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Advancing nursing education through social and emotional learning: A systematic review guided by the Collaborative for Academic, Social, and Emotional Learning framework.

BACKGROUND: With Generation Z entering the nursing workforce in growing numbers, strengthening social and emotional learning is critical for academic success, professional adaptation, and safe practice. However, the existing evidence remains fragmented because of varied interventions and inconsistent approaches. OBJECTIVES: This systematic review examined (1) the social and emotional learning essential for nursing students and nurses within the Collaborative for Academic, Social, and Emotional Learning framework, (2) their impact on educational and clinical outcomes, and (3) implications for advancing nursing education and practice. METHODS: Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five international (PubMed, EMBASE, CINAHL, PsycINFO, Cochrane) and three Korean (RISS, KoreaMed, KMBASE) databases were searched up to June 2025. Eighteen studies involving 2,952 participants met the inclusion criteria, including quasi-experimental quantitative studies, descriptive quantitative studies, qualitative studies, and mixed-methods studies. The methodological quality of the included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS: Within the Collaborative for Academic, Social, and Emotional Learning framework, relationship skills and self-management were the most frequently studied competencies, emphasizing teamwork, communication, and stress regulation. Self-awareness and social awareness were underexplored, despite their importance in empathy, resilience, and reflective practice. Responsible decision-making was the least studied competency, despite its importance in ethical reasoning. Social and emotional learning was consistently associated with enhanced adaptation, communication, leadership, relationships, and clinical performance. Effective strategies included blended learning, simulation, reflective activities, and mentorship, which are aligned with Generation Z's learning preferences. CONCLUSION: Although social and emotional learning integration is associated with improvements in educational and clinical outcomes in nursing, current research has largely centered on relational and stress-related competencies while underrepresenting responsible decision-making. To cultivate reflective, empathetic, and ethically grounded nurses, curricula should integrate social and emotional learning through a balanced and structured approach. REGISTRATION: This study was registered on PROSPERO (ID: CRD420251005683).

Humans

Hemispheric equality in reaction times to emotional and non-emotional nouns.

Twenty presentations of 6 emotional and 6 non-emotional words in mixed random orders were monaurally presented to the right or left ear. Using the left hand, subjects pushed one of two response buttons indicating type of word heard. Performance improved in later trials and emotional words were recognized more quickly regardless of ear presentation. No differences were associated with the separate ear presentations. Equivalent hemispheric performance indicates equal processing sensitivity to four-letter emotional and non-emotional nouns and substantiates the right hemisphere's verbal processing capability for simple nouns.

Acoustic Stimulation

[Effect of behavior changing drugs, imipramine and tranylcypromine, on the composition of the blood and activity of the alkaline leukocytophosphatase of emotive and non-emotive adult male Wistar rats].

The corpuscular composition of the blood and the alcalic leucocytophosphatase (ALP) activity was measured for a total of 40 emotive and non-emotive adult male Wistar rats in order to test the influence of a single dose of imipramine (IMI) and tranylcypromine (TRAN) as well as of IMI and TRAN given in a period of 8 days. Special attention was paid to the reaction type of the animals. Changes in the red and white components of the blood were found due to drug application and to reaction type. The relationship between reaction type and drug application we assumed to exist was confirmed. The ALP activity also changed depending on the type of drug dosage. The assumption that ALP activity is higher for emotive rats than for non-emotive ones was confirmed as well.

Alkaline Phosphatase

Facial patterning and infant emotional expression: happiness, surprise, and fear.

Although recent studies have convincingly demonstrated that emotional expressions can be judged reliably from actor-posed facial displays, there exists little evidence that facial expressions in lifelike settings are similar to actor-posed displays, are reliable across situations designed to elicit the same emotion, or provide sufficient information to mediate consistent emotion judgments by raters. The present study therefore investigated these issues as they related to the emotions of happiness, surprise, and fear. 27 infants between 10 and 12 months of age (when emotion masking is not likely to confound results) were tested in 2 situations designed to elicit hapiness (peek-a-boo game and a collapsing toy), 2 to elicit surprise (a toy-switch and a vanishing-object task), and 2 to elicit fear (the visual cliff and the approach of a stranger. Dependent variables included changes in 28 facial response components taken from previous work using actor poses, as well as judgments of the presence of 6 discrete emotions. In addition, instrumental behaviors were used to verify with other than facial expression responses whether the predicted emotion was elicited. In contrast to previous conclusions on the subject, we found that judges were able to make all facial expression judgments reliably, even in the absence of contextual information. Support was also obtained for at least some degree of specificity of facial component response patterns, especially for happiness and surprise. Emotion judgments by raters were found to be a function of the presence of discrete facial components predicted to be linked to those emotions. Finally, almost all situations elicited blends, rather than discrete emotions.

