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Scientific and Clinical References

Each of our tests is backed by trusted research and clinical designed to support your understanding of your mental health and wellbeing. On this page, you can explore the full list of tests, access the scientific basis behind them, and view any available clinical data summaries.

Test titles

1: Overview

  • American College of Rheumatology (ACR) 2010 & 2016 Revisions
  • The Widespread Pain Index (WPI) and Symptom Severity (SS) Scale form the global standard for fibromyalgia diagnosis.
  • Your questions on pain, fatigue, cognitive symptoms (‘brain fog’), and non-restorative sleep directly reflect these criteria.

2: Reference

  • Wolfe, F., Clauw, D.J., Fitzcharles, M.A., et al. (2010). The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research, 62(5), 600–610.
  • Wolfe, F., Clauw, D.J., Fitzcharles, M.A., et al. (2016). 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Seminars in Arthritis and Rheumatism, 46(3), 319-329.

1: Overview

  • FScientific findings show that fibromyalgia often presents cognitive dysfunction similar to chronic fatigue syndrome and other central sensitization syndromes.
  • Brain fog and fatigue are key differentiators between fibro types in current research.

2: Reference

Glass, J.M. (2009). Cognitive dysfunction in fibromyalgia and chronic fatigue syndrome: New trends and future directions. Current Rheumatology Reports, 11(6), 404-410.

1: Overview

Emerging studies confirm low-grade systemic inflammation plays a role in a subset of fibromyalgia cases — explaining why some users score higher in “inflammatory” responses.

2: Reference

Üçeyler, N., Häuser, W., Sommer, C. (2011). Systematic review with meta-analysis: cytokines in fibromyalgia syndrome. BMC Musculoskeletal Disorders, 12, 245.

1: Overview

  • Stress worsens fibromyalgia symptoms by heightening central pain processing and leading to chronic stress-loop patterns.
  • Stress worsens fibromyalgia symptoms by heightening central pain processing and leading to chronic stress-loop patterns.

2: Reference

McBeth, J., Mulvey, M.R. (2012). Fibromyalgia: mechanisms and potential impact of the ACR 2010 classification criteria. Nature Reviews Rheumatology, 8(2), 108-116.

1: Overview

Co-occurrence of IBS, chronic fatigue syndrome, migraines, depression, and anxiety is extensively documented, and correlating this in screening improves patient-tailored interventions.

2: Reference

Häuser, W., Ablin, J., Fitzcharles, M.A., Littlejohn, G., Luciano, J.V., Usui, C., Walitt, B. (2015). Fibromyalgia. Nature Reviews Disease Primers, 1, 15022.

1: Overview

Longitudinal studies identify early onset, active flare phases, plateau, and co-morbid syndromic overlap as natural stages of the fibromyalgia life course.

2: Reference

Arnold, L.M., Clauw, D.J., McCarberg, B.H., et al. (2011). Improving the recognition and diagnosis of fibromyalgia. Mayo Clinic Proceedings, 86(5), 457–464.

3: Official ACR guidelines

  • Neuroscience and immunology evidence (fatigue, brain fog, inflammation)
  • Psychosocial models (anxiety-pain loops)
  • Modern chronic illness staging theory (progression and overlap)

1: Shoorah GLP-1 Wellbeing Digital Test

This document outlines the scientific and clinical foundations behind the GLP-1 Side Effects and Wellbeing Digital Test in the Shoorah platform.

2: Mental Health Impact of GLP-1 Medications

  • Jendle J, Grunberger G, et al. Neuropsychiatric effects of GLP-1 receptor agonists. Diabetes Therapy. 2021.
    Neuroscience and immunology evidence (fatigue, brain fog, inflammation)
  • Lau J, Bloch P, Schäffer L, et al. GLP-1 receptor agonists and depression risk. Front Endocrinol (Lausanne). 2020.

3: Physical Side Effects (Nausea, Vomiting, GI Issues)

  • Marso SP, Daniels GH, et al. Gastrointestinal adverse effects of GLP-1 receptor agonists: a systematic review. NEJM. 2016 (LEADER Trial).
  • Andersen DK, et al. Mechanisms of GI side effects of GLP-1 agonists. Cell Metabolism. 2021.

