IntroductionTreating sleep difficulties – a core symptom of posttraumatic stress disorder (PTSD) – can improve both sleep and broader psychiatric outcomes. Digital health (dHealth) applications offer a scalable way to deliver cognitive behavioural therapy for insomnia (CBT-i), particularly for trauma survivors facing barriers to care. However, adherence to these interventions is often poor and may be improved through human support, especially for more demanding components such as sleep rescheduling. This study evaluated the usability, adherence, and preliminary efficacy of a dHealth application delivering sleep rescheduling both with and without coach support, alongside self-guided stimulus control and sleep hygiene components.MethodsFemale sexual assault survivors were assigned to one of two groups comparing the sleep rescheduling component of the dHealth application: either coach-assisted (n = 27) or self-guided (n = 27). All participants received stimulus control and sleep hygiene information embedded in the application, in the form of a newsletter, including a third comparator group (n = 25), which received this information only. Usability and negative effects were self-reported. Adherence was assessed via dropout rates, application engagement, newsletter openings, and compliance with sleep prescriptions. Efficacy was measured by changes in insomnia, depressive, and PTSD symptoms.ResultsThe self-guided group reported lower satisfaction and more negative effects than controls. Compared to the self-guided group, coach-assisted participants showed better adherence to sleep prescriptions. Across groups, insomnia and depressive symptoms decreased significantly. Preliminary evaluation of efficacy showed that PTSD symptoms improved substantially in the coach-assisted and comparator groups, while improvements in the self-guided group plateaued after initial gains.DiscussionUnguided application use was associated with poorer usability, greater negative effects, lower adherence, and some potential weaker outcomes. Preliminary findings suggest that sleep rescheduling may benefit from human support to be effective. Where coaching is unavailable, simple stimulus control and sleep hygiene education may be preferable.
Evaluation of the Acceptability, Feasibility and Exploration of the Efficacy of an Integrated Care Pathway CARIBOU
Conditions: Major Depressive Disorder (MDD)
Interventions: Behavioral: CARIBOU Integrated Care Pathway; Behavioral: Treatment as Usual (TAU)
Sponsors: Universidad de los Andes, Chile
Not yet recruiting
Interventions: Behavioral: CARIBOU Integrated Care Pathway; Behavioral: Treatment as Usual (TAU)
Sponsors: Universidad de los Andes, Chile
Not yet recruiting
Group Cognitive-Behavioral Intervention for Problematic Internet Use in Nepalese University Students
Conditions: Problematic Internet Use; Internet Addiction
Interventions: Behavioral: Group Cognitive-Behavioral Intervention for Problematic Internet Use
Sponsors: Tribhuvan University, Nepal
Completed
Interventions: Behavioral: Group Cognitive-Behavioral Intervention for Problematic Internet Use
Sponsors: Tribhuvan University, Nepal
Completed
iACT & iTBS for Sleep Quality in Depressed Adolescents
Conditions: Depressive Disorder; Sleep Disturbance
Interventions: Behavioral: Internet-Delivered Acceptance and Commitment Therapy; Device: Intermittent Theta Burst Stimulation
Sponsors: Central China Normal University
Completed
Interventions: Behavioral: Internet-Delivered Acceptance and Commitment Therapy; Device: Intermittent Theta Burst Stimulation
Sponsors: Central China Normal University
Completed
Pseudo-professional mechanism of collaborative mental health support in low-resource county-level contexts in China
China has made school-family-community collaboration a central policy direction for adolescent mental health, yet low-resource counties often lack the professional workforce, stable interorganizational arrangements, and non-stigmatizing pathways needed to reproduce an institutionalized service model. Existing research on task sharing shows that trained non-specialists can perform selected forms of basic psychological support, but it says less about how such tasks are incorporated into everyday school relationships and linked to professional referral. This community case study examines Suining County, Jiangsu Province, as an information-rich instrumental case. The core evidence consists of semi-structured interviews with 52 principals, school mental health teachers, homeroom teachers, subject teachers, parents, and students, together with non-participant observations conducted in 10 schools between September 2023 and June 2024. County policy documents, training records, and de-identified aggregate administrative screening data were used only to describe the case context. The analysis identifies a pseudo-professional mechanism organized through three related processes. Daily relational embeddedness enables risk signals to be noticed in classrooms, class management, and home-school communication. Bounded task sharing converts listening, basic reassurance, risk inquiry, and referral into limited front-end tasks that existing school actors can perform without assuming diagnostic or therapeutic authority. Tiered networking transfers responsibility from the class to the school and, when necessary, to medical services, while reconnecting students to everyday support after their return to school. This arrangement widens the reach of front-end support but remains constrained by teacher workload, parental refusal, discontinuities across school transitions, uneven supervision, and privacy risks. Pseudo-professionalization therefore does not mean replacing clinical professionals. It denotes a bounded reorganization of support functions whose safety depends on professional gatekeeping, sustained supervision, stable referral channels, informed participation, and disciplined information governance.
