Temporal associations of emotional and social loneliness and psychosocial functioning in emerging adulthood

Emerging adulthood is an important developmental phase often accompanied by peaks in loneliness, social anxiety, and depression. However, knowledge is lacking on how the relationships between emotional loneliness, social loneliness, social isolation, social anxiety and depression evolve over time. Gaining insight in these temporal relations is crucial for our understanding of how these problems arise and maintain each other across time. Young adults from a university sample (N = 1,357; M = 23.60 years, SD = 6.30) filled out questionnaires on emotional and social loneliness, social isolation, depressive and social anxiety symptoms at three time points within a 3-year period. Random intercept cross-lagged panel models were used to disentangle reciprocal and prospective associations of loneliness subtypes, social isolation, depressive and social anxiety symptoms across time. Results showed that on the within-person level, increases in emotional and social loneliness as well as social isolation predicted higher depression levels on later timepoints. Increases in depressive symptoms also predicted increases in subsequent social loneliness, but not in emotional loneliness. Finally, increases in depressive symptoms predicted increases in social isolation. There were no significant temporal relations between loneliness and social isolation on the one hand and social anxiety symptoms on the other hand. Social distancing imposed by COVID-19 related government restrictions may have impacted the current results. The findings suggest that emotional and social loneliness precede development of depressive symptoms, which in turn precedes development of social loneliness and social isolation, indicating a potential vicious cycle of social loneliness, social isolation and depressive symptoms in emerging adulthood. Social anxiety did not precede nor follow loneliness, depressive symptoms, or social isolation. The current study sheds more light on the temporal order of loneliness and psychopathological symptoms and hereby assists in identifying times where prevention and intervention efforts may be especially helpful to counter development of depression and loneliness.

(Complex) PTSD in Ukrainian refugees: Prevalence and association with acts of war in the Danish refugee cohort (DARECO)

BACKGROUND

The Russian invasion of Ukraine has driven millions of Ukrainians away from their homes. Among these, the majority have likely experienced war-related potentially traumatic events, and some will experience symptoms of posttraumatic stress disorder (PTSD). The aims of the study are to estimate the prevalence of PTSD and Complex PTSD (CPTSD) in displaced Ukrainians and examine associations between war- and other potentially traumatic exposures and (C)PTSD.

METHODS

Questionnaires were distributed to all registered adult Ukrainians (18+) who arrived in Denmark between February 24th 2022 and February 15th 2023 (N = 18,389). We estimate the prevalence of war exposures, other potentially traumatic exposures, and (C)PTSD. In logistic regression analyses, we test if exposure to war and other potentially traumatic events are associated with PTSD and CPTSD.

RESULTS

The final sample size was 6993 (38.0 %). Responders were more likely to be female and younger than non-responders. Prevalence of PTSD and CPTSD was 15.9 % and 13.5 %, respectively. Female gender, high education, and loss of a relative due to the war were associated with (C)PTSD. Direct and indirect exposure to war and combat was related to PTSD but not CPTSD, while exposure to war prior to the 2022 invasion was related to CPTSD but not PTSD.

LIMITATIONS

The study is cross-sectional and based on self-report.

CONCLUSION

Close to one third of the sample fulfill the criteria of PTSD or CPTSD. War exposures are differentially related to PTSD and CPTSD. The findings illustrate that trauma-related psychopathology is a pertinent problem in displaced Ukrainians.

Environmental sensitivity moderates the longitudinal effect of fathers' positive parenting on mental disorders in Chinese adolescents

BACKGROUND

Exposure to fathers' positive parenting has been associated reducing mental disorder symptoms during adolescence, evidence on the mechanisms underlying this association is lacking. One potential mechanism linking fathers' positive parenting and mental disorders is environmental sensitivity (ES). Here we studied whether the increased positive behaviors of both parents (1) separately, (2) relatively, (3) and jointly predict reduced depression, attention deficit hyperactivity disorder (ADHD) symptoms, suicidal ideation (SI), and increased well-being in Chinese adolescents. Additionally we investigated (4) whether ES moderates these relationships.

METHODS

This study involving 7010 Chinese adolescents (55.6 % girls) aged 15 to 18 from six junior high schools in Shaanxi, China was conducted at four timepoints. ES was assessed using the Highly Sensitive Child (HSC) scale at ages 15 and 16, parental positive behaviors using the Parental Bonding Instrument (PBI) at ages 16 and 17, and psychopathology symptoms using the 9-item Patient Health Questionnaire (PHQ-9), Strengths and Difficulties Questionnaire (SDQ), and Positive and Negative Suicide Ideation (PANSI) Inventory at ages 17 and 18.

RESULTS

(1) Multilevel analyses revealed that increased positive parenting predicted reduced psychiatric disorder symptoms and improved well-being; (2) trend interaction indicated that the compensatory effect of fathers' positive parenting was stronger in alleviating mental problems in adolescents than that of mothers'; (3) Simple slope analyses suggested that both high levels of fathers' and mothers' positive parenting predicted fewer subsequent psychiatric disorder symptoms, particularly for sensitive adolescents.

LIMITATIONS

This study was limited to its generalizability to the Western Chinese adolescents.

CONCLUSIONS

Substantial differences in the effects of positive paternal and maternal parenting highlight the important role of fathers' positive parenting in mental development, especially for highly sensitive adolescents.

Exploring the bidirectional causal association between Sleep Apnea Syndrome and Depression: A Mendelian randomization study involving gut microbiota, serum metabolites, and inflammatory factors

OBJECTIVE

This study aimed to investigate the potential causal association between Sleep Apnea Syndrome (SAS) and Depression, focusing on the roles of gut microbiota, serum metabolites, and inflammatory factors in these conditions.

METHODS

Mendelian Randomization (MR) analysis was performed using data from genome-wide association studies to assess 211 types of gut microbiota, 1400 serum metabolites, and 91 inflammatory factors as potential contributing factors. Causal inference was conducted using the Inverse Variance Weighted (IVW) method, with additional robustness checks through Cochran's Q test, MR-Egger regression intercept test, MR-PRESSO global test, and leave-one-out analysis.

RESULTS

The MR analysis indicated a positive correlation between the risk of SAS and Depression (OR = 1.12, 95 % CI: 1.05-1.19, P < 0.001), with a reciprocal analysis showing a similar positive correlation between Depression and the risk of SAS (OR = 1.19, 95 % CI: 1.07-1.31, P = 0.001). Additionally, causal associations were identified between 15 types of gut microbiota, 36 serum metabolites, and 2 inflammatory factors with SAS, and between 11 types of gut microbiota, 23 serum metabolites, and 3 inflammatory factors with Depression (IVW, all P < 0.05). The robustness of these findings was confirmed through the MR-Egger regression intercept test and MR-PRESSO global test.

CONCLUSION

This study provides epidemiological evidence of a bidirectional causal association between SAS and Depression, emphasizing the potential roles of gut microbiota, serum metabolites, and inflammatory factors in the pathogenesis of these disorders. These findings may inform the development of new therapeutic strategies.

The relationship of race, ethnicity, gender identity, sex assigned at birth, sexual orientation, parental education, financial hardship and comorbid mental disorders with quality of life in college students with anxiety, depression or eating disorders

BACKGROUND

Previous studies showed that comorbidity and demographic factors added to burden on health-related quality of life (HRQoL). Only one study explored the relationship between HRQoL and comorbidity in college students with mental disorders, leaving generalizability of findings uncertain. Less is known about the association of demographics on HRQoL. This study investigated HRQoL based on demographics and comorbidity among college students with mental disorders.

METHODS

Participants were students (N = 5535) across 26 U.S. colleges and universities who met criteria for depression, generalized anxiety, panic, social anxiety, post-traumatic stress, or eating disorders based on self-report measures. ANOVA and linear regressions were conducted.

RESULTS

Overall, female, minoritized (gender, sexual orientation, race, or ethnicity), and lower socioeconomic status students reported lower HRQoL than male, heterosexual, White, non-Hispanic, and higher socioeconomic status peers. After accounting for comorbidity, differences in physical HRQoL based on sex assigned at birth and gender were no longer significant. For mental HRQoL, only gender and sexual orientation remained significant. A greater number of comorbidities was associated with lower HRQoL regardless of demographic group.

LIMITATIONS

The non-experimental design limits causal inference. The study focused on univariable associations without examining potential interactions between demographic factors. Future research should explore structural factors like discrimination.

CONCLUSION

Results suggested that increased comorbidities placed an additional burden on HRQoL and that certain demographic groups were more vulnerable to HRQoL impairment among students with mental disorders. Findings suggest the need for prevention of disorders and their comorbidity and implementing tailored interventions for specific student subgroups with increased vulnerability.

