Author: admin

Posted on

My Journey with Body Dysmorphic Disorder

– by Ryan Lipsett
Next Gen Youth Advisor
National Alliance on Mental Illness (NAMI)

If you met me a few years ago, you probably would have seen someone who looked “fine.” I smiled when I needed to, went to school, spent time with friends, and tried to blend in. What you wouldn’t have seen was the constant battle happening in my mind.

I lived with Body Dysmorphic Disorder (BDD), and for a long time, I didn’t even know there was a name for what I was experiencing. I became consumed by the belief that there was something wrong with the way I looked. I would spend so much time analyzing my appearance, avoiding mirrors one moment and compulsively checking them the next. Every reflection felt different, and none of them felt right. It became exhausting.

BDD didn’t just affect how I saw myself, it affected every part of my life. It isolated me from friends, made social situations overwhelming, and convinced me that everyone around me noticed the flaws I couldn’t stop thinking about. I canceled plans, withdrew from people I cared about, and felt trapped by thoughts that seemed impossible to escape.

For a long time, I believed I was alone.

One of the hardest parts of living with BDD was how little people talked about it, especially among men. Even within conversations about mental health, I rarely heard anyone mention body dysmorphic disorder. I wondered if anyone else understood what I was experiencing. That silence made it even harder to reach out.

What began to change everything for me was finding community.

Hearing other people share experiences that sounded so similar to mine was something I’ll never forget. For the first time, I realized I wasn’t “crazy,” and I wasn’t the only person whose mind distorted the way they saw themselves. Peer support didn’t make my BDD disappear overnight, but it gave me something I desperately needed: hope.

Knowing that other people understood without judgment made it easier to be honest about my own struggles. Their stories reminded me that recovery wasn’t about becoming perfect or never having difficult days, it was about learning that my thoughts didn’t have to control my life.

My own journey also included professional support. Therapy, medication, and learning healthier coping strategies all played important roles in my recovery. It wasn’t a straight path. There were setbacks, frustrating days, and moments when I questioned whether things would ever get better. But little by little, they did.

As I became more comfortable talking about my experiences, I realized how powerful sharing our stories can be. Today, I have the privilege of speaking about mental health through organizations like NAMI, where I share my experiences with anxiety, depression, and BDD. What once felt like something I had to hide has become one of the ways I can help others feel less alone.

Advocacy hasn’t “cured” my BDD, but it has transformed how I see it. Instead of carrying shame, I now use my experience to challenge stigma and remind others that mental illnesses deserve understanding, not judgment. Every time someone tells me, “I thought I was the only one,” I’m reminded why these conversations matter.

BDD Awareness Day is important because awareness creates recognition, recognition creates understanding, and understanding helps people reach out sooner. The more we talk openly about BDD, the more likely someone struggling in silence will realize there is a name for what they’re experiencing, and that effective treatment and support exist.

If you’re reading this and struggling with BDD, I want you to know that you are not alone. Even if your mind is telling you otherwise, you are so much more than the thoughts BDD feeds you. Recovery doesn’t mean every difficult thought disappears. It means those thoughts no longer define who you are or determine how you live your life.

There is hope. There are people who understand. There is help available.

If sharing my story helps even one person realize they aren’t alone, then every difficult step along my journey has been worth it.

The post My Journey with Body Dysmorphic Disorder appeared first on International OCD Foundation.

Posted on

Experiences and Perceptions of Crisis Text Services: Interview Study Among Young Adults With Suicidal Ideation

Background: Suicide remains a leading cause of death among young adults aged 18 to 25 years. Young adults experiencing suicidal ideation (SI) are increasingly using crisis text services (CTSs), a free and accessible option for crisis intervention. Little is known about CTSs from the young adult perspective. Objective: This study aimed to characterize young adults’ experiences with and perceptions of CTSs for SI. Methods: We conducted in-depth interviews, by phone, Zoom, or text, with young adults (n=39) in the United States who had a lifetime history of SI. Participants included those who had or had not engaged with CTSs for SI. Semistructured interviews were conducted from January to July 2024. The data were analyzed using a modified grounded theory approach. Results: We constructed 5 key themes to characterize young adults’ perceptions of and experiences with CTSs for SI. Young adults perceived CTSs as a unique component of their mental health crisis management. They appreciated CTSs’ technological features, particularly the privacy they provided and the ability to reflect on and edit responses. However, they expressed dissatisfaction with the nonspecific nature of many CTS interactions. The perceived anonymity of CTSs served multiple functions, both as a motivator for CTS use and as a potential point of vulnerability, should it be lost during a CTS interaction. Participants’ perceptions of CTSs’ impact varied; some viewed them as beneficial, whereas others reported neutral or inconsistent effects over time. Conclusions: Among young adults with SI, CTSs are a key yet imperfect resource. Quality improvement and evaluation efforts may be needed to understand how responders can better tailor responses to improve conversational quality and consistency for young adult texters.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/d067f311886d3f965f9d972e0feaaec8" />