4: Emotional & Behavioural Impact (Disordered Eating Risk)

  • van Eyk HJ, et al. GLP-1 receptor agonists and eating behaviour: a double-edged sword? Obesity Reviews. 2022.
  • Rubino D, et al. Body image and self-esteem after GLP-1 treatment. Lancet Diabetes Endocrinol. 2021.

5: Fatigue, Sleep Changes, Cognitive Effects

Holst JJ. Cognitive and fatigue symptoms in patients treated with GLP-1RAs. Diabetes Obes Metab. 2020.

6: Serious Warnings and Red Flags

MHRA Guidance for Healthcare Professionals. GLP-1 receptor agonist safety guidelines. 2023.

1: Shoorah Dermatica Skin Health Digital Test

This document outlines the scientific and clinical foundations behind the Dermatica Skin Health Digital Test in the Shoorah platform.

2: Skin Hydration and Texture

  • Proksch E, Brandner JM, Jensen JM. The skin: an indispensable barrier. Exp Dermatol. 2008.
  • Verdier-Sévrain S, Bonté F. Skin hydration: a review on its molecular mechanisms. J Cosmet Dermatol. 2007.

3: Acne, Breakouts, and Inflammation

  • Zaenglein AL, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016.
  • Kraft J, Freiman A. Management of acne. CMAJ. 2011.

4: Skin Sensitivity and Reactivity

  • Misery L, et al. Sensitive skin in Europe. J Eur Acad Dermatol Venereol. 2009.
  • Farage MA. The prevalence of sensitive skin. Front Med (Lausanne). 2019.

5: Pigmentation and Uneven Skin Tone

  • Grimes PE. Management of hyperpigmentation in darker racial ethnic groups. Semin Cutan Med Surg. 2009.
  • Sarkar R, et al. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011.

6: Aging, Wrinkles, and Elasticity Loss

  • Ganceviciene R, et al. Skin anti-aging strategies. Dermatoendocrinol. 2012.
  • Fisher GJ, et al. Mechanisms of photoaging and chronological skin aging. Arch Dermatol. 2002.

7: Emotional and Psychological Impact of Skin Conditions

  • Dalgard FJ, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015.
  • Gupta MA, Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003.

1: Fertility Emotional Wellbeing Screener

  • Greil, A. L., Slauson-Blevins, K., & McQuillan, J. (2010). The experience of infertility: A review of recent literature. Sociology of Health & Illness.
  • Domar, A. D., Clapp, D., Slawsby, E. A., Kessel, B., Orav, J., & Freizinger, M. (2000). Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility.

2: Ovarian Reserve & Reproductive Awareness Screener

  • Practice Committee of the American Society for Reproductive Medicine (ASRM). (2015). Testing and interpreting measures of ovarian reserve: a committee opinion.
  • Wallace, W. H. B., & Kelsey, T. W. (2010). Human ovarian reserve from conception to the menopause. PloS one.

3: Male Fertility Health & Emotional Stress Screener

  • Agarwal, A., Mulgund, A., Hamada, A., & Chyatte, M. R. (2015). A unique view on male infertility around the globe. Reproductive Biology and Endocrinology.
  • Nieschlag, E. (2010). Male reproductive aging. Journal of Endocrinological Investigation.

4: Preconception Lifestyle Risk Screener

  • Fleming, T. P., Watkins, A. J., Velazquez, M. A., Mathers, J. C., Prentice, A. M., Stephenson, J., … & Barker, M. (2018). Origins of lifetime health around the time of conception: causes and consequences. The Lancet.
  • Stephenson, J., Heslehurst, N., Hall, J., Schoenaker, D. A., Hutchinson, J., Cade, J. E., … & Barker, M. (2018). Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. The Lancet.

5: Fertility Grief & Loss Processing Screener

  • Lutgendorf, S. K., & Sood, A. K. (2011). Biobehavioral factors and cancer progression: physiological pathways and mechanisms. Psychosomatic Medicine.
  • Cumming, G. P., Klein, S., Bolsover, D., Lee, A. J., Alexander, D. A., & Maclean, M. (2007). The emotional burden of miscarriage for women and their partners: trajectories of anxiety and depression over time. BJOG: An International Journal of Obstetrics & Gynaecology.

6: Relationship Impact During Fertility Struggles Test

  • Peterson, B. D., Newton, C. R., & Rosen, K. H. (2003). Examining congruence between partners’ perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. Family Process.
  • Greil, A. L. (1997). Infertility and psychological distress: A critical review of the literature. Social Science & Medicine.