Systematic Review of Gender-Specific Child and Adolescent Mental Health Care

Gender differences in mental health emerge as early as in childhood and adolescence, highlighting the potential need for gender-specific child and adolescent mental health care. However, it is unclear how gender-specific child and adolescent mental health care is implemented and whether its' approaches are useful. Therefore, this study reviews gender-specific interventions and their effectiveness for child and adolescent mental health. Five databases were searched for articles published between 2000 and 2021. In total, 43 studies were included. Most interventions were conducted in school (n = 15) or community settings (n = 8). Substance-related disorders (n = 13) and eating disorders (n = 12) were addressed most frequently. Most interventions targeted girls (n = 31). Various gender-specific aspects were considered, including gender-specific risk and protective factors (n = 35) and needs (n = 35). Although most interventions yielded significant improvements in mental health outcomes (n = 32), only few studies reported medium or large effect sizes (n = 13). Additionally, there was a lack of strong causal evidence derived from randomized controlled trials, calling for more rigorous trials in the research field. Nevertheless, our findings indicate that gender-specific mental health care can be a promising approach to meet gender-specific mental health needs.

Mindfulness-based therapy for insomnia in Black women: a pilot randomized controlled trial

The purpose of the study was to evaluate the feasibility, acceptability, and preliminary efficacy of mindfulness-based therapy for insomnia (MBT-I) among Black women. The MBT-I group received weekly sessions that included mindfulness meditation and behavioral sleep strategies. The time and attention control group received lifestyle health education (HE) that included healthy eating, physical activity, and sleep hygiene. The primary outcome was post-intervention changes in insomnia severity score by the Insomnia Severity Index (ISI) at week 10. Other measures included: Pittsburgh Sleep Quality Index, Sleep Hygiene Practice, Spielberger State-Trait Anxiety Inventory (STAI), and Patient Health Questionnaire-9 (PHQ-9). Objective sleep was measured by Actiwatch™ at baseline and week 10. Thirty Black women completed the interventions with no attrition. About 97% of all participants attended 6-8 out of 8 sessions. The ISI scores were reduced at week 10 (MBT-I vs. HE: -7.67 vs. -7.22, p < .05). Anxiety and depression symptoms were significantly improved only in the MBT-I group. This is the first MBT-I for Black women with insomnia. Online MBT-I may be feasible and acceptable for Black women. The MBT-I and HE showed a clinically significant improvement in insomnia symptoms (ISI reduction > 7). MBT-I may be more effective in improving anxiety and depression symptoms than HE. Our findings encourage further study efforts with a longer follow-up and larger sample size to address sleep health disparities among Black women.

Effects of Sleep Deficiency on Risk, Course, and Treatment of Psychopathology

This article reviews the literature on the relationship between sleep deficiency and unipolar and bipolar depression, anxiety disorders, and posttraumatic stress disorder. We consider the evidence for sleep as a contributory causal factor in the development of psychiatric disorders, as well as sleep as an influential factor related to the outcome and recurrence of psychopathology. A case for sleep deficiency being an important treatment target when sleep and psychiatric disorders are comorbid is also made. Our recommendation is that sleep deficiency is recognized as a means to positively impact the development and course of psychopathology and, as such, is routinely assessed and treated in clinical practice.

Problematic Sexual Behavior in Children: The Influence of Transgressions of Interpersonal Boundaries and Family Adversity Across Generations

Problematic sexual behavior (PSBs) in children have been linked to difficulties or challenges within the family environment. Despite this association, few studies have examined how interpersonal boundary transgressions influence children's PSBs. Based on a sample of 112 parent-child dyads recruited before undergoing PSB-focused psychotherapy, this study first aims to explore the concept of sexual, physical, and emotional boundary transgressions within the current family environment in relation to reported levels of PSBs. The study further investigates the connections between parents' current boundary transgressions and their past and present family environments. Bivariate analyses revealed a positive correlation between heightened levels of interpersonal boundary transgressions and increased PBS, alongside elevated externalized behaviors. Two hierarchical linear regression models were employed: one to predict children's PSB scores with boundary transgressions as a predictor, and another to predict current boundary transgressions within the family environment. Results showed that current boundary transgressions within the family predicted the level of PSBs. However, once the child's externalized behaviors were considered, boundary transgressions ceased to be significant. Regarding the parents, transgression of interpersonal boundaries within the current family environment was associated with exposure to higher levels of interpersonal boundary transgressions during their childhood, current socioeconomic status, and a higher level of parental psychological distress. Keywords: problematic sexual behavior, PSBs, transgression of interpersonal boundaries, conceptual model, victimization experiences, intergenerational cycle.

The Pathogenesis of Borderline Personality Disorder: Evolution of Evidence and Treatment Implications for Two Prominent Models

Since Stern first started his work in 1938, the field has recognized several empirically supported models of the etiology of borderline personality disorder (BPD). Two such models are the Tripartite Model of the Development of BPD and the Biosocial Development Model of BPD. The Tripartite Model of the Development of BPD suggests that it is a combination of a hyperbolic temperament, traumatic childhood experiences, and an event or series of events that trigger the onset of BPD. Whereas the Biosocial Development Model of BPD elaborates on the work of Linehan's Biosocial Theory. This model suggests a combination of an emotionally vulnerable temperament and an invalidating environment cause BPD. Over 70 years of research support these models. This article covers a detailed description of each of these models, the decades of research supporting these models, similarities, differences, treatment implications, the latest research, and future directions.

The gut microbiome and the brain

PURPOSE OF REVIEW

The importance of the gut microbiome for human health and well-being is generally accepted, and elucidating the signaling pathways between the gut microbiome and the host offers novel mechanistic insight into the (patho)physiology and multifaceted aspects of healthy aging and human brain functions.

RECENT FINDINGS

The gut microbiome is tightly linked with the nervous system, and gut microbiota are increasingly emerging as important regulators of emotional and cognitive performance. They send and receive signals for the bidirectional communication between gut and brain via immunological, neuroanatomical, and humoral pathways. The composition of the gut microbiota and the spectrum of metabolites and neurotransmitters that they release changes with increasing age, nutrition, hypoxia, and other pathological conditions. Changes in gut microbiota (dysbiosis) are associated with critical illnesses such as cancer, cardiovascular, and chronic kidney disease but also neurological, mental, and pain disorders, as well as chemotherapies and antibiotics affecting brain development and function.

SUMMARY

Dysbiosis and a concomitant imbalance of mediators are increasingly emerging both as causes and consequences of diseases affecting the brain. Understanding the microbiota's role in the pathogenesis of these disorders will have major clinical implications and offer new opportunities for therapeutic interventions.

Cultural Adaptations, Efficacy, and Acceptability of Psychological Interventions for Mental Health in Adults with Refugees and Asylum-Seeker Status: A Systematic Review

People with refugees and asylum seeker status (R/AS) have been forced to leave their home and resettle in new countries due to political unrest, conflict, and violence. This review aimed to describe the nature and extent of cultural adaptations to psychological interventions for adults with R/AS experiencing clinically significant psychological distress, and the acceptability and efficacy of these interventions. A search was conducted in October 2023 and February 2024 across five electronic databases: PsycINFO, Medline, Embase, PubMed, and Cochrane. Eligible studies were randomized controlled trials of psychological interventions conducted in any geographic context. Studies reporting on interventions with minimal adaptations only to facilitate treatment access, with no clear evidence for cultural adaptation, were excluded. Eighteen studies were identified, and cultural adaptations were described in line with the Ecological Validity Model. Studies investigating transdiagnostic interventions, cognitive behavioral therapy (CBT) interventions, and other psychotherapies were synthesized. Analysis and reporting of acceptability were limited across intervention groups, highlighting a need for more robust research in this area. CBT interventions and other psychological therapies were found to be most efficacious with moderate to large effects across validated psychological measures. Small to moderate effect sizes were observed across transdiagnostic interventions. The evidence quality was generally of some concerns. While the evidence requires further developments, the current review provides a timely synthesis of culturally adapted interventions for adults with R/AS to inform intervention development and clinical practice. Strengths, limitations, and recommendations for future research are discussed.