Emotions

Effectiveness of transcranial direct current stimulation with and without positive mood induction on worry and transdiagnostic cognitive-emotional processes: A randomized controlled trial.

The present study investigated the effectiveness of transcranial direct current stimulation (tDCS), with and without positive mood induction, on worry and key transdiagnostic cognitive-emotional processes, including attentional bias, working memory, problem solving, and emotion regulation, in individuals with high levels of worry. This single-blind randomized controlled trial included 45 individuals with high levels of worry. After a structured clinical interview, participants were randomly assigned, with gender balancing, to one of three groups: (1) tDCS alone, (2) tDCS combined with positive mood induction, or (3) a sham control group. Outcome measures were administered at three time points (pretest, posttest, and one-month follow-up) and assessed attentional bias (Dot Probe Task), working memory (1-back task), problem solving (Tower of London task), emotion regulation (Gross's Emotion Regulation Questionnaire), and worry severity (Penn State Worry Questionnaire; PSWQ). Repeated-measures ANOVA showed that both active groups (tDCS alone and tDCS + positive mood induction) significantly improved attentional bias, worry, working memory, problem solving, and emotion regulation compared to controls (p < 0.05). The combined intervention produced significantly greater gains than tDCS alone in working memory, problem solving, emotion regulation (p < 0.05), and reductions in attentional bias and worry (p < 0.001). All effects persisted at one-month follow-up (p < 0.05). tDCS reduces worry and attentional bias and enhances cognition and emotion regulation in individuals with high levels of worry. The combined intervention produced larger and more sustained improvements than tDCS alone across the assessed behavioral outcomes. These findings support further investigation of combining tDCS with structured positive mood induction while the mechanisms underlying the additional benefits remain to be established.

Humans

Neurovascular coupling in the basolateral amygdala modulates negative emotions.

Emotion induces changes in regional cerebral blood flow, a manifestation of neurovascular coupling (NVC). However, whether NVC provides feedback to actively modulate emotion remains unexplored. Here, we demonstrate that NVC actively and bidirectionally modulates stress-induced negative emotions. We established bidirectional manipulations of NVC in freely moving mice by employing integrated pharmacological, genetic, and arteriolar optogenetic approaches. Our results showed that both systemic and region-specific NVC deficiencies in the basolateral amygdala (BLA) heightened emotional responses when mice transitioned from a safe, familiar environment to anxiogenic environments and that local restoration of NVC in the BLA normalized these responses. Mechanistically, NVC dysfunction impaired the capacity of BLA neuronal scaling during state transitions, manifesting as a characteristic biphasic pattern of c-Fos topology. NVC-deficient animals aberrantly adopted high-stress configurations under mild stress but regressed to low-stress templates during high-demand survival threats, thereby compromising defensive sustainability. Notably, the genetic NVC-enhancement model counteracted NVC impairments caused by chronic stress, thereby alleviating stress-driven emotional distress. These findings establish NVC in the BLA as an allostatic program that fine-tunes neural circuit activity during emotional responses, with implications for understanding and treating emotional disorders.

Animals

Examining the Relationship Between Physical Neglect, Inflammation and Anterior Cingulate Activation During Facial Emotion Recognition in Patients With Schizophrenia and Healthy Controls: A Functional Magnetic Resonance Imaging Study.

