Objective: The efficacy of trauma-focused cognitive behaviour therapy (tf-CBT) has been well established in randomized controlled trials (RCTs). More research is needed to demonstrate the effectiveness of tf-CBT in routine clinical care settings.Method: Eighty-five patients (68 female) with a primary diagnosis of PTSD received tf-CBT at two German outpatient centres (Münster and Mannheim) between 2014 and 2016. Treatment was delivered mainly by therapists in training and treatment duration was based on symptom course. The treatment consisted of a preparation phase, a trauma-focused phase (comprising imaginal exposure, discrimination training, changing dysfunctional appraisals) and a phase of reclaiming-your-life assignments, and relapse prevention. In an intent-to-treat-analysis (ITT), linear mixed effects models were fitted for self-assessments of traumatic symptom severity using the PTSD Checklist for DSM-5 (PCL-5) and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Potential moderators for treatment outcome, e.g. number of suicide attempts, were investigated.Results: The observed treatment effect was large for both the CAPS-5 (ITT: Cohen's d = 2.07, CI [1.62, 2.51]; completers d = 2.34, CI [1.84, 2.83]) and PCL-5 respectively (ITT: d = 2.02, CI [1.56, 2.48]; completers d = 2.15, CI [1.66, 2.64]), and remained stable six months and one-year post-treatment. N = 27 patients (31.48%) were defined as study dropout and of these, n = 12 (14.12%) dropped out of the study but completed treatment. None of the fixed-effect estimates for treatment predictors interacted significantly with the effect of time.Conclusions: Tf-CBT is well-tolerated and it can be effectively delivered in routine clinical care. Its large treatment effects underline the practicability and benefits of the approach. This trial demonstrates its broad applicability among individuals with diverse patterns of clinical characteristics and comorbidities.

Background: As the number of older adults increases worldwide, understanding their mental health is crucial, including the impact of traumatic experiences that can lead to posttraumatic stress disorder (PTSD). However, validated screening and diagnostic instruments for PTSD in older adults are limited.Objective: We sought to provide a comprehensive summary of the diagnostic accuracy of PTSD screening and diagnostic instruments used in older adults (Mage ≥ 60 years).Method: A systematic search of MEDLINE, EMBASE, PsycINFO and Web of Science databases was conducted for January 1980 through 10 January 2025. Studies that focused on the psychometric properties of PTSD instruments in older adults were included.Results: Out of 21,197 publications screened, only 40 studies including 24 instruments met the eligibility criteria. Only seven were conducted with participants from the general population or primary care patient samples. There were 14 relevant studies in the last ten years, with only six based on the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) criteria. Validation studies conducted in non-Western and/or non-English speaking older adult samples are rare.Conclusions: There is a shortage of validation studies of PTSD screening and diagnostic tools in the general older adult population. We recommend using the Clinician-Administered PTSD Scale for DSM-5 in clinical practice. It is the gold standard for assessing current and lifetime PTSD in the general population. Further research is required to establish evidence-based clinical cut-off scores and cross-cultural validity for PTSD screening in different populations of older adults. Future studies should also assess measures that consider the multimorbidity in this population (e.g. cognitive impairment and other psychiatric or medical disorders) and are easy to administer in clinical practice.

Existing studies that simultaneously consider the effects of lifestyle and family environment factors on mental health problems (MHPs), particularly in preschoolers, are limited. This study aims to explore lifestyle and family environment factors associated with MHPs, externalising problems (EPs) and internalising problems (IPs) in preschoolers.

This territory-wide, school-based study conducted from 2020 to 2022 involved 1926 preschoolers. MHPs, EPs, and IPs and factors such as sleep duration, sleep latency, entertainment screen time, educational screen time, parent-child recreation and learning activities were assessed. Linear and logistic regression analyses were used to explore the relationships between these factors and MHPs, EPs, and IPs.

The average sleep duration was 9.94 h per day, average screen time of 2.53 h per day, and 42.6 % experienced sleep latency exceeding 20 min per day among preschoolers (mean age: 4.39 years, 49.1 % female). Adjusted analyses showed that decreased parent-child recreation activities, prolonged sleep latency and excessive entertainment screen time were associated with increased MHPs, EPs, and IPs (β: 0.05 to 0.20, all p < 0.05). Weekend sleep duration of <10 h per day, sleep latency of >20 min per day, and educational screen time of >30 min per day were identified as risk factors for MHPs, EPs, and IPs, with an adjusted odds ratio ranging from 1.32 to 2.32 (all p < 0.05).

Preschoolers' lifestyle and family environment factors are associated with MHPs, EPs, and IPs respectively. Ensuring adequate sleep duration, avoiding sleep latency exceeding 20 min per day, reducing entertainment screen time, limiting educational screen time to 30 min per day, and increasing parent-child interactions may help to minimise mental health problems.

Substance use is common among youth, with emerging adulthood a high-risk period for developing both substance use disorder (SUD) and mental illness. Youth receiving mental health treatment have higher rates of substance use than their peers, providing an opportunity for early intervention for SUDs. To facilitate this, a better understanding of substance use patterns among help-seeking youth is needed.

We employed exploratory and confirmatory latent class analyses (LCA) to identify discrete classes of youth attending mental health services based on their substance use patterns, and assessed differences between groups in demographics, quality of life (QOL) and psychiatric symptoms.

Participants were treatment-seeking youth (15 - 25 years) recruited from headspace, Australia's national network of youth-focused primary mental health services, in 2 cohorts (Study 1, n = 676, female = 67.8 %; Study 2, n = 295, female = 66.3 %). Measurements included demographics, lifetime and recent substance use, mental health symptomatology and QOL.

Exploratory LCA (Study 1) revealed a four-class model of substance use: 1) current alcohol or no substance use (ALC), 2) current tobacco, alcohol, and cannabis use (TAC), 3) past polysubstance use, and 4) current polysubstance use. The current polysubstance use group reported more psychological distress than the ALC group and lower QOL than youth without polysubstance use (ALC and TAC). Confirmatory LCA (Study 2) identified four similar classes, however no differences between groups in distress or QOL were observed.

Findings identify clinically-significant substance use patterns among youth accessing mental health care, with implications for development of early interventions to address substance use in this risk-enriched population.

Traditional categorical systems for diagnosing psychopathological symptoms, such as the DSM-5, face limitations including high comorbidity rates and insufficient support for transdiagnostic treatment protocols. Dimensional, person-centered approaches can address these limitations by focusing on cross-cutting psychiatric symptoms.

This study leverages data from the Adolescent Brain Cognitive Development℠ Study (ABCD Study®) to develop dimensional models of preadolescent psychopathology, focusing on a large, diverse sample of youths aged 9-10. We used latent profile analysis (LPA) on Child Behavior Checklist (CBCL) syndrome scales collected from an elevated symptomatology subsample to delineate subgroups for targeted interventions.

Four distinct profiles emerged: "Mildly Elevated" and "Highly Elevated" (on both internalizing and externalizing), "Moderately Elevated - Rule-Breaking," and "Moderately Elevated - Internalizing & Thought Problems." These profiles differed significantly across sociodemographic, neurocognitive, and life experience characteristics. The "Highly Elevated" group showed the highest levels of risk, including greater trauma exposure and higher rates of parental psychopathology. In contrast, the "Mildly Elevated" group demonstrated lower levels of risk factors and higher fluid intelligence compared to the other groups. The two Moderately Elevated profiles were largely similar across most risk indicators, though the Internalizing & Thought Problems group had a slightly higher proportion of parents with a college education.