Prevalence and correlates of irritability among U.S. adults

This study aimed to characterize the prevalence of irritability among U.S. adults, and the extent to which it co-occurs with major depressive and anxious symptoms. A non-probability internet survey of individuals 18 and older in 50 U.S. states and the District of Columbia was conducted between November 2, 2023, and January 8, 2024. Regression models with survey weighting were used to examine associations between the Brief Irritability Test (BITe5) and sociodemographic and clinical features. The survey cohort included 42,739 individuals, mean age 46.0 (SD 17.0) years; 25,001 (58.5%) identified as women, 17,281 (40.4%) as men, and 457 (1.1%) as nonbinary. A total of 1218(2.8%) identified as Asian American, 5971 (14.0%) as Black, 5348 (12.5%) as Hispanic, 1775 (4.2%) as another race, and 28,427 (66.5%) as white. Mean irritability score was 13.6 (SD 5.6) on a scale from 5 to 30. In linear regression models, irritability was greater among respondents who were female, younger, had lower levels of education, and lower household income. Greater irritability was associated with likelihood of thoughts of suicide in logistic regression models adjusted for sociodemographic features (OR 1.23, 95% CI 1.22-1.24). Among 1979 individuals without thoughts of suicide on the initial survey assessed for such thoughts on a subsequent survey, greater irritability was also associated with greater likelihood of thoughts of suicide being present (adjusted OR 1.17, 95% CI 1.12-1.23). The prevalence of irritability and its association with thoughts of suicide suggests the need to better understand its implications among adults outside of acute mood episodes.

Leaders' mental health and leader-member exchange: Exploring relations on different levels of analysis

INTRODUCTION

Research on leader-member exchange (LMX) has shown that the relation between leaders and followers may be considered from different angles. Leaders may form individual relationships with followers (LMX quality), may agree with their followers on these relationships (LMX agreement), and may form different relationships within their work group (LMX variability). We posit that leaders' mental health may function as an antecedent for these different forms of LMX. We use conservation-of-resources theory as a theoretical model to describe how leaders' mental health may interact with relationship quality with followers on different levels.

METHODS

We operationalized leaders' mental health using depressive symptoms, anxiety, and stress reactivity. Our sample consisted of 322 followers of 75 leaders. Followers rated the LMX quality with their respective leader. Leaders rated depressive symptoms, anxiety, levels of stress reactivity, and LMX quality with their followers.

RESULTS

Results of multilevel modeling showed that stress reactivity was negatively related to LMX quality and anxiety was positively linked to LMX agreement. Depressive symptoms were not related to aspects of LMX.

CONCLUSION

By using multisource data on different analysis levels, we are able to include different perspectives on antecedents of LMX relationship quality. Implications for LMX at different levels of analysis as well as future research are discussed.

Self-compassion and psychological well-being of radiographers at work

OBJECTIVES

The aim of this study was to assess how self-compassion affects the psychological well-being of radiographers at work.

METHODS

An online survey was sent to radiology and radiotherapy departments in Rhône-Alpes, a region of France (from October 2021 to February 2022). The study is mixed: quantitative data, with closed questions and two validated scales, and qualitative data, with open questions aimed at assessing perceptions among radiologists as regards self-compassion.

RESULTS

A total of 253 radiographers (mean age 32.9 years), took part in this survey. Radiographers reported a poor level of well-being and a moderate level of self-compassion. We found a link between well-being at work and self-compassion. Gender, age, number of years of experience and the desire to receive training on well-being appear to have an impact on the level of self-compassion. The perception of self-compassion by radiologists is essentially positive.

CONCLUSION

Particular attention should be paid to radiologists who are female, young, and with only a few years of experience. Self-compassion is a protective factor for radiologists and may help them take care of themselves to continue caring for others. Training related to self-compassion should be promoted in medical imaging departments.

Virtual reality-based Mindfulness-Oriented Recovery Enhancement (MORE-VR) as an adjunct to medications for opioid use disorder: a Phase 1 trial

INTRODUCTION

Medications for opioid use disorder (MOUD) are the most effective interventions for this condition, yet many patients discontinue treatment. Though adjunct psychosocial treatments are recommended to increase retention and reduce relapse, the scarcity of trained providers hinders access to and utilization of evidence-based interventions. We conducted a Phase 1 study to assess the feasibility of a virtual reality-delivered Mindfulness-Oriented Recovery Enhancement (MORE-VR) intervention for patients receiving MOUD.

PATIENTS AND METHODS

Patients receiving buprenorphine or methadone for OUD (N = 34) were scheduled for 8 weekly sessions of MORE-VR. Enrollment and retention rates were analyzed. Participants reported on the usability and acceptability of MORE-VR, opioid use, and craving and affect before and after each VR session. Heart rate was monitored during one session of MORE-VR.

RESULTS

Twenty-three participants completed four or more MORE-VR sessions (minimum recommended intervention dose). Participants reported high usability and acceptability of MORE-VR, which had an excellent safety profile. Illicit opioid use decreased significantly from pre- to post-treatment (F = 4.44, p=.04). We observed a significant within-session decrease in opioid craving (F = 39.3, p<.001) and negative affect (F = 36.3, p<.001), and a significant within-session increase in positive affect (F = 23.6, p<.001). Heart rate shifted during cue-exposure and mindfulness practices (F = 6.79, p<.001).

CONCLUSIONS

High retention, usability and acceptability rates and low adverse events demonstrated that MORE-VR is a feasible, engaging, and safe intervention. Our findings show that MORE-VR can be delivered as an adjunctive intervention to MOUD and suggest that MORE-VR may improve OUD treatment outcomes and modulate autonomic responses. MORE-VR's efficacy will be tested in a subsequent Phase 2 trial.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05034276; https://classic.clinicaltrials.gov/ct2/show/NCT05034276.

Preschool Behavioral Problems: Links with Maternal Oxytocin and Caregiving Sensitivity in the Postnatal Period, and Concurrent Maternal Psychopathology and Attachment State-of-Mind

This study investigated maternal oxytocin, caregiving sensitivity and mother-to-infant bonding at 3-months postpartum as predictors of child behavior and psychological outcomes in the preschool years, when controlling for concurrent maternal negative emotional symptoms and adult attachment state-of-mind. Forty-five mother-child dyads were assessed at 3-months and 3.5 years postpartum using mix of questionnaires, observational, interview and biological methods. Results showed that lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted emotional reactivity in the child at 3.5 years. When maternal adult attachment state-of-mind and negative emotional symptoms were included, lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted withdrawn child behavior. In addition, unresolved adult attachment and maternal negative emotional symptoms were significantly associated child behavioral disturbance in a range of areas. Findings highlight maternal postnatal oxytocin as a potential indicator of children who may be more likely to show emotional reactivity and withdrawn behavior in the preschool years.

The association of physical activity duration and intensity on emotional intelligence in 10-13 year-old Children

Previous studies have shown that Physical Activity (PA) has a positive association with emotional health and intelligence in adolescents but none have focused on the relationship of PA duration and intensity on Emotional Intelligence (EI). The purpose of this study was to cross-sectionally assess the association of PA measures on overall EI and its domains in a cohort of 2 029 adolescents aged 10-13 years of age in the National Longitudinal Survey for Children and Youth (NLSCY) from Canada. Multivariable linear regression analysis of EI was adjusted for age, sex, annual household income, and health status. One-way analysis of variance (ANOVA) was used to relate PA duration measured in minutes, frequency, and intensity categories with continuous GEI scores and also the corresponding scores for domains of GEI. The mean GEI scores were (28.3 ​± ​6.6) for 0-30 ​minute (min) PA duration, (30.0 ​± ​6.5) for 30 to ​< ​60 ​min, (30.8 ​± ​6.7) for 60-120 ​min, and (30.1 ​± ​6.5) for ≥ 121 ​min. There was a statistically significant linear trend across PA duration categories, p ​= ​0.000 4. Post-hoc pairwise comparison revealed that compared to the referent category (< 30 ​min ​PA category) was statistically significantly lower GEI than each of the other two PA categories (30-59 ​min; and 60-120 ​min), both p-values < 0.01. Meeting World Health Organization (WHO) guidelines for duration and vigorous intensity were positively associated with the higher overall EI and its domains except for Stress Management.

A Nunavut community-directed Inuit youth mental wellness initiative: making I-SPARX fly

Inuit youth in Nunavut (NU) are resilient but face a protracted suicide crisis. The SPARX serious game and e-intervention, developed originally in New Zealand, teaches youth cognitive behavioural therapy (CBT) skills to ameliorate stress and depression. Inuit youth in NU reviewed and culturally adapted SPARX and an existing wellness outcome measure for Inuit. One hundred and twenty-one youth, aged 13 to 24, across NU then tested, played, and evaluated I(nuit)-SPARX, showing improvement in several areas of wellbeing post-play. Youth completed a CBT skills survey, engaged in sharing circles to assess CBT skill retention, and shared their thoughts about the usefulness and cultural fit of I-SPARX with Inuit Qaujimajatuqangit (IQ). Communication Skills, Listening Skills, and Problem Solving emerged as the most helpful learned CBT skills, and NU youth provided real-world examples of using I-SPARX skills to support their mental wellness. Several principles of IQ were exemplified and upheld in the content of the adapted SPARX tool and the process of the project as a whole. Empirically grounded, asynchronous e-tools, developed in collaboration with Inuit communities to ensure cultural specificity, may support psychological wellness in communities where mental health resources are scarce.

