exposed to substantial academic and psychosocial stressors, making them particularly vulnerable to mental health disorders such as stress, anxiety, and depression. These conditions can adversely affect academic performance, professional development, and overall well-being. Aim: To estimate the pooled prevalence of stress, anxiety, and depression among medical students through a systematic review and meta-analysis. Materials and Methods: This study was conducted as a systematic review and meta-analysis following PRISMA guidelines. A comprehensive literature search was performed across PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2010 and 2025. Studies reporting prevalence of stress, anxiety, and depression among medical students were included. Data extraction and quality assessment using the Newcastle-Ottawa Scale were performed independently. Meta-analysis was conducted using a random-effects model. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. Results: A total of 30 studies comprising approximately 15,200 medical students were included. The pooled prevalence of depression was 27.2% (95% CI: 24.1%–30.3%), anxiety was 33.8% (95% CI: 29.4%–38.2%), and stress ranged from 34% to 50%. High heterogeneity was observed across studies (I² >90%). Subgroup analysis revealed higher prevalence among female students and those in preclinical years. Mild publication bias was detected. Conclusion: Stress, anxiety, and depression are highly prevalent among medical students globally, indicating a substantial mental health burden. Early screening, institutional support systems, and targeted interventions are essential to address these issues and promote psychological well-being among future healthcare professionals
Medical students, depression, anxiety, stress, prevalence, meta-analysis.
Screen Time and Mental Health Outcomes in Adolescents: A Systematic Review and Meta-Analysis
Background: The rapid expansion of digital technology has led to a substantial increase in screen time among adolescents, raising concerns about its potential impact on mental health. Emerging evidence suggests a possible association between excessive screen exposure and adverse psychological outcomes, including depression, anxiety, and reduced well-being. Objective: To systematically evaluate and quantitatively synthesize the association between screen time and mental health outcomes in adolescents. Methods: A systematic search of PubMed, Scopus, Web of Science, and PsycINFO was conducted for studies published up to December 2025. Observational studies involving adolescents aged 10–19 years that assessed screen time and mental health outcomes were included. Data were extracted and analyzed using a random-effects meta-analysis model. Effect sizes were pooled as Odds Ratios (ORs) for categorical outcomes and Standardized Mean Differences (SMDs) for continuous variables. Study quality was assessed using the Newcastle-Ottawa Scale. Results: A total of 32 studies comprising approximately 180,000 adolescents were included. High screen time was significantly associated with increased risk of depression (OR = 1.18; 95% CI: 1.10–1.26) and anxiety (OR = 1.32; 95% CI: 1.15–1.50). Additionally, greater screen exposure was associated with poorer psychological well-being (SMD = −0.21; 95% CI: −0.30 to −0.12). Subgroup analyses revealed stronger associations for screen time exceeding 3 hours per day, social media use, and female adolescents. Moderate to high heterogeneity was observed across studies. Conclusion: Excessive screen time is significantly associated with adverse mental health outcomes in adolescents. Although the effect sizes are modest, the high prevalence of screen use highlights its importance as a public health concern. Strategies promoting balanced digital use and mental health awareness are essential
Screen time, adolescents, depression, anxiety, mental health, systematic review, meta-analysis.
Prevalence of Insomnia and Its Impact on Academic Performance among Students: A Systematic Review
Background: Insomnia is one of the most common sleep disorders among students and is increasingly recognized as a significant factor affecting academic outcomes. Academic pressure, psychological stress, and lifestyle behaviors contribute to poor sleep quality in this population. Objective: To systematically review the prevalence of insomnia among students and evaluate its impact on academic performance. Methods: A systematic review was conducted following PRISMA guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were searched for studies published between 2000 and 2025. Observational studies assessing insomnia prevalence and its association with academic performance among students were included. Data were extracted and synthesized qualitatively due to heterogeneity in study designs and outcome measures. Results: A total of 42 studies involving over 98,000 students were included. The prevalence of insomnia varied widely, ranging from 9.4% to 98.7%, with most studies reporting rates between 30% and 60%. Insomnia was consistently associated with impaired cognitive function, reduced concentration, memory deficits, and poorer academic performance, including lower grade point averages and increased risk of academic failure. Contributing factors included academic stress, mental health conditions, irregular sleep patterns, and excessive screen time. Conclusion: Insomnia is highly prevalent among students and has a significant negative impact on academic performance. Early identification and targeted interventions, including sleep hygiene education and mental health support, are essential to improve both sleep quality and educational outcomes.