These profiles offer the beginnings of a foundation for classifying symptom co-occurrence and highlight the need for developmentally specific nosologies to improve risk detection and intervention strategies. Future research should further validate these profiles and explore their stability across developmental stages to inform targeted interventions.

Recent studies have suggested a link between nociception and depression. However, the specific genes involved remain unclear.

This study investigates this genetic link using multi-omics data. We collected nociception-related genes from the GeneCards database and integrated quantitative trait loci (mQTLs, eQTLs and pQTLs) data for gene expression, DNA methylation and protein expression. GWAS data from the IEU database served as the discovery cohort for depression, with FinnGen and GWAS Catalog data used for validation. Summary data-based Mendelian Randomization (SMR) analysis was employed to examine the interactions between nociception-related genes and depression, and colocalization analysis identified shared causal variants. The associations between depression and target gene expression in specific tissues and specific cell types were assessed using the GTEx v8 dataset and single-cell eQTL data.

SMR analysis revealed 215 mQTLs, 12 eQTLs, and 1 pQTL associated with depression in the discovery cohort. By integrating multi-omics evidence, we found that the hypermethylation of the TNXB gene (cg02272968, cg02432444, cg27624229) and the hypomethylation of the CTNND1 gene (cg16127573) and the P2RY6 gene (cg12889420) were found to upregulate their expression, potentially increasing the risk of depression. GTEx eQTL analysis confirmed CBL expression in the substantia nigra positively correlates with depression risk. However, none of the key genes were confirmed in the single-cell eQTL analysis.

Our study emphasizes the importance of nociception-related genes, particularly TNXB, CTNND1 and CBL in the pathogenesis of depression. Future research should build on these findings for potential prevention and treatment strategies.

Intensive longitudinal designs, made possible due to the ubiquitous nature of smartphones, improve the ability to measure state and trait components of psychological processes like anxious arousal simultaneously. To maximize the potential of these designs, reliable and valid measures must be developed. We report the psychometric properties of a state version of the Brief Penn State Worry Questionnaire (SB-PSWQ) in 90 participants (M age = 29.14, SD = 12.21; 61.1 % Female). Participants completed a diagnostic interview and a battery of self-report questionnaires in one session, a series of cognitive tasks while hooked up to EEG equipment in another session and then participants completed two weeks of surveys sent five times per day to their smartphone. During these daily surveys, participants were asked to report current anxious apprehension, anxious arousal, and stressful life events. Using confirmatory factor analysis (CFA), we found that a one-factor solution showed acceptable fit for the SB-PSWQ at both within- and between-persons levels. Further, between-person SB-PSWQ scores were positively associated with anxious arousal and anxious apprehension, but not symptoms of an alcohol use disorder, all measured at baseline. In addition, within-person SB-PSWQ scores were positively associated with within-person anxious arousal scores. The present study provides initial evidence for the validation of a brief measure of anxious apprehension to be used in intensive longitudinal designs.

To investigate the inequalities in mental health service utilisation amongst socio-demographic classes of Australian children and adolescents diagnosed with major mental and/or behavioural disorders, and suicidality.

A nationally representative sample of Australian children and adolescents was assessed, comprising 2898 parent and 1736 child participants. The Bolck, Croon, and Hagenaars (BCH) method was applied to pre-identified latent classes to determine adjusted class membership. Logistic regressions and predictive marginal analysis examined associations between these classes and mental health service utilisation in three scenarios: overall, with mental and/or behavioural disorders, and with suicidality.

Children and adolescents in Class 1 (Underprivileged) characterised by low socio-economic status and non-intact families showed the highest prevalence of mental and/or behavioural disorders and suicidality and the highest utilisation of mental health services. Classes 2 (Low-Skilled but Cohesive) and 4 (Affluent Single Parent) had higher prevalence rates of disorders and suicidality than Classes 3 (Stable Middle Class) and 5 (Privileged). However, Class 4 utilised services less than Classes 3 and 5, while Class 2 had the lowest utilisation amongst all classes, despite higher disorder prevalence.

The study highlights significant disparities in mental health service utilisation across socio-demographic classes. Children and adolescents from underprivileged and non-intact family backgrounds face the highest burden of mental health issues but also utilise services more frequently. In contrast, Classes 2 and 4, despite higher disorder prevalence, underutilise services, indicating barriers to access. Government initiatives should focus on improving parental awareness, family structures, and socio-economic conditions to enhance service utilisation and reduce mental health disparities.

This study investigated whether having a familial risk of affective disorders, subclinical psychopathology, functioning, personality traits, stressful life events, and childhood trauma predict the onset or recurrence of affective episodes.

The present study is a 7-year follow-up study of a baseline sample of 204 monozygotic twins (MZ) with unipolar or bipolar disorder in remission or partial remission (affected), their unaffected co-twins (high-risk), and healthy twins with no personal or familial history of affective disorder (low-risk).

During the 7.0-year median follow-up time, 59.3 % of the affected twins had a recurrence of an affective episode, 33.3 % of high-risk twins, and 7.5 % of low-risk twins had an onset. Familial risk and being affected were predictors for onset and recurrence. Including the whole sample, subclinical symptoms, functioning, stressful life events, and the personality trait neuroticism were statistically significant predictors of onset and recurrence. Regarding the individual risk groups, increasing age was a significant predictor of increased hazard in the affected risk group and lower hazard in the low-risk group.

This follow-up study revealed that the most potent predictors for onset or recurrence were familial risk and having an affective disorder at baseline. Subclinical depressive symptoms, personality traits, stressful life events, and impaired functioning were significant contributors to onset risk and recurrence. These findings highlight the need to integrate relevant risk factors into daily clinical settings and integrate the most well-established factors as potential targets for primary care interventions.

Evidence suggests that adults with major depressive disorder appraise daily stressor events as more severe and report stronger stressor-related negative emotions than non-depressed adults. Despite the growing number of young adults (~18-25 yrs) experiencing depressive symptoms in the absence of a formal clinical diagnosis, limited studies have examined whether current depressive symptom severity influences affective responsivity to daily stressors in young men and women. We tested the hypotheses that greater depressive symptom severity would be related to greater negative stressor appraisal characteristics and greater affective responsivity to daily stressors but not to stressor exposure frequency. We further hypothesized that the relations between depressive symptom severity and daily stress processes would be sensitized in young females compared to males.

Depressive symptom severity (Patient Health Questionnaire-9) and daily stress processes (8-day daily dairy) were assessed in 235 young adults (18-30 yrs.; 166 females).

Greater depressive symptom severity was related to greater likelihood of daily stressor exposure, intensity of feelings of anger and shame following a stressor event, and negative and positive affective responsivity to daily stressors. Self-reported biological sex moderated the association between depressive symptom severity and positive (but not negative) affective responsivity to daily stressors.

Causality cannot be established from this daily diary study design.

These data demonstrate that daily stressors are more pervasively reported and worsen negative affect to a greater extent in young adults currently experiencing more severe symptoms of depression, which may contribute to an increased risk of developing future chronic disease.