Serial Multiple Mediation of the Marital Satisfaction and Parenting Competence in the Relationship Between Postpartum Depression and Parent-Infant Attachment in First-Time Parents With Low- and High-Risk Pregnancy Experiences: A Cross-Sectional Study

Little is known regarding the effects of postpartum depression on parent-infant attachment in high-risk parents. Based on Mercer's theory of becoming a mother, this study aimed to (1) examine the mediating effects of marital satisfaction and parenting competence in the relationship between postpartum depression and parent-infant attachment using a serial mediation model in first-time parent couples during the first 6 months postpartum, and (2) compare the serial mediation models between parents who had experienced low-risk and high-risk pregnancies. In this cross-sectional study, a total of 194 first-time parent couples at 1 to 6 months postpartum were included. Participants completed an online survey on postpartum depression, marital satisfaction, parenting competence, and parent-infant attachment. In both low- and high-risk groups, parenting competence was a common mediator of the impact of postpartum depression on parent-infant attachment. A sequential mediation effect involving both marital satisfaction and parenting competence was observed in high-risk mothers. Our findings suggest that the adverse impacts of postpartum depression on parent-infant attachment can be mitigated by boosting parenting competence or improving the marital satisfaction in couples experiencing first high-risk pregnancy.

Prenatal cannabis exposure in the clinic and laboratory: What do we know and where do we need to go?

Coincident with the legalisation of cannabis in many nations, rates of cannabis use during pregnancy have increased. Like prior investigations on smoking and alcohol, understanding how prenatal cannabis exposure (PCE) impacts offspring outcomes across the lifespan will be critical for informing choices for pregnant people, clinicians, and policy makers alike. A thorough characterization of the life-long impacts is especially urgent for supporting all of these stakeholders in the decision-making process. While studies in humans bring forth the most direct information, it can be difficult to parse the impact of PCE from confounding variables. Laboratory studies in animal models can provide experimental designs that allow for causal inferences to be drawn, however there can be challenges in designing experiments with external validity in mirroring real-world exposure, as well as challenges translating results from the laboratory back to the clinic. In this literature review, we first highlight what is known about patterns of cannabis use during pregnancy. We then seek to lay out updates to the current understanding of the impact of PCE on offspring development informed by both human and nonhuman animal experiments. Finally we highlight opportunities for information exchange among the laboratory, clinic, and policy, identifying gaps to be filled by future research.

Identifying and understanding how people living with a lower-grade glioma engage in self-management

PURPOSE

Lower-grade gliomas (LGG) are mostly diagnosed in working-aged adults and rarely cured. LGG patients may face chronic impairments (e.g. fatigue, cognitive deficits). Self-management can improve clinical and psychosocial outcomes, yet how LGG patients self-manage the consequences of their tumour and its treatment is not fully understood. This study, therefore, aimed to identify and understand how LGG patients engage in the self-management of their condition.

METHODS

A diverse group of 28 LGG patients (age range 22-69 years; male n = 16, female n = 12; mean time since diagnosis = 8.7 years) who had completed primary treatment, were recruited from across the United Kingdom. Semi-structured interviews were conducted. Informed by a self-management strategy framework developed in cancer, directed content analysis identified and categorised self-management types and strategies used by patients.

RESULTS

Overall, 20 self-management strategy types, comprising 123 self-management strategies were reported; each participant detailed extensive engagement in self-management. The most used strategy types were 'using support' (n = 28), 'creating a healthy environment' (n = 28), 'meaning making' (n = 27), and 'self-monitoring' (n = 27). The most used strategies were 'accepting the tumour and its consequences' (n = 26), 'receiving support from friends (n = 24) and family' (n = 24), and 'reinterpreting negative consequences' (n = 24).

CONCLUSIONS

This study provides a comprehensive understanding of the strategies used by LGG patients to self-manage their health and wellbeing, with a diverse, and substantial number of self-management strategies reported.

IMPLICATIONS FOR CANCER SURVIVORS

The findings will inform the development of a supported self-management intervention for LGG patients, which will be novel for this patient group.

Which symptom to address in psychological treatment for cancer survivors when fear of cancer recurrence, depressive symptoms, and cancer-related fatigue co-occur? Exploring the level of agreement between three systematic approaches to select the focus of treatment

PURPOSE

To investigate the extent to which three systematic approaches for prioritizing symptoms lead to similar treatment advices in cancer survivors with co-occurring fear of cancer recurrence, depressive symptoms, and/or cancer-related fatigue.

METHODS

Psychological treatment advices were was based on three approaches: patient preference, symptom severity, and temporal precedence of symptoms based on ecological momentary assessments. The level of agreement was calculated according to the Kappa statistic.

RESULTS

Overall, we found limited agreement between the three approaches. Pairwise comparison showed moderate agreement between patient preference and symptom severity. Most patients preferred treatment for fatigue. Treatment for fear of cancer recurrence was mostly indicated when based on symptom severity. Agreement between temporal precedence and the other approaches was slight. A clear treatment advice based on temporal precedence was possible in 57% of cases. In cases where it was possible, all symptoms were about equally likely to be indicated.

CONCLUSIONS

The three approaches lead to different treatment advices. Future research should determine how the approaches are related to treatment outcome. We propose to discuss the results of each approach in a shared decision-making process to make a well-informed and personalized decision with regard to which symptom to target in psychological treatment.

IMPLICATIONS FOR CANCER SURVIVORS

This study contributes to the development of systematic approaches for selecting the focus of psychological treatment in cancer survivors with co-occurring symptoms by providing and comparing three different systematic approaches for prioritizing symptoms.

What can the psychoneuroimmunology of yoga teach us about depression's psychopathology?

Depression, the most prevailing mental health condition, remains untreated in over 30% of patients. This cluster presents with sub-clinical inflammation. Investigations trialling anti-inflammatory medications had mixed results. The lack of results may result from inflammation's complexity and targeting only a few of depression's abnormal pathways. Mind-body therapies' biological and neuro-imaging studies offer valuable insights into depression psychopathology. Interestingly, mind-body therapies, like yoga, reverse the aberrant pathways in depression. These aberrant pathways include decreased cognitive function, interoception, neuroplasticity, salience and default mode networks connectivity, parasympathetic tone, increased hypothalamic-pituitary-adrenal (HPA) axis activity, and metabolic hyper/hypofunction. Abundant evidence found yogic techniques improving self-reported depressive symptoms across various populations. Yoga may be more effective in treating depression in conjunction with pharmacological and cognitive therapies. Yoga's psychoneuroimmunology teaches us that reducing allostatic load is crucial in improving depressive symptoms. Mind-body therapies promote parasympathetic tone, downregulate the HPA axis, reduce inflammation and boost immunity. The reduced inflammation promotes neuroplasticity and, subsequently, neurogenesis. Improving interoception resolves the metabolic needs prediction error and restores homeostasis. Additionally, by improving functional connectivity within the salience network, they restore the dynamic switching between the default mode and central executive networks, reducing rumination and mind-wandering. Future investigations should engineer therapies targeting the mechanisms mentioned above. The creation of multi-disciplinary health teams offering a combination of pharmacological, gene, neurofeedback, behavioural, mind-body and psychological therapies may treat treatment-resistant depression.

Perceptions of Academic Performance, Impairment, and Mental Health in University Students With and Without ADHD

OBJECTIVE

This study aims to investigate the impact of positive illusory bias (PIB) on the relationship between ADHD symptoms and functioning in college students, with a focus on gender differences.

METHOD

The sample consisted of 195 college students, including 148 with ADHD and 47 without ADHD. Measures of ADHD symptomatology, life satisfaction, affect, gender identity, and impairment were collected, along with cumulative grade point average.

RESULTS

ADHD symptomatology was inversely linked to subjective well-being, with PIB acting as a significant moderator. Functional impairment was predicted by ADHD symptoms and subjective well-being, while social impairment and academic functioning were predicted by PIB and well-being. Significant gender differences were found, particularly in the interaction between PIB and ADHD symptoms for non-binary individuals.

CONCLUSION

This study suggests that PIB is relevant for emerging adults with ADHD enrolled in higher education. Subjective well-being and PIB act as buffers against the detrimental functional and social effects of ADHD symptoms in emerging adult college students. The study highlights the importance of considering gender-specific approaches in understanding and supporting the mental health of this population.

