IntroductionFunctional neurological disorders (FND) are characterized by involuntary sensory, motor, and/or other seemingly neurological symptoms lacking expected medical explanation. Once diagnosed, patients often are referred to mental health providers for psychotherapy, which is effective in treating many FND symptom presentations either alone or as part of an integrative approach. Mental health providers may feel reluctant or unprepared to accept these referrals, however.MethodsWe conducted a U.S.-based online survey of 286 practicing psychological service providers (psychologists, psychiatrists, counselors, social workers in private practice, neuropsychologists) to examine knowledge of, attitudes toward, and preparedness to treat FND.ResultsFindings revealed that most of our sample had limited exposure to FND in routine practice. Confidence in treating FND was modest, with neuropsychologists reporting more knowledge of and more confidence in treating FND than other psychologists/mental health providers. Greater perceived adequacy of psychotherapy training for, and more experience working with, FND each were associated with more positive FND attitudes, including greater confidence and enjoyment in treating FND and greater belief that symptoms would improve.DiscussionThis study is novel in its examination of knowledge and attitudes among psychological service providers, who are pivotal in furnishing effective treatment for FND patients but may not be well-versed in their needs. In contrast to existing studies of medical providers that revealed stigma as a major barrier to providing adequate care for FND, our findings suggest lack of knowledge and lack of access to FND patients may limit the ability to gain more training and expertise. Targeted training and consultation for mental health providers may improve confidence and motivation and expand the workforce capable of delivering effective treatment for FND.
From single pathways to holistic networks: unraveling the multimechanistic actions of acupuncture in depression
Depression is a globally prevalent mental disorder; however, current pharmacological treatments are limited by a delayed onset of action and significant adverse effects. As a safe and effective non-pharmacological therapy, acupuncture demonstrates unique advantages in treating mild to moderate depression. Its antidepressant mechanisms are multifaceted. Primarily, acupuncture mitigates neuroinflammation by inhibiting classical signaling pathways (e.g., nuclear factor kappa B/NOD-like receptor family pyrin domain containing 3), modulating microglial polarization, and restoring cytokine homeostasis. Furthermore, it enhances neuroplasticity by upregulating brain-derived neurotrophic factor expression, improving synaptic plasticity, and promoting adult neurogenesis. At the cellular level, acupuncture exerts neuroprotective effects by suppressing apoptotic cascades associated with mitochondrial dysfunction and endoplasmic reticulum stress, regulating autophagic balance, and restoring neuronal excitability. Systemically, it ameliorates metabolic dysregulation by optimizing cerebral energy metabolism, modulating gut microbiota composition, and reinforcing intestinal barrier integrity. Additionally, acupuncture effectively alleviates comorbid pain by modulating peripheral nociceptive signaling and central pain-emotion feedback loops. These synergistic effects across multiple systems and targets may together ameliorate the pathophysiological alterations associated with depression. Despite these advances, current research faces challenges, including the translational gap between animal models and clinical pathology, as well as an insufficient investigation of multi-mechanism interactions. Future efforts should focus on developing clinically relevant models, integrating multi-omics technologies, conducting high-quality clinical trials, and exploring biomarker-guided personalized treatments to advance the scientific and standardized application of acupuncture for depression.
When support becomes dependence: conversational continuity and relational safety in human-AI interaction
BackgroundConversational artificial intelligence (AI) is increasingly used for emotional support, reflection, and consequential decision-making. Although conversational continuity may improve responsiveness, sustained interaction also exposes AI systems to their own prior relational language, potentially shaping how they respond when users become increasingly dependent or surrender personal agency. We examined whether model-generated conversational history alters relational-safety behavior as human–AI interactions escalate from ordinary support-seeking toward emotional dependence, social displacement, and decision delegation.MethodsWe conducted a standardized multi-turn benchmarking study of ChatGPT, Gemini, and Doubao. Twelve four-turn trajectories represented two agency-related domains: emotional dependency and displacement of human support, and decision delegation and surrender of personal agency. Each trajectory was evaluated under two matched context architectures: reconstructed cumulative user-only context, which retained all prior user disclosures but excluded previous AI responses, and native continuous conversation, which retained the complete interaction history. Across 72 model-condition-trajectory sequences comprising 288 turn-level responses, relational safety was independently evaluated for dependency reinforcement, agency preservation, and human-support preservation using predefined ordinal criteria. Context effects and their interaction with escalating relational risk were examined using cumulative-link mixed-effects models.ResultsRelational-safety differences between context architectures increased across successive turns of the standardized trajectories. Overall, explicit dependency reinforcement increased from 9.7% in cumulative user-only contexts to 18.1% in continuous conversations, while strong agency preservation declined from 75.7% to 65.3% and strong human-support preservation from 73.6% to 63.2%. Outcome-specific analyses showed condition-by-turn interactions for dependency reinforcement (cumulative odds ratio [cOR], 1.26; 95% CI, 1.03–1.55; unadjusted P = .026), agency preservation (cOR, 0.82; 95% CI, 0.69–0.98; unadjusted P = .031), and human-support preservation (cOR, 0.78; 95% CI, 0.65–0.94; unadjusted P = .009), indicating progressively greater divergence between context conditions across successive turns. After Holm adjustment across the three interaction tests, only the human-support-preservation interaction remained below the.05 threshold (adjusted P = .027).The overall pattern was observed across systems and was directionally consistent in predefined binary sensitivity analyses.ConclusionsAcross this benchmark, between-condition differences generally widened across successive turns, although the present design cannot determine whether this pattern reflects increasing relational-risk intensity, increasing accumulated model-generated history, or their combination. Only the human-support-preservation interaction remained below the.05 threshold after Holm adjustment, whereas the dependency-reinforcement and agency-preservation interactions were directionally similar but less robust after multiplicity adjustment. The observed pattern is compatible with a post-hoc interpretive framework of relational inertia but does not establish this process as a causal mechanism or demonstrate downstream psychological effects in human users.