Depression and anxiety disorders are often exacerbated by social stress, necessitating the exploration of molecular mechanisms underlying stress resilience. Tissue plasminogen activator (tPA), a serine protease with pleiotropic effects in the brain, plays a critical role in modulating neuroplasticity and stress responses. This study investigates the behavioral and molecular effects of tPA gain-of-function in a social stress paradigm in male C57BL/6 mice using lentiviral vectors. Behaviorally, hippocampal tPA gain-of-function mitigated depression-like responses in the novelty-suppressed feeding, sucrose splash, tail suspension, and forced swim tests following exposure to chronic social stress. Additionally, in a two-bottle choice drinking paradigm, tPA overexpression reduced social stress-induced ethanol intake and preference, suggesting a role in dampening maladaptive coping behaviors. However, analysis of tastants' intake and preference revealed no significant effects of tPA overexpression, indicating that it does not influence hedonic responses under stress conditions. Molecularly, tPA overexpression preserved hippocampal tPA mRNA expression and maintained levels of mature brain-derived neurotrophic factor in the hippocampus despite chronic stress exposure. These findings highlight the potential neuroprotective effects of tPA in maintaining hippocampal plasticity and mitigating stress-induced dysregulation of critical neurotrophic pathways. Collectively, this study underscores the potential of tPA as a therapeutic target for stress-induced mood and substance use disorders by modulating behavioral and neurobiological responses to chronic social stress.

Non-invasive brain stimulation (NIBS) has the potential to treat generalized anxiety disorder (GAD). To assess the efficacy (response/remission/post-treatment continuous anxiety severity scores) and acceptability (failure to complete treatment for any reason) of NIBS, we searched PubMed, Web of Science, and the Cochrane Library (as of April 2024) for articles on NIBS for GAD and conducted a network meta-analysis of eight randomized trials (20 treatment arms, 405 participants). Data were pooled using standardized mean difference (SMD) and odds ratio (OR) with 95 % confidence interval (CI). Repetitive transcranial magnetic stimulation (rTMS) was the most widely studied treatment for GAD. The right dorsolateral prefrontal cortex (DLPFC) was the most common treatment target for GAD. High-frequency rTMS showed higher response rates (OR 291.40, 95 % CI 13.08 to 6490.21) and remission rates (OR 182.14, 95 % CI 8.72 to 3805.76) compared with other active therapies. Continuous theta burst stimulation (cTBS) greatly improved continuous post-treatment anxiety severity scores (SMD -2.56, 95 % CI -3.16 to -1.96). No significant differences in acceptability were found between the treatment strategies and the sham stimulation group. These findings provide evidence to consider NIBS techniques as alternative or adjunctive treatments for GAD.

Clinical practice guidelines indicate treatments for specific anxiety diagnoses. Misdiagnosing specific anxiety disorders as unspecified anxiety may prevent patients from receiving appropriate care. Provider knowledge and attitudes may influence diagnostic practices. This study evaluated provider knowledge of diagnostic criteria for anxiety disorders and attitudes toward diagnostic processes and the relevance of diagnosis to patients' treatment. This qualitative analysis of interviews included 32 Veterans Health Administration providers in Primary Care Behavioral Health and Specialty Mental Health. Interview guides were created using a framework that outlines barriers regarding provider knowledge, attitudes, and behaviors as they pertain to following clinical practice guidelines. Most providers described themselves as familiar with diagnostic criteria for anxiety disorders and discussed consulting the Diagnostic and Statistical Manual of Mental Disorders if unsure about criteria. Providers were divided on the relevance of diagnostic specificity to a patient's treatment plan and outcomes. In the Veterans Health Administration, providers across different settings, roles, and tendency toward assigning specific diagnosis disagree on the relevance of diagnostic specificity for a patient's treatment and outcomes. Future research should seek to understand this divide and evaluate methods for optimizing a patient's likelihood of receiving a proper, accurate diagnosis.

Fear generalization has been identified as an important mechanism that might contribute to the etiology and maintenance of anxiety disorders. It is, however, yet unclear to what degree attentional processes contribute to overgeneralization of fear in clinical samples. To address this issue, we utilized a set of facial photographs that was meticulously created such that pairs of faces could either be distinguished by looking into the eyes or the region around mouth and nose, respectively. These pairs were then employed as CS+ and CS- in a differential fear conditioning paradigm followed by a generalization test with morphs in steps of 20 %, creating a continuum between CS+ and CS-. In a sample with diverse levels of social and general anxiety (N = 87), we demonstrated that the amount of fear generalization depends on attentional orienting towards diagnostic facial features. While social anxiety did not affect the shape of generalization gradients, we observed altered visual exploration patterns and a distinct multi-phasic heart rate modulation in participants with higher social anxiety. General anxiety symptomatology was also related to these characteristics of visual exploration and additionally predicted a broad elevation of threat ratings. In summary, fear generalization depends on attentional deployment. Future work should build on these findings to further explore these processes in clinical populations.

Intolerance of uncertainty (IU) has received increasing attention for its role in the development and maintenance of generalized anxiety. However, little is known about the temporal and causal relationships between IU and generalized anxiety, particularly in adolescents. Furthermore, much of the existing literature treats IU and generalized anxiety as unidimensional constructs, limiting a detailed understanding of their internal elements and specific symptom interactions. To address the gaps, this study employed a cross-lagged panel network (CLPN) approach to examine the temporal interactions and predictive relationships between IU elements and generalized anxiety symptoms.

A sample of 7,434 nonclinical adolescents (mean age = 15.33 years, range = 11-19 years, 50.6% girls) completed the Intolerance of Uncertainty Scale (Short Form) for Children (IUSC-12) and the Generalized Anxiety Disorder Scale (GAD-7) across two waves, six months apart. Data was analyzed using the CLPN approach.

Bidirectional predictive relationships were found between IU elements and generalized anxiety symptoms, with generalized anxiety symptoms more frequently predicting IU elements. The generalized anxiety symptom named "nervousness" was the strongest predictor of increases in both IU elements and other generalized anxiety symptoms over time, while the IU elements named "frustration" and "work with hindrance" were the strongest predictors of future generalized anxiety symptoms.

This study provides new insights into the reciprocal relationships between IU and generalized anxiety among adolescents, highlighting the complex interplay between vulnerability and mental health problems. By identifying key IU elements and generalized anxiety symptoms that drive these relationships, the findings contribute to a more nuanced understanding of adolescent psychopathology and inform targeted interventions.

Around half of all eating disorder cases start during emerging adulthood (i.e., 18-25 years of age). This is an important time of change in interpersonal relationships, marked by individuation from the family of origin. Interpersonal relationships have long featured in theories of eating disorder maintenance and recovery. Increased understanding of the interplay between eating disorders and changes in the interpersonal domain may be key to improving the efficacy of existing treatments and developing novel interventions for this population group.

This study aimed to explore experiences of support from family and friends amongst emerging adults with anorexia nervosa.

A convenience sample of emerging adults who had received specialist treatment for anorexia nervosa in the United Kingdom (N = 10) was recruited via advertisements on social media. Semi-structured interviews were conducted focusing on experiences of support from family and friends during their eating disorder. Data were analysed using Interpretative Phenomenological Analysis.