Investigating Working Memory Deficits in School-Age Children with Attention-Deficit/Hyperactivity Disorder: An Event-Related Potentials Study During Delayed-Match-to-Sample Task

OBJECTIVE

To investigate the neural mechanisms underlying working memory (WM) deficits in children with ADHD.

METHOD

WM was compared between thirty-four children with ADHD and thirty-four matched controls using neuropsychological tests, spatial and verbal versions of modified delayed matching-to-sample (DMTS) tasks, and the event-related potential technique.

RESULTS

Children with ADHD demonstrated poor behavioral performance, delayed P3 latencies in high-load spatial modified DMTS tasks during encoding, and delayed P2 and N2 latencies during retrieval in spatial modified DMTS tasks. In high-load verbal modified DMTS tasks during encoding, they showed a smaller P3 amplitude.

DISCUSSION

Pronounced deficits in the central executive system in children with ADHD were exhibited by neuropsychological tests and the modified DMTS task. Children with ADHD exhibited a slowing of processing speed during encoding. Under high-load conditions, they showed a reduced P3 amplitude during retrieval, suggesting reduced neural resource allocation was available when the central executive of the working memory was heavily loaded.

Assessing age invariance of the Male Depression Risk Scale-22 in younger and older adult males

OBJECTIVES

Women are twice as likely to be diagnosed with major depressive disorder as men. Yet suicide rates are four times higher in men than women, increasing to six times when comparing older men to older women. Investigators have begun researching if depression presents differently in individuals who adhere to masculine norms, leading to the conceptualization of masculine depression. Despite validity evidence for the Male Depression Risk Scale-22 (MDRS-22) in mixed-age samples, few studies have investigated the possibility of age-related differences in masculine depression. The present study aimed to test for age invariance of the MDRS-22.

METHOD

Age invariance for the MDRS-22 was tested via a multi-group confirmatory factor analysis with groups of younger (18-64 years) and older (65+ years) males (N = 469).

RESULTS

Age invariance for the MDRS-22 was not established, ΔX2 = 451.47, Δdf = 16, p < 0.001.

CONCLUSION

Results of the study indicate that masculine depression may present differently between younger and older men. To fully understand the construct of masculine depression, it is important to investigate how symptoms may present in individuals of all ages. Overall, the study highlights the importance of investigating how masculine depression may present differently in older men.

The brief mind wandering three-factor scale (BMW-3)

In recent years, researchers from different fields have become increasingly interested in measuring individual differences in mind wandering as a psychological trait. Although there are several questionnaires that allow for an assessment of people's perceptions of their mind wandering experiences, they either define mind wandering in a very broad sense or do not sufficiently separate different aspects of mind wandering. Here, we introduce the Brief Mind Wandering Three-Factor Scale (BMW-3), a 12-item questionnaire available in German and English. The BMW-3 conceptualizes mind wandering as task-unrelated thought and measures three dimensions of mind wandering: unintentional mind wandering, intentional mind wandering, and meta-awareness of mind wandering. Based on results from 1038 participants (823 German speakers, 215 English speakers), we found support for the proposed three-factorial structure of mind wandering and for scalar measurement invariance of the German and English versions. All subscales showed good internal consistencies and moderate to high test-retest correlations and thus provide an effective assessment of individual differences in mind wandering. Moreover, the BMW-3 showed good convergent validity when compared to existing retrospective measures of mind wandering and mindfulness and was related to conscientiousness, emotional stability, and openness as well as self-reported attentional control. Lastly, it predicted the propensity for mind wandering inside and outside the lab (as assessed by in-the-moment experience sampling), the frequency of experiencing depressive symptoms, and the use of functional and dysfunctional emotion regulation strategies. All in all, the BMW-3 provides a brief, reliable, and valid assessment of mind wandering for basic and clinical research.

The effect of social anxiety, impulsiveness, self-esteem on non-suicidal self-injury among college students: A conditional process model

Non-suicidal self-injury (NSSI) is an emerging concern in the field of public health. The objective of this study is to develop a conditional process model to investigate the relationship between social anxiety and NSSI, and the role of impulsiveness and self-esteem in this relationship. A convenience sample of 2717 university students (Mage = 19.81, 22.49% male) from Southern China was recruited. The age range of the participants is between 18 and 25 years. The data were analysed using Spearman correlation analysis, mediation analysis and moderation analysis. The study revealed a positive correlation between social anxiety and NSSI, with impulsiveness serving as a mediating factor in this association. The relationship between social anxiety and NSSI, impulsiveness and social anxiety, impulsiveness and NSSI were all found to be moderated by self-esteem. The prevalence of NSSI among college students exhibited a strong association with social anxiety and impulsiveness. The present investigation additionally demonstrated that there was no significant association between social anxiety, impulsivity and NSSI when high self-esteem was included. This finding implies that self-esteem plays a crucial role in safeguarding against NSSI.

Revealing motor insensitivity to food in Anorexia Nervosa as a potential mechanism contributing to calorie restriction: A mobile Approach Avoidance Task study

A change in implicit behavioural tendencies toward foods may contribute to the maintenance of calorie restriction in Anorexia Nervosa (AN). To test this hypothesis, we assessed approach-avoidance tendencies toward different categories of stimuli using a novel mobile version of the approach-avoidance task (AAT). The sample included 66 patients with restrictive AN and 84 healthy controls, all females. All participants performed the AAT in which they were required to approach or avoid stimuli (high-calorie foods, low-calorie foods, and neutral objects) by respectively pulling their phone towards themselves of pushing it away. Both the response time and the force of each movement were collected by means of the smartphone's accelerometer. The results revealed that patients with AN had a reduced tendency to approach food stimuli compared to healthy controls, who instead presented faster and stronger movements in approaching rather than avoiding foods as compared to neutral objects. This finding was particularly pronounced in patients with greater levels of malnutrition. No differences were instead observed comparing high-calorie and low-calorie foods. The observed reduction in the natural tendency to approach food stimuli is consistent with patients' eating behaviour and may contribute to the maintenance of calorie restriction, thus representing a possible target for novel therapeutic approaches.

The Role of Wait Time During the Questioning of Children: A Systematic Review

The benefits of wait time in classroom discourses have been well documented in the field of education since the 1970s. While current forensic interview guidelines recognize the importance of pauses, whether there is sufficient empirical evidence to inform wait time guidelines in the legal context remains unanswered. This systematic review aimed to synthesize and provide a holistic update on the available research on the role of wait time when questioning children and recommended future direction to develop wait time guidelines specific to child forensic interviews. Systematic searches were conducted using four databases (PsycINFO, MedLine, ERIC, and Scopus). A total of 3,953 unique articles were returned, following a title and abstract screening, 68 full texts were reviewed, and 26 (including five additional studies identified through a hand search) were included. Inclusion criteria were the study sample included children under 18, published a measure of wait time in a questioning context, and in English. Overall, most knowledge of wait time remains in the field of education. Natural wait time is short, but with training, extended wait time yields significant benefits for both child and adult talk. Only one study examined the role of wait time in the forensic interviewing setting where a 10-s wait time appears to be more productive than shorter pauses. Extended wait time is a promising and simple interviewing practice with the potential to facilitate children's disclosure. The current review is a call for research in the area as it pertains to forensic interviewing of children and youth.

Maternal Emotional and Behavioral Regulation/Dysregulation and Parenting Practices: A Systematic Review

Emotional and behavioral regulations are crucial for the development of perceptive, responsive, and flexible parenting. Moreover, maternal emotional dysregulation constitutes a risk for maltreatment behaviors. The present study aimed to conduct a systematic review of empirical studies on the associations between mothers' emotional and behavioral regulations and parenting practices with their children or adolescents. A systematic review was conducted, including papers that addressed these variables, analyzing the direct effects, and moderation or mediation effects of maternal emotional and behavioral regulation on parenting practices, targeting child and adolescent samples. We identified 35 studies for analysis. Most of the studies (86%) showed significant associations between maternal emotional and behavioral regulation and parenting practices. Mothers' emotional dysregulation was related to a high risk of maltreatment and negative parenting, such as unsupportive reactions and harsh discipline. High maternal emotional dysregulation and negative parenting, in turn, were associated with children's aggressive behaviors. Conversely, when mothers exhibited high emotional regulation, they engaged in more positive and supportive parenting. Additionally, maternal behavioral regulation with inhibitory control and effortful control led to supportive and warm parenting. Individual and contextual factors, such as maternal victimization history and symptoms of inattention and hyperactivity, had effects on maternal emotional dysregulation, which, in turn, impacted their parenting practices. Consequently, emotional and behavioral regulation played a crucial role in mothers' parenting practices with their children and adolescents. The findings of the current review could contribute to planning parenting interventions, including maternal emotional and behavioral regulation skills, aimed at preventing maltreatment of their children.