Positive–affective and negative–cognitive brain–behavior axes in clinical high risk for psychosis
Individuals at clinical high risk for psychosis (CHR) present with heterogeneous combinations of positive, negative, and affective symptoms, cognitive difficulties, and functional impairment. However, reproducible multivariate links between this multidomain phenotype and brain morphology remain limited. This study explored the multivariate brain–behavior associations in CHR using a data-driven approach.
Rosie en Español, a Chatbot-Delivered Intervention for Spanish-Speaking, US-Based Latina Mothers: Pilot Randomized Controlled Trial
Background: Latina pregnant women and mothers of infants in the United States experience elevated risk for perinatal anxiety, stress, and depression alongside persistent barriers to culturally and linguistically responsive care. AI-powered digital health tools offer a potentially scalable approach to address these gaps, yet evidence on their acceptability and effectiveness for this population remains limited. Objective: We aimed to evaluate the feasibility, acceptability, and preliminary outcome changes of Rosie, a Spanish-language AI-powered chatbot designed with and for Latina mothers, on maternal mental health and healthcareuse outcomes. Methods: We conducted a mixed methods pilot randomized controlled trial with 30 Spanish-speaking Latina participants who were pregnant or parenting an infant younger than 6 months. Participants were randomized 1:1 to the Rosie intervention or a comparison book club condition that provided monthly children’s board books. Surveys administered at baseline and 3-month follow-up assessed depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), perceived stress (Perceived Stress Scale), and health care use. Quantitative analyses examined within- and between-group changes, and qualitative feedback assessed acceptability and user experience. Results: Baseline mental health scores were low in both groups; however, several baseline demographic differences were observed between study arms, including age, pregnancy vs parenting status, marital status, education, and country of origin. Over 3 months, participants in the Rosie group demonstrated statistically significant within-group reductions in anxiety (mean baseline 3.27, SD 2.89; mean change −2.00, SD 2.94; =.02) and perceived stress (mean baseline 30.00, SD 5.53; mean change −12.20, SD 12.99; =.003). Depression scores declined modestly in both groups, with no significant between-group differences. No significant differences were observed in maternal emergency department use or adherence to well-baby visits. Engagement with Rosie was high, and qualitative feedback indicated that participants found the chatbot useful and supportive. Conclusions: This pilot study suggests that a culturally and linguistically tailored AI-powered chatbot is feasible and acceptable among Latina mothers during the perinatal period. Although anxiety and perceived stress decreased within the Rosie group, no significant between-group differences were observed. Within-group reductions in anxiety and perceived stress among Rosie participants are preliminary and should be interpreted cautiously because the trial was not powered to detect between-group effects and no statistically significant between-group differences were observed. Larger, adequately powered trials are needed to evaluate effectiveness.
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What Living With OCD Really Feels Like
By Adolfo Flores-Quilcate
I view having OCD like living inside a glass box while holding the keys to the door, looking out at the world. Everyone around you can come and go inside their own box. Most people have the choice to leave whenever they want. With OCD, it feels like you do not.
One of the main ways it works is rumination: rewinding an old cassette tape over and over with no clear end. I have spent too much time trapped in that box, playing the same tape. The scariest part is how many adults live this way without realizing it. OCD affects roughly 1 in 40 adults in the U.S., yet a lot of people have no idea they are behind that glass.