Five key themes in participants' experiences were identified: (i) feeling isolated and lacking close friends; (ii) resisting involvement of family due to perceiving them as part of the problem; (iii) feeling family and friends' feelings; (iv) desiring flexible boundaries, and (v) feeling ambivalent towards family and friends' lived experience.

Findings suggest a complex entanglement of development of and recovery from AN with the process of individuating from parents during emerging adulthood. Clinicians may find benefit in helping emerging adults to develop their independence and supporting parents to adopt helpful emotional and behavioural postures that tackle the AN maintenance cycle, for example developing parental emotion regulation skills and supporting parents to facilitate age-appropriate levels of independence and responsibility.

Attention-deficit hyperactivity disorder, obsessive-compulsive disorder, depression, and anxiety are highly comorbid in Tourette's syndrome. Cutoff points of screening instruments for these conditions have been validated in the general population. The authors assessed whether established cutoff points on the General Anxiety Disorder-7 (GAD-7) scale; Patient Health Questionnaire-9 (PHQ-9); PHQ-2; Adult ADHD Self-Report Scale, version 1.1 (ASRS v1.1); and Obsessive-Compulsive Inventory (OCI) need to be adjusted for adults with Tourette's syndrome.

Thirty-six adults with Tourette's syndrome completed these instruments and a diagnostic psychiatric interview. Measures of diagnostic accuracy were calculated (area under the receiver operating characteristic curve [AUC], sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio) for each instrument at various cutoffs. Cutoffs for the sample of adults with Tourette's syndrome were suggested by the lowest value derived from a Euclidean distance method.

In this sample of adults with Tourette's syndrome, the optimal cutoff points were a GAD-7 score ≥13 (sensitivity, 67%; specificity, 91%; and AUC, 79%), a PHQ-9 score ≥15 (sensitivity, 67%; specificity, 73%; and AUC, 70%), a PHQ-2 score ≥3 (sensitivity, 67%; specificity, 67%; and AUC, 67%), an ASRS v1.1 score ≥14 (sensitivity, 83%; specificity, 77%; and AUC, 80%), and an OCI score ≥63 (sensitivity, 70%; specificity, 89%; and AUC, 79%). The best-performing instrument was the ASRS v1.1, followed by the GAD-7 and OCI; the PHQ-9 and PHQ-2 performed least well in this population.

Further research is needed to adapt screening instruments for the assessment of comorbid conditions among patients with Tourette's syndrome.

Although several studies have shown that one person's trauma is associated with romantic relationship difficulties for both partners in adulthood, most have overlooked the particularity of dual-trauma couples, in which both partners have experienced traumatic experiences. This rapid review investigated the dynamics and challenges within dual-trauma couples. A rapid review methodology was employed to consolidate and evaluate existing knowledge in this field. Fifteen empirical research studies meeting the inclusion criteria were identified through a comprehensive search across multiple databases, including CINAHL, Family Studies Abstracts, PsycInfo, PubMed, Google Scholar, Web of Science, and Dissertations and Theses Global. Studies included encompassed different methodological approaches. The review focused on studies explicitly addressing dual-trauma couples, excluding those examining secondary trauma or broader impacts of trauma on couples without a specific analysis of dual-trauma dynamics. Key findings revealed a comprehensive understanding of the complexities faced by these couples, including relationship dynamics, communication patterns, psychological impacts of trauma, and factors influencing relationship satisfaction. The review showed that despite facing significant challenges, dual-trauma couples demonstrate remarkable strengths and resilience, emphasizing the importance of open communication and mutual support in coping with past traumas. The review underscored the need for tailored interventions and trauma-informed care to address the unique needs of dual-trauma couples. Through a focused exploration of existing literature, this review provides valuable insights for clinicians, researchers, and professionals working in the field of trauma and relationships, aiming to enhance understanding and support for these vulnerable couples.

This study examines how adolescent leisure activity networks relate to subjective well-being (SWB) using Statistics Korea's 2019 Time Use Survey. The analysis includes 241 high-SWB and 241 low-SWB adolescents, assessing network density, inclusiveness, average distance, isolated nodes, degree centrality, and cohesion through NetMiner 4.0, with descriptive statistics processed in SPSS ver. 25.0. The results show clear differences in leisure activity networks. High-SWB adolescents engaged in more social activities and sports, while low-SWB adolescents participated in fewer, more solitary activities. High-SWB networks were diverse and well-connected, whereas low-SWB networks were more fragmented. Screen-based activities also played different roles: supporting social connections in high-SWB adolescents but reinforcing isolation in low-SWB adolescents. This study visually highlights that leisure participation varies by SWB level. The findings suggest that promoting diverse and interactive leisure activities can improve adolescent well-being, offering insights for policy and intervention programs.

Stuttering is associated with clinically significant social anxiety, which emerges during early childhood for some, but not all, children who begin to stutter. The purpose of this review article is to develop a model of social anxiety development during early childhood stuttering and to present an empirical method by which it can be tested.

We propose a mediation model of how the exposure variable of stuttering may lead to an outcome of social anxiety. Our model includes confounder and mediator variables. We explain the concepts and procedures of mediation analysis and present a method to test our model.

We present the idea that negative peer responses to stuttering and negative self-perception of children are mediators of social anxiety development. We propose several confounder variables that involve children, their parents, and the home environment. We depict our model with a directed acyclic graph, and we present details of how it can be tested with a longitudinal research design.

This is the first attempt to model the development of social anxiety shortly after stuttering onset with an empirically testable method. The intended benefit of this innovation is to direct future clinical directions for the clinical management of stuttering arising shortly after childhood onset.

Physical activity is associated with social network site addiction in adolescents, yet the mechanisms remain unclear. This study examines whether anxiety and ego-depletion mediate this relationship.

A survey was conducted among 1,174 Chinese adolescents (614 boys, 560 girls; mean age = 12.59, SD = 1.13). Physical activity was assessed with a single item on moderate-to-vigorous exercise in the past 7 days. Social network site addiction, anxiety, and ego-depletion were measured using validated self-report questionnaires. Descriptive statistics, correlation analyses, and a chained mediation model were employed.

Physical activity was negatively correlated with social network site addiction (r = -0.165, p < 0.001), anxiety (r = -0.121, p < 0.001), and ego-depletion (r = -0.119, p < 0.001). Anxiety was positively correlated with ego-depletion (r = 0.574, p < 0.001) and social network site addiction (r = 0.388, p < 0.001). Ego-depletion was positively associated with social network site addiction (r = 0.456, p < 0.001). Anxiety and ego-depletion sequentially mediated the relationship between physical activity and social network site addiction.

This study clarifies the psychological mechanisms linking physical activity and social network site addiction in adolescents, identifying anxiety and ego-depletion as key mediators. The findings emphasize the need to target these factors for more effective interventions.

People with past suicidal thoughts and behavior (STB) are often excluded from digital mental health intervention (DMHI) treatment trials. This may perpetuate barriers to care and reduce treatment generalizability, especially in populations with elevated rates of STB, such as body dysmorphic disorder (BDD). We conducted a cohort study of randomized controlled trial (RCT) participants (N=80) who received a smartphone-based cognitive behavioral therapy (CBT) treatment for BDD that allowed for most forms of past STB, except for past-month active suicidal ideation.

