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

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

The path to artificial superintelligence

Imagine a healthcare system made up of multiple AI agents: one that manages symptom assessment, another scheduