Background: Community college (CC) students face significant mental health concerns but are unlikely to receive treatment. Barriers to mental health service uptake among CC students have been delineated, but few studies have identified strategies to improve uptake. Text messaging has been used to address engagement barriers to mental health services among adolescents and adults, but little research has explored this strategy for CC students. Objective: The goal of this study was to partner with CC students to co-design and conduct pilot usability testing of a text messaging intervention to address barriers and increase uptake of a mental health screening and treatment program, called Screening and Treatment for Anxiety and Depression (STAND), offered to CC students. Methods: We conducted 2 parallel sets of 4 co-design focus groups with CC students who had varying levels of engagement with STAND. We used rapid qualitative analysis to extract key themes, create text message prototypes and refine them, and present updated prototypes to gather feedback across workshops. We also assessed six usability factors on a 5-point Likert scale: satisfaction, helpfulness, attractiveness, readability, comprehension, and likelihood of getting started with STAND after receiving texts. Results: Key themes emerged about perceptions of texting, barriers to STAND, a basic framework for the text message intervention, feedback about the format of messages, and feedback about the content of messages. Students expressed positive regard for text messaging and general agreement on key barriers to STAND. Students codeveloped a framework for the intervention, including (1) delivering introductory texts to engage students in the text messages, (2) providing a personalized approach for students to select barriers most salient for them, and (3) delivering tailored content designed by students to address each barrier. Across workshops, several themes emerged with regard to how messages should be formatted and delivered, including the following: use short messages; use not too many messages; use relevant language; use images, memes, and short videos; and make messages “human-like.” Themes related to the content of messages included the following: reminders that you are not alone, knowledge that STAND has worked for other students, expressing understanding of student context and stressors, and providing an option to speak to a team member. Mean ratings on usability factors ranged from 3.88 (SD 0.64) to 4.25 (SD 0.46). Conclusions: This study describes a process for co-designing a text messaging mental health engagement intervention with CC students that is grounded in a human-centered design approach. Further research is needed to rigorously test this intervention and make iterative refinements to improve response and effectiveness.
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Digital Reassurance Seeking in OCD
– by Jordan Karr, PhD
We all need reassurance once in a while. Receiving reassurance from a friend, loved one, or expert can reduce short-term distress, foster a sense of connection, and help us move forward in a productive way. On the other hand, excessive reassurance seeking can lead to a painful cycle of stress and doubt. For individuals with obsessive-compulsive disorder (OCD), reassurance is fleeting and is quickly followed by a resurgence of perceived threat and a compelling drive to seek additional reassurance.
As an OCD and anxiety specialist, I am no stranger to reassurance traps. I see them in the patient who repeatedly consults doctors but never fully trusts their answers; the partner who keeps asking, “Do you still love me?” while scrutinizing every response; and the teenager who needs her homework checked repeatedly but does not learn to tolerate uncertainty. While the content of excessive reassurance seeking may vary, its function remains the same, relieving anxiety momentarily while allowing obsessions to rebound more strongly in the long run. In each example, we see an individual desperately trying to protect something they hold dear while being misled by one of OCD’s most convincing lines: “What if this time the reassurance sticks?”
Psychologists have long argued that excessive reassurance seeking helps maintain OCD, anxiety, and depression (Abramowitz et al., 2002; Burns et al., 2006). What is new is the landscape. Today, reassurance is available instantly and endlessly through search engines, medical websites, social media, and artificial intelligence tools. Emerging research suggests that online reassurance seeking may be as prevalent as interpersonal reassurance seeking (Parsons & Alden, 2022). These digital reassurance traps present in a variety of forms, including:
- Excessive symptom-checking on WebMD
- Checking a loved one’s location on Find My Friends to make sure they are still alive or where they promised they would be
- Asking Google Gemini whether an intrusive thought makes you a monster, a pedophile, or a bad Christian, Muslim, or Jew
- Analyzing the contents of a partner’s Instagram to see whether their feelings have changed
- Endlessly searching Reddit for answers to existential questions
- Obsessively checking likes and read receipts to monitor the durability of a relationship
- Finding creative ways to ask ChatGPT whether you might be responsible for spreading a virus or causing someone harm
- Compulsively checking the news to confirm whether a feared event has taken place
Why do some individuals seek reassurance primarily from others in face-to-face contexts while others turn to the internet? Findings from one study suggest that individuals may be more likely to seek interpersonal reassurance when they desire emotional support, whereas online reassurance seeking is more likely when individuals feel ashamed or fear judgment from others (Parsons et al., 2025). In the same study, shame was reported more frequently among individuals with OCD. The perceived anonymity of the internet creates a compelling environment for seeking reassurance about our most distressing fears and the fears we feel ashamed to have.