Chronic pain-induced methylation in the prefrontal cortex targets gene networks associated with cognition and Alzheimer's disease

Chronic pain is prevalent among aging adults. Epidemiologic evidence has demonstrated that individuals with chronic pain have accelerated memory decline and increased probability of dementia. Neurophysiologic, molecular, and pharmacologic hypotheses have been proposed to explain the relationship between chronic pain and cognitive decline, but there remains currently limited evidence supporting any of these. Here, we integrate multi-omic data across human cohorts and rodent species and demonstrate that methylation in the prefrontal cortex induced by chronic pain specifically targets transcriptional networks associated with cognitive ability, memory, and Alzheimer's disease in humans. We validate this with multiple independent data sets and identify cortical microglia as a likely mechanism by which chronic pain can increase dementia risk. Our analyses support the molecular hypothesis for the role of chronic pain in cognitive decline and identifies several potential therapeutic targets.

Unraveling the complexities of adolescent depression: A call for action

The adolescent years are a period of profound change, both physically and psychologically. For many, these years are marked by excitement and exploration, but for others, they are fraught with challenges that can lead to significant mental health issues. Depression, in particular, has become an increasingly prevalent concern among adolescents worldwide, and its multifaceted etiology requires a comprehensive approach to understanding and intervention. A recent study on the relationships among negative life events, dysfunctional attitudes, social support, and depressive symptoms in Chinese adolescents offers valuable insights into the complex interplay between various factors contributing to adolescent depression. The authors explore a moderated mediation model to better understand how these factors interact with and contribute to the onset of depression. This article aims to delve into the key findings of the study, highlight its implications for clinical practice, and encourage further research in this critical area.

Pubertal Development and Pregnancy Outcomes Among System-Involved Youth

System-involved youth are a vulnerable population at high-risk of experiencing numerous sexual reproductive health (SRH) outcomes. They are likely to have several risk factors for teen pregnancy and parenting including abuse and neglect histories, lack of a supportive consistent adult in their lives, and limited opportunities to experience normal romantic relationships. Issues of pubertal development are rarely addressed in this population. Data is from system-involved adolescents (n = 301) enrolled in a SRH intervention. The final analysis is restricted to those who were sexually active at baseline (n = 229). Most participants were African Americans between 13-21 years of age. More than 70% reported an early mean age of first sex. Approximately a quarter self-reported early pubertal development. Logistic regression was utilized to examine the odds of pregnancy in relation to self-reported pubertal timing. The findings support the need to develop programming for system-involved youth which address their unique needs.

Effectiveness of sports intervention: A meta-analysis of the effects of different interventions on adolescent internet addiction

BACKGROUND

To evaluate the effects of different interventions on adolescent internet addiction, a meta-analysis and network meta-analysis were performed to determine the possible intervention effects of these interventions.

METHODS

Computer searches of the China National Knowledge Network, Wanfang, VIP, EMBASE, PubMed, Web of Science, EBSCO, and Cochrane Library databases were performed. The relevant randomized controlled trials were designed to assess the effects of interventions on adolescent internet addiction. The retrieval period ranged from the establishment of the database to January 31, 2024. Literature screening, data extraction, and bias risk assessment were carried out independently by two researchers. CMA 3.3, Stata 17.0 software and Review Manager 5.3 were used for the data analysis.

RESULTS

A total of 89 studies with 6876 samples were included. A traditional meta-analysis of 51 single interventions and controlled studies revealed that sports intervention, cognitive behavior therapy, family therapy, mindfulness intervention, attention bias training and group counseling significantly improved adolescent Internet addiction [standardized mean difference (SMD) = -1.75, 95 % CI (-2.07, -1.44), p < 0.01; I2 = 94 %] compared to no-treatment groups. A network meta-analysis showed that combined intervention (Sucra = 93.5) had the highest probability of being the best intervention for adolescent Internet addiction, and acupuncture interventions showed the most promise as a single intervention modality; however, due to the limited number of studies, we believe that sports intervention could be the most appropriate single intervention.

DISCUSSION

The evidence provided by existing studies shows that compared with other single interventions, combined interventions have the greatest effect on adolescent IA, and sports may be the best single intervention. However, because of the limitations of sample size and quality of individual studies, the strength of the evidence still needs to be further verified by additional standardized and high-quality studies.

Healthcare resource utilisation and suicidal ideation amongst adolescents in the US with posttraumatic stress disorder, major depressive disorder, and substance use disorders using electronic health records

BACKGROUND

While PTSD is commonly associated with multiple comorbidities, studies have yet to quantify the impact of these comorbidities on key clinical outcomes and HCRU. This study explored risks of emergency room (ER) visits, inpatient admissions (IA), suicidal ideation (SI), and treatment follow-up duration (FU), amongst PTSD patients with comorbid MDD and/or SUD.

METHODS

Using real-world data (RWD) generated by electronic health records accessed from the NeuroBlu database, a cohort of adolescent patients (12-17 yrs) was examined over a one-year study period following PTSD diagnosis.

RESULTS

5794 patients were included in the cohort. Compared to patients with only PTSD (n = 3061), those with comorbid MDD (n = 1820) had greater odds of ER (4.5 times), IA (1.6 times), and FU (4.3 times). Those with comorbid SUD (n = 653) had greater odds of IA (4.5 times), shorter FU (34 days), and lower odds of ER (0.5 times). Both comorbidities (n = 260) had greater odds of ER (3.8 times), IA (2.6 times), SI (3.6 times), and shorter FU (12 days).

LIMITATIONS

These RWD had a high proportion of missingness. Health records of patients who changed service providers could not be accounted for in this study.

CONCLUSIONS

Both MDD and SUD substantially elevated the risk of HCRU and suicidal ideation for PTSD patients.

Maternal emotional availability and perinatal depressive symptoms as predictors of early childhood executive function

BACKGROUND

The interconnected effects of maternal perinatal depression and the early mother-infant relational quality on children's executive function development are crucial yet understudied. This study addresses this gap, focusing on how perinatal depressive symptoms and emotional availability at 6 months predict child executive function performance at age four, with an emphasis on the moderating role of emotional availability.

METHOD

This study included 282 mother-infant pairs recruited from the Mercy Pregnancy and Emotional Wellbeing Study, utilising repeated Edinburgh Postnatal Depression Scale measurement over the perinatal period, Emotional Availability Scales, and child executive function assessments (Shape School, NEPSY-II, Preschool Age Psychiatric Assessment, Attention Deficit Hyperactivity scale, inattentive subscale). Latent growth curve analysis incorporated controls for socioeconomic status and maternal cognitive abilities, and moderation effects were examined through multiplicative interaction terms.

RESULTS

We found that emotional availability influences children's executive function, specifically switching, motor inhibition, and inattentive symptoms, irrespective of maternal depressive symptom changes. This effect is further nuanced by emotional availability's moderating role in the association between depressive symptom change and switching.

LIMITATIONS

The study's limitations include a relatively small sample size for moderation analysis and the exclusion of paternal influences.

CONCLUSION

This study is a significant step in understanding the profound influence of maternal emotional availability in infancy on child executive function development, offering new avenues for research and, if replicated, a foundation for innovative intervention approaches.

The path of depression in rural children: A fuzzy-set qualitative comparative analysis across multiple provinces in China

OBJECTIVES

This study explores the combinations of conditional variables contributing to depressive symptoms in rural children.

METHODS

We analyzed data from 715 children from a rural mental health database, conducting detailed follow-up investigations on 129 children in Zhejiang and Henan provinces. We used fuzzy set Qualitative Comparative Analysis (fsQCA) and regression analysis to identify causal pathways leading to depression.

RESULTS

The results indicate that depression in rural children does not stem from a single, necessary condition but arises from multiple factors. Our findings highlight significant contributions from both maternal and paternal involvement. Specifically, maternal involvement, combined synergistically with peer support and problematic behaviors, as well as paternal involvement, together with peer support and anxiety, significantly affects depressive outcomes. Additionally, anxiety and strong peer relationships independently have a substantial impact on these outcomes. Effective mitigation strategies involve active parental engagement and robust peer support, reducing the influence of risk factors such as problematic behaviors and anxiety.

LIMITATIONS

The generalizability of the results is limited by cultural and geographical variations. The study also does not account for all potential factors influencing depression in rural children.

