Tag: Academic research

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Resting-state functional connectivity of the sensorimotor network in medication-naïve Chinese children with ADHD: cross-sectional associations with hyperactivity/impulsivity and executive function

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often—but not always—characterized by inattention, hyperactivity/impulsivity, and deficits in executive functions (EFs); some individuals may also exhibit sensorimotor dysfunction. While SMN dysfunction has been implicated in ADHD, the patterns of SMN functional connectivity (FC) and their relationships with clinical symptoms and EFs remain inconsistent, partly due to methodological heterogeneity.MethodsThe study included 62 medication-naïve patients with ADHD (aged 6–15 years) and 46 healthy controls matched for age, sex, and IQ. Clinical symptoms and EFs were assessed using CPRS, IVA-CPT, and Stroop tests. Resting-state fMRI data were acquired, and ROIs within SMN, SN, DMN, and FPN were selected from the Dosenbach atlas. FC was analyzed using Network-Based Statistics (NBS). Partial correlations explored FC–behavior relationships in the ADHD group, controlling for age, sex, and IQ.ResultsThe ADHD group showed significantly higher CPRS hyperactivity/impulsivity scores and poorer IVA-CPT and Stroop performance. Compared to controls, ADHD showed increased FC within SMN (right posterior insula to left precentral gyrus/parietal lobe), between SMN–DMN (precentral gyrus, dorsal frontal cortex, temporal lobe, angular gyrus, posterior cingulate cortex, and precuneus), and SMN–SN (middle insula, superior parietal lobule, superior temporal gyrus, basal ganglia, and fusiform gyrus). Enhanced intra-SMN FC was negatively correlated with impulsivity/hyperactivity and hyperactivity index scores. Enhanced SMN–DMN FC was negatively correlated with hyperactivity symptoms and positively correlated with control quotients in IVA-CPT. Enhanced SMN–SN FC was negatively correlated with Stroop correct responses and positively correlated with omission errors.ConclusionsIn this medication-naïve pediatric sample, distinct SMN connectivity patterns differentially related to ADHD symptoms and executive function. However, given the cross-sectional design and modest sample size, these associations cannot establish causality; they require replication in longitudinal studies and larger cohorts to clarify whether they reflect developmental variation, neurobiological subtypes, or epiphenomena.
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Clinical Outcomes and Predictors of Improvement With Virtual Behavioral Health Care for Gambling Disorder: Retrospective Cohort Study

<strong>Background:</strong> Gambling disorder is associated with substantial psychiatric and functional burden, yet few individuals receive treatment. Limited real-world evidence exists evaluating outcomes of virtually delivered behavioral health care for gambling disorder, particularly among clinically complex patients. <strong>Objective:</strong> The purpose of this study was to evaluate gambling symptom severity outcomes among adults with gambling disorder receiving care from Birches Health. We aimed to (1) characterize the clinical profile of adults seeking treatment for gambling disorder; (2) quantify changes in gambling symptom severity over the initial 12 weeks of treatment and examine whether baseline clinical complexity, such as gambling symptom severity, depression severity, and psychiatric comorbidities, was associated with differences in gambling symptom severity improvement over time; and (3) estimate the timing and likelihood of achieving clinically meaningful improvement in gambling symptom severity. <strong>Methods:</strong> This retrospective cohort study included 1305 adults receiving virtual behavioral health treatment for gambling disorder through Birches Health between June 2024 and April 2026. Gambling symptom severity was assessed using the Gambling Symptom Assessment Scale (G-SAS) weekly. Linear mixed-effects models evaluated changes in gambling symptom severity over 12 weeks and associations with baseline clinical characteristics. Clinically meaningful improvement was defined as a reduction of 4 or more points in the G-SAS score. <strong>Results:</strong> Participants had a mean age of 41.5 (SD 13.1) years, 65.2% (851/1305) were male, and baseline gambling symptom severity was moderate (mean G-SAS score 20.5, SD 11.83). Over half (730/1305, 56%) of participants presented with at least one psychiatric comorbidity, most commonly anxiety disorder (351/1305, 26.9%) and depressive disorder (276/1305, 21.1%). Gambling symptom severity declined significantly over the first 12 weeks of treatment, with G-SAS scores decreasing by approximately 0.099 points per day (<i>P</i>&lt;.001), corresponding to an estimated 8.3-point reduction over 12 weeks. Higher baseline depressive symptom severity was associated with faster improvement in gambling symptoms (<i>P</i>=.01), whereas depressive disorder (<i>P</i>=.03) and attention-deficit/hyperactivity disorder (<i>P</i>=.008) diagnoses were associated with slower improvement trajectories. Among patients with routine follow-up assessments recorded during the initial 12 weeks of treatment (1071/1305, 82.1%), 71.7% (935/1305) achieved clinically meaningful improvement in gambling symptom severity, with a median time to improvement of 14 days. <strong>Conclusions:</strong> A clinically complex population of adults receiving care through a national virtual behavioral health care provider demonstrated rapid and clinically meaningful reductions in gambling symptom severity. These findings highlight the potential of specialized virtual care models to expand access to gambling treatment and support symptom improvement in routine care settings. Future research should evaluate longer-term recovery trajectories and identify factors associated with sustained improvement and ongoing engagement in care.
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The associations between emotional neglect and positive mental health: the mediating role of stress-is-enhancing mindset and the moderating role of stress-is-debilitating mindset