Wait, hold on… shouldn’t having access to all the information on the internet be empowering? After all, there’s that famous saying, “Knowledge is Power.” Well I’m not sure what Francis Bacon would say if he could scroll on TikTok, but in the age of the internet, more information does not always mean more power or knowledge. In fact, information overload seems to trigger excessive reassurance seeking online (Yang & Luo, 2024). Once digital algorithms detect health-related concerns, users may be exposed to increasingly frequent and targeted content, further amplifying health anxiety and driving additional reassurance seeking online (Zhang et al., 2024).
Despite these challenges, evidence-based treatments offer hope. Exposure and response prevention (ERP), the gold-standard treatment for OCD, helps individuals tolerate uncertainty and break free from compulsive behaviors. ERP therapists are prepared to respond to clients who compulsively seek reassurance while taking care to avoid reinforcing a client’s anxiety and setting boundaries when appropriate. On the other hand, AI chatbots are available 24/7 and will continue to reassure users when it would be clear to a skilled therapist that more reassurance is harmful. Some helpful activities I have encouraged clients to try include:
- Going for a walk and leaving your phone behind
- When you have the urge to seek reassurance, use a timer to delay. Start with 5 minutes and gradually increase the time as you go.
- Imaginal exposure: Writing out OCD’s worst case scenario while refraining from seeking reassurance.
- Embracing the uncertainty: When you have the urge to seek reassurance, lean into the uncertainty by responding “maybe that will happen, maybe not.”
- Watch a movie that triggers obsessions but leave your phone in the other room
- Try a fast from social media. Start with a short fast and increase the length of each fast as you gain confidence.
- Agreeing with the obsessions: Whatever your OCD throws at you, respond by saying “Sure, that is true!”
Clinicians working with youth should also attend to parental accommodations that inadvertently facilitate online reassurance seeking. Supportive Parenting for Anxious Childhood Emotions (SPACE) is an evidence-based, parent-focused intervention that emphasizes increasing supportive statements while reducing unhelpful accommodations. Setting reasonable limits on smartphone use while responding with empathy and confidence can help youth build resilience and independence (i.e. “I know it’s tough to be away from your phone and I know you got this!”).
Finally, because shame plays a central role in digital reassurance traps, incorporating self-compassion practices may be beneficial. Compassion-focused exercises help individuals respond to their struggles with kindness rather than self-criticism, complementing ERP by fostering emotional resilience. I sometimes ask clients to imagine that a close friend or loved one is feeling ashamed because they are experiencing obsessions and are stuck in an OCD loop. Then, I invite them to write down how they would support this friend while paying special attention to how compassion feels in their body. By practicing compassion for others, we strengthen the same muscles in our brains that help us turn compassion inward.
If you are getting stuck in digital reassurance traps, you are not alone! Many of these technologies are brand new and we are learning how to integrate them into our lives in a healthy way. If you need help managing compulsive online habits, finding a therapist trained in ERP could be a useful step!