CONCLUSION

Depression in rural children results from multiple interacting factors. Tailored interventions addressing these specific combinations are recommended.

Evaluation of low vagally-mediated heart rate variability as an early marker of depression risk

BACKGROUND

Both low vagally-mediated heart rate variability (HRV) and depression have been shown to be risk factors for cardiovascular disease (CVD). We recently identified an HRV cutpoint below which persons have an increased risk for several cardiometabolic disorders. However, no cutpoint exists to identify those at risk for depression.

METHODS

The association between daytime HRV and diagnostically validated depression cutoffs using the five-item World Health Organization Well-being Index (WHO-5) was examined in adults from the Mannheim Industrial Cohort Study (n = 9973; Mage = 41.9[10.9]; 20 % women [n = 1934]). The aim was to identify HRV cutpoints for individuals who may have clinical depression.

RESULTS

Regression adjusting for age, sex, and linear trend showed a significant quadratic association between depression, indexed by WHO-5 scores and HRV, indexed by the root mean square successive differences (RMSSD) in milliseconds (ms) (p < 0.001). Logistic regression models adjusting for age, sex, and heart period (i.e., inter-beat intervals) compared the clinically depressed (WHO-5 ≤ 28) and those with a screening diagnosis of depression (WHO-5 ≤ 50) to the rest of the population. Significant odds ratios suggested two RMSSD values 25 ± 2 ms (OR = 1.39 [1.17, 1.64]) and 35 ± 2 ms (OR = 1.17 [1.02, 1.34]) that may be used to identify those with an elevated risk for depression.

LIMITATIONS

The sample was primarily German men. Fitness and anti-depressant use were not available.

CONCLUSIONS

As HRV is a brief measure that can be used in clinical settings, our HRV cutpoints have implications for the early detection of those at risk for psychological and cardiometabolic disorders.

Does response to treatment differ between anorexia nervosa and atypical anorexia nervosa? Findings from two open series trials

BACKGROUND

No evidence-based treatments exist for atypical anorexia nervosa (AAN) and little is known about differences in response to treatment between anorexia nervosa (AN) and AAN. The purpose of this paper is to explore treatment outcomes in two pilot trials for those with AN and AAN.

METHODS

Study 1 (N = 127) examined treatment outcomes in a digital imaginal exposure trial and Study 2 (N = 34) examined outcomes in a personalized treatment trial. Participants with an active eating disorder (ED) were eligible and those with AN or AAN were included in these analyses. ED symptoms and ED-related fears were assessed at pre-treatment, post-treatment, and one and six-month follow-up. Linear mixed effects models explored treatment outcomes by diagnosis.

RESULTS

There were no significant differences in treatment response between diagnoses for most outcome measures. In Study 2, participants with AAN had a significant decrease in global ED symptoms across time, while AN did not.

LIMITATIONS

The samples were primarily white and female, limiting the generalizability of the studies. Additionally, due to limited consensus on "significant weight loss," a less conservative definition was used to diagnose AAN which may impact the results.

CONCLUSIONS

In general, those with AN and AAN may respond to treatment similarly, with some small differences. Digital exposure therapy may be effective treatments for both AN and AAN, especially for ED-related fears. Personalized treatment may be more effective for those with AAN than those with AN.

Early mother-infant interactions within the context of childbirth-related posttraumatic stress symptoms

BACKGROUND

Childbirth may lead to perinatal mental health issues, such as childbirth-related posttraumatic stress symptoms (CB-PTSS), depression, and anxiety. Despite well explored mother-infant interactions in the context of maternal depression and anxiety, only limited studies investigated mother-infant interactions in the context of CB-PTSS, which is the aim of the present study.

METHODS

One-hundred mother-infant dyads in the French speaking part of Switzerland were classified into three groups: birth-related symptoms (BRS, i.e., symptoms of re-experiencing and avoidance) (n = 20), general symptoms (GS, i.e., symptoms of negative cognition and mood and hyperarousal) (n = 46), and non-symptomatic (NS) (n = 34) based on maternal report on PTSD Checklist for DSM-5 (PCL-5). At six months postpartum, mother-infant interactions were video-recorded and their quality was assessed using the Global Rating Scale. Data was analyzed using ordinal logistic and negative binomial regressions.

RESULTS

In the adjusted model, mothers in BRS group engaged in more frequent coercions compared to the NS group (B = -1.46, p = 0.01, 95%CI = -2.63, -0.36) and showed lower reciprocity in their interactions with their infants compared to the GS group (B = 1.21, p = 0.03, 95%CI = 0.05, 2.37).

LIMITATIONS

The use of a cross-sectional design limited the exploration of how consistent these findings are regarding mother-infant interactions between groups over time.

CONCLUSIONS

Mothers with higher BRS may need support to improve interactions with their infants. Future studies should consider longitudinal design to observe mother-infant interaction changes between CB-PTSS groups over time.

Perceived stress and suicidal ideation among transgender women in Shenyang and Kunming, China: Exploring the mediating roles of thwarted belongingness, perceived burdensomeness and social exclusion

BACKGROUND

Transgender women have a high prevalence of suicidal ideation, with stress and low interpersonal needs as its main risk factors. This study aimed to investigate the mediating role of interpersonal needs on the relationship between perceived stress and suicidal ideation among transgender women in China.

METHODS

A cross-sectional study was conducted in Shenyang and Kunming from April to September 2018. 247 transgender women were recruited. Sociodemographic statistics, perceived stress, interpersonal needs and suicidal ideation were obtained. Correlation analysis and mediation analysis were performed to test the relationship among perceived stress, suicidal ideation and interpersonal needs.

RESULTS

14.6 % of the participants reported suicidal ideation within a year. Perceived stress was positively correlated with suicidal ideation (r = 0.228, p < 0.001), interpersonal needs and its three dimensions (r = 0.300-0.583, ps < 0.001)-thwarted belongingness, perceived burdensomeness and social exclusion. Interpersonal needs and its three dimensions were also positively correlated with suicidal ideation (r = 0.148-0.299, ps < 0.05). Interpersonal needs, perceived burdensomeness and social exclusion partly mediated the relationship between perceived stress and suicidal ideation, while thwarted belongingness didn't play a mediating role.

LIMITATIONS

Cross-sectional study limited confirmation of causality between variables. The investigation didn't aim at the specific stressors of sexual minorities. And that participants came from only two regions might affect the generalization of the results.

CONCLUSIONS

We found a partial mediating role of interpersonal needs between stress and suicidal ideation. Stress reduction and increased social inclusion are needed to reduce suicidal ideation in transgender women.

A novel antidepressant homogeneous polysaccharide YLP-1 from Millettia pulchra ameliorates tryptophan metabolism and SCFAs through modulating gut microbiota

The root of Millettia pulchra (YLS) has been traditionally used as a folk medicine for the treatment of depression and insomnia in the Zhuang nationality of China, and its polysaccharides have potential antidepressant effect. In this study, a novel homogeneous polysaccharide (YLP-1) was purified from the crude polysaccharides of YLS, and it is mainly composed of glucose, arabinose and mannose with molar ratio of 87.25%, 10.77%, and 1.98%, respectively. YLP-1 is a novel α-glucan with the backbone of 1,4-Glcp and branched at C6 of 1,4,6-Glcp to combine 1,4-Manp and 1,5-Araf. The microstructure of YLP-1 displayed a uniform ellipsoidal-like chain morphology and dispersed uniformly in solution. YLP-1 effectively ameliorated depression-like ethological behaviors and restored the decreased catecholamine levels in chronic variable stress (CVS)-induced depression rats. Additionally, it significantly improved the disturbance of gut microbiota induced by CVS stimuli, particularly affecting bacteria that produce short-chain fatty acids (SCFAs), such as bacteria species Lactobacillus spp.. In vitro fermentation study further confirmed that YLP-1 intake could promote SCFAs production by Lactobacillus spp. YLP-1 also mitigated the disruption of tryptophan metabolites in urine and serum. These findings provide evidences for the further development of YLP-1 as a macromolecular antidepressant drug.

Psychological interventions for social anxiety disorder in children and adolescents: A systematic review and network meta-analysis

BACKGROUND

Social anxiety disorder (SAD) is a high-prevalence mental disorder among children and adolescents. The aim of this study is to compare and rank the effectiveness of several psychotherapies for SAD among children and adolescents.

METHODS

Only randomized controlled trials (RCTs) were utilized by searching PubMed, Embase, Cochrane Library, and Web of Science. We used network meta-analysis in the Bayesian framework to analyze the data. This study is registered with PROSPERO, number CRD42023476829.