ObjectiveThis study aimed to investigate the associations among emotional neglect (EN), stress-is-enhancing mindset (SIEM), stress-is-debilitating mindset (SIDM), and positive mental health (PMH).MethodsThe cross-sectional survey was employed in this study. A sample of 2150 college students (826 males) completed the emotional neglect subscale of the Childhood Trauma Questionnaire Short Form, the Stress Mindset Measure and the Positive Mental Health Scale. The PROCESS macro version 4.2 for SPSS was used to examine the moderated mediation model.ResultsEN negatively predicted PMH (p < 0.001). SIEM mediated the association between EN and PMH. Moreover, SIDM (β = 0.04, p < 0.001) not merely moderated the relationship between EN and PMH, but also moderated the link between EN and SIEM (β = 0.04, p < 0.001).ConclusionEN has a direct negative link to PMH and an indirect negative link to PMH through SIEM. Importantly, high SIDM mitigates the direct negative relation between EN and PMH. Moreover, the indirect negative effects of EN on PMH via SIEM diminish as SIDM increases, and the mediation pathway of SIEM is neutralized under high SIDM. These findings preliminary reveal the interplay between SIEM and SIDM in post-traumatic cognitive processing, offering new insights into the non-linear processes of psychological adaptation following early adversity.
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Cross-national comparisons of adolescent mental health and suicidality in the Middle East: a cross-sectional secondary analysis of the global school-based student health survey

BackgroundAdolescent mental health and suicidality represent growing global public health concerns, yet comparative evidence from the Middle East remains limited. This study examined the prevalence and correlates of psychological distress and suicidal behaviors among adolescents across Middle Eastern countries using the Global School-based Student Health Survey (GSHS).MethodsA cross-sectional analysis of nationally representative GSHS datasets from 12 Middle Eastern countries collected between 2004 and 2017. The pooled sample included 90,573 school-attending adolescents aged 11–18 years. Multivariable logistic regression models assessed associations between psychosocial factors and suicidal behaviors while adjusting for age, sex, and country.ResultsSubstantial cross-country variation in mental health indicators and suicidality was observed. Loneliness ranged from 11.5% in Bahrain to over 50.0% among female adolescents in Tunisia and Morocco. Suicidal ideation affected 16.3% of adolescents overall, while suicide planning was reported by 13.4%. Suicide attempts were reported by 9.1% of adolescents at least once. Female adolescents consistently reported higher levels of loneliness and anxiety, whereas males showed slightly higher adjusted odds of suicidal ideation and attempts (OR = 1.2). Lack of parental support, low school connectedness, and fewer friendships were significantly associated with higher odds of suicidal ideation, planning, and attempts. Emotional symptoms such as loneliness (OR = 1.7) and anxiety (OR = 1.8) were also strongly associated with suicide attempts.ConclusionsPsychological distress and suicidality are prevalent among adolescents across the Middle East, with notable gender and cross-country differences. Strengthening family support, peer relationships, and school connectedness should be central to regional adolescent mental health and suicide prevention strategies.
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NeuroCon-AutismNet: a privacy-preserving multimodal framework toward autism screening via diffusion-regularized EEG biomarkers and empathy-aware multilingual dialogue