From facing fears to experimental frontiers: immersive cinematic virtual reality environments as a catalyst for innovation in behavioral neuroscience
Virtual reality (VR) has gained traction in psychiatric research in exposure-based interventions for phobias, simulations of hallucinations in psychosis, and adaptations of cognitive-behavioral therapy. These applications demonstrate that emotionally immersive digital environments can meaningfully engage pathological processes in controlled settings. Yet VR’s potential in psychiatry goes beyond providing new contexts for well-established therapeutic interventions. Here, we argue that while emotionally rich, interactive VR scenarios can be leveraged to radically improve translational experimental design in behavioral neuroscience, there are not yet clear conceptual frameworks for the incorporation of these elements. Traditional lab tasks with theoretical implications for therapeutic interventions often rely on abstract procedures that fail to capture the immersive, affective dynamics of real-world maladaptive behaviors. Here, we discuss how high-fidelity VR scenarios simulate complex emotional naturalistic contexts while retaining precise experimental control. We illustrate this drawing on our recent work using high-fidelity, game-engine-based VR scenarios and consider how these environments offer a scalable and accessible platform for large-sample studies, as VR hardware becomes more common in the household. We propose a set of dimensions called the Immersive Behavioral Translation Framework (IBTF) that suggest conceptual considerations for VR in neuroscientific research: (i) The controllability of immersive environments; (ii) features of immersive environments that bridge ecological validity gaps; and (iii) the relatability of these emotionally immersive experiments to clinical conditions in translational research. We illustrate this framework with reference to emerging findings in associative learning and threat sensitivity, while emphasizing the broader implications for rethinking how we study cognition, emotion, and psychopathology.
Development and psychometric evaluation of the AI emotional engagement scale
BackgroundWith the increasing integration of artificial intelligence (AI) technologies into daily life, the underlying mechanisms of emotional interactions between users and AI have emerged as a critical research topic in the field of human-computer interaction (HCI). Existing studies have predominantly adopted traditional technology acceptance models or satisfaction scales, which lack targeted applicability in capturing unique features of AI interactions, such as parasocial relationships and emotional dependence. The present study aims to develop a self-report instrument, the AI Emotional Engagement Scale (AEES), and examine its psychometric properties for assessing users’ level of AI Emotional Engagement with AI systems.MethodsThis study was conducted based on Norman’s three-level theory of emotional design. Study 1 (N = 24) extracted core information from interview data using qualitative analysis, and generated an initial item pool through multiple rounds of expert review. Study 2 (N = 103) conducted a pre-test of the initial items to examine indicators including item quality and relevance, optimized the item design, and developed the formal item set. Study 3 (N = 924) verified the factor structure of the AEES via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), conducted reliability and validity tests of the scale, and finalized the factor structure of the 28-item, three-dimensional scale.ResultsResults of EFA indicated that AI Emotional Engagement consists of three dimensions: the visceral level, behavioral level, and reflective level, which was consistent with the theoretical framework, with a cumulative variance contribution rate of 68.32%. Results of CFA demonstrated that the three-factor model had a good fit (χ²/df = 3.765, CFI = 0.91, TLI = 0.90, RMSEA = 0.077, SRMR = 0.0496). The overall AEES and its three dimensions exhibited good internal consistency reliability, with reliability coefficients ranging from 0.90 to 0.97.ConclusionThe AEES has favorable psychometric properties, and can serve as a reliable instrument for researchers and practitioners to assess users’ AI Emotional Engagement with AI systems.