The most frustrating part is being judged by people who do not understand what it is actually like. They can see you rewinding the tape and call you crazy. The sad part is, so can I. I can see out of the box just fine. I can see the key. I can even put the key in the lock. But OCD holds me back from turning it. I can remember times when I could open the door. I can see my family looking at me from the other side, concerned.
In a sense, having OCD is like being in purgatory without committing any sins, just for existing. It is unfair, and I used to constantly ask, why me? It was unfair enough being the shortest male on my dad’s side. Why did I have to measure myself 45 times a day and keep over 300 lists on my phone of the height I wanted to be? It was unfair enough getting physical headaches and dizziness. Why did I have 150 panic attacks over it and stay in bed all day? It was bad enough when my ex-girlfriend broke up with me. Why did I loop the breakup 500 times a day for ten months? OCD does not care if you are sick or happy. It latches onto anything that catches your attention.
My diagnosis came as a massive surprise in April of this year. At first I told myself I was not sick. That denial eventually gave way to a bigger realization: the diagnosis was a blessing in disguise. My whole life I thought something was wrong with me, that I was defective. Then it clicked. That was not me. That was my OCD. All those days measuring myself and writing lists — that was my OCD. Checking my oxygen levels every 20 minutes during panic attacks over a headache — that was my OCD. Checking her social media and ruminating for hours on what could have been — that was my OCD.
My relationship with OCD is a lot like a long marriage between two people who do not really get along anymore. The arguments are endless and usually petty: ruminating all day on why I did not study harder, or believing that if I drink out of a certain cup my family will die. Most of the time I would rather just think about the cold beer after my shift or watching the game than keep listening to the nagging.
When I walked into therapy on February 22, 2026, the tape was still running on overdrive. Like a lot of people, I was stubborn about getting help. Four months in, three times a week, my therapist helped me see what I was doing to myself. I was like a guy standing under a coconut tree, shaking it until a coconut fell and hit me in the head, then complaining about the headache and going right back to shake the tree again.
I started treating intrusive thoughts like an unwanted knock on the door. Sometimes a knock is good: Aunt Peppy with a pie, a friend wanting to swim, the girl next door. Intrusive thoughts are more like the annoying neighbor complaining about noise, or kids ding-dong-ditching. We cannot control who knocks. We can control who we answer and who we let inside. Now when a thought shows up — “My ex has replaced me” — I label it for what it is: an intrusive thought, a fear of replacement. Then I move on. Leaning into the fear or accepting “maybe, maybe not” became useful tools.
Working on OCD is the hardest thing I have ever done. I have lost 65 pounds and gone to community college with 57-year-old accountants while my friends partied. ERP is no joke. I still remember some of the worst exposures: my therapist describing a detailed scenario of my ex getting a massage from another guy, or making me write my own obituary because I was terrified of getting a colonoscopy. Doing exposures sucks. It can ruin your weekend. But it sucks more to stay trapped in the glass box while the world passes you by.
I am only 19, and this is just the beginning. My goal is to start an OCD awareness club at my university and one day speak to people who feel like there is no hope. If you are struggling, take the first step: therapy, a support group, anything. It takes time and a lot of exposure, but healing is possible.
You are not alone. You are not your OCD. You are uniquely yourself, and you hold the key to that glass box. Do not let your OCD rule you. Rule your OCD.
Adolfo Flores-Quilcate is a 20-year-old college student at FIU who hopes to become an OCD advocate and create an OCD awareness and mental health club at FIU this upcoming semester. He was diagnosed early 2026 and is hopeful for the future of OCD awareness.
The post What Living With OCD Really Feels Like appeared first on International OCD Foundation.
Microglia in the neurogenic niche: emerging roles of immunometabolism
Adult neurogenesis is dynamically regulated by the neurogenic niche, yet the mechanisms governing its remodeling are not fully elucidated. Current research has increasingly extended beyond the intrinsic properties of neural stem cells to consider the broader microenvironment in which neurogenesis occurs, with microglia emerging as important regulators of the neurogenic niche. Drawing upon pathological contexts such as depression and aging, this review characterizes the hallmarks of neurogenic niche dysregulation and synthesizes the mechanisms by which microglia modulate neurogenic efficiency. Particular emphasis is placed on the role of immunometabolism in shaping microglial functional states and subsequent niche remodeling. We propose that microglial immunometabolic states may serve as an important interface through which pathological perturbations within the brain are linked to remodeling of the neurogenic niche, providing a conceptual framework for understanding neurogenic decline across distinct pathological contexts.