IntroductionAutism Spectrum Disorder (ASD) screening requires multimodal biomarkers to capture the heterogeneous neurological and behavioral phenotypes. Current screening approaches remain siloed across EEG analysis and conversational assessment, limiting integrated diagnostic architecture. Privacy-preserving machine learning frameworks for mental health screening are underdeveloped, particularly for multilingual deployment contexts. This paper presents NeuroCon-AutismNet, a candidate multimodal architecture integrating diffusion-regularized EEG synthesis, multilingual conversational screening, and formal differential privacy as architectural proof-of-concept. No diagnostic discrimination capability is claimed; all validation is scoped to synthetic evaluation.MethodsNeuroCon-AutismNet comprises four modules: (1) Temporal Diffusion Biomarker Generator (TDBG), a latent diffusion model over VAE-encoded 19-channel EEG; (2) Multilingual Affective Dialogue Screening Network (MADSN), a fine-tuned GPT-2-small module deployed in English, Spanish, and Hindi; (3) Neuro-Linguistic Fusion Transformer (NLFT), enforcing positional alignment as a design prior rather than learned cross-modal association; and (4) Adaptive Mixture-of-Experts Layer (AMEL-X) for entropy-regularized multimodal fusion. Formal (ε, δ)-differential privacy (ε = 1.0, δ = 1e-5) is verified via DP-SGD RDP composition (σ = 1.2, q = 0.0914, T = 550 steps, verified ε = 0.97). Privacy verification establishes architectural readiness for future real-data deployment; no real patient records are present in the training set.Results and DiscussionWithin closed synthetic evaluation, held-out diagnostic AUC is 0.503 (95% CI: 0.487–0.519, DeLong p = 0.67), statistically indistinguishable from chance and the central limitation of this study. Two partial external benchmarks are provided. Spectral comparison against three independently published real ASD EEG studies yields Pearson r = 0.87 across five frequency bands; delta and alpha directions are reproduced, but theta and gamma reproduce poorly with large amplitude errors (delta MAE 14.79%, alpha MAE 11.57%). Expert evaluation of MADSN outputs by 50 annotators under single-blind protocol yields 90% empathy satisfaction and Cohen’s κ = 0.82, reflecting text quality rather than clinical screening validity. The null diagnostic AUC and synthetic-only evaluation prevent any current screening or clinical-utility claims. Real-data EEG validation, clinician-caregiver interaction studies for MADSN, and DP-protected training on real patient records are prerequisites for future clinical deployment.
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Big Five personality profiles, self-reported distress, and resilience resources among adults in Italy after the acute COVID-19 emergency: a cross-sectional cluster-analytic study

IntroductionPsychological recovery after the acute COVID-19 emergency has been uneven, and brief non-diagnostic markers that stratify vulnerability may support public mental health monitoring. We examined whether person-centered Big Five profiles differentiated self-reported distress and resilience resources among adults living in Italy after the end of the World Health Organization-declared COVID-19 public health emergency.MethodsThis cross-sectional anonymous online survey included 2,169 adults assessed between 22 May 2023 and 23 December 2024. Participants completed the Big Five Inventory-10 (BFI-10), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-10 (PSS-10), and Resilience Scale for Adults-11 (RSA-11). Standardized Big Five scores were clustered using k-means, and the number of profiles was evaluated using elbow, silhouette, and hierarchical-clustering methods.ResultsA two-profile solution was retained, although separation was modest (average silhouette width = 0.185). Compared with the resourceful trait profile (n = 1,113), the vulnerable trait profile (n = 1,056), characterized especially by lower emotional stability and conscientiousness, reported higher anxiety symptoms (g = 0.74), depressive symptoms (g = 0.76), and perceived stress (g = 0.86), and lower resilience resources (g = −1.02; all p < 0.001).DiscussionBrief person-centered Big Five profiling differentiated adults with greater self-reported symptom burden and fewer resilience resources in a prolonged post-emergency context. These findings are non-diagnostic and do not establish COVID-specific causal mechanisms, but may inform vulnerability stratification during future prolonged crises.
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3-Dimensional Optical Scanning to Assess and Monitor Malnutrition in Eating Disorders (3D-ED) Study