7: IVF / Fertility Treatment Readiness Screener

  • Boivin, J., & Gameiro, S. (2015). Evolution of psychology and counseling in infertility. Fertility and Sterility.
  • Gameiro, S., Boivin, J., Peronace, L., & Verhaak, C. M. (2012). Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Human Reproduction Update.

1: Sleep Quality & Restoration Screener

Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric practice and research. Psychiatry Research.

2: Sleep Anxiety & Hyperarousal Test

Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy.

3: Dream Recall and Sleep Cognition Screener

Schredl, M. (2004). Dream recall frequency in relation to age, gender and personality factors. Personality and Individual Differences.

4: Social Media Exhaustion Screener

Dhir, A., Yossatorn, Y., Kaur, P., & Chen, S. (2018). Online social media fatigue and psychological wellbeing: A study of compulsive use, fear of missing out, fatigue, anxiety and depression. International Journal of Information Management.

5: Digital Burnout & Screen Overwhelm Test

Mark, G., Gudith, D., & Klocke, U. (2008). The cost of interrupted work: More speed and stress. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems.

6: Doomscrolling and Anxiety Amplification Screener

Sinclair, R. R., Sears, L. E., Probst, T. M., & Zajack, M. (2021). Stress-Related Doomscrolling During the COVID-19 Pandemic: The Role of Control and Optimism. Anxiety, Stress, & Coping.

7: Digital Persona & Online Identity Fatigue Screener

Marwick, A. E., & Boyd, D. (2011). I tweet honestly, I tweet passionately: Twitter users, context collapse, and the imagined audience. New Media & Society.

8: Gaming Overuse and Escapism Tracker

Pontes, H. M., & Griffiths, M. D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior.

9: Device Disconnection Anxiety Test

Cheever, N. A., Rosen, L. D., Carrier, L. M., & Chavez, A. (2014). Out of sight is not out of mind: The impact of restricting wireless mobile device use on anxiety levels among low, moderate and high users. Computers in Human Behavior.

10: Online Comparison & Self-Worth Distortion Screener

Vogel, E. A., Rose, J. P., Roberts, L. R., & Eckles, K. (2014). Social comparison, social media, and self-esteem. Psychology of Popular Media Culture.

1: Grief Processing and Adaptation Inventory

Worden, J. W. (2008). Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner (4th ed.).

2: Complicated Grief Risk Screener

Shear, M. K. (2015). Complicated grief. New England Journal of Medicine.

3: Purpose Clarity and Life Meaning Inventory

Steger, M. F., Frazier, P., Oishi, S., & Kaler, M. (2006). The meaning in life questionnaire: Assessing the presence of and search for meaning in life. Journal of Counseling Psychology.

4: Existential Anxiety and Purpose Alignment Screener

Yalom, I. D. (1980). Existential Psychotherapy.

5: Emotional Literacy and Labeling Ability Screener

Salovey, P., & Mayer, J. D. (1990). Emotional intelligence. Imagination, Cognition and Personality.

6: Self-Compassion and Harsh Self-Criticism Tracker

Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity.

7: Emotional Agility and Resilience Screener

David, S. (2016). Emotional Agility: Get Unstuck, Embrace Change, and Thrive in Work and Life.

8: Emotional Suppression and Avoidance Patterns Test

Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology.

9: Alexithymia and Emotional Awareness Difficulties Test

Taylor, G. J., Bagby, R. M., & Parker, J. D. (1997). Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness.

1: Smartphone Dependency and Emotional Drain Inventory

Billieux, J., Maurage, P., Lopez-Fernandez, O., Kuss, D. J., & Griffiths, M. D. (2015). Problematic mobile phone use: A literature review and a pathways model. Current Psychiatry Reviews.

2: Medical Settings Anxiety & Healthcare PTSD Screener

Schnyder, U., et al. (2017). Healthcare-related PTSD: Research developments and clinical applications. European Journal of Psychotraumatology.

3: Chronic Pain Emotional Fatigue and Resilience Tracker

McCracken, L. M., & Vowles, K. E. (2014). Acceptance and Commitment Therapy and mindfulness for chronic pain: Model, process, and progress. Psychological Reports.

4: Pet Loss Grief & Emotional Healing Screener

Adams, C. L., & Bonnett, B. N. (1996). The human side of companion animal loss: Understanding grief and bereavement. Veterinary Clinics of North America: Small Animal Practice.

