Tag: Academic research

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Implementing BEAM: A Scalable Digital Mental Health Program, for Families of Children Referred to Neurodevelopmental Services

Conditions: Depression and Anxiety Symptom; Anger; Parenting; Stress (Psychology); Parent Child Relationship; Child Development; Neurodevelopmental Conditions

Interventions: Behavioral: The Building Emotional Awareness and Mental Health (BEAM) Program

Sponsors: University of Manitoba; Children’s Hospital Research Institute of Manitoba; Kids Brain Health Network

Not yet recruiting
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Creative Art Teletherapy for Veterans With PTSD

Conditions: Post-Traumatic Stress Disorder F03.950.750.500 D013313

Interventions: Behavioral: Art-therapy Remote Treatment for Veterans Experiencing Trauma

Sponsors: VA Office of Research and Development; Henry M. Jackson Foundation for the Advancement of Military Medicine; Drexel University

Not yet recruiting
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Standardized Manual-Based Smoking Cessation Treatment in Patients With Comorbid Mental Disorders: Qualitative Interview Study

Background: Smoking prevalence is disproportionately high among individuals with mental disorders, who also show reduced cessation success, suggesting that current cessation interventions may not fully address their specific needs. A barrier to smoking cessation is the fear that quitting may worsen mental health, yet little is known about how individuals with mental disorders experience guideline-conform cessation treatments, which may address such concerns. Objective: This qualitative study explored the perspectives of smoking individuals with comorbid mental disorders who participated in a standardized, manual-based, cognitive behavioral smoking cessation program to identify targets for optimizing guideline-conform interventions for this population, spanning treatment engagement, perceived challenges, and facilitators within this context. Methods: Semistructured interviews were conducted with 11 participants representing diverse cessation trajectories (sustained abstinence, relapse, and no quit attempt) 6 months after treatment completion. Data were analyzed using reflexive thematic analysis. Results: Three overarching themes were identified. First, participants described smoking cessation as a multidimensional, processual experience extending beyond behavioral change to encompass psychological and social dimensions, characterized by nonlinearity, adaptive meaning-making, and improvements in self-efficacy despite transient strain during early abstinence. Second, smoking was experienced as a functionally embedded practice serving affective, habitual, and social functions, with motivation emerging as dynamic and relationally sustained rather than stable. Third, treatment engagement was shaped by motivational states and contextual circumstances, with participants offering favorable evaluations of the structured intervention alongside recommendations for greater individualization and flexibility. Notably, mental health–related concerns about cessation largely persisted despite predominantly positive or neutral mental health outcomes, a pattern consistent with cognitive immunization processes. Conclusions: Guideline-conform smoking cessation treatment appears feasible and largely well-received by individuals with comorbid mental disorders. The findings highlight the need for targeted psychoeducation to address persistent misconceptions about the mental health risks of cessation, as well as individualized, context-sensitive treatment adaptations, including greater flexibility in session structure, motivational support beyond the active treatment phase, and explicit attention to the social and functional embeddedness of smoking, to improve cessation outcomes in this high-risk population. Trial Registration: ISCRTN ISRCTN12859609; https://www.isrctn.com/ISRCTN12859609
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Trajectories of Persistent Exposure to Self-Harm–Encouraging Websites and Subsequent Mental Health Outcomes in US Youth: Longitudinal Cohort Study