Physical neglect is associated with poorer cognitive functioning in patients with schizophrenia, including deficits in facial emotion recognition. Recent research by our group showed the relationship between physical neglect and facial emotion recognition is mediated by inflammation. While this mediation effect was observed at the level of behaviour, examining the relationship between physical neglect, inflammation and neural activation during facial emotion recognition would help confirm brain regions impacted and support behavioural findings, but these relationships are unclear. Two hundred twelve participants (52 patients with schizophrenia and 160 healthy controls) underwent functional magnetic resonance imaging while performing an established facial emotion recognition task and a subset completed the Childhood Trauma Questionnaire and provided blood samples outside of the scanner. Inflammation was measured using a latent variable that combined basal plasma levels of interleukin-6, tumour necrosis factor-alpha and C-reactive protein. The relationships between physical neglect, inflammation and neural activation were examined using multiple regression. Neither physical neglect nor inflammation predicted altered neural response during facial emotion recognition at p&#x2009;<&#x2009;0.05, family-wise error corrected for multiple comparisons within an anterior cingulate region of interest, across the whole brain, in the whole sample or separately in patients or controls. Future research should examine relationships between physical neglect, inflammation and brain activation in larger samples, which may have sensitivity to detect smaller effects, and use tasks that require active recognition of emotions, in addition to passive viewing of faces, which might be associated with additional neural responses.

Humans

On the mechanism of an increase of muscle performance and of vasodilation during emotional stress in man.

The mechanism of the increase of muscle performance and of vasodilation during emotional stress was studied. The "emotional" increment of voluntary performance does not depend on the level of blood supply to the working muscles, and the effect is maintained under conditions of cessation of arterial inflow. Augmentation of muscle performance is also observed during emotional stress when isometric contraction is evoked by electrical tetanic stimulation of the nerve, when the number of muscle fibres participating in the evoked response does not increase during emotional stress. The "emotional" vasodilation is greatly reduced in patients suffering from McArdle's syndrome, in whom the normal course of glycolysis in muscles is disrupted. It is suggested that acetylcholine liberated from sympathetic fibres causes the activation of glycolysis in muscles, which in its turn induces vasodilation in resting skeletal muscles and increase of muscle performance during emotional stress.

Adolescent

Genome-wide association meta-analysis of eating behavior traits revealed one susceptibility locus for emotional eating.

In order to identify new and genome-wide significant loci for eating behavior traits (cognitive restraint, uncontrolled eating and emotional eating), we conducted a meta-GWAS with seven studies of European ancestry (n&#x2009;=&#x2009;11,250). Eating behavior was assessed using the Three-Factor Eating Questionnaire. Genotype effects of single studies were estimated using additive models adjusting for age, sex, BMI, and principal components and single study results were combined by fixed-effect meta-analysis.For cognitive restraint and uncontrolled eating, no genome-wide significant association could be detected. For emotional eating, one genomic region on chromosome 5 comprising two polymorphisms attained genome-wide significance (P&#x2009;=&#x2009;4.0&#xd7;10-8 for rs6877636 and P&#x2009;=&#x2009;3.2&#xd7;10-8 for rs6897090). The minor alleles were associated with higher emotional eating scores (&#x3b2;=0.093&#x2009;&#xb1;&#x2009;0.017), with a similar direction of effect in each study. Both SNPs, in near perfect linkage disequilibrium, mapped to RP11-24P24.1, a processed pseudogene of ornithine decarboxylase 1 (ODC1). Enrichment analysis revealed a significant overlap between genome-wide BMI-associated variants and nominal emotional eating variants, supporting the hypothesis that shared genetic factors may influence both eating behavior traits and obesity risk. Finally, we observed a number of interesting associations reaching suggestive significance (P&#x2009;<&#x2009;10-6) involving BMI candidate genes, including a suggestive association between FTO variants and cognitive restraint (rs9922708, &#x3b2;&#x2009;=&#x2009;0.069, P&#x2009;=&#x2009;5.9&#xd7;10-7).In conclusion, our meta-GWAS identified for the first time a robust chromosomal region associated with emotional eating in seven studies. Given that emotional eating strongly influences body weight but is often stigmatized, recognizing genetic susceptibility to certain eating behaviors may help reduce stigma and alleviate guilt.

Journal Article

The Impact of Baseline Negative Emotions on Postoperative Quality of Life in Adolescent Idiopathic Scoliosis Patients: A 2-Year Follow-Up Study.