Conditions: Anorexia in Adolescence; Anorexia Nervosa; Anorexia Nervosa, Atypical; Anorexia Nervosa, Binge Eating/Purging Type; Anorexia Nervosa Restricting Type; Anorexia Nervosa With Significantly Low Body Weight; Body Composition Changes; Growth & Development; Malnutrition Severe; Malnutrition, Calorie

Sponsors: University of California, San Francisco; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); Denver Health and Hospital Authority; University of Hawaii

Not yet recruiting
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A Digital Acceptance and Commitment Therapy and Education Intervention for Caregivers of Very Preterm Infants in the Neonatal Intensive Care Unit: Randomized Controlled Trial

Background: Parents of very preterm infants admitted to the neonatal intensive care unit (NICU) experience high levels of psychological distress, yet access to timely, evidence-based mental health support is limited by staffing and resource constraints. Digital mental health interventions offer a scalable approach to addressing this gap; however, their effectiveness has not been well established in NICU caregiver populations, particularly during periods of acute stress. Objective: This study aims to evaluate the effectiveness of a self-guided digital acceptance and commitment therapy (ACT)–based intervention combined with NICU-specific education (NICU parent acceptance and commitment therapy [NPACT]). The study explored the intervention’s effects on stress among parents and primary caregivers of very preterm infants, compared to a digital education-only intervention, and active control. Methods: We conducted a 3-arm, single-center, randomized controlled cluster trial in a tertiary NICU. Parents and primary caregivers of very preterm infants (<32 wk’ gestational age,<1 wk old) were randomized by family cluster to (1) NPACT (ACT+ education), (2) a digital education-only intervention, or (3) active control. Digital interventions were delivered via a web-based platform over 2 weeks. The primary outcome was NICU-related stress on the Parent Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) at 2 weeks postrandomization. Secondary outcomes included caregiver anxiety, depression, perceived stress, and selected neonatal outcomes. Engagement and perceived helpfulness were assessed for digital interventions. Results: A total of 102 caregivers from 68 family clusters (79 infants; mean gestational age 28.1, SD 2.2 wk) were enrolled. There were no statistically significant between-group differences in the mean PSS:NICU scores at 2 weeks (NPACT 3.0, SD 0.9; education-only 2.5, SD 1; active control 2.6, SD 0.9; adjusted mean difference for NPACT vs active control 0.04, 95% CI −0.39 to 0.47). No between-group differences were observed for secondary psychological outcomes at any time point. However, caregivers in both digital intervention groups had higher odds of full breastfeeding at discharge compared with active control. Engagement with the digital interventions was high, with 97% (28/29) of NPACT participants and 76% (19/25) of education-only participants completing at least 5 of 7 modules, and both interventions were rated as very helpful. Conclusions: In this trial, an unguided digital mental health intervention delivered during NICU admission did not reduce NICU-specific parental stress or other psychological outcomes relative to active control. However, the intervention was highly used by caregivers. These findings suggest that while a brief digital mental health intervention can be successfully implemented in a high-stress clinical setting with caregivers, its capacity to reduce acute psychological distress may be limited. Secondary findings indicate potential benefits of the digital intervention on breastfeeding, generating hypotheses for future research. Digital mental health interventions in neonatal settings may be most effective when integrated within hybrid models of care and/or delivered beyond the acute admission phase. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12623000641695; https://tinyurl.com/2e8677bb International Registered Report Identifier (IRRID): RR2-10.1016/j.cct.2024.107519