Posted on

The Child Mind Institute Marks Fourth Year of Empowering California High School Students with Resources for a Career in Mental Health Care through its Youth Mental Health Academy

The program — in partnership with the state of California — builds a diverse pipeline of future mental health professionals through hands-on training, mentorship, and paid internships.

Los Angeles, CA – This summer, the Child Mind Institute welcomed a new class of Youth Mental Health Academy (YMHA) students for the 2026–2027 program. As part of a larger partnership with the state of California, YMHA connects high school students with education, mentorship, and career development opportunities across mental health professions. Since launching in 2023, the program has trained more than 2,700 high school students — prioritizing admission within communities that are historically underrepresented across mental health professions, including BIPOC, individuals from low-income backgrounds, LGBTQIA+ youth, and students living with disabilities.

More than half of the U.S. population lives in an area with a shortage of mental health professionals and, while a third of the U.S. population is Black or Hispanic, only about 10% of mental health professionals come from those communities. By exposing a diverse group of students to the field, and providing them with real career pathways, the Child Mind Institute believes YMHA helps address this shortage and lack of culturally relevant care.

“As the need for mental health care continues to grow, the Child Mind Institute is committed to helping build a future workforce that reflects the communities it serves,” said Harold S. Koplewicz, MD, president and medical director at the Child Mind Institute. “We’re proud to welcome students into this year’s academy where they’ll get an inside look at the rewarding and diverse careers available in mental health, furthering our investment in the next generation of professionals who will make a difference in the field.”

YMHA spans 14-months and includes three phases: a paid five-week Summer Academy that introduces students to mental health careers and core skills; year-round mentorship and professional development workshops; and a paid internship placement with a mental health organization.

Over 850 students from the 2025 cohort are currently participating in paid internships across more than 100 mental health partner organizations. These students will log more than 8,000 collective working hours, gaining experience at organizations like the National Alliance on Mental Illness, the Children’s Institute, Stanford Center for Youth Mental Health and Wellbeing, and Didi Hirsch. About 76% of program graduates plan to pursue a career related to mental health.

The 2026 Summer Academy welcomed a new cohort of students in June. This phase of the program culminated in a statewide celebration on July 23, with over 400 students across five sites presenting group capstone projects. The projects synthesized the skills students acquired throughout the summer, and focused on topics that are meaningful to them and their communities. Common themes included the mental health impact of social media, identity and economic background and its relationship to mental health outcomes, and the influence of generational trauma.

About 40 additional students are participating in the Summer Academy and mentorship program through Child Mind Institute’s partnership with the Bridge Builders Foundation, a Los Angeles-based 501(c)(3) nonprofit dedicated to expanding STEM education, mentorship, and college scholarships for youth and communities of color.

“The partnership between Bridge Builders Foundation and the Child Mind Institute’s Youth Mental Health Academy (YMHA) reflects a shared commitment to improving the mental health and well-being of young people while expanding access to education and career opportunities,” said Keith Parker, deputy executive director of the Bridge Builders Foundation. “Together, we are equipping students with the knowledge, skills, and mentorship needed to become future leaders and advocates in behavioral health.”

For visuals related to the YMHA program, please follow this link. For press questions, contact cmiscience@ssmandl.com or mediaoffice@childmind.org.

About Child Mind Institute

The Child Mind Institute is the leading nonprofit dedicated to transforming the lives of children and families experiencing mental health and learning disorders. Since its founding in 2009, the Child Mind Institute has become a global institution reaching millions of families each year through excellence in evidence-based clinical care, renowned educational resources and training, and science to advance the next generation of treatment. 

Visit the Child Mind Institute on social media: Instagram, Facebook, X, LinkedIn 

For press questions, contact us at childmindinstitute@ssmandl.com or mediaoffice@childmind.org.

The post The Child Mind Institute Marks Fourth Year of Empowering California High School Students with Resources for a Career in Mental Health Care through its Youth Mental Health Academy appeared first on Child Mind Institute.

