Beyond distress relief: the Anhedonic Subtype of nonsuicidal self-injury and the imperative for Positive Affect Treatment

This perspective article argues that the theoretical landscape of nonsuicidal self-injury (NSSI) has long been stabilized by the “hydraulic” model of Automatic Negative Reinforcement, which conceptualizes self-harm primarily as a mechanism to down-regulate aversive hyper-arousal. While this framework successfully elucidates the etiology of self-injury driven by high-intensity negative affect, it fails to account for a substantial, treatment-resistant phenotype: adolescents driven by profound anhedonia and ventral striatal hypofunction. This perspective article argues for the formal recognition of an “Anhedonic Subtype” of NSSI. Synthesizing recent epidemiological data identifying “emptiness” as a central symptom network bridge, alongside neurobiological evidence of reward blunting, we posit that for this subtype, NSSI functions not as a sedative, but as a mechanism of “forced activation.” We propose a preliminary differential diagnostic framework distinguishing defensive dissociation from anhedonic deficit and outline the theoretical rationale for exploring a shift in clinical intervention from distress tolerance toward positive affect up-regulation. The clinical utility of this framework remains to be evaluated in future empirical research.

Resonance across cultures and faiths: examining the violin music’s role in emotional, psychological, and spiritual well-being for sustainable societies

Music is a decisive factor of the everyday life and the core focus of human being of any culture. People of all ages, races and ethnicities prefer to listen to it and play it. But music is not only entertainment because scientific research has shown that it can also create an impact on the physiological processes that can be used to enhance physical and mental illnesses. The current study analyzes the ways in which the violin may be employed in enhancing emotional, psychological and spiritual well-being of different cultures and religions. It relies on secondary data to examine the emotional appeal of the instrument, the psychological resilience benefits, and the spiritual meaning of the instrument particularly in the intercultural and interfaith context. The sound of the violin that is very flexible and familiar in various cultural and religious practices is also a channel of emotional expression, psychological healing, and spiritual intercourse. Therapeutic interventions and educational environments have been linked to it, as a means of improving emotional control, decreasing stress and increasing resilience. Also, the violin can be used as a significant instrument of spiritual reflection in other religious practices, in the Christian church service as well as in Hindu devotional music. Findings indicate that the violin facilitates interfaith communication and social integration by way of sharing of emotions and spirituality. It is a cultural preservation and common good, that promotes inclusivity and comprehension of the multicultural societies and results in sustainable communities. The paper shows that the field of special role of the violin in promoting resilience, empathy and sustainable development of society needs more empirical studies to advance the knowledge on the topic.

Identifying clinical features associated with electroconvulsive therapy response in adolescents with major depressive disorder using machine learning

BackgroundElectroconvulsive therapy (ECT) is an effective treatment for adolescent major depressive disorder (MDD), but its efficacy varies. This study utilized machine learning (ML) to identify baseline clinical factors associated with poor ECT response.MethodsWe retrospectively enrolled 503 adolescent MDD patients. A poor response was defined as a <50% reduction on the Hamilton Depression Scale (HAMD-24). The optimal ML algorithm (Random Forest, RF) was selected from nine candidates and then simplified using recursive feature elimination (RFE) and interpreted via Shapley Additive Explanations (SHAP).ResultsA simplified model using two baseline features—the neutrophil-to-platelet ratio (NPR) and pre-treatment HAMD score—achieved an AUC of 0.731 on the testing set, comparable to the full-feature model (AUC: 0.751). SHAP analysis revealed that a lower baseline NPR and a lower pre-treatment HAMD score were associated with a poor response. Furthermore, retrospective statistical comparisons revealed that patients in the poor response group completed significantly fewer ECT sessions than those in the good response group.ConclusionsWe developed a concise explanatory model demonstrating that routine clinical data available at admission (blood NPR and HAMD score) can effectively stratify the risk of poor ECT efficacy. Crucially, identifying these high-risk patients early empowers clinicians to implement targeted management, ensuring they complete a full and adequate course of ECT to maximize therapeutic benefits and prevent premature termination.

A two-decade bibliometric analysis (2004–2024) of parental factors in the context of internet gaming disorder research