This study had two objectives: (1) to characterize the sample's lifetime prevalence of STB and (2) to estimate and predict STB incidence during the trial.

We completed secondary analyses on data from an RCT of smartphone-delivered CBT for BDD. The primary outcomes consisted of STB severity and suicide attempt assessed at baseline with the Columbia-Suicide Severity Rating Scale (C-SSRS) and weekly during the trial via one item from the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR item #12; 1043 observations). We computed descriptive statistics (n, %) and ran a series of bi- and multivariate linear regressions predicting STB incidence during the 3-month trial.

At baseline, 40% of participants reported a lifetime history of active suicidal thoughts and 10% reported lifetime suicide attempts. During the 3-month trial, 42.5% reporting thinking about death or suicide via weekly assessment. No participants reported frequent or acute suicidal thoughts, plans, or attempts. Lifetime suicide attempt (odds ratio 11, 95% CI 2.14-59.14; P<.01) and lifetime severity of suicidal thoughts (odds ratio 1.76, 95% CI 1.21-2.77; P<.01) were significant bivariate predictors of death- or suicide-related thought incidence reported during the trial. Multivariate models including STB risk factor covariates (eg, age, and sexual orientation) modestly improved prediction of death- or suicide-related thoughts (eg, positive predictive value=0.91, negative predictive value=0.75, and area under the receiver operating characteristic curve=0.83).

Although some participants may think about death and suicide during a DMHI trial, it may be safe and feasible to include participants with most forms of past STB. Among other procedures, researchers should carefully select eligibility criteria, use frequent, ongoing, low-burden, and valid monitoring procedures, and implement risk mitigation protocols tailored to the presenting problem.

Obsessive-Compulsive Disorder (OCD) demonstrates substantial heritability, implicating a genetic contribution to its pathophysiology. Neuroimaging studies of unaffected first-degree relatives offer insight into the neurobiology of the disorder.

A systematic search of PubMed, Web of Science, and Scopus was conducted in August 2024 to identify Magnetic Resonance Imaging (MRI) studies comparing unaffected relatives of individuals with OCD to healthy controls. Significant findings were reported based on patterns of brain changes in individuals with OCD and their relatives.

A total of 32 studies were reviewed, including 18 functional MRI, 8 structural MRI, and 7 diffusion tensor imaging studies. Despite inconsistencies arising from heterogeneity in imaging modalities, age groups, and analytic methods, certain regions and patterns emerged repeatedly. Results were grouped into four clusters. Cluster 1, the most consistently reported, involved shared or intermediate alterations in relatives, suggesting putative endophenotypes. Frequently implicated regions included the insula, thalamus, dorsolateral and ventromedial prefrontal cortices, and parietal cortex. Cluster 2 described more pronounced alterations in relatives than in OCD patients, often in frontoparietal regions, possibly reflecting preclinical vulnerability or protective features. Cluster 3 showed opposite trends in relatives, particularly in occipital and parietal regions, which may indicate compensatory or protective processes. Although very few, there were some findings that were specific to relatives (cluster 4).

This review identifies neuroimaging findings in unaffected relatives of individuals with OCD. Most studies suggest potential endophenotypes, with some reflecting compensatory mechanisms. These findings support further research to validate the proposed clusters and clarify heritable neural markers of OCD.

Despite growing attention to child and youth mental health, knowledge gaps exist related to how mental disorders vary for children and youth from diverse backgrounds. The purpose of the present study was to investigate how conduct, attention deficit hyperactivity disorder (ADHD), and mood/anxiety diagnoses varied by immigrant, refugee, and non-immigrant background in British Columbia, Canada. The study utilized population-based, linked administrative data for nearly half a million children and youth (N = 470,464) between 1996 and 2016 (ages 3 to 19) to examine variations in mental disorder diagnosis (defined via administrative health data records) by immigrant generation and admission category (economic, family, refugee) and the predictive/moderating effects of key socio-demographic factors (e.g., sex, socioeconomic status). Findings indicated that first- and second-generation children and youth were less likely to receive a mental disorder diagnosis compared to non-immigrant children and youth. Those in the refugee admission category had higher odds of conduct and mood/anxiety disorder diagnosis and those in the family admission category had higher odds of conduct, ADHD, and mood/anxiety disorder diagnosis (versus the economic admission category). Significant interactions revealed that sex at birth and socioeconomic status differently predicted mental disorder diagnoses for children and youth from immigrant and refugee backgrounds (versus non-immigrant). The findings contribute to a more nuanced understanding of mental disorder diagnoses for children and youth from diverse backgrounds and that well-established predictors of mental disorders for the general population (i.e., sex, SES) differ for children and youth from immigrant and refugee backgrounds.

Growing evidence has identified potential biomarkers of cognitive-behavioural therapy (CBT) efficacy in obsessive-compulsive disorder (OCD). Genetic and epigenetic mechanisms (e.g., polymorphisms, DNA methylation) contribute to OCD pathogenesis and CBT response variability, establishing them as a key research focus. To evaluate their associations with CBT outcomes in OCD, we conducted a systematic review of PubMed, Web of Science, CNKI, and Cochrane Library (from inception to January 2025), identifying eight studies that met rigorous inclusion criteria. The identified predictors included: (1) Genetic polymorphisms (BDNF); (2) Epigenetic modifications (DNA methylation of MAOA, SLC6A4, OXTR, PIWIL1, MIR886, PLEKHA1, KCNQ1, TRPM8, HEBP1, HTR7P1, MAPK8IP3, ENAH, RABGGTB (SNORD45C), MYEF2, GALK2, CEP192, and UIMC1). These markers may influence neural plasticity, neurotransmitter regulation, and related processes, providing molecular substrates for the observed treatment effects. Converging evidence suggests that distinct neurocognitive mechanisms may mediate CBT efficacy in OCD, particularly fear extinction learning and goal-directed behaviors (GDBs), which we analyze mechanistically. Future studies should integrate polygenic risk scores (PRS) with functional neuroimaging to dissect individual variability in CBT response, mainly through cortico-striato-thalamo-cortical (CSTC) circuit profiling. To our knowledge, this is the first systematic review synthesizing genetic and epigenetic predictors of CBT response in OCD; these findings provide compelling evidence for biomarkers for CBT personalization in OCD, advancing a novel precision psychiatry framework.

Anxiety and anxiety-related disorders are, as a group, the most common mental health conditions and are more common among women compared with among men. It is now evident that these disorders affect one in five pregnant and postpartum people and are more common than depression. For some disorders (e.g., obsessive-compulsive disorder), there is also evidence of an elevated risk for their development and exacerbation during perinatal periods. In this article, we review the literature pertaining to anxiety and anxiety-related disorders during the perinatal period. We also provide information related to pregnancy-specific anxiety and fear of childbirth constructs that exist outside of diagnostic classification but are particularly important in the perinatal context. We review the scope, prevalence, and etiology of these disorders as well as comorbidity, screening, assessment, and treatment. We conclude with an overview of some of the key gaps in knowledge and recommendations for future research.

Mental health conditions such as anxiety, depression, and suicidal ideation or suicide are prevalent among college students and are a growing public health concern. The COVID-19 pandemic exacerbated this crisis. Nurses are a vital component of college health services and may be the first or only health care provider to evaluate college students experiencing a mental health condition. However, the literature has limited evidence on the nurse's role and its impact on college mental health. Our systematic review examines nurse-led mental health interventions for college students.