Posted on

Understanding Sensory Phenomena in OCD

By Goi Khia Eng, PhD

This article describes the results of a 2022 Michael Jenike Young Investigator Award, an IOCDF-funded research project.

Obsessive compulsive disorder (OCD) is a chronic condition with diverse symptom presentations. OCD is often thought of as driven by fears, such as fear of germs leading to washing, or worries about safety driving checking. However, many people with OCD also experience sensory phenomena, which are uncomfortable and aversive sensory experiences, including sensory-based physical urges. Consider someone who experiences a compelling need to tap both sides of the body the same number of times until it feels “even”, not out of fear that something bad might happen if they do not, but because of an intense urge like a persistent itch demanding relief. Sensory phenomena affect as many as 60% of individuals with OCD (Miguel et al., 2000; Shavitt et al., 2014) and can drive compulsive behaviors such as touching, tapping, repeating, evening-up or arranging objects that are performed until they feel “just right” (Ferrão et al., 2012; Katz et al., 2022).

The Science Behind Sensory Urges

Sensory-based urges in OCD (and the urges before tics in Tourette disorder) are similar to everyday urges-for-action, such as the urge to blink or scratch an itch, both in how they feel and in the brain processes involved. Like everyday urges, sensory urges are internally generated and tend to intensify when they are suppressed or delayed (Berman et al., 2012; Neuner et al., 2014). Brain imaging studies in people without mental health diagnoses show that everyday urges-for-action activate a network of brain areas involved in movement preparation, as well as physical sensations and sensations arising from within the body. This brain network involves the insula and sensorimotor regions (including the postcentral gyrus, precentral gyrus, supplementary motor area, and cingulate cortex) (Jackson et al., 2011; Zouki et al., 2024). Most work examining brain regions related to pathological urges has been conducted in Tourette disorder, where studies found increased activation in a similar network of brain regions a few seconds prior to the onset of tics (Bohlhalter et al., 2006; Neuner et al., 2014). Our previous work examining the urge to blink in people with OCD also found activation in similar regions when participants were told to suppress blinking (Stern et al., 2020).

Current Treatments for Sensory Phenomena Are Lacking

Although they are common and distressing, sensory phenomena are not well addressed by first-line OCD treatments, behavioral therapies like cognitive behavioral therapy (CBT) and exposure and response prevention (ERP), and serotonin reuptake inhibitor (SRI) medication (Abramowitz et al., 2003; Stein et al., 2007). Although these treatments help many people with OCD, symptoms like sensory phenomena without a fear component may be more challenging to treat, as behavioral therapies may not be as readily applicable and medications may be less effective (Foa et al., 1999; Stein et al., 2007). Even when sensory phenomena do respond to these treatments, only about half of patients achieve full recovery, underscoring the need to develop new approaches to targeting sensory symptoms in OCD.

Transcranial Magnetic Stimulation (TMS)

TMS is a non-invasive neuromodulation technique that involves placing a specialized coil against the scalp, which generates a magnetic field that induces small electrical currents in the brain (Hallett, 2007). Depending on the stimulation parameters, TMS can either increase or reduce brain activity in the targeted region.

TMS offers several research and clinical advantages. It requires no surgical intervention, no needles, and no substances entering the body beyond the magnetic field itself. Individuals remain seated while the coil is positioned against the scalp using anatomical landmarks or a neuronavigation system. Aside from clicking sounds and mild scalp sensations, TMS is generally well-tolerated with minimal side effects. TMS received FDA approval for treatment-resistant depression in 2008 and for OCD in 2018; it is typically delivered in multiple sessions over several days or weeks, and has an established safety profile across multiple psychiatric applications (Cotovio et al., 2023; Rossi et al., 2021).

From Eyeblinks to Clinically Relevant Sensory Urges

Our research began by studying eyeblink suppression as a model for investigating sensory-based urges (Bragdon et al., 2023; Eng et al., 2024; Stern et al., 2020). People with OCD failed to suppress eyeblinks more than control participants when instructed to do so (Stern et al., 2020). These failures were associated with more severe sensory phenomena (Eng et al., 2024), measured using the gold-standard University of São Paulo-Sensory Phenomena Scale (USP-SPS) (Rosario et al., 2009). Importantly, greater activation in several brain regions, including the postcentral gyrus (involved in processing sensory information), was associated with both eyeblink suppression failures and more severe sensory phenomena in OCD (Eng et al., 2025).