OBJECTIVE: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that develops during puberty without a clear etiology. Beyond physical manifestations, AIS severely impacts adolescents' psychological and social well-being, leading to anxiety, depression, and low self-esteem. While advancements in surgical techniques have enhanced objective outcomes, existing studies on AIS have primarily focused on objective indices, with limited attention to the long-term impact of preoperative negative emotions on patient-reported subjective quality of life. METHODS: This was a retrospective cohort study. A total of 112 eligible AIS patients who underwent posterior spinal correction surgery between April and August 2023 were enrolled. Inclusion criteria included confirmed AIS, completion of 2-year follow-up, and informed consent; exclusion criteria included missing imaging/questionnaire data, comorbid psychiatric/neurological diseases, or prior spinal surgery. Patients were grouped using the Hospital Anxiety and Depression Scale (HADS) administered on admission. Quality of life was assessed preoperatively and 2&#x2009;years postoperatively using the Scoliosis Research Society-22 (SRS-22, evaluating self-image, mental health, pain, function, treatment satisfaction) and Short Form 36 Health Survey (SF-36, assessing 8 physical and mental health dimensions). Statistical analysis was performed via SPSS, using independent t-tests, paired t-tests, Mann-Whitney U test, and chi-square test. p&#x2009;<&#x2009;0.05 was considered significant. RESULTS: There were no significant differences in baseline characteristics (age, gender, BMI, surgical parameters, scoliosis type, preoperative/postoperative Cobb angles) between the two groups (all p&#x2009;>&#x2009;0.05). Preoperatively, SRS-22 and SF-36 scores showed no inter-group differences (all p&#x2009;>&#x2009;0.05). Postoperatively, the Negative Emotion Group had significantly lower scores in SRS-22 mental health (3.9&#x2009;&#xb1;&#x2009;0.3 vs. 4.5&#x2009;&#xb1;&#x2009;0.2) and treatment satisfaction (4.0&#x2009;&#xb1;&#x2009;0.3 vs. 4.6&#x2009;&#xb1;&#x2009;0.7), as well as SF-36 general health (68.6&#x2009;&#xb1;&#x2009;6.4 vs. 79.7&#x2009;&#xb1;&#x2009;13.3), role-emotional (61.3&#x2009;&#xb1;&#x2009;9.3 vs. 70.8&#x2009;&#xb1;&#x2009;9.7), and mental health (61.8&#x2009;&#xb1;&#x2009;14.3 vs. 68.9&#x2009;&#xb1;&#x2009;10.7) (all p&#x2009;<&#x2009;0.05); no inter-group differences were observed in physical function-related dimensions. Both groups showed significant improvements in physical function-related dimensions postoperatively. The Non-Negative Emotion Group also exhibited significant improvements in SRS-22 self-image/pain and SF-36 bodily pain (all p&#x2009;<&#x2009;0.05), while the Negative Emotion Group showed no significant improvements in these dimensions. CONCLUSIONS: Preoperative anxiety and depression do not affect the recovery of physical function in AIS patients after spinal correction surgery but significantly impede improvements in subjective quality of life dimensions, including mental health and treatment satisfaction. These findings highlight the need to integrate psychological assessment and targeted interventions into the perioperative management of AIS. Such a patient-centered approach will help optimize both physical and psychological outcomes, ultimately achieving comprehensive rehabilitation for AIS adolescents.

Humans

Head and neck cancer--emotional management.

The complete care of a patient with head and neck cancer should attend to the emotional as well as the physical aspects of the disease; usually the physical component of the disease is emphasized, while care of the emotional response of the patient and family is rarely addressed. There is no single, caring way to respond or cope with the emotional aspects of this disease. Nonetheless, it should be underscored that communication between the providers of health care (i.e., physician, nurse, aid, therapist, etc.) and the patient and family should be maintained during all phases of care. This article describes an approach to providing emotional support to cancer patients and their families during the phases of initial diagnosis and treatment, posttherapy, rehabilitation, recurrence, dying, and death. The emotional response of the health care provider in these circumstances is also addressed.

Death

The effect of tDCS on emotion-related risk-taking behavior and delay discounting in adults with ADHD.