ObjectiveThis is the first targeted bibliometric analysis which explores the development of scientific production on the relationship between parenting and Internet Gaming Disorder (IGD) over twenty years, emphasizing the central role of the family context in the etiology and maintenance of IGD.MethodsPapers indexed in Scopus and Web of Science databases from 2004 to December 31, 2024, were analyzed using the PRISMA guidelines, the R package Bibliometrix, and VOSviewer. A comprehensive search strategy was developed using Boolean operators to capture variations of parental and gaming-related terminology. Records were exported in BibTeX format and were merged and cleaned to remove duplicates before the analysis. A descriptive bibliometric analysis, bibliometric mapping, and content analysis were conducted to identify trends and thematic clusters. The analysis included 389 publications.ResultsThe most cited papers confirm the association of low parental warmth, family dysfunction, and comorbid psychiatric symptoms with a higher risk of IGD. Thematic mapping reveals six dominant clusters covering the conceptualization and diagnosis of IGD, parental mediation and virtual environment, psychological vulnerability and mental health, parenting and attachment, parenting styles and self-control, and problematic screen-related behaviors, and a strong concentration of publications in China, Germany, and the USA. The analysis also revealed an increase in publication output after 2013, with a notable acceleration following the inclusion of gaming disorder in the International Classification of Diseases 11th Revision (ICD-11).ConclusionThe bibliometric analysis reveals the rapid growth of research on parenting and IGD, highlighting the multifactorial nature of the disorder where dysfunctional family relationships increase risk, while supportive ones reduce it. Despite progress, longitudinal studies are needed for better understanding of causality and interventions.

Trends of incident stimulant use disorder diagnoses before and after the COVID-19 pandemic in British Columbia (2013-2024): a population-based study

BackgroundThere is rising detection of unregulated stimulants (e.g. cocaine and methamphetamine) in toxicology results among people who died of unregulated drug poisoning. Nevertheless, little research describes the population-level trends of incident (new) stimulant use disorder (StUD) diagnoses. This study reports on trends of incident StUD diagnoses pre- and post-Covid-19 public health emergency in British Columbia (BC), Canada.MethodsInterrupted time series analyses were conducted with BC’s COVID-19 public health emergency declaration on March 16, 2020 as the interruption point. Descriptive statistics on demographic and health service contact were conducted for the population diagnosed before (January 1, 2013 – March 16, 2020) and after (March 17, 2020 – December 31, 2024) the COVID-19 pandemic emergency declaration. Seasonal autoregressive integrated moving average (sARIMA) models were used to .estimate changes to incident StuD diagnoses rates before and after the COVID-19 pandemic declaration.Results38, 217 people were identified with incident StUD diagnoses between January 1, 2013 and March 31, 2024. The average diagnosis rate of incident StUD was 5.18 per 100, 000 in the pre-pandemic period and increased by 19.9% to 6.21 per 100, 000 in the post-pandemic period. The estimated increase in slope (ramp) of incident StUD was 0.0315 cases per 100, 000 population per month (95% CI: -0.00182, 0.06482).ConclusionsWe identified a rate of increase in incident StUD diagnoses since the COVID-19 pandemic declaration in BC that was not statistically significant. Our study highlights the need for more comprehensive linked data -including, administrative health data, surveys, and other services/program data (e.g., community services, private sector) to better disentangle StUD incidence and prevalence to inform services to meet the needs of people with StUD. Stimulant use, Stimulant use disorder, pandemic, Covid-19, methamphetamines, cocaine, interrupted time series.

STAT+: FDA to reconsider treatment for rare cancer after its surprise rejection

Two companies developing a therapy for a rare blood cancer have reached an agreement with the Food and Drug Administration that walked back the agency’s main reason for rejecting the drug in January. 

Pierre Fabre Pharmaceuticals and Atara Biotherapeutics, makers of the drug called Ebvallo, said Thursday that a meeting held in late April with FDA officials ended with the agency agreeing that their already completed, single-arm clinical trial was sufficient to support a review and potential approval. 

When the FDA rejected Ebvallo, the agency said the same study was flawed and the data produced from it was “insufficient” to support the drug’s approval. The drug’s review was conducted by the FDA’s Center for Biologics Evaluation and Research, led at the time by Vinay Prasad. He departed the agency at the end of April. 

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STAT+: Next-gen Duchenne drug from Entrada disappoints

Entrada Therapeutics’ next-generation drug for Duchenne muscular dystrophy disappointed in an early trial, raising questions about the company’s competitiveness in an increasingly crowded field.

Entrada is one of a group of companies developing new exon-skipping drugs. These medicines are designed to help patients with certain mutations produce shortened but still functional forms of dystrophin, the protein missing in Duchenne. 

The first such drug, from Sarepta Therapeutics, had only marginal effects on protein production but was approved in 2016 under immense pressure from patient advocates. Since then, scientists have devised ways of redesigning these molecules to better infiltrate muscle cells, leading to vastly higher dystrophin levels. 

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STAT+: Color me skeptical: Drinking gold is not an ALS cure

This is the online version of Adam’s Biotech Scorecard, a subscriber-only newsletter. STAT+ subscribers can sign up here to get it delivered to their inbox.

It’s been a while since I wrote a “Mean Adam” newsletter.

The biotech company Clene is developing a treatment for ALS called CNM-Au8 that it describes as a “highly concentrated aqueous suspension of catalytically-active, clean-surfaced, faceted gold nanocrystals.”

Allow me to translate: The Clene “drug” is gold microdust suspended in water.

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