Background: Self-harm, including suicidal thoughts, self-injurious behavior, and disordered eating, is a major public health concern among adolescents and young adults. Youth increasingly encounter self-harm–related content online, including websites that explicitly encourage harmful behaviors. Although exposure to such content has been linked to poorer mental health, most research is cross-sectional and has not examined longitudinal exposure trajectories. Whether persistent exposure represents a distinct digital risk pattern remains unclear. Objective: This study examined longitudinal trajectories and correlates of exposure to self-harm–encouraging websites over 1 year and tested whether persistent exposure was associated with subsequent suicidal ideation, self-injury, and disordered eating. Methods: We analyzed data from 2197 US youth aged 13 to 22 years who completed waves 2 and 4 of Project Lift Up, a national longitudinal cohort study. Website exposure was categorized into 4 trajectories: none, desist (wave 2 only), new (wave 4 only), and persistent (both waves). Categories reflected reported exposure at the 2 assessment waves rather than the frequency or continuity of website use between assessments. Logistic regression models estimated associations between exposure trajectory and wave 4 suicidal ideation, self-injury, and disordered eating, restricting analyses to participants without the respective outcome at wave 2. Models were adjusted for demographics and wave 2 depression or anxiety symptoms and other mental health indicators. Results: Overall, 26.5% (583/2197) reported exposure to self-harm–encouraging websites at wave 2, and 18.5% (407/2197) reported persistent exposure. Privacy concerns, embarrassment, curiosity, and lack of offline support were associated with greater odds of persistence (adjusted odds ratios [aORs] 1.84‐3.23), whereas accidental exposure was associated with lower odds of persistence (aOR 0.28, 95% CI 0.19‐0.41). Compared with no exposure, persistent exposure was associated with higher odds of suicidal ideation (aOR 1.88, 95% CI 1.24‐2.86; =.003), self-injury (aOR 3.14, 95% CI 2.05‐4.80; <.001), and disordered eating (aOR 2.46, 95% CI 1.54‐3.93; <.001). Adjusted predicted probabilities showed a graded pattern, with persistent exposure associated with the highest predicted probabilities (suicidal ideation: 33.4% vs 21.3%; self-injury: 25.7% vs 10.2%; disordered eating: 11.7% vs 5.3%). New exposure was associated with increased odds of self-injury (aOR 2.32, 95% CI 1.30‐4.15; =.004) but was not significantly associated with suicidal ideation or disordered eating. The desist trajectory was not significantly associated with outcomes. Conclusions: Persistent exposure to self-harm–encouraging websites may represent a distinct digital risk pattern associated with higher subsequent odds of suicidal ideation, self-injury, and disordered eating. Assessing patterns of repeated website exposure and youths’ motivations for seeking this content—not merely whether exposure occurred—may improve the identification of youth at heightened risk and inform digital prevention and clinical intervention strategies.
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Relationship between loneliness and self-efficacy: the mediating role of internet addiction and the moderating role of sleep quality

IntroductionThis study aimed to examine the association between loneliness and self-efficacy among adolescents and to investigate whether internet addiction mediated this association and whether sleep quality moderated the direct and indirect pathways. Although previous research has demonstrated significant associations between loneliness and both general and social self-efficacy, the behavioral mechanisms underlying these associations and the conditions under which their strength may vary remain insufficiently understood.MethodsA cross-sectional survey was conducted among 1,323 students in Grades 7–9 from two schools in Baotou, Inner Mongolia, China. Participants completed the UCLA Loneliness Scale, the General Self-Efficacy Scale, the Internet Addiction Diagnostic Questionnaire, and the Athens Insomnia Scale. A moderated mediation model was used to examine the mediating role of internet addiction and the moderating role of sleep quality in the association between loneliness and self-efficacy.ResultsLoneliness was negatively associated with self-efficacy. Internet addiction partially mediated the association between loneliness and self-efficacy. In addition, sleep quality moderated the direct association between loneliness and self-efficacy and the first stage of the indirect pathway from loneliness to internet addiction. Specifically, the associations of loneliness with self-efficacy and internet addiction varied across different levels of sleep quality.DiscussionThese findings provide a more comprehensive understanding of the mechanisms linking loneliness to adolescent self-efficacy by identifying internet addiction as an important behavioral mediator and sleep quality as a moderating factor. The findings highlight the importance of considering problematic Internet use and sleep quality when developing interventions aimed at promoting adolescents’ psychological adjustment, self-efficacy, and well-being.
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Maternal folate receptor alpha autoantibodies and folate levels during pregnancy in relation to autism spectrum disorder: a pilot case-control study

BackgroundFolate receptor alpha autoantibodies (FRAA) are reported to be associated with autism spectrum disorder (ASD) and are found more frequently in mothers of children with ASD. However, the relationship between maternal FRAA during pregnancy, folate status, and ASD risk in offspring remains unclear.ObjectiveIn this exploratory pilot study, we compared maternal serum binding FRAA measured during pregnancy between high-folate ASD cases and childbirth-time–matched mothers of typically developing children.MethodsFRAA were retrospectively analyzed in serum samples collected between gestational weeks 7 and 18 from women whose children were later diagnosed with ASD (case subgroup, n = 10) and mothers of neurotypical children (control subgroup, n = 10). Case samples were selected based on previously measured elevated folate levels, while controls were selected to minimize differences in biobank storage duration.ResultsFRAA were detected in 2 of 10 samples in each group, corresponding to a prevalence of 20%. Although based on limited statistical power, no significant difference in FRAA prevalence was observed.ConclusionIn this exploratory pilot study, no difference in binding FRAA prevalence was found between mothers of children with ASD, who were selected for elevated maternal folate levels, and mothers of neurotypical children. While this finding does not support a link between FRAA and elevated maternal folate levels, the small sample size and selection criteria limit interpretation.LimitationsThe study was limited by the small sample size, differences in subgroup selection, uncertainty in gestational age at sampling, and the inability to assess blocking FRAA.
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Low-burden speech-based screening of depressive symptoms using ultra-short speech samples