INTRODUCTION: Adults with Attention Deficit Hyperactivity Disorder (ADHD) often engage in risky behaviors due to impaired decision-making processes. This study aims to investigate the effects of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC) on emotion-related risk-taking behavior and delay discounting in adults with ADHD. METHODS: Thirty adults with ADHD underwent three tDCS conditions, administered in a randomized order with at least one week between sessions: (1) left dlPFC anode/right vmPFC cathode, (2) left dlPFC cathode/right vmPFC anode, and (3) sham stimulation. In each session, participants completed the Delay Discounting Task (DDT) and the Modified Balloon Analogue Risk Task (mBART) under three emotional conditions (neutral, positive, and negative) which were induced using emotionally congruent photographs and sounds. Galvanic skin responses (GSR) were also recorded. In the DDT, both area under the curve (AUC) values and log-transformed discounting rates (log k) were calculated for small, medium, and large reward magnitudes (RM). Exploratory electric field modeling was also performed to characterize current distribution. RESULTS: The findings demonstrated task-specific effects of tDCS on decision-making. Although no overall tDCS effect was observed on DDT performance, significant tDCS&#x202f;&#xd7;&#x202f;RM interactions emerged, particularly for smaller rewards. In contrast, exploratory analyses suggested that tDCS affected all mBART scores. Emotional condition did not influence consistently behavioral performance in either task, whereas both emotional stimulation and tDCS significantly affected GSR responses. However, exploratory electric field modeling indicated a broad prefrontal current distribution extending beyond the intended cortical targets. CONCLUSIONS: These findings suggest preliminary evidence that prefrontal tDCS can influence risk-related decision-making and autonomic responses in adults with ADHD. However, its effects on delay discounting appear to be context-dependent and limited to specific RMs. Future studies combining neuroimaging with individualized electric field modeling are needed to clarify the neural mechanisms underlying the observed effects of tDCS and to optimize stimulation protocols in adults with ADHD.

Humans

Emotion recognition: the role of facial movement and the relative importance of upper and lower areas of the face.

In order to investigate the role of facial movement in the recognition of emotions, faces were covered with black makeup and white spots. Video recordings of such faces were played back so that only the white spots were visible. The results demonstrated that moving displays of happiness, sadness, fear, surprise, anger and disgust were recognized more accurately than static displays of the white spots at the apex of the expressions. This indicated that facial motion, in the absence of information about the shape and position of facial features, is informative about these basic emotions. Normally illuminated dynamic displays of these expressions, however, were recognized more accurately than displays of moving spots. The relative effectiveness of upper and lower facial areas for the recognition of these six emotions was also investigated using normally illuminated and spots-only displays. In both instances the results indicated that different facial regions are more informative for different emitions. The movement patterns characterizing the various emotional expressions as well as common confusions between emotions are also discussed.

Communication

The role of facial response in the experience of emotion.

Facial expression and emotional stimuli were varied orthogonally in a 3 x 4 factorial design in order to test whether facial expression is necessary or sufficient to influence emotional experience. Subjects watched a film eliciting fear, sadness, or no emotion, while holding their facial muscles in the position characteristic of fear or sadness, or in an effortful but nonemotional grimace; those in a fourth group received no facial instructions. The subjects believed that the study concerned subliminal perception and that the facial positions were necessary to prevent physiological recording artifacts. The films had powerful effects on reported emotions, the facial expressions none. Correlations between facial expression and reported emotion were zero. Sad and fearful subjects showed distinctive patterns of physiological arousal. Facial expression also tended to affect physiological responses in a manner consistent with an effort hypothesis.

Arousal

Proxemics, locus of control, anxiety, and type of movement in emotionally disturbed and normal boys.

In order to determine the interpersonal distancing requirements for emotionally disturbed and normal children and in order to investigate the relationship of locus of control and anxiety to interpersonal space, 20 emotionally disturbed and 20 normal boys were randomly required to approach an object person and to let the object person approach them until they felt uncomfortable. Results indicated that emotionally disturbed boys required more space than normals; that subjects would approach closer than they would allow the object person to approach them; and that externals required more space than internals. There were no significant differences between high and low anxious subjects, nor between emotionally disturbed children diagnostically classified as overanxious reaction and those with other diagnosis. Finally, neither anxiety nor locus of control explained the significant normal-emotionally disturbed differences in space requirements. Theoretical and practical implications were discussed as well as the relationship between the present and previous research.

Affective Symptoms

Perceived partner substance use, genetic predispositions, and their associations with problematic alcohol use, emotional well-being, and relationship quality.

BACKGROUND: Romantic relationships are important contexts for substance use and emotional well-being. We tested the hypotheses that (i) genetic predispositions for alcohol consumption would be positively associated with partner substance use, (ii) partner substance use would moderate genetic influences on one's own alcohol outcomes, and (iii) partner discordance in substance use would be associated with lower emotional well-being and relationship quality. METHODS: Analyses included 2,357 participants (Mage&#xa0;=&#xa0;51.4, 58.2% female) from the Collaborative Studies on the Genetics of Alcoholism. Focal measures included participants' reports of their own and their current partner's past-year substance use (frequencies of alcohol use, heavy drinking, drunkenness, cannabis use, and nicotine use), emotional well-being, and relationship quality. Participants' genetic predispositions were indexed with genome-wide polygenic scores for alcohol consumption (PGSAlc). Participant-partner substance use discordance was calculated as the difference between the participant's and their partner's use for each substance use measure, separately. RESULTS: Participant PGSAlc was not significantly associated with partners' perceived substance use. Frequent perceived partner alcohol use and heavy drinking significantly amplified the association between PGSAlc and alcohol use or drunkenness. Frequent perceived partner drunkenness and cannabis use significantly attenuated the association between PGSAlc and heavy drinking or frequency of alcohol use. Participant-partner discordance for several substance use measures was significantly associated with lower emotional well-being and relationship quality, controlling for participant and partner substance use main effects. CONCLUSIONS: The results highlight the importance of partner substance use in etiological models of alcohol use, emotional health outcomes, and relationship quality.

Humans

Psychological interventions for children with chronic physical conditions: a systematic review assessing the role of coping, emotional and cognitive processes.

OBJECTIVES: Coping, emotional and cognitive processes are crucial in child development, particularly in children with pediatric chronic physical conditions (CPC). No systematic review in pediatric psychology has investigated the effectiveness of interventions on these processes concurrently. This review addresses this gap by focusing on the effectiveness of psychological interventions on coping, emotional and cognitive processes in children with CPCs. METHODS: Five electronic databases were searched for studies assessing at least one of these processes. Only randomized-controlled trials with children (8-12&#x2009;years) with a CPC (e.g. diabetes, asthma), which implemented a psychological intervention were included. This study is registered in (CRD42021233505). RESULTS: Ten intervention studies were identified. While cognitive interventions (Cogmed) showed some improvements in working memory, the effects varied across studies despite similar methodologies. Coping interventions (e.g. Coping Skills Training) showed little effect on coping strategies or psychological health variables and were no more beneficial than control groups. No study trained coping, emotional processes and cognitive processes together. CONCLUSION: This review shows current limitations in evaluating psychological interventions targeting coping, cognitive or emotional processes in children with CPCs, limiting a comprehensive understanding of the interventions' action mechanisms. Systematically including underlying processes in intervention studies could help to better adjust those interventions.

Humans

[Emotional reactivity and neurovegetative balance in the rat (author's transl)].

It has been shown in male rats of two albino strains, Wistar and Sprague-Dawley, that differences in emotional reactivity were related to physiological differences (Bernet and Denimal, 1978). Particularly the resting heart rate was slower in the more emotionally reactive rats. It has been suggested that emotional reactivity is linked with a certain neurovegetative balance. This possibility was investigated in twelve rats of each strain by means of differential blockade of the autonomic nervous system by atropine and propranolol. The heart rate response of the emotionally reactive strain to propranolol was statistically smaller than that of the non reactive strain. On the other hand, the heart rate increase resulting from atropine treatment was more elevated in the same rats. The calculated sympathetic and parasympathetic tones (as % of intrinsic heart rate) were 8% and 30% respectively in the reactive rats. However, both of the tones were 14% in the non reactive rats. In conclusion, the high defecating rats in the open-field exhibit a lower sympathetic tone linked with a higher parasympathetic tone.

Animals