RESULTS

In total, 30 RCTs with 1547 individuals were included, and nine psychotherapies with three control conditions were compared and ranked in this study. The findings revealed that internet-delivered cognitive behavioural therapy (surface under the cumulative ranking curve [SUCRA: 71.2 %]), group cognitive behavioural therapy (SUCRA: 68.4 %), and individual cognitive behavioural therapy (SUCRA: 66.0 %) significantly reduced social anxiety symptoms; internet-delivered cognitive behavioural therapy also significantly decreased depression symptoms in these patients (SUCRA: 92.2 %). In addition, group cognitive behavioural therapy can enhance functioning in these patients (SUCRA: 89.6 %).

CONCLUSION

These results suggest that internet-delivered cognitive behavioural therapy is the optimal type of psychotherapy for reducing social anxiety and depression symptoms in children and adolescents with SAD, internet-delivered parent-child interaction therapy and cognitive bias modification of interpretation have relatively poor treatment effects on social anxiety symptoms in children than other psychological interventions, and group cognitive behavioural therapy has better benefits in enhancing the functioning among children and adolescents with SAD. Further studies are needed to ascertain these results due to the limited number of included studies.

Childhood lead exposure increases the risk of attention-deficit-hyperactivity disorder: A meta-analysis

Environmental lead exposure has been a much-discussed risk factor for the development of ADHD for decades. However, due to methodological shortcomings, the existing research on this topic is highly inconsistent. We will attempt to clarify this question by performing a meta-analysis based on a systematic literature search until February 2024 including different databases such as Pubmed and Google Scholar. The effects of environmental lead exposure were synthesized by odds ratios. A random effects model was deployed with a Paule-Mandel estimator using Hedges' invariance weighting. In addition, we carried out sensitivity analyses to examine the robustness of effects, including the detection of outliers, publication bias, p-hacking and moderating variables. In total, 14 studies with 14 effect sizes were included which had investigated the effects of lead exposure on the development of ADHD. The analyses were based on a final sample size of N = 7618 with n = 2554 ADHD cases (33,53 %) and n = 5064 healthy controls (66.47 %). Our results show that lead exposure was significantly associated with a higher risk of ADHD development. Regression analyses demonstrated that increased age of participants and increased lead significantly enhanced the risk of ADHD. Summing up we present novel results concerning the relationship between environmental lead exposure and the development of ADHD, while discussing underlying pathomechanisms as well as limitations. Finally, we provide recommendations for future studies and public health policies.

Romantic relationships buffer minority stress in transgender and non-binary adults: Effects on depressive symptoms and suicidality

BACKGROUND

Transgender and non-binary (TNB) individuals are at greater risk of mental health concerns relative to their cisgender peers due to experiences of minority stress. Thus, it is critically important to identify factors that may be protective and buffer the effects of minority stress. This study examined whether romantic relationship involvement and quality buffered effects of TNB minority stress on depressive symptoms and suicidal ideation.

METHODS

A large international sample (n = 1156) of TNB adults (n = 654 partnered; n = 502 single) reported on minority stress experiences, relationship status and quality, and mental health outcomes (i.e., depressive symptoms and suicidal ideation).

RESULTS

The effects of victimization and rejection on depressive symptoms and suicidal ideation were attenuated among partnered individuals. However, once relationship quality was considered, the buffering effects of relationship involvement applied only to those in more satisfying relationships; the stress-buffering effects were not observed among those in distressed relationships. Of particular importance, general interpersonal satisfaction did not act as a minority stress buffer, suggesting there may be unique stress-buffering effects of being in a satisfying romantic relationship on depressive symptoms and suicidal ideation.

LIMITATIONS

The cross-sectional nature of the current study precludes definitive conclusions regarding causation.

CONCLUSIONS

These findings suggest that romantic involvement may serve a stress-buffering role for TNB adults, but only when these relationships are satisfying. Our results have important theoretical and clinical implications, and further research is needed to investigate the utility of relationship interventions to buffer the effects of TNB minority stress on depressive symptoms and suicidality.

Greater perceived stress and lower cortisol concentration increase the odds of depressive symptoms among adolescents

BACKGROUND

Adolescent depression is a major public health concern. Although stress has been linked to more severe depression, its association with mild depression among adolescents is not understood. This study assesses the relationship between perceived stress and cortisol (a physiologic measure of stress) and examines the relationships between these stress measures and depressive symptoms among adolescents 13-19 years of age.

METHODS

Stress was measured with the Perceived Stress Scale-10 and through salivary sampling for cortisol four times throughout the day. The Patient Health Questionnaire-9 was used to measure depressive symptoms (range 0-27), where ≥5 indicated the threshold for experiencing at least mild depressive symptoms. Spearman coefficients and multiple logistic regression models were used to examine the relationships between our variables of interest.

RESULTS

The mean age of the 73 participants in our study was 15.82 years. 49 % of the participants reported depressive symptoms (PHQ-9 score ≥ 5). Both higher perceived stress (odds ratio [OR] = 1.11, p = 0.022) and lower cortisol (area-under-the curve; AUCG) (OR = 0.99, p = 0.009) were associated with increased odds of having depressive symptoms.

LIMITATIONS

Few participants had moderate to severe PHQ-9 depression, therefore our study reported findings on mild depression or greater.

CONCLUSIONS

Perceived stress and cortisol appear to reflect distinct, independent components of the stress experience. However, both greater perceived stress and less circulating cortisol may indicate difficulties in regulating stress as potential factors underlying depressive symptoms. Future research should focus on the different types of adolescent stressors and the importance of routine screening of stress and depression, including mild depression.

Non-suicidal self-injury trajectories among adolescents during the COVID-19 pandemic: The role of parenting dimensions and stress reactions

BACKGROUND

The literature on the trajectories of NSSI behavior during the pandemic is scarce and mainly short-term. Furthermore, studies have not explored the buffering mechanisms that may have altered risk trajectories during this vulnerable period. This study aims to analyze the univariate change of NSSI during adolescence and to examine the alteration of the univariate growth due to the time-varying effect of COVID-19-related stress, parenting dimensions (i.e., positive and negative parenting), and their interaction.

METHODS

Participants included 830 Italian adolescents (44.2 % females; Mage = 14.52; SD = 0.80), who participated in at least one time point of data collection, from a three-wave longitudinal study (T1: from December 2019 to January 2020; T2: December 2020; T3: December 2021).

RESULTS

The Latent Growth Curve Analyses show a linear increase in NSSI over time. In regards to time-varying, at T1, the results highlight that higher levels of negative parenting are associated with higher levels of NSSI at the same time point. Instead, at T2, results show that pandemic stress is associated with higher levels of NSSI at T2. Regarding the interaction effect, positive parenting significantly buffered the effect of COVID-19 stress on NSSI at both T2 and T3.

LIMITATIONS

Only some dimensions of parenting style (i.e., positive and negative parenting) are included.

CONCLUSIONS

This study attempts to deepen the trajectory of NSSI behavior during the two years of the pandemic and examine the changes caused by the time-varying effects, thus providing suggestions for designing programs to prevent engagement in NSSI.

Identifying trajectories of change in sleep disturbance during psychological treatment for depression

BACKGROUND

Sleep disturbance may impact response to psychological treatment for depression. Understanding how sleep disturbance changes during the course of psychological treatment, and identifying the risk factors for sleep disturbance response may inform clinical decision-making.

METHOD

This analysis included 18,915 patients receiving high-intensity psychological therapy for depression from one of eight London-based Improving Access to Psychological Therapies (IAPT) services between 2011 and 2020. Distinct trajectories of change in sleep disturbance were identified using growth mixture modelling. The study also investigated associations between identified trajectory classes, pre-treatment patient characteristics, and eventual treatment outcomes from combined PHQ-9 and GAD-7 metrics used by the services.

RESULTS

Six distinct trajectories of sleep disturbance were identified: two demonstrated improvement, while one showed initial deterioration and the other three groups displayed only limited change in sleep disturbance, each with varying baseline sleep disturbance. Associations with trajectory class membership were found based on: gender, ethnicity, employment status, psychotropic medication use, long-term health condition status, severity of depressive symptoms, and functional impairment. Groups that showed improvement in sleep had the best eventual outcomes from depression treatment, followed by groups that consistently slept well.

LIMITATION

Single item on sleep disturbance used, no data on treatment adherence.

CONCLUSIONS

These findings reveal heterogeneity in the course of sleep disturbance during psychological treatment for depression. Closer monitoring of changes in sleep disturbance during treatment might inform treatment planning. This includes decisions about when to incorporate sleep management interventions, and whether to change or augment therapy with interventions to reduce sleep disturbance.