Building on these findings, we tested whether reducing activity in the postcentral gyrus could modulate sensory urges and brain activation. In an initial pilot sample of four participants with OCD, we delivered single-session inhibitory TMS to an individualized target in the postcentral gyrus on one day (active TMS) and sham (inactive) TMS on another (Eng et al., 2025). Active TMS, compared to sham, was generally associated with reduced activity in this brain region during eyeblink suppression and lower self-reported urge to perform compulsions.

Through funding from the Michael Jenike Young Investigator Award, we expanded data collection to include 12 additional participants, for a total sample of 16. Each participant completed i) one baseline brain-imaging session, during which they performed the eyeblink suppression task while their brains were scanned using magnetic resonance imaging (MRI), and ii) two single-session TMS visits on different days, at least 5 days apart. Of these two TMS visits, one visit delivered active inhibitory TMS to an individualized target in the postcentral gyrus, and the other delivered sham TMS, which followed the same procedures but without actual brain stimulation. Participants were not told which condition they received. Immediately before and after each TMS session, participants rated the strength of their urge to perform compulsions using visual analogue scales (VAS). Changes in this rating served as the primary outcome, reflecting acute changes of clinically relevant OCD urges. Immediately after TMS and completing the VAS ratings, participants performed the eyeblink suppression task in the MRI scanner.

The Innovation

To our knowledge, this is the first study to use neuromodulation to specifically target sensory-based urges and the postcentral gyrus in individuals with OCD. Our selection of the postcentral gyrus as a target region is novel and supported by evidence linking higher activation there to more eyeblink suppression failures and more severe sensory phenomena. To tailor stimulation for each participant, we did not target the exact same brain location in everyone. Instead, we used each participant’s own brain scan to identify the specific “hotspot” within the postcentral gyrus that was most active during eyeblink suppression. To lessen discomfort, we delivered TMS in quick bursts rather than using traditional repetitive protocols, so that stimulation can be completed in under a minute. Neuronavigation technology, which is essentially a GPS system for the brain, was used throughout the session to track the TMS coil’s position in real time relative to the participant’s brain to ensure precise and consistent targeting. These approaches acknowledge individual differences in brain anatomy and apply principles of personalized medicine to neuromodulation.

Study Findings

Our study results, while preliminary given the small sample size, showed encouraging patterns across multiple measures. Most importantly from a clinical perspective, participants reported greater reductions in the strength of their urge to perform OCD-related compulsions following active TMS compared to sham, suggesting that modulating activity in the postcentral gyrus may have clinical relevance. In terms of brain activation, regions of the urge network including the postcentral gyrus, precentral gyrus, and insula showed less activation during eyeblink suppression following active TMS compared to sham.

Notably, there was individual variability in response. Some participants showed substantial decreases in the strength of their urge to perform compulsions following active TMS compared to sham, while others showed smaller decreases or minimal change. We found that participants who reported greater reduction in their urge to perform compulsions after active TMS (compared to sham) showed greater decreases in brain activity in regions associated with urges-for-action (including the postcentral gyrus, precentral gyrus, supplementary motor area, and insula), as well as regions involved in cognition and emotional processing, and reduced connectivity between the postcentral gyrus TMS target and these regions.

Conclusion and study implications

This proof-of-concept investigation represents an important step toward addressing a significant unmet clinical need. By demonstrating that modulating activity in the postcentral gyrus was associated with changes in both the urge to perform compulsions and underlying brain circuitry (with notable individual variability), we established a foundation for developing targeted neuromodulation approaches for sensory-based urges in OCD. These findings are promising and worthy of replication in a larger sample.

Although this study examined only short-term effects, these mechanistic findings will inform future clinical trials employing repeated (multi-week) sessions of individualized TMS to achieve longer-term modulation of sensory phenomena in OCD. Beyond TMS, the insights gained from this work are also guiding our exploration of other cutting-edge non-invasive brain stimulation techniques, such as low-intensity focused ultrasound, which can reach deeper brain structures and may ultimately expand treatment options for individuals with sensory phenomena.

About the Author

Goi Khia Eng, PhD, is a Research Scientist at Nathan Kline Institute for Psychiatric Research. Her current research involves understanding the neural underpinnings of sensory phenomena in OCD and she aims to utilize non-invasive stimulation methods to elucidate the pathophysiology of these processes.