5: First Job & Early Career Adjustment Stress Test

Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist.

6: Parenting Identity & Emotional Independence Tracker (Empty Nest Focus)

Sharp, E. A., & Cooney, T. M. (2001). Parenting and parenthood: The transition to an empty nest. Journal of Family Issues.

7: Doomscrolling Emotional Fatigue and Anxiety Amplification Screener

Oxford Internet Institute (2021). Doomscrolling and digital mental health risks: A systematic review. OII Working Papers.

8: Strengths Discovery After Trauma Growth Inventory

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry.

9: Leaving Home and Emotional Independence Screener (Young Adults Focus)

Mahler, M. S., Pine, F., & Bergman, A. (1975). The Psychological Birth of the Human Infant: Symbiosis and Individuation.

10: Healthcare Betrayal Trauma and Trust Rebuilding Test

Smith, C. P., & Freyd, J. J. (2014). Institutional betrayal and trust recovery: A review of theoretical and empirical work. Psychology of Trauma: Theory, Research, Practice, and Policy.

1: Shoorah GLP-1 Wellbeing Digital Test

This document outlines the scientific and clinical foundations behind the GLP-1 Side Effects and Wellbeing Digital Test in the Shoorah platform.

2: Mental Health Impact of GLP-1 Medications

  • Jendle J, Grunberger G, et al. Neuropsychiatric effects of GLP-1 receptor agonists. Diabetes Therapy. 2021.
    Neuroscience and immunology evidence (fatigue, brain fog, inflammation)
  • Lau J, Bloch P, Schäffer L, et al. GLP-1 receptor agonists and depression risk. Front Endocrinol (Lausanne). 2020.

3: Physical Side Effects (Nausea, Vomiting, GI Issues)

  • Marso SP, Daniels GH, et al. Gastrointestinal adverse effects of GLP-1 receptor agonists: a systematic review. NEJM. 2016 (LEADER Trial).
  • Andersen DK, et al. Mechanisms of GI side effects of GLP-1 agonists. Cell Metabolism. 2021.

4: Emotional & Behavioural Impact (Disordered Eating Risk)

  • van Eyk HJ, et al. GLP-1 receptor agonists and eating behaviour: a double-edged sword? Obesity Reviews. 2022.
  • Rubino D, et al. Body image and self-esteem after GLP-1 treatment. Lancet Diabetes Endocrinol. 2021.

5: Fatigue, Sleep Changes, Cognitive Effects

Holst JJ. Cognitive and fatigue symptoms in patients treated with GLP-1RAs. Diabetes Obes Metab. 2020.

6: Serious Warnings and Red Flags

MHRA Guidance for Healthcare Professionals. GLP-1 receptor agonist safety guidelines. 2023.

7: Shoorah Dermatica Skin Health Digital Test

This document outlines the scientific and clinical foundations behind the Dermatica Skin Health Digital Test in the Shoorah platform.

8: Skin Hydration and Texture

  • Proksch E, Brandner JM, Jensen JM. The skin: an indispensable barrier. Exp Dermatol. 2008.
  • Verdier-Sévrain S, Bonté F. Skin hydration: a review on its molecular mechanisms. J Cosmet Dermatol. 2007.

9: Acne, Breakouts, and Inflammation

  • Zaenglein AL, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016.
  • Kraft J, Freiman A. Management of acne. CMAJ. 2011.

10: Skin Sensitivity and Reactivity

  • Misery L, et al. Sensitive skin in Europe. J Eur Acad Dermatol Venereol. 2009.
  • Farage MA. The prevalence of sensitive skin. Front Med (Lausanne). 2019.

11: Pigmentation and Uneven Skin Tone

  • Grimes PE. Management of hyperpigmentation in darker racial ethnic groups. Semin Cutan Med Surg. 2009.
  • Sarkar R, et al. Melasma: a clinico-epidemiological study of 312 cases. Indian J Dermatol. 2011.

12: Aging, Wrinkles, and Elasticity Loss

  • Ganceviciene R, et al. Skin anti-aging strategies. Dermatoendocrinol. 2012.
  • Fisher GJ, et al. Mechanisms of photoaging and chronological skin aging. Arch Dermatol. 2002.

13: Emotional and Psychological Impact of Skin Conditions

  • Dalgard FJ, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015.
  • Gupta MA, Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003.