We conducted a comprehensive search for nurse-led interventions in college mental health by using PubMed, Embase, CINAHL, PsycInfo, and ERIC databases. A total of 2,814 articles were identified, and 2,290 were screened after removal of 524 duplicates. Thirty-five studies were reviewed for eligibility, and 16 were included in this review. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Hierarchy of Evidence Guide and Appraisal Tools were used to rate the strength and quality of the evidence, and the selected articles were generally of good quality.

The 16 articles came from institutions in North America (n = 5), southeastern Europe (n = 3), and Asia (n = 8). The studies focused on samples with a pre-existing mental health diagnosis or on mental health symptoms and interventions aimed at addressing mental health concerns. The interventions were facilitated by nurses and included various approaches, including experimental, quality improvement, and educational strategies.

This review underscores the crucial role of nurses in addressing mental health issues among college students. Despite variability in approaches, nurse-led interventions offer promise in enhancing student well-being. Further studies are essential to gauge effectiveness and shape policies for supporting the nurse's unique role in higher education. Integrating these findings into practice and policy will equip college health services to meet students' evolving needs. Leveraging the expertise of nurses can enhance student mental well-being, leading to improved academic outcomes and overall quality of life.

Although individual prosociality, defined as voluntary behavior intended to benefit another, is known to promote help-seeking behaviors among adolescents, it remains unclear whether a prosocial community, such as the classroom, also facilitates these behaviors.

To investigate the associations of classroom-level and individual-level prosociality with help-seeking behaviors, considering age and gender, and to examine moderation effects of being bullied.

In this cross-sectional study, annual surveys were conducted via questionnaire among students in Japanese junior and senior high schools from 2020 to 2023. The first wave was administered from October 1 to November 7, 2020, followed by the second wave from June 4 to July 13, 2021, the third wave from June 17 to July 19, 2022, and the fourth wave from June 19 to July 28, 2023.

Classroom-level prosociality was defined as the mean prosociality of all students within a classroom, while individual-level prosociality was measured as the deviation from this classroom mean. Prosociality was assessed using the prosocial subscale of the self-reported Strengths and Difficulties Questionnaire.

Generalized mixed-effects models estimated the associations of classroom-level and individual-level prosociality with help-seeking behaviors (including poor help-seeking and seeking help from friends, family members, homeroom teachers, and physicians) while considering subgroups based on grades and gender, as well as the moderation effect of being bullied. Help-seeking behaviors were evaluated by a question about seeking help for one's mental health problems ("Are you currently consulting anyone to discuss your psychological stress or mental health problems?"), with multiple options. The robustness of the main findings were tested by models stratified by survey year.

The analysis included 21 845 participants (mean [SD] school grade, 10.4 [1.2]; 16.6% junior high school students and 83.4% senior high school students; 53.3% boys). Classroom-level prosociality was associated with a higher rate of help-seeking from friends among senior high school students (odds ratio [OR], 1.26, 95% CI, 1.17-1.35), which confirmed the robustness. No moderation effect of being bullied was found in this association. Higher individual-level prosociality was associated with increased help-seeking from various sources across nearly all models and subgroups, regardless of being bullied (friends: OR, 1.15 [95% CI, 1.13-1.17]; P < .001; family members: OR, 1.09 [95% CI, 1.07-1.11]; P < .001; homeroom teachers: OR, 1.15 [95% CI, 1.10-1.19]; P < .001; school nurses: OR, 1.19 [95% CI, 1.12-1.28]; P < .001; and physicians: OR, 1.14 [95% CI, 1.07-1.20]; P < .001).

This cross-sectional study of 21 845 students found that both classroom-level and individual-level prosociality were associated with higher rates of help-seeking from peers among senior high school students, while accounting for individual characteristics. Enhancing classroom prosociality could foster help-seeking behaviors through reciprocal peer support, benefiting even those who experienced bullying.

Targeted interventions are needed to prevent depression in at-risk children and adolescents. Children and adolescents are commonly at risk of depression due to subsyndromal depressive symptoms or problems in their social environment.

This review was conducted according to the Cochrane guidelines (2023) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was done in December 2023 using three electronic databases and a manual search. The methodological quality of all eligible studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias.

This review includes 77 intervention studies of which 13 are follow-ups. Of the 64 identified main studies (n = 11,808), 19 were selective interventions targeting the problems in a social environment. Of the participants 63.6 % were girls and the mean age ranged between 9 and 17. Most of the studies were conducted in a Western school setting using psychological interventions, with the majority being CBT (cognitive behavioral therapy) based programs. Targeted interventions reduced the symptoms of depression statistically significantly at postintervention (SMD 0.27, 95 % confidence interval 0.16-0.37) and 6-month follow-up (SMD 0.32, 0.18-0.45) compared to any comparator. Intervention effects were not statistically significant at the 12-month follow-up.

Indicated and selective interventions targeted to children and adolescents at risk of depression due to their social environment have a small effect on depressive symptoms. Interventions should be delivered by mental health experts.

Both cortical and parasympathetic systems are believed to regulate emotional arousal in the service of healthy development. Systemic coordination, or coupling, between putative regulatory functions begins in early childhood. Yet the degree of coupling between cortical and parasympathetic systems in young children remains unclear, particularly in relation to the development of typical or atypical emotion function. We tested whether cortical (ERN) and parasympathetic (respiratory sinus arrhythmia [RSA]) markers of regulation were coupled during cognitive challenge in preschoolers (N = 121). We found no main effect of RSA predicting ERN. We then tested children's typical and atypical emotion behavior (context-appropriate/context-inappropriate fear, anxiety symptoms, neuroendocrine reactivity) as moderators of early coupling in an effort to link patterns of coupling to adaptive emotional development. Negative coupling (i.e., smaller ERN, more RSA suppression or larger ERN, less RSA suppression) at age 3 was associated with greater atypical and less typical emotion behaviors, indicative of greater risk. Negative age 3 coupling was also visible for children who had greater Generalized Anxiety Disorder symptoms and blunted cortisol reactivity at age 5. Results suggest that negative coupling may reflect a maladaptive pattern across regulatory systems that is identifiable during the preschool years.

The present study focused on the emotional experience of anger among individuals with and without social anxiety disorder (SAD). Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not meet criteria for SAD. Participants completed a 21-day experience sampling measurement (ESM) in which they reported on daily social interactions and emotions. Using multilevel linear modeling we found that individuals with SAD experienced more anger compared to individuals without SAD. We also found a Diagnosis × Social Context interaction such that interactions with distant others were associated with elevated anger compared to interactions with close others for individuals with SAD but not for individuals without SAD. Finally, we found that for individuals with SAD (but not those without SAD) anger on a given day (day t) was associated with elevated anxiety on the following day (day t + 1), above and beyond previous anxiety, sadness and guilt (i.e. anxiety, sadness and guilt reported on day t). This suggests that anger may play a unique role in maintaining or exacerbating anxiety among individuals with SAD. Additional implications of our findings for models of psychopathology and for treatment of SAD are discussed.