References

Abramowitz, J. S., Franklin, M. E., Schwartz, S. A., & Furr, J. M. (2003). Symptom Presentation and Outcome of Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder. Journal of Consulting and Clinical Psychology, 71(6), 1049-1057. https://doi.org/10.1037/0022-006X.71.6.1049

Berman, B. D., Horovitz, S. G., Morel, B., & Hallett, M. (2012). Neural correlates of blink suppression and the buildup of a natural bodily urge. Neuroimage, 59(2), 1441-1450. https://doi.org/10.1016/j.neuroimage.2011.08.050

Bohlhalter, S., Goldfine, A., Matteson, S., Garraux, G., Hanakawa, T., Kansaku, K., Wurzman, R., & Hallett, M. (2006). Neural correlates of tic generation in Tourette syndrome: An event-related functional MRI study. Brain : a journal of neurology, 129, 2029-2037. https://doi.org/10.1093/brain/awl050

Bragdon, L. B., Nota, J. A., Eng, G. K., Recchia, N., Kravets, P., Collins, K. A., & Stern, E. R. (2023). Failures of Urge Suppression in Obsessive-Compulsive Disorder: Behavioral Modeling Using a Blink Suppression Task. Journal of Obsessive-Compulsive and Related Disorders, 38, 100824. https://doi.org/10.1016/j.jocrd.2023.100824

Cotovio, G., Ventura, F., Rodrigues da Silva, D., Pereira, P., & Oliveira-Maia, A. J. (2023). Regulatory clearance and approval of therapeutic protocols of transcranial magnetic stimulation for psychiatric disorders. Brain Sciences, 13(7), 1029.

Eng, G. K., De Nadai, A. S., Collins, K. A., Recchia, N., Tobe, R. H., Bragdon, L. B., & Stern, E. R. (2024). Identifying subgroups of urge suppression in Obsessive-Compulsive Disorder using machine learning. Journal of Psychiatric Research, 177, 129-139.

Eng, G. K., Tambini, A., Hermiller, M. S., Recchia, N., Harvey, J. R., Iosifescu, D. V., Tobe, R. H., & Stern, E. R. (2025). Personalized non-invasive neuromodulation for sensory-based urge suppression in individuals with OCD: a proof-of-concept investigation. Frontiers in Human Neuroscience, 19, 1587644. https://doi.org/10.3389/fnhum.2025.1587644

Ferrão, Y. A., Shavitt, R. G., Prado, H., Fontenelle, L. F., Malavazzi, D. M., de Mathis, M. A., Hounie, A. G., Miguel, E. C., & do Rosário, M. C. (2012). Sensory phenomena associated with repetitive behaviors in obsessive-compulsive disorder: an exploratory study of 1001 patients. Psychiatry Research, 197(3), 253-258.

Foa, E. B., Abramowitz, J. S., Franklin, M. E., & Kozak, M. J. (1999). Feared consequences, fixity of belief, and treatment outcome in patients with obsessive-compulsive disorder. Behavior Therapy, 30(4), 717-724. https://doi.org/https://doi.org/10.1016/S0005-7894(99)80035-5

Hallett, M. (2007). Transcranial Magnetic Stimulation: A Primer. Neuron, 55(2), 187-199. https://doi.org/https://doi.org/10.1016/j.neuron.2007.06.026

Jackson, S. R., Parkinson, A., Kim, S. Y., Schüermann, M., & Eickhoff, S. B. (2011). On the functional anatomy of the urge-for-action. Cognitive Neuroscience, 2(3-4), 227-243. https://doi.org/10.1080/17588928.2011.604717

Katz, T. C., Bui, T. H., Worhach, J., Bogut, G., & Tomczak, K. K. (2022). Tourettic OCD: Current understanding and treatment challenges of a unique endophenotype. Front Psychiatry, 13, 929526. https://doi.org/10.3389/fpsyt.2022.929526

Miguel, E. C., do Rosario-Campos, M. C., Prado, H. S., do Valle, R., Rauch, S. L., Coffey, B. J., Baer, L., Savage, C. R., O’Sullivan, R. L., Jenike, M. A., & Leckman, J. F. (2000). Sensory phenomena in obsessive-compulsive disorder and Tourette’s disorder. Journal of Clinical Psychiatry, 61(2), 150-156.