BackgroundSpeech holds promise for depressive symptom screening, but practical applications require clearer guidance on effective segmentation, optimal speech tasks, minimum duration, and feature-model matching.ObjectiveTo enable low-burden screening for depressive symptoms, this study aims to evaluate the effectiveness of short speech samples and systematically investigate how to identify the optimal practical combination of different speech tasks, time-window lengths, and the matching between features and models.MethodsUsing the HMU-DDAC-24 dataset of 143 participants aged 18–22 years, we evaluated 10 segmentation lengths (0.1–15 s), 5 models (Random Forest, Extreme Gradient Boosting (XGBoost), Long Short-Term Memory (LSTM), Transformer, Extended Long Short-Term Memory (xLSTM)), and 3 feature types (frame-level, statistical, fused). We also assessed 19 window lengths (1–35 s) across four speech tasks and their combinations. In addition, supplementary cross-dataset validation analysis was performed using the external Emotional Audio-Textual Depression (EATD) dataset.ResultsFrame-level features performed best with sequence models and short windows (0.1–2 s; Transformer accuracy: 0.731 at 2 s). Statistical features paired best with tree models and short windows (Random Forest accuracy: 0.698 at 1 s). Fused features improved tree models (Random Forest accuracy: 0.703 at 4 s) but introduced noise into sequence models. Task 4 (positive recall) achieved the best overall performance (Area Under the Receiver Operating Characteristic Curve (AUC) = 0.860), outperforming all single and combined tasks, showing no multi-task synergy. A 1-s segment performed comparably to full-length speech (3.14% relative performance loss). Kullback-Leibler divergence analysis showed short segments closely approximated the full recording’s distribution (Task 4 KL = 9.56 at 1 s).ConclusionsWhen combined with appropriate speech tasks and feature-model matching, short speech samples can facilitate low-burden screening for depressive symptoms. Supplementary analysis on the EATD dataset supported these trends, though absolute performance depended on feature representation. We recommend positive recall with 2-s truncation, frame-level features, and Transformer for accuracy-oriented settings; and 1-s truncation, statistical features, and Random Forest for resource-limited settings. These findings may inform rapid, remote speech-based screening for depressive symptoms, especially in resource-limited primary-care settings.
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Irreconcilable differences?: epistemic injustice and the integration of mental healthcare for LGBTQ+ young people

BackgroundIntegrated youth mental healthcare is an approach that has evolved in response to the global escalation of young people’s poor mental health, and the failure of current mental health systems and models to improve this situation. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) young people have disproportionately high rates of poor mental health compared with their cisgender, heterosexual peers, but there is a dearth of research examining how best to integrate mental healthcare for LGBTQ+ youth.AimTo identify differences in the discursive construction of LGBTQ+ identity, youth, and mental health between LGBTQ+-specific youth mental health services and mainstream services and how these differences may facilitate or limit the integration of mental healthcare.MethodsWe conducted a qualitative secondary analysis using Foucauldian discourse analysis, a method that centralises power and knowledge, to examine the discourses used to construct LGBTQ+ identity, youth, and mental health across four different mental health services. Using epistemic injustice as a theoretical framework, we analysed interviews with LGBTQ+ young people and staff (n = 30).ResultsMainstream discourses of LGBTQ+ youth mental health concentrate on risks, trauma, and harm, and reinforce a passive, pathologised, and patronised subject position for LGBTQ+ youth. In contrast, we identified three counter-discourses in LGBTQ+-specific mental health services: Knowing and telling, Resisting pathology, and Capability. These counter-discourses allowed for wider, transformative possibilities for LGBTQ+ youth subjectivities and mental wellbeing.DiscussionExisting models of integrated youth mental healthcare privilege a clinical, developmental, and universal approach that does not consider justice or the oppressive power systems implicated in LGBTQ+ young people’s mental healthcare. Without addressing in/justice, there will remain fundamental irreconcilable differences that will forfeit effective and inclusive systems of mental healthcare for LGBTQ+ young people.
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In Vivo Characterization of Fatty Acid Amide Hydrolase in Posttraumatic Stress Disorder: A [11C]CURB Positron Emission Tomography Study

Posttraumatic stress disorder (PTSD) is associated with impaired fear extinction and dysfunction in amygdala-centered circuits, for which treatments remain insufficient. The endocannabinoid system, particularly anandamide signaling regulated by fatty acid amide hydrolase (FAAH), has been implicated in stress and fear regulation. Preclinical studies suggest increased FAAH is linked to heightened stress responsivity, but FAAH status in PTSD remains unclear. We used [11C]CURB positron emission tomography (PET) to characterize FAAH levels in the amygdala and in corticolimbic regions in PTSD and examine associations with clinical symptoms.