Currently, there are few pharmacotherapy options for clinicians treating post-traumatic stress disorder (PTSD), and antidepressants are usually the medication of choice. This meta-analysis aimed to review the efficacy of antidepressants in the acute treatment of PTSD in adults while investigating the contribution of study design and placebo response to the findings of these studies. Randomized, double-blind, placebo-controlled clinical trials that compared antidepressants with placebo for acute treatment of PTSD were selected. Standardized mean difference (SMD) in change in Clinician-Administered PTSD Scale scores were pooled after examining for heterogeneity. A random-effects meta-analysis was performed. Twenty-nine antidepressant-placebo comparisons, involving 4575 subjects, were analyzed. The SMD among all studies was 0.25, a small to medium effect size, lower than that in studies of antidepressants in adult major depressive disorder. The SMDs for low and high mean placebo responses, were 0.27 and 0.22, respectively. The overall SMD for paroxetine studies was in the moderate range (0.43) and that for sertraline studies was in the small range (0.12). Our findings suggest that antidepressants have modest efficacy in alleviating PTSD symptoms. Patient-level meta-analyses are required to further explore the potential clinical relevance of sertraline for PTSD.

To progress adolescent mental health research beyond our present achievements-a complex account of brain and environmental risk factors without understanding neurobiological embedding in the environment-we need methods to uncover relationships between the developing brain and real-world environmental experiences.

We investigated associations between brain function, environments, and emotional and behavioral problems using participants from the Adolescent Brain Cognitive Development (ABCD) Study (n = 2401 female). We applied manifold learning, a promising technique for uncovering latent structure from high-dimensional biomedical data such as functional magnetic resonance imaging. Specifically, we developed exogenous PHATE (potential of heat-diffusion for affinity-based trajectory embedding) (E-PHATE) to model brain-environment interactions. We used E-PHATE embeddings of participants' brain activation during emotional and cognitive processing tasks to predict individual differences in cognition and emotional and behavioral problems both cross-sectionally and longitudinally.

E-PHATE embeddings of participants' brain activation and environments at baseline showed moderate-to-large associations with total, externalizing, and internalizing problems at baseline, across several subcortical regions and large-scale cortical networks, compared with the zero-to-small effects achieved by voxelwise data or common low-dimensional embedding methods. E-PHATE embeddings of the brain and environment at baseline were also related to emotional and behavioral problems 2 years later. These longitudinal predictions showed a consistent moderate effect in the frontoparietal and attention networks.

The embedding of the adolescent brain in the environment yields enriched insight into emotional and behavioral problems. Using E-PHATE, we demonstrated how the harmonization of cutting-edge computational methods with longstanding developmental theories advances the detection and prediction of adolescent emotional and behavioral problems.

Preliminary work suggests anxiety moderates the relationship between irritability and bullying. As anxiety increases, the link between irritability and perpetration decreases. We hypothesize that any moderation effect of anxiety is driven by social anxiety symptoms. We sought to explicate the moderating effect of anxiety, while clarifying relations to other aggressive behaviors.

A sample of adolescents (n = 169, mean = 12.42 years of age) were assessed using clinician rated assessments of anxiety, parent reports of irritability and bullying behaviors (perpetration, generalized aggression, and victimization). Correlations assessed zero-order relations between variables, and regression-based moderation analyses were used to test interactions. Johnson-Neyman methods were used to represent significant interactions.

Irritability was significantly related to bullying (r = .403, p < .001). Social, but not generalized, anxiety symptoms significantly moderated the effect of irritability on bully perpetration (t(160) = -2.94, b = -.01, p = .0038, ΔR2 = .0229, F(1, 160) = 8.635). As social anxiety symptoms increase, the link between irritability and perpetration decreases.

Understanding how psychopathology interacts with social behaviors is of great importance. Higher social anxiety is linked to reduced relations between irritability and bullying; however, the link between irritability and other aggression remains positive. Comprehensively assessing how treatment of psychopathology impacts social behaviors may improve future intervention.

Poor sleep quality is a major problem for women with post-traumatic stress disorder (PTSD). Potential causes of poor sleep quality include elevated symptoms of anxiety, hyperarousal, and decreased high frequency-heart rate variability (HF-HRV). Exercise training both decreases anxiety symptoms and increases HF-HRV among samples without PTSD. The effect of exercise training on sleep quality, HF-HRV and PTSD-related symptoms has not been tested in a sample of women exposed to trauma. This study aimed to evaluate the impact of High-Intensity Interval Training (HIIT) on sleep quality in a sample of women with probable PTSD and test if reductions in anxiety or hyperarousal symptoms and/or increased HF-HRV mediate improved sleep quality. Thirty women with poor sleep quality and a Post-Traumatic Diagnostic Scale (PDS-5) score indicative of PTSD (≥ 28) were randomly assigned to either six-weeks of HIIT or a waitlist control (WL). Sleep quality, PTSD and anxiety symptoms were assessed at baseline (BL), weeks 2, 4, 6, and post-intervention (POST). HF-HRV was measured at BL and POST. A mixed model ANOVA 2 group × 5 time interaction for sleep quality was significant (p < 0.001; HIIT BL: 11.27 ± 2.55; POST: 5.60 ± 2.03 versus WL BL: 9.47 ± 2.83; POST: 8.23 ± 2.39; Hedges' d = -1.57). Anxiety and hyperarousal symptom reductions significantly mediated sleep quality changes. HF-HRV mediation models were non-significant. HIIT-based cycle exercise training in a sample of women with probable PTSD improves sleep quality, and reductions in trait anxiety and hyperarousal symptoms mediated these improvements. CLINICAL TRIAL REGISTRATION: (Clinical Trials. gov) Identifier: NCT05097352.

Understanding the neurobiology of resilient emotion regulation following adversities is critical for addressing mental health problems globally. However, the functional neurobiology of resilience has rarely been studied in low- and middle-income countries, which comprise 90% of the world's population and experience more consistent adversities. Here, we describe how we are investigating the neurodevelopment of resilient emotion regulation in adolescents (anticipated N = 525) from a South African birth cohort recruited from a low-income, high-adversity township. Across 2 longitudinal time points (13-14 and 15-16 years), magnetic resonance imaging, behavior, and self-report measures from adolescents and their caregivers are collected. These data are complemented by existing developmental histories (from the prenatal period to 8 years). The culturally adapted measures, protocols, and analytic plans for investigating resilient emotion regulation are presented. By characterizing neurodevelopmental correlates of adolescent resilience from an understudied low- and middle-income country, this research will provide deeper insights into mental health globally.

Findings from the Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) project, including sociodemographic and clinical information from older age bipolar disorder (OABD) and healthy participants around the globe (approximately N = 5000) were reviewed. Data was collected in multiple waves to create a large integrated dataset.

BD does not seem to fade with age. BD subtype and early/late onset did not show significant differences in daily functioning. Physical comorbidities were more frequent in OABD compared with controls. Women with OABD had an earlier age at onset and more psychiatric hospitalizations. GAGE-BD is the largest OABD cohort. Dataset results offer a unique and comprehensive resource for understanding the long-term trajectory of BD and the specific needs of this population. Findings are vital for guiding future research and improving care strategies for aging individuals with BD.