Neuner, I., Werner, C. J., Arrubla, J., Stöcker, T., Ehlen, C., Wegener, H. P., Schneider, F., & Shah, N. J. (2014). Imaging the where and when of tic generation and resting state networks in adult Tourette patients. Frontiers in Human Neuroscience, 8, 362. https://doi.org/10.3389/fnhum.2014.00362

Rosario, M. C., Prado, H. S., Borcato, S., Diniz, J. B., Shavitt, R. G., Hounie, A. G., Mathis, M. E., Mastrorosa, R. S., Velloso, P., Perin, E. A., Fossaluza, V., Pereira, C. A., Geller, D., Leckman, J., & Miguel, E. (2009). Validation of the University of Sao Paulo Sensory Phenomena Scale: initial psychometric properties. CNS Spectr, 14(6), 315-323. https://doi.org/10.1017/s1092852900020319

Rossi, S., Antal, A., Bestmann, S., Bikson, M., Brewer, C., Brockmöller, J., Carpenter, L. L., Cincotta, M., Chen, R., Daskalakis, J. D., Di Lazzaro, V., Fox, M. D., George, M. S., Gilbert, D., Kimiskidis, V. K., Koch, G., Ilmoniemi, R. J., Lefaucheur, J. P., Leocani, L., . . . Hallett, M. (2021). Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clinical Neurophysiology, 132(1), 269-306. https://doi.org/10.1016/j.clinph.2020.10.003

Saturnino, G. B., Puonti, O., Nielsen, J. D., Antonenko, D., Madsen, K. H., & Thielscher, A. (2019). SimNIBS 2.1: A Comprehensive Pipeline for Individualized Electric Field Modelling for Transcranial Brain Stimulation. In S. Makarov, M. Horner, & G. Noetscher (Eds.), Brain and Human Body Modeling: Computational Human Modeling at EMBC 2018 (pp. 3-25). Springer International Publishing. https://doi.org/10.1007/978-3-030-21293-3_1

Shavitt, R. G., de Mathis, M. A., Oki, F., Ferrao, Y. A., Fontenelle, L. F., Torres, A. R., Diniz, J. B., Costa, D. L., do Rosario, M. C., Hoexter, M. Q., Miguel, E. C., & Simpson, H. B. (2014). Phenomenology of OCD: lessons from a large multicenter study and implications for ICD-11. Journal of Psychiatric Research, 57, 141-148. https://doi.org/10.1016/j.jpsychires.2014.06.010

Stein, D. J., Andersen, E. W., & Overo, K. F. (2007). Response of symptom dimensions in obsessive-compulsive disorder to treatment with citalopram or placebo. Brazilian Journal of Psychiatry, 29, 303-307.

Stern, E. R., Brown, C., Ludlow, M., Shahab, R., Collins, K., Lieval, A., Tobe, R. H., Iosifescu, D. V., Burdick, K. E., & Fleysher, L. (2020). The buildup of an urge in obsessive–compulsive disorder: Behavioral and neuroimaging correlates. Human Brain Mapping, 41(6), 1611-1625. https://doi.org/10.1002/hbm.24898

Weise, K., Numssen, O., Thielscher, A., Hartwigsen, G., & Knösche, T. R. (2020). A novel approach to localize cortical TMS effects. Neuroimage, 209, 116486.

Zouki, J.-J., Eapen, V., Efron, D., Maxwell, A., Corp, D. T., & Silk, T. J. (2024). Functional brain networks associated with the urge for action: Implications for pathological urge. Neuroscience and Biobehavioral Reviews, 163, 105779. https://doi.org/https://doi.org/10.1016/j.neubiorev.2024.105779

The post Understanding Sensory Phenomena in OCD appeared first on International OCD Foundation.

Posted on

Comparison of subject-to-template registration schemes using CT and MR radiotherapy images with brain lesions