References
Abramowitz, J. S., Schwartz, S. A., & Whiteside, S. P. (2002). A contemporary conceptual model of hypochondriasis. Mayo Clinic Proceedings, 77(12), 1323–1330. https://doi.org/10.4065/77.12.1323
Burns, A. B., Brown, J. S., Plant, E. A., Sachs-Ericsson, N., & Joiner, T. E., Jr. (2006). On the specific depressotypic nature of excessive reassurance-seeking. Personality and Individual Differences, 40(1), 135–145. https://doi.org/10.1016/j.paid.2005.05.019
Parsons, C. A., & Alden, L. E. (2022). Online reassurance-seeking and relationships with obsessive-compulsive symptoms, shame, and fear of self. Journal of Obsessive-Compulsive and Related Disorders, 33, 100714. https://doi.org/10.1016/j.jocrd.2022.100714
Parsons, C. A., Kim, H. J., Singh, S., Lkhagva, T., Wang, J., & Alden, L. E. (2025). Covert or connected: Motivations for online and interpersonal reassurance-seeking in OCD. Journal of Anxiety Disorders, 115, 103057. https://doi.org/10.1016/j.janxdis.2025.103057
Yang, X., & Luo, X. (2024). Unpacking cyberchondria: The roles of online health information seeking, health information overload, and health misperceptions. Telematics and Informatics, 97, 102225.
Zhang, X., Zheng, H., Zeng, Y., Zou, J., & Zhao, L. (2024). Exploring how health-related advertising interference contributes to the development of cyberchondria: A stressor–strain–outcome approach. BMC Public Health, 24, 534.
Jordan Karr, PhD, is the owner of River Falls Therapy in Portland, OR. He is a licensed psychologist in Oregon and Virginia, and specializes in evidence-based therapies for OCD and anxiety disorders. Dr. Karr has experience working in outpatient, community-based, and school-based settings.
The post Digital Reassurance Seeking in OCD appeared first on International OCD Foundation.
Curcumin attenuates α-synuclein pathology in Parkinson’s disease model mice through modulation of UBC9-associated SUMOylation signaling
BackgroundPost-translational modifications, particularly SUMOylation, plays a crucial role in α-synuclein (α-syn) aggregation, a key pathological feature of Parkinson’s disease (PD). Curcumin, a natural polyphenol, has shown neuroprotective potential, but its effects on SUMOylation-related signaling in PD remain unclear.ObjectiveThis study aimed to investigate whether curcumin modulates α-syn SUMOylation and to elucidate the underlying molecular mechanisms in PD model mice.MethodsA PD model was established in male C57BL/6 mice via unilateral intrastriatal injection of α-syn preformed fibrils (PFFs). Six months after α-syn PFFs injection, mice were treated intravenously with curcumin (25 mg/kg/day) or vehicle for 1 month. Behavioral tests (open field, rotarod) assessed motor function. Neuropathology was evaluated by immunohistochemistry and western blotting for tyrosine hydroxylase (TH), phosphorylated α-syn (p-syn), SUMOylation pathway components (SUMO1, SAE2, UBC9, PIAS1/2), and ubiquitin. Striatal dopamine levels were measured by HPLC.ResultsCurcumin treatment ameliorated motor deficits and anxiety-like behaviors in PD mice. It partially preserved dopaminergic neurons and reduced p-syn aggregation in the substantia nigra, accompanied by increased striatal dopamine levels. Mechanistically, curcumin was associated with reduced SUMO1 and increased ubiquitin levels, suggesting modulation of SUMOylation-related signaling. Among SUMOylation enzymes, UBC9 expression was decreased, whereas E1 (SAE2) and E3 (PIAS1/2) components were not substantially affected.ConclusionOur findings demonstrated that curcumin exerted neuroprotective effects in a PD model by attenuating α-syn pathology. The protective mechanism involves the inhibition of α-syn SUMOylation, primarily through the downregulation of the UBC9 enzyme. This study identifies UBC9-mediated SUMOylation as a potential target for curcumin and highlight a promising strategy for modifying α-syn-associated pathology in PD.