ADHD-related mental health and school impairments across educational stages: sex-specific patterns in Japanese youth
IntroductionWhile ADHD-related challenges are well-documented internationally, understanding of how these manifest across educational stages and sexes remains limited. This study examined mental health symptoms and school functioning in Japanese children with and without ADHD across elementary, junior high, and senior high school.MethodsIn this comparative cross-sectional study, parents of 1,594 Japanese children (797 with ADHD, 797 without ADHD) aged 6–18 years completed questionnaires assessing ADHD symptoms (ADHD-RS-IV), depression (SMFQ), anxiety (SCAS), irritability (ARI), bullying victimization, academic achievement, and social support. Three-way ANOVAs examined interactions between ADHD status, child sex, and educational stage, with Cohen’s d effect sizes calculated for group comparisons.ResultsChildren with ADHD demonstrated significantly poorer outcomes across nearly all domains, except for teacher support, with effect sizes ranging from moderate to very large (d = 0.35–1.44). Contrary to expectations, the largest group difference for girls’ depression emerged in elementary school (d = 1.44) rather than junior high school, and girls’ anxiety differences were comparably large in elementary (d = 1.25) and junior high school (d = 1.30). Girls with ADHD showed consistently larger effect sizes than boys for depression (mean d: 1.14 vs. 0.84), anxiety (1.13 vs. 0.73), and irritability (1.32 vs. 0.90) across all stages. Significant ADHD × sex interactions emerged for depression, anxiety, and irritability. Bullying victimization affected 31.0% of children with ADHD compared to 7.5% of non-ADHD children, with peak effects in elementary school. Academic difficulties showed the anticipated pattern of increasing impairment from elementary to junior high school, particularly for boys (d = 0.65 to 1.07).DiscussionThese findings reveal pronounced sex differences in ADHD-related mental health burden, with girls experiencing what may be a “hidden burden” of greater internalizing symptoms across development. The smaller group differences for internalizing symptoms in adolescence may partly reflect decreased parental awareness of adolescent internalizing symptoms. These results underscore the need for sex-specific, developmentally-informed interventions with particular attention to early identification and support for girls with ADHD who may be overlooked in clinical and educational settings.
Outcome indicators used in recovery college effectiveness studies: a scoping review
IntroductionRecovery Colleges (RCs) are educational, recovery-oriented approaches in mental health. Differences in evaluation purposes and settings may lead to diverse outcome indicators, making it important to map their use and supporting measurement evidence. This scoping review aimed to identify the outcome indicators used in RC evaluations and clarify their measured constructs, patterns of use, and reporting of reliability and validity. Methods: The review followed JBI methodology and PRISMA-ScR reporting guidance. PubMed, Web of Science, CINAHL Ultimate, ERIC, and seven databases accessed through ProQuest were searched. English-language journal articles reporting quantitative RC evaluations, including quantitative components of mixed-methods studies, were eligible. Eligible data included questionnaire scores before and after RC participation and health service utilization indicators, such as hospital admissions and service contacts. Three reviewers independently screened titles and abstracts and assessed full texts. Data were extracted collaboratively by two reviewers and independently checked by a third. Measured constructs were classified using inductive content analysis. Results: Of 336 records identified, 149 remained after deduplication and 22 articles were included. Thirty-nine measure and indicator entries were identified across three domains: intra-personal and psychological changes, behavioral and social changes, and system and environment. The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), including its short version (SWEMWBS), appeared in 11 articles (50.0%) and the Questionnaire about the Process of Recovery (QPR) in four (18.2%); 28 entries appeared in one article only. Fifteen articles (68.2%) cited previous psychometric information or identifiable validation literature, two (9.1%) explicitly reported within-study reliability estimates, and six (27.3%) reported neither specific psychometric evidence nor an identifiable validation citation. One article was not applicable to scale psychometrics. Conclusion: RC evaluations used diverse measures, while direct assessment of educational processes and outcomes was comparatively limited. This review mapped measurement choices rather than RC effects. The findings can inform co-produced decisions about outcome selection and study design, alongside further evaluation of existing instruments’ suitability for the intended RC populations. Involving learners and other stakeholders in these decisions can help align evaluation with research purposes and RCs’ educational philosophy while ensuring that participants’ individual goals are also assessed.
Evaluating the PolarUs App in People With Bipolar Disorder
Conditions: Bipolar Disorder (BD); Quality of Life (QOL)
Interventions: Device: PolarUs Mobile App
Sponsors: University of British Columbia; Canadian Institutes of Health Research (CIHR)
Not yet recruiting
Interventions: Device: PolarUs Mobile App
Sponsors: University of British Columbia; Canadian Institutes of Health Research (CIHR)
Not yet recruiting