IntroductionVoxel-based analyses have been used more widely in radiotherapy in recent years. The purpose of this study is to compare eight different methods of registering images on to a template space for such analyses. A novel way, using both CT and MR data, is proposed.MethodsCT and MR brain images from 85 participants in the CoDe-B-Rad study (NCT06466720) were registered on an age-specific template. The registration schemes used included sCT-Template (linear and non-linear); MR-Template (linear, non-linear, masked, and enantiomorphic); and Dual-Template (linear and non-linear). The registrations were compared qualitatively and quantitatively against the template MR images with scores ranging from 1 (lowest) to 5 (highest) and quantitatively (via Jaccard, ASD, and HD95).ResultsQualitatively, the best registration scheme was the Dual-Template-non-linear registration, with 60 participants scoring above 4. The second best was the MR-Template-enantiomorphic, with 53 participants scoring above 4. Quantitatively, the Dual-Template-non-linear method outperformed on the mean (±SD) for the ASD and HD95, with 0.918 (±0.1774) and 2.965 (±0.5392) respectively. For ASD the difference compared to other methods was significant (p = 0.03). The MR-Template-masked outperformed on the Jaccard mean (±SD), median (IQR), and ASD, achieving values of 0.567 (±0.0557), 0.555 (0.055), and 0.808 (0.162) respectively. The Dual-Template-non-linear and MR-Template-masked and non-linear had the same result for the median HD95: 2.639. The performance of all linear schemes was inadequate both quantitatively and qualitatively. All non-linear registration schemes had issues with distortions of tissue and landmarks, however, for the Dual-Template scheme these were minimal.ConclusionThe Dual-Template-non-linear registration scheme is a new way of registering lesioned brain images for use with voxel-wise techniques in radiotherapy, which utilises both CT and MR image data. The scheme provides fidelity of the underlying soft tissue as well as the surrounding skull, minimising anatomical and dosimetric distortions.
Posted on

RutiSafeNet: a behavioral risk and nursing workload monitoring tool for open-door acute inpatient mental health units

IntroductionOpen-door policies for acute inpatient mental health units (AIMHU) have shown promising results in reducing coercive measures, but concerns remain among patients and staff regarding increased workload, constant surveillance, and potential safety risks associated with these policies. This study aims to develop a monitoring tool to facilitate safety management in AIMHUs by monitoring behavioral risks and nursing workload.MethodsThis study employed a qualitative approach using the content analysis method. Data were collected through three in-depth interviews and two focus groups involving staff (n=19) from the AIMHU of the hospital.Results34 items were identified to define behavioral risks related to self-harm and suicide, aggressiveness, and absconding, alongside factors affecting nursing workload. These items were categorized into three levels of risk: low, moderate, and high.DiscussionRutiSafeNet is a preliminary, observation-based monitoring prototype intended to support, rather than to predict, structured risk and workload monitoring in acute inpatient mental health units. As a qualitatively developed instrument, it requires psychometric validation, including inter-rater reliability, construct and criterion validity, predictive value, and clinical feasibility, before it can be implemented as a validated scale in clinical practice.
Posted on

Path and Bayesian network analyses in the complex design of a well-being survey via New Zealand’s Integrated Data Infrastructure

IntroductionIn mental health research involved with sensitive features and privacy issues, using integrated data offers an efficient alternative to traditional approaches such as interviews or in−person data collection. These conventional methods frequently face logistical barriers, including low response rates among study populations. Using integrated data from multiple existing administrative and survey sources provides protection for participants and economic savings for researchers, despite being constrained by the limitations of the original data sources. Our research questions were: 1) Can we conduct path and network analyses of school absenteeism, psychosocial factors, and mental health outcomes using the integrated survey data from New Zealand’s Integrated Data Infrastructure (IDI)? and 2) How can we account for the complex design of the General Social Survey (GSS) to ensure representative inference?Materials and methodsThe study population was New Zealand youth enrolled in school, aged 15 years and older in 2018, who participated in the 2018 GSS. The study analyzed the Ministry of Education data integrated with the 2018 GSS survey data from New Zealand’s IDI. To explore the relationship between outcomes of including the WHO-5, “perceived life worthwhileness”, “perceived general health”, and predictors including school absenteeism, psychosocial factors, and family factors, quantile mixed−effects regression, path analysis, and Bayesian network (BN) analysis were used. The complex survey design was calibrated using replicated weights from the GSS, a design-based method for complex sampling, in path and regression analyses, and bootstrap resampling, in BN analysis.ResultsIn descending order from the weighted path model, overall life satisfaction (standardized path coefficient: 0.36), perceived health condition (0.34), ease in accepting cultural identity (0.12), and trust in the education system (0.07) were all significantly (positively) related to students’ mental health well-being (WHO-5). Perceived life worthwhileness correlated with the WHO-5 but was only connected to overall life satisfaction. Similar factors were identified for perceived health, with additional attributing factors, such as fear of crime in the area and the family’s overall well-being.ConclusionThe integration of Bayesian networks and path analysis offers rigorous methods for detecting complex interrelationships among integrated mental health outcomes from population data and variables from a complex survey design.
Posted on

The relationship between trait mindfulness and psychotic-like experiences in a brief AI-generated music listening context: the roles of presence, perceived interactivity, and emotional arousal