Illness perception, family resilience, and emotional distress among hospitalized older adults with multimorbidity in Xinjiang, China: a latent profile and mediation analysis
BackgroundOlder adults with multimorbidity frequently encounter significant psychological challenges, with negative illness perception being a prevalent issue. Such perceptions can intensify emotional distress. Family resilience—the ability of a family system to adapt positively to adversity—plays a crucial role in alleviating negative emotions, including anxiety and depression. This study aimed to investigate the heterogeneity of illness perception among older patients with multimorbidity and to assess the mediating effect of family resilience on the relationship between illness perception and emotional distress.Materials and MethodsBetween October 2025 and January 2026, 420 multimorbid older patients were recruited in three tertiary hospitals of Xinjiang Province. The evaluation was done based on the Brief Illness Perception Questionnaire, the Chinese version of the Family Resilience Assessment Scale, and the Hospital Anxiety and Depression Scale. The two methods of analysis were the latent profile analysis used to determine the unique patterns of illness perception and the bootstrap-based mediation analysis to determine whether family resilience mediates.ResultsThree distinct illness perception profiles were identified: low (32.6%), moderate (47.6%), and high (19.8%) illness perceptions. Using the low illness perception group as the reference, family resilience showed a significant partial mediating effect between moderate illness perception and anxiety (indirect effect = 0.510, 95% CI: 0.325–0.724), moderate illness perception and depression (indirect effect = 0.450, 95% CI: 0.283–0.631), high illness perception and anxiety (indirect effect = 1.263, 95% CI: 0.819–1.739), and high illness perception and depression (indirect effect = 1.114, 95% CI: 0.707–1.555).DiscussionThe results demonstrated heterogeneity in the perception of illness among older multimorbid patients, as a substantial percentage of the sample had moderate-to-high levels. Family resilience played a major partial mediating role between illness perception and emotional distress. The findings suggest the significance of shifting the clinical emphasis to the family system and integrating family resilience improvement as one of the psychological support measures for chronic patients.
Defining and Assessing Empathic Communication in Patient Portal Secure Messages: Adapted Coding Framework Development Study
Background: Empathic communication in the clinical setting has been associated with improved clinical outcomes, decreased anxiety, and increased patient satisfaction, treatment adherence, and trust. Despite the recent growth in patient portal use, the expression of empathic communication through patient portal secure messages is not well understood. Objective: This study aimed to construct a coding schema to define and assess empathic opportunities initiated by patients and primary care clinicians’ responses to these opportunities within a patient portal messaging environment. Methods: Data for this study included adult patient secure messages and responding messages from clinicians working in family practice clinics within a regional health care system serving central and northeast Pennsylvania between January 2018 and December 2023. We conducted a manual review of messages using the Empathic Communication Coding System as a guiding framework, which defines empathic opportunities created by patients and corresponding empathic responses by clinicians. We double-coded 500 patient messages for 3 empathic opportunity types: statements of emotion, progress, and challenge. Coding definitions were iteratively updated to describe specific textual cues unique to the patient portal context. This procedure was repeated to code for empathy in clinician responses to empathic opportunities. An additional 100 patient messages were double-coded for interrater reliability testing, and 500 patient messages were single-coded using the finalized coding schema. Results: Among 1100 patient messages coded, 576 (52.4%) included an empathic opportunity. Of these messages, 100 (17.3%) included a statement of emotion, 85 (14.7%) included a statement of progress, and 539 (93.6%) included a statement of challenge. Statements of challenge were primarily characterized by patients explicitly describing physical or mental health issues, a barrier in care, or difficulties in their personal lives. Among the 576 patient messages with empathic opportunities, 446 (77.4%) received at least 1 response from a clinician. Clinicians sent 483 response messages, of which 64 (13.2%) expressed empathy. Conclusions: While patients created empathic opportunities in over half of patient portal secure messages, primary care clinicians infrequently responded with empathy. The findings of this study provide initial evidence of gaps in empathic communication within patient portal secure messages and lay the groundwork for using artificial intelligence models to systematically measure and improve this communication across the patient portal messaging system.