Assessment of cancer patients´ quality of life (QoL) through patient-reported outcomes (PRO) during and after treatment is gaining ground. The HM-PRO is the first generic Haematological Malignancy specific PRO measure for use in clinical practice and clinical trials. Such generic tools are needed in Denmark. The study aim was to translate and cross-culturally adapt the HM-PRO into Danish and evaluate the psychometric properties.

Translation and cross-cultural adaptation of the original English HM-PRO into Danish followed established guidelines. After cognitive debriefing interviews, it underwent psychometric testing with a variety of hematologic malignancies. Construct validity, internal consistency, dimensionality, item response theory (IRT) and differential item functioning were investigated.

295 patients were included for psychometric evaluation; confirmatory factor and bifactor analyses for both HM-PRO parts provided good evidence to support the suggested factor structure (Cronbach's-α Part-A = 0.81, Part-B = 0.84; Part-A CFA CFI = 0.922, TLI = 0.912; bi-factor CFI = 0.989, TLI = 0.978). IRT showed good item-fit and factor loadings and absence of local dependency.

The HM-PRO has demonstrated favourable psychometric properties and can be used broadly within the Danish Healthcare system to monitor symptoms as well as QoL impact of patients with haematological cancer and optimize patient engagement during routine cancer care. WHAT IS THE NEW ASPECT OF YOUR WORK?: In response to the intention of the Danish Health Authority to systematically collect PRO data on health-related QoL in Danish cancer patients, this study investigates the translation and cross-cultural adaptation of the original English HM-PRO into Danish. WHAT IS THE CENTRAL FINDING OF YOUR WORK?: Few issues were met with the translation and adaptation of HM-PRO into Danish. WHAT IS (OR COULD BE) THE SPECIFIC CLINICAL RELEVANCE OF YOUR WORK?: The HM-PRO has demonstrated favourable psychometric properties and can be used broadly within the Danish Healthcare system to monitor symptoms as well as QoL impact of patients with haematological cancer and optimize patient engagement during routine cancer care.

There has been a growing concern regarding the development of parental anxiety and child anxiety. However, the dynamic bidirectional relationship between parental anxiety and child anxiety remains unclear, particularly across different genders and developmental stages. This study investigated the bidirectional relationships between parental anxiety and child anxiety, and further explored the relationships across gender and age.

Data were collected across four waves from 2019 to 2022 in Sichuan Province, China, including 6,117 students (49.00% girls; 61.10% adolescents; M = 10.32 years, SD = 2.14). Parental anxiety was evaluated by the Self-Rating Anxiety Scale (SAS), and child anxiety was assessed using the Screen for Child Anxiety-Related Emotional Disorders (SCARED). A random intercept cross-lagged panel model (RI-CLPM) was constructed to distinguish between within- and between-person levels of parental anxiety and child anxiety.

Results found that parental anxiety significantly predicted child anxiety across all time points, which supports the "parent effects" model. Meanwhile, child anxiety also influenced parental anxiety from Time 3 to Time 4, partially supporting the "reciprocal effects" model. Moreover, the impact of parental anxiety on girls' anxiety was significantly stronger than on boys, and parental anxiety had a more substantial influence on children than on adolescents.

These findings underscore the distinct roles of gender and developmental stages in the transmission of parental anxiety to children. The present findings provide theoretical and practical evidence for the development of parental anxiety and child anxiety in the Chinese context.

Negative life events (NLEs) have been shown to perturb neurodevelopment and are correlated with poor mental health outcomes in adolescence, the most common period of psychopathology onset. Emotion regulation is a critical component of psychological response to NLEs and interacts, neurobiologically and behaviorally, with working memory. This study leveraged an emotional n-back task to examine how NLEs influence emotion- and working memory-related brain activation using data from 2150 youth in the Adolescent Brain Cognitive Development (ABCD) Study. Greater incidence of NLEs was associated with less activation in the amygdala and more pronounced deactivation in other limbic and frontal brain regions previously implicated in emotion-related cognition; however, this association was present only during emotion processing conditions of the task. While NLEs were not significantly associated with task performance in the final sample, behavioural analyses including youth excluded for low task accuracy and poor neuroimaging data quality showed a significant negative association between NLEs and overall task performance. While behavioural findings across the entire sample support prior work, somewhat incongruent with prior literature, imaging results may suggest that during early adolescence the effects of negative experiences on patterns of neural activation are specific to contexts necessitating emotion processing.

Mood, anxiety, and trauma-related disorders (MATRDs) are highly prevalent and comorbid. A sizable number of patients do not respond to first-line treatments. Non-invasive neuromodulation is a second-line treatment approach, but current methods rely on cortical targets to indirectly modulate subcortical structures, e.g., the amygdala, implicated in MATRDs. Low-intensity transcranial focused ultrasound (tFUS) is a non-invasive technique for direct subcortical neuromodulation, but its safety, feasibility, and promise as a potential treatment is largely unknown. In a target engagement study, magnetic resonance imaging (MRI)-guided tFUS to the left amygdala was administered during functional MRI (tFUS/fMRI) to test for acute modulation of blood oxygenation level dependent (BOLD) signal in a double-blind, within-subject, sham-controlled design in patients with MATRDs (N = 29) and healthy comparison subjects (N = 23). In an unblinded treatment trial, the same patients then underwent 3-week daily (15 sessions) MRI-guided repetitive tFUS (rtFUS) to the left amygdala to examine safety, feasibility, symptom change, and change in amygdala reactivity to emotional faces. Active vs. sham tFUS/fMRI reduced, on average, left amygdala BOLD signal and produced patient-related differences in hippocampal and insular responses. rtFUS was well-tolerated with no serious adverse events. There were significant reductions on the primary outcome (Mood and Anxiety Symptom Questionnaire General Distress subscale; p = 0.001, Cohen's d = 0.77), secondary outcomes (Cohen's d of 0.43-1.50), and amygdala activation to emotional stimuli. Findings provide initial evidence of tFUS capability to modulate amygdala function, rtFUS safety and feasibility in MATRDs, and motivate double-blind randomized controlled trials to examine efficacy.ClinicalTrials.gov registration: NCT05228964.

Adolescence is a critical period marked by significant physical and neurocognitive development as well as increased vulnerability to mental health issues. While the benefits of physical activity (PA) on adult mental health (MH) are well-established, the dose-response relationships and underlying neurobiological mechanisms in adolescents remain elusive. This study investigated the dose-response relationships between wearable-measured PA and MH outcomes in over 7000 adolescents (11-12 years) from the ABCD study through linear and nonlinear modeling. We further examined the genetic influence and mediation effects of brain structure and function underlying the relationships. We found that all intensity levels of PA were associated with reduced internalizing and thought problems but not with externalizing problems. Durations of moderate activity around 90 min and vigorous activity around 120 min each day and frequency of physical exercise four days each week were associated with lowest MH burden. Polygenic risk scores (PRSs) for neuropsychiatric disorders were associated with reduced step count and light activity, while PRS for walking was associated with reduced thought problems. Reduced functional connectivity between cingulo-parietal and auditory networks, and between cingulo-opercular network and left putamen is the common neural pathways mediating the associations between different PA measurements and better mental health. These findings suggest that excessive moderate and vigorous activity may not be always better for adolescent mental health. Brain functional integration and segregation centered on cognitive control as well as genetic interplay may be the potential neurobiological factors underlying the link between PA and MH.