Insomnia, Students, Academic Performance, Sleep Quality, Systematic Review.
A Study On Efficacy And Perception Of Mind Map As Learning Tool In Information Retrieval
Background: Medical students face challenges revising vast pathology syllabi under time constraints, limiting retention. Objectives: This study evaluates Mind Map technique efficacy for enhancing short- and long-term recall in pathology, plus phase-II students' perceptions of it as a learning tool. Methods and Materials: Concurrent mixed-methods study at Katuri Medical College (2024-2025) evaluated Mind Map (MM) vs. Standard Text Notes (STN)in 128 phase-II MBBS pathology students. Groups underwent baseline, short-term, and 6-month retention MCQ tests (independent t-test, p<0.005), plus validated Likert-scale analysis. Mind Map demonstrated superior retention. Results: MM showed superior scores (Quiz-1: 12.7±1.96 vs 9.7±2.7, p=0.0001; Quiz-2: 10.3±2.4 vs 8.5±3.6, p=0.001). >76% found MM engaging, concept-enhancing despite time concern. Conclusion: Mind Map boosts pathology recalls and student satisfaction.
Mind Map, medical student, Learning tool, Retention, Standard Text Notes.
A Global Systematic Review & Meta-Analysis of Psychological Morbidity in Medical Students: Depression, Anxiety, and Stress
Psychological morbidity among medical students has become a major global concern due to the demanding nature of medical education. Depression, anxiety, and stress are highly prevalent and may adversely affect academic performance, professional development, and patient care outcomes. Objective: To systematically review and meta-analyze the global prevalence of depression, anxiety, and stress among medical students. Methods: A systematic review and meta-analysis was conducted following standard reporting guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were searched up to December 2025. Observational studies reporting prevalence of depression, anxiety, and/or stress among medical students using validated tools (PHQ-9, GAD-7, DASS-21) were included. A random-effects model was used to estimate pooled prevalence, and heterogeneity was assessed using the I² statistic. Results: A total of 52 studies involving approximately 68,400 medical students across 22 countries were included. The pooled prevalence of depression was 29.4% (95% CI: 26.1–32.9%), anxiety 35.7% (95% CI: 31.8–39.8%), and stress 40.2% (95% CI: 36.0–44.5%). Female students and those in clinical years demonstrated higher prevalence rates. Substantial heterogeneity was observed across studies (I² > 85%). Regional variations indicated higher prevalence in South Asia and the Middle East compared to Europe. Conclusion: Psychological morbidity among medical students is alarmingly high worldwide, with a significant proportion experiencing depression, anxiety, and stress. These findings highlight the urgent need for early screening, institutional mental health support, and curriculum reforms to promote student well-being and resilience.
Medical students, depression, anxiety, stress, systematic review, meta-analysis, mental health
Prevalence of Stress, Anxiety, and Depression Among Medical Students: A Systematic Review and Meta-Analysis
Background: Medical students are exposed to intense academic and clinical demands that make them particularly vulnerable to psychological distress. Increasing evidence suggests a high burden of stress, anxiety, and depression in this population, which may adversely affect both personal well-being and professional development. Objective: To estimate the pooled prevalence of stress, anxiety, and depression among medical students through a systematic review and meta-analysis. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published up to December 2025. Observational studies reporting the prevalence of stress, anxiety, and/or depression among medical students were included. Data were extracted independently by two reviewers. A random-effects meta-analysis was performed to calculate pooled prevalence estimates with 95% confidence intervals. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots. Results: A total of 110 studies involving approximately 120,000 medical students were included. The pooled prevalence of depression was 27.2% (95% CI: 24.7–29.9), anxiety was 33.8% (95% CI: 29.2–38.7), and stress was approximately 50% (range: 39–62%). Substantial heterogeneity was observed across studies. Higher prevalence rates were noted among female students and those in clinical years. Conclusion: Stress, anxiety, and depression are highly prevalent among medical students worldwide, highlighting a significant and persistent mental health burden. These findings underscore the need for early identification, targeted interventions, and systemic changes within medical education to promote student well-being.