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Effects of Social Media Narratives on Affective and Behavioral Responses to Menopause Content: Randomized Online Experimental Study
Background: Social media is an increasingly prominent channel for communicating menopause information and experiences, yet the affective and behavioral consequences of different narrative framings remain unclear. Objective: We examined how distress, normalizing, and transformative narratives influenced women’s immediate responses to menopause content online, drawing on established narrative framings of menopause as normality, distress, and transformation. Methods: In an online experiment, UK women aged 40 to 83 years who were perimenopausal or postmenopausal were recruited via Prolific, a widely used online recruitment platform for behavioral and social science research. A total of 737 women were randomly assigned to view 4 anonymized and standardized social media posts from a pool of 12 reflecting 1 of 3 narratives: <i>normal</i> (n=248, 33.6%), <i>distress</i> (n=241, 32.7%), or <i>transformative</i> (n=248, 33.6%). Participants then reported affective reactions, expected behavioral responses, and perceptions of the posts using 5-point ordered response scales. Ordinal logistic regression models tested demographic predictors and condition effects controlling for demographic factors. Results: Participants who viewed distress-framed posts reported greater levels of worry (β=.910; <i>P</i><.001), confusion (β=.818; <i>P</i><.001), and anxiety (β=.817; <i>P</i><.001) and lower levels of reassurance (β=−.970; <i>P</i><.001), optimism (β=−.708; <i>P</i><.001), and empowerment (β=−.540; <i>P</i><.001). Distress framing also increased perceived knowledge of menopause (β=.564; <i>P</i><.001) despite participants feeling more negatively toward the posts. Neither distress nor transformative narratives influenced expected behavioral intentions to like, share, save, comment on, search for, or discuss social media posts compared with normalizing narratives. Postmenopausal status (β=−.630; <i>P</i><.001) and older age (β=−.492; <i>P</i><.001) were independently associated with less worry and anxiety. Participants rated distress (β=−.806; <i>P</i><.001) and transformative posts (β=−.968; <i>P</i><.001) as less representative of health professionals than normalizing posts; transformative posts were also judged to be less representative of newspapers or television (β=−.687; <i>P</i><.001). Conclusions: Narrative framing shaped immediate affect but not intended engagement with menopause content. Because this study assessed short-term responses to controlled, standardized posts, future research should examine whether these effects persist over time and how they operate in more ecologically valid social media environments. As public discussion expands, diverse, balanced narratives may help reduce stigma and temper the disproportionate salience of negative framing. This study advances understanding of how narrative framing shapes responses to health content online.
Playing the Long Game for Youth Mental Health: A conversation with Grassroot Soccer on the power of sport and partnership
By Mai El Shoush, Partnership Campaign Manager, SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute
Few events unite the world quite like the FIFA World Cup, demonstrating soccer’s unique ability to connect people across cultures and communities. As millions tune in, the moment offers a timely reminder on how sports can reach young people far beyond the field. This belief underpins the work of Grassroot Soccer, a valued partner of the SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute. They utilize the power of soccer to advance youth mental health — and have reached more than 25 million young people around the world through this approach.
The partnership incorporates three interconnected areas:
- Building capacity for frontline workers
- Generating evidence
- Contributing to thought leadership on child and adolescent mental health in low-resource settings
The 2026 Men’s World Cup in North America and the upcoming 2027 Women’s World Cup in Brazil present an important opportunity for the organization to take its mental health programming from sub-Saharan Africa and adapt it to the U.S. context.
We spoke with Grassroot Soccer’s Mental Health Specialist Charmaine Nyakonda about the organization’s approach, the impact of their collaboration with SNF, and the growing role of sports in improving the mental health of young people and communities globally.
As international attention increasingly turns towards soccer’s global reach with the 2026 FIFA Men’s World Cup, what role can sports play in advancing youth mental health care across diverse communities?
Soccer is the most popular and accessible sport in the world. From the largest global stages like the World Cup to the most remote rural villages, it’s played everywhere on the planet. As the World Cup shows, soccer has the power to captivate across geographies, cultures, and time zones.
Soccer (and sport in general) is a powerful tool that teaches youth important life skills and character-building lessons like resiliency, hard work, courage, trust, and teamwork. On top of this, soccer’s universal appeal across diverse communities means using the language of the game can also be an effective way to break through the stigma around sensitive but pressing topics like mental health. This is why Grassroot Soccer uses soccer as a teaching tool for mental health.
Grassroot Soccer has successfully touched the lives of millions of young people across settings worldwide. What has the team learned about the universal role that sports can play in supporting mental health, resilience, and social connection?
Across our programs, soccer serves as a universal entry point that hooks young people and meets them where they are. From there, our play-based activities use soccer games and metaphors to make learning about mental health fun and engaging. They break down stigma and create safe spaces where young people can feel comfortable opening up and being vulnerable. This drives exceptional participation and completion rates.
