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Article History

Received: 8 May 2025

Accepted: 18 September 2025

First Online: 30 October 2025

Declarations

:

: The study protocol was approved by the Ethics Committee of Mashhad University of Medical Sciences, Iran (Approval Code: IR.MUMS.MEDICAL.REC.1403.344) and conducted in accordance with the Declaration of Helsinki (2013 version). All participants received written information about the study’s aims, procedures, confidentiality, and potential risks/benefits. Written informed consent was obtained via electronic/paper-based forms, and participation was voluntary with the right to withdraw at any time without penalty. No personally identifiable information (e.g., names, IDs) was collected. Data were anonymized at the point of collection using unique codes and stored on encrypted, password-protected servers with access limited to the principal investigators. Data will be retained for 2 years before secure deletion. Due to sensitive content (e.g., childhood abuse), participants were advised to complete the survey privately. Contact details for 24/7 support (Mashhad University Counseling Center and Iran’s National Psychological Helpline) were provided. For language polishing only, ChatGPT (OpenAI, GPT-4, May 2024 version) assisted in preliminary English translation. No AI tool was used for data analysis or interpretation. All content was rigorously reviewed and approved by the authors.

: Not applicable.

: The authors declare no competing interests.

: Not applicable.