Medical students, depression, anxiety, stress, prevalence, systematic review, meta-analysis
A Global Perspective on Mental Health in Medical Students: Evidence from Systematic Review and Meta-Analysis
Background: Medical education is associated with substantial academic pressure and emotional challenges, placing students at increased risk of psychological disorders such as stress, anxiety, and depression. These conditions can adversely affect academic performance, professional development, and future patient care. Objective: To systematically review and meta-analyze the global prevalence of stress, anxiety, and depression among medical students. Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published up to December 2025. Observational studies reporting the prevalence of stress, anxiety, and/or depression among undergraduate medical students were included. Data were extracted using a standardized form, and study quality was assessed using the Newcastle–Ottawa Scale. A random-effects model was used to calculate pooled prevalence estimates with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. Results: A total of 52 studies comprising 41,348 medical students were included. The pooled prevalence of depression was 32.4% (95% CI: 29.1–35.8), anxiety 33.8% (95% CI: 30.2–37.5), and stress 39.6% (95% CI: 35.0–44.3). High heterogeneity was observed across studies (I² > 90%). Subgroup analysis showed higher prevalence among females, preclinical students, and those in low- and middle-income countries. Studies conducted during the COVID-19 pandemic reported increased levels of psychological distress. Conclusion: Stress, anxiety, and depression are highly prevalent among medical students globally, indicating a significant public health concern. Implementation of early screening, mental health support systems, and curriculum reforms is essential to mitigate psychological burden and promote student well-being.
Medical students, Depression, Anxiety, Stress, Systematic review, Meta-analysis.
Beyond the White Coat: Depression, Anxiety, and Stress Among Medical Students Worldwide: A Systematic Review and Meta-Analysis
Background: Medical training is inherently demanding and has been associated with a high risk of psychological distress. Increasing global evidence indicates that medical students experience elevated levels of depression, anxiety, and stress compared to their non-medical peers, raising concerns about their well-being and future professional performance. Objective: To estimate the global prevalence of depression, anxiety, and stress among medical students through a systematic review and meta-analysis. Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published up to December 2025. Observational studies reporting the prevalence of depression, anxiety, and/or stress among medical students using validated assessment tools were included. Data extraction and quality assessment were performed independently by two reviewers. A random-effects meta-analysis (DerSimonian–Laird method) was used to calculate pooled prevalence estimates with 95% confidence intervals. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. Results: A total of 42 studies comprising 38,512 medical students across multiple regions were included. The pooled prevalence of depression was 32.4% (95% CI: 28.1–36.7%), anxiety was 36.8% (95% CI: 31.5–42.2%), and stress was 34.1% (95% CI: 29.3–38.9%). Substantial heterogeneity was observed (I² > 85% for all outcomes). Higher prevalence rates were reported in Asia and the Middle East compared to Europe and North America. Funnel plot analysis suggested minimal publication bias. Conclusion: Depression, anxiety, and stress are highly prevalent among medical students worldwide, affecting nearly one-third of this population. These findings highlight an urgent need for structured mental health interventions, including early screening, accessible counseling services, and curriculum reforms, to promote well-being and ensure the development of resilient future healthcare professionals.
Medical students; Depression; Anxiety; Stress; Mental health; Systematic review; Meta-analysis
Mental Health Crisis in Medical Education: A Global Systematic Review and Meta-Analysis of Medical Students on Depression, Anxiety, and Stress
Background: Medical education is inherently demanding and has been increasingly associated with significant psychological distress among students. Depression, anxiety, and stress are widely reported, raising concerns about the well-being of future healthcare professionals and the quality of patient care. Objective: To systematically review and meta-analyze the global prevalence of depression, anxiety, and stress among medical students and to explore associated demographic and regional variations. Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published between January 2000 and March 2025. Observational studies reporting prevalence of depression, anxiety, or stress among medical students using validated assessment tools (PHQ-9, GAD-7, DASS-21) were included. Two independent reviewers performed study selection and data extraction. Study quality was assessed using the Newcastle–Ottawa Scale. A random-effects model was used to estimate pooled prevalence with 95% confidence intervals (CI). Heterogeneity was evaluated using the I² statistic, and publication bias was assessed through funnel plots and Egger’s test. Results: A total of 120 studies encompassing approximately 150,000 medical students across more than 50 countries were included. The pooled prevalence was 37.5% (95% CI: 34.0–41.0) for depression, 41.2% (95% CI: 37.5–45.0) for anxiety, and 47.0% (95% CI: 43.0–51.0) for stress. Subgroup analyses revealed higher prevalence among female students, those in preclinical years, and students from low- and middle-income countries. Significant heterogeneity was observed across studies (I² > 90%). Funnel plot asymmetry suggested mild publication bias. Conclusion: Depression, anxiety, and stress are highly prevalent among medical students worldwide, indicating a substantial and growing mental health crisis in medical education. Urgent, multi-level interventions including institutional support systems, curricular reforms, and policy-level strategies are essential to promote student well-being and ensure a resilient healthcare workforce.