Importantly, our signature soccer-based mental health promotion and prevention program, called MindSKILLZ, is guided by core mental health design principles. This includes grassroots co-creation, trauma-informed practice, relationship-centered delivery, and strengths-based learning — which ensures that programs are ethical, culturally grounded, and safe for adolescents in both stable and crisis-affected settings.
“Soccer (and sport in general) is a powerful tool that teaches youth important life skills and character-building lessons like resiliency, hard work, courage, trust, and teamwork.”
What elements of Grassroot Soccer’s approach do you believe could serve as a transferable blueprint for other organizations seeking to improve outcomes for young people in different sectors and communities?
Our commitment to co-design with young people: We believe that young people are the experts on their lives and needs, so we intentionally apply the principle of “Nothing about us without us” to our work. We put this into practice by engaging young people at every point in the program life cycle to ensure our work meets their needs, from design to implementation to evaluation.
In 2023, Grassroot Soccer officially launched a Youth Advisory Committee (YAC) composed of young leaders that serves as an internal advisory and advocacy body for the organization. The Committee consists of SKILLZ Coaches, Master Coaches, and trainers between the ages of 18 to 30 from the communities we serve.
Mental health integration: Mental health promotion and prevention must be woven into every service that young people access. Mental health is both a driver and an outcome of young people’s overall well-being. Unaddressed mental health challenges undermine progress in HIV, sexual and reproductive health, education, and other youth development areas. And those same factors profoundly shape young people’s mental health in return.
What has made the partnership with the SNF Global Center particularly valuable, and what role do cross-sector and multidisciplinary partnerships play in expanding support and opportunities for young people?
The diverse cultural perspectives from Greece, Brazil, the United States, and South Africa — and especially youth voices — have enriched our understanding of the barriers young people face, the values that motivate them, and the creative solutions they come up with when it comes to mental health.
We’ve also benefited tremendously from the scientific and clinical expertise at the SNF Global Center. We were able to co-develop an open-access, near-peer emotional support online training that aims to enhance the capacity of frontline workers to identify, refer, and support common mental health problems among children and adolescents. This is especially important in low-resource settings.
Additionally, through thought leadership and advocacy collaboration, this partnership has been valuable in contributing to an important shift in the global conversation to framing low-resource settings (the Global South) as sources of innovation that can positively impact the Global North.
Over the years, what has most reinforced your belief in the power of soccer to support youth mental health, and what examples best bring that impact to life?
We’ve seen a few powerful stories of impact in humanitarian settings, where the need for mental health care is at its greatest but resources are at its most limited.
For example, in 2024, relentless downpours following a tropical cyclone caused rivers in Malawi’s Nkhotakota and Karonga districts to overflow, leading to widespread flooding impacting over 150,000 people and forcing many displaced residents to seek refuge in makeshift internally displaced person (IDP) camps.
In the camps, people had no access to mental health and psychological support services or safe spaces, and youth were not attending school. The Malawi Ministry of Health identified a major gap in mental health support for adolescents and young people and called on Grassroot Soccer to deliver MindSKILLZ to respond to this need.
Grassroot Soccer’s response team focused heavily on play, coping skills development, and trauma-informed support, creating critical psychological and physical safe spaces for youth within the camp environment.
Looking ahead, how would you like to see the conversation evolve at the intersection of sports, youth well-being, and mental health?
Firstly, we would like to see the conversation move beyond asking whether adolescent girls and young women like to play sports and instead asking, “What can we unlock when they do?”
For too long, sports (and soccer in particular) have been understood as primarily a significant part of adolescent boys’ and young men’s lives only. That assumption has shaped who gets access, who feels welcome, and whose well-being is centered. Grassroot Soccer’s own programming challenges this directly — we have reached more adolescent girls than boys, and in doing so have created space for girls to reconstruct gendered ideas about soccer. The conversation on sports, youth, and mental health needs to evolve to view sports games like soccer as universal tools that can transcend gender norms, age, and socio-economic background to support young people.
At the same time, we want to see the conversation take adolescent boys’ mental health more seriously, not less. Qualitative insights from Grassroot Soccer show that rigid masculine norms remain a profound barrier for boys.