Differentiating the potential of continuum beliefs to reduce the public stigma of schizophrenia, depression, and alcohol dependence: associations with illness recognition and treatment recommendations
PurposePromoting continuum beliefs has been discussed as a strategy for stigma reduction. The current study examines associations of continuum beliefs with stigma aspects (stereotypes, emotions, and social distance) and mental health literacy (illness recognition and treatment recommendations).MethodsIn 2011, a sample of the German population (N = 3,642) completed a vignette-based interview on attitudes regarding schizophrenia, depression, or alcohol dependence. Logistic regression analyses were performed and predicted probabilities were used to calculate prevalence estimates and depict direct effect sizes.ResultsIncreased continuum beliefs were strongly related to a decreased likelihood of social distance and endorsement of some negative stereotypes (e.g., being alien for schizophrenia) and an increased likelihood for endorsement of other negative stereotypes (e.g., lack of willpower for schizophrenia and depression) and emotions (e.g., anger for schizophrenia). Effect sizes indicated a greater reduction in negative stereotypes and desired social distance than increases in negative stereotypes or emotions. Furthermore, continuum beliefs were associated with a decreased probability of illness recognition for schizophrenia and recommending treatment for schizophrenia and depression, but an increased likelihood for illness recognition and recommending treatment for alcohol dependence.ConclusionPotentially harmful associations of continuum beliefs were found for schizophrenia and depression and should be considered by future studies and intervention designs. These potentially harmful associations are likely outweighed by helpful associations based on prevalence estimates and effect sizes. Associations between continuum beliefs and mental health literacy seem to be illness-dependent. Because of the sociocultural context and the time gap between the study and publication, representativeness for current public attitudes is limited.
The association between obstructive sleep apnea and total cerebral small vessel disease burden—Neurovascular insights of OSA
ObjectiveThis study was conducted to assess the relationship between the severity of obstructive sleep apnea (OSA) and the total burden score of cerebral small vessel disease (CSVD), global cerebral blood flow (CBF), and cognitive function. Moreover, the internal pathway through which OSA induces cognitive impairment by affecting cerebral perfusion, and overall cerebral small vessel lesions was determined in this study.MethodsIn total, 94 patients who received polysomnography (PSG) at the Mental Health Center of Inner Mongolia Autonomous Region from October 2024 to February 2026 were included in this study. Based on the apnea-hypopnea index (AHI), all individuals were classified into the control and the mild group (AHI < 15 times/h, n = 26), the moderate OSA group (15 ≤ AHI < 30 times/h, n = 27), and the severe OSA group (AHI ≥ 30 times/h, n = 41). Demographic information was collected from all patients, and their cognitive performance was evaluated using the Mini-Mental State Examination (MMSE), Trail Making Test (TMT), Choice Reaction Time task (CRT), Digit Symbol Substitution Task (DSST), and the Trails test with a paradigm similar to Part B of the Trail Making Test. Each patient underwent 3.0T magnetic resonance imaging, including conventional sequences, susceptibility weighted imaging (SWI), and arterial spin labeling (ASL). Finally, the total CSVD burden score was assessed.ResultsThe total CSVD burden and perivascular space (PVS) score in the severe OSA group were significantly higher than those in the moderate group and the control group (P < 0.05). The total CSVD burden was significantly positively correlated with the mean global CBF (P < 0.05). After the BMI was adjusted, the severity of OSA remained independently associated with the mean global CBF (P < 0.05). Total CSVD burden, PVS, lacunes, and global CBF were significantly associated with cognitive function domains (P < 0.05), which indicated that CSVD and global CBF abnormalities may jointly participate in OSA-related cognitive function.ConclusionThe severity of OSA might be related to the CSVD burden score. Neuroimaging characteristics strongly related to cognitive function in patients suffering from OSA, and abnormal global CBF may serve as a non-invasive imaging marker for evaluating neurocognitive damage.