Background and objectiveWithin the interdisciplinary field of cyberpsychology and mental health, trait mindfulness has been associated with lower levels of subclinical anomalous symptoms, such as Psychotic-Like Experiences (PLEs), has gained increasing attention. However, in the context of daily digital human-computer interactions (e.g., listening to AI-generated music), the specific pathways through which Mindfulness operates (the involvement with Presence and Perceived Interactivity) and the boundary conditions of physiological arousal, remain to be clarified. This study aims to explore the direct predictive relationship between mindfulness and individuals’ PLEs, and to investigate the multipath effect of brief AI-generated music listening context (with Presence and Perceived Interactivity), along with the moderating effect of Arousal.MethodsWith a cross-sectional survey design, self-reported multimodal data were collected from 527 Chinese participants. Structural equation modeling (SEM) was conducted using Mplus 8.3 to empirically test the main effects (path coefficients) of the theoretical hypotheses and the moderation model.ResultsBoth the measurement and structural models demonstrated good fit. The path analysis results indicated that: (1) trait trait mindfulness was significantly and negatively associated with PLEs (p < 0.001); (2) regarding the main effect paths of brief AI-generated music listening context, mindfulness significantly and positively predict individuals’ Presence and Perceived Interactivity, while both significantly and negatively predict PLEs; (3) Arousal played a significant moderating role in the relationship between mindfulness and brief AI-generated music listening context, exhibiting a synergistic enhancement effect. Higher levels of Arousal significantly amplified the positive prediction of Mindfulness on both Presence and Perceived Interactivity (p < 0.01).ConclusionsWith the help the SEM, this study maps out the underlying multipath network through which mindfulness is associated with lower PLEs within a brief AI-generated music listening context. The observed associations suggest that presence and perceived interactivity may function as pivotal correlational nodes relevant to mental health correlates, while these results also nuance classic cognitive load assumptions by indicating a potential synergistic association between trait mindfulness and emotional arousal. These results provide a solid empirical foundation and prospective insights, for the mental health-oriented design of AI music products, such as the immersive acoustic environment construction and dynamic, arousal-based interaction recommendations.
Posted on

Psychometric properties of the Chinese version of the school refusal assessment scale–revised in a clinical sample of adolescents and their caregivers with depressive disorders

School refusal behavior (SRB) is a prevalent and functionally heterogeneous problem among children and adolescents that can lead to serious academic, social, and psychological consequences. The School Refusal Assessment Scale–Revised (SRAS-R) is the most widely used instrument for identifying the functional motivations underlying school refusal, yet its psychometric properties have not been examined in Chinese clinical populations. The present study aimed to translate and culturally adapt the SRAS-R into Chinese and to evaluate its psychometric properties in a clinical sample of adolescents with depressive disorders. A total of 171 adolescent outpatients (age range 12–19 years; M = 15.5, SD = 1.90; 67.3% female) diagnosed with DSM-5 depressive disorders and meeting criteria for school refusal behavior completed both child and parent versions of the Chinese SRAS-R. Confirmatory factor analysis (CFA) using diagonally weighted least squares estimation was conducted. After removing Items 20 and 24, the four-factor model yielded strong CFI and RMSEA values for both parent (CFI = 0.99, RMSEA = 0.021, SRMR = 0.094) and child reports (CFI = 0.98, RMSEA = 0.028, SRMR = 0.097), although SRMR values were marginally above the prespecified threshold. Internal consistency reliability ranged from marginal to good across subscales (Cronbach’s α: parent = 0.664–0.815; child = 0.700–0.864), with parent-reported Factor 4 showing the weakest reliability. Factor 1 (avoidance of aversive school situations) obtained the highest mean scores for both informants, consistent with the depression-related negative affectivity characteristic of this clinical sample. Cross-informant discrepancy analyses revealed that children reported significantly higher scores than parents on Factor 2 (escape from social/evaluative situations; p = .017, d = 0.18) and Factor 4 (pursuit of tangible reinforcement; p <.001, d = 0.27), suggesting that parents may underestimate internally driven motivations. Intraclass correlation coefficients indicated fair to good parent–child agreement (ICC = 0.45–0.62), with the highest agreement for Factor 1 and the lowest for Factor 4. The findings provide initial internal-structure and reliability evidence for the Chinese SRAS-R in this single-site clinical sample and underscore the need for multi-informant assessment, while future studies should examine convergent, discriminant, criterion-related, and predictive validity in more diverse samples.