More broadly, we ultimately want to see the conversation shift from individual resilience to multi-systemic access and inclusive enabling environments. Young people need culturally grounded, safe environments that work for them — and include them in design and delivery to help them develop into healthy adults who carry that capacity forward.
What do you see as the greatest opportunities for the next generation of young people, and what must we do collectively to help make that future possible?
With the largest generation of adolescents coming of age, their ability to live healthy and productive lives will have a profound impact on not just their own life trajectories, but also on the world. Tackling critical global issues from poverty to climate change will require a generation of young people who are strong, healthy, and empowered — and their mental health is central to all this.
At Grassroot Soccer, we are committed to investing in youth mental health to realize a world where mental health challenges have been normalized. We want young people to understand their own mental health, have practical coping skills to deal with frustration and aggression, and recognize the value in seeking support from others. This will help develop a population with reduced symptoms of depression and anxiety, as well as overall improved mental well-being. Then we can collectively realize our vision for a better future.
Through the SNF Global Center, the Child Mind Institute partners with organizations around the world to strengthen child and adolescent mental health systems by combining scientific expertise, local leadership, evidence-based innovation and youth voices. Grassroot Soccer is one example of how cross-sector partnerships can expand access to mental health support in communities where young people already learn, connect, and thrive.
The post Playing the Long Game for Youth Mental Health: A conversation with Grassroot Soccer on the power of sport and partnership appeared first on Child Mind Institute.
Pharmacotherapy, acupoint stimulation, and psychotherapy for perimenopausal women with anxiety, depression, and panic disorder: a systematic review and network meta-analysis of randomized controlled trials
BackgroundPerimenopausal women frequently experience physiological and psychological symptoms, including anxiety, depression, and panic disorders, mainly due to declining ovarian function and hormonal changes. Current options include pharmacotherapy, acupoint stimulation (AcuStim), and psychotherapy (psych), but their comparative efficacy and safety remain controversial.ObjectiveThis network meta-analysis (NMA) systematically compared pharmacotherapy, AcuStim, and psychotherapy for perimenopausal anxiety, depression, and panic disorder, assessing clinical efficacy, adverse events (AEs), and changes in the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Kupperman Index (KI), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI), and serum hormone levels.MethodsWe searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed from inception to June 14, 2026, for randomized controlled trials (RCTs). A Bayesian NMA was performed, and the Surface Under the Cumulative Ranking Curve (SUCRA) was calculated.ResultsThe study included 131 RCTs, encompassing 11457 perimenopausal women diagnosed with emotional disorders. These trials evaluated three distinct treatment strategies. The NMA showed that the highest SUCRA probabilities were observed for drug_psych across HAMD (SUCRA = 92.4%), KI (SUCRA = 97.9%), SDS (SUCRA = 94.5%), PSQI (SUCRA = 98.1%), and follicle-stimulating hormone (FSH) (SUCRA = 96.1%) reduction and estradiol (E2) (SUCRA = 0.1%) elevation; for AcuStim_psych (SUCRA = 93.7%) in HAMA reduction; for psych (SUCRA = 98.9%) in SAS reduction; for drug_AcuStim in clinical efficacy (SUCRA = 9.0%) and luteinizing hormone (LH) reduction (SUCRA = 100%); and for control (SUCRA = 65.5%) in safety outcomes. In pharmacotherapy subgroup analyses, antidepressants (ADs)_Traditional Chinese medicine (TCM) ranked highest for HAMD (SUCRA = 87.2%) and safety (SUCRA = 82%), ADs_antipsychotics (AP) (SUCRA = 97.5%) for HAMA, and ADs_hormone replacement therapy (HRT) (SUCRA = 10.2%) for clinical efficacy.ConclusionPharmacological, acupoint stimulation, and psychological interventions each demonstrated therapeutic benefits for perimenopausal women with emotional disorders. Combination therapies generally showed more favorable efficacy across multiple psychological and endocrine outcomes than single-modality interventions, while no single treatment strategy was consistently superior across all outcomes. These findings may provide evidence to support individualized treatment selection according to patients’ clinical characteristics and therapeutic goals.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261340530.
A study on the relationship between research stress, research anxiety, research performance, and job satisfaction among Chinese healthcare professionals and its influencing mechanisms: a national multi-center survey
BackgroundChinese healthcare professionals face dual pressures from clinical duties and research activities, which may increase research-related anxiety and reduce job satisfaction. While occupational stress has been well studied, the mechanisms linking research stress to job satisfaction are unclear. Research performance may also play a key role, but its impact remains uncertain. This study explores the relationships between research stress, research anxiety, research performance, and job satisfaction, and identifies the pathways connecting these variables.MethodsA cross-sectional survey was conducted among healthcare professionals (nurses, physicians, and pharmacists) from eastern, central, and western regions of China to assess research-related conditions and job satisfaction (JS). Job satisfaction was measured using a modified validated scale. Research stress (RS), research anxiety (RA), and research performance (RP) were assessed using self-developed instruments. Structural equation modeling (SEM) was employed to perform path analysis and mediation analysis.ResultsA total of 924 healthcare professionals were included in the study. Over 85% reported working more than 40 hours per week, and 66.5% rated their health status as fair or poor. Regarding the types of research conducted by healthcare professionals, clinical research accounted for the highest proportion (63.2%), followed by basic science research (9.8%), while health services research and community-based research were relatively less common. The mean scores of JS, RS, RA, and RP were 3.40 ± 0.88, 2.56 ± 0.70, 2.34 ± 0.87, and 3.55 ± 0.82, respectively. Path analysis revealed that research stress was positively associated with research anxiety and negatively associated with both research performance and job satisfaction. Research anxiety was also negatively associated with research performance and job satisfaction, whereas research performance was positively associated with job satisfaction. Mediation analysis indicated that research stress was associated with job satisfaction both directly and indirectly through research anxiety and research performance.ConclusionsResearch stress is negatively associated with job satisfaction among healthcare professionals through increased research anxiety, whereas higher research performance is positively associated with job satisfaction. Hospitals and healthcare institutions should optimize the research environment, strengthen psychological support, and enhance research resource allocation to reduce research stress, improve research performance, and ultimately increase job satisfaction.
Fragile self, mechanical world: mechanistic delusions and ego fragility in schizotypal–affective spectrum disorder—a CARE case report
Categorical nosological systems frequently fall short when confronted with patients whose presentations cross established diagnostic boundaries. We report M.S., a 44-year-old Brazilian man involuntarily admitted to a psychiatric inpatient unit who presented with systematized persecutory ideation of mechanistic–technological content (chip implantation, satellite-based surveillance), structural ego fragility, absent insight, and progressive social and occupational deterioration. While prior diagnoses of bipolar disorder and provisional schizophrenia had been considered, neither fully captured the clinical complexity. Psychopathological-dimensional analysis, grounded in phenomenological observation and contemporary psychopathological theory, suggests three potentially interacting axes: (1) structural ego fragility (Ich-Schwäche), potentially arising from impaired early attachment and deficient relational learning; (2) a relational causality deficit replaced by concrete–mechanistic reasoning; and (3) limbic hyperactivation that appears to sustain an anxiety–perplexity–paranoia feedback loop. These converge on a schizotypal–affective spectrum formulation. Laboratory investigations identified severe dyslipidemia and marked hyperandrogenism (total testosterone 1,367 ng/dL), the latter potentially associated with limbic hyperactivation, though causality cannot be established from a single cross-sectional measurement. Psychometric assessment (BPRS-18) at admission yielded a total score of 43, with suspiciousness (5) and unusual thought content (5) as dominant items. During a seven-day inpatient course, a multimodal thymic strategy—risperidone, lithium carbonate, and structured psychotherapy—produced attenuation of paranoid reactivity, improved family engagement, and the spontaneous resumption of guitar playing from day 3, as a functional correlate of behavioral stabilization. The patient was discharged with a referral for a three-monthly paliperidone palmitate long-acting injectable. The pharmacological response retrospectively supports the dimensional formulation and illustrates the heuristic value of psychopathological analysis grounded in ego structure, causal reasoning, and affective dysregulation as a complementary approach to categorical nosology in complex psychotic–affective presentations.