Psychological Profiling Using Digital Behavior Signals
Digital behavior signals—ranging from browsing patterns, language use, interaction frequency, biometric metadata, and online social network structures—have enabled computational models to infer psychological traits and behavioral tendencies. While these predictive systems advance research in personalized learning, mental health screening, and user experience optimization, they raise concerns around privacy, consent, algorithmic bias, and potential misuse. This paper synthesizes interdisciplinary literature from computational psychology, data science, digital sociology, and ethics to examine how behavioral signals correlate with psychological constructs. A new model, the Digital Behavioral Profiling Framework (DBPF), is proposed to conceptualize ethical analysis, data interpretation, and safeguards. The paper explicitly focuses on ethical, privacy-aligned, and non-exploitative applications.
digital psychology, behavioral signals, computational profiling, online behavior, ethical AI, privacy.
Copyright (c) 2025 American Journal of Forensic Psychology
Reintegration Stress in Released Inmates
Reintegration stress refers to the psychological, social, and economic strain experienced by formerly incarcerated individuals as they transition back into society. This paper examines the root causes, psychological outcomes, re-entry conditions, and systemic barriers that shape post-release stress among ex-inmates. The study analyzes societal stigma, employment denial, family fragmentation, addiction relapse, mental health challenges, and policy failures that hinder successful reintegration. Drawing on global rehabilitation initiatives, this paper introduces the Reintegration Stress Cycle (RSC) model and proposes multi-level interventions, including community-based rehabilitation, trauma-informed counseling, employment incentives, and post-release monitoring systems. Findings indicate that early-stage post-release support significantly reduces recidivism and promotes long-term social stability.
prison re-entry, recidivism, post-release trauma, social stigma, community rehabilitation, desistance theory
Psychological Impact of Privatized Prisons
Privatized prisons—correctional institutions managed by corporate entities for profit—are increasingly adopted by governments seeking reduced public expenditure and operational efficiency. However, the psychological consequences of such systems on inmates, staff, and communities remain insufficiently studied. This paper examines the mental and behavioral impacts of privatization, including profit-driven punishment models, reduced rehabilitation investment, scarcity of mental-health support, staff burnout, safety risks, and ownership-driven disciplinary practices. Drawing from comparative institutional analysis, behavioral studies, and penal economics, this research proposes the Corporate Incarceration Psychological Impact Framework (CIPIF). Findings indicate that privatization correlates with higher stress, deteriorated mental health, lower rehabilitation outcomes, and increased recidivism due to institutional cost-cutting and profit-based incentives.
privatized prisons, prison psychology, neoliberal punishment, rehabilitation outcomes, carceral capitalism, inmate mental health
Family Bonding Interventions for Prisoners
Family bonding interventions are a critical component of rehabilitative corrections, supporting social stability, emotional development, and post-release reintegration. Incarceration often disrupts parental identity, marital relationships, and intergenerational emotional ties, resulting in trauma, stigma, and social isolation. This paper evaluates the psychological rationale and effectiveness of structured family bonding programs in prisons, including family visitation frameworks, parental training workshops, trauma-informed counseling, therapeutic mediation, and digital communication systems. A new Family Reintegration Support Model (FRSM) is proposed to highlight how healthy family attachment reduces recidivism, improves emotional regulation, and strengthens community relationships.
Family Bonding Interventions, Correctional Rehabilitation, Attachment Theory, Post-Release Reintegration, Recidivism Reduction
Faith-Based Prison Rehabilitation Programs
Faith-based prison rehabilitation programs utilize religious teachings, spiritual counseling, community support networks, and moral development strategies to support offender transformation and post-release reintegration. Rooted in restorative justice principles, these programs aim to reduce recidivism, promote emotional healing, and reshape identity through spiritual meaning-making. While empirical research shows positive outcomes in motivation, behavior reform, and post-release adjustment, concerns remain about religious coercion, unequal access, doctrinal bias, and constitutional limitations. This paper synthesizes criminology, theology, cognitive psychology, and sociological perspectives to evaluate how faith-based interventions influence rehabilitation and reintegration trajectories. A Holistic Spiritual Rehabilitation Model (HSRM) is proposed to balance personal faith with ethical inclusivity.
Prison Reform, Faith-Based Programs, Spiritual Rehabilitation, Recidivism Reduction, Restorative Justice, Correctional Psychology
Copyright (c) 2024 American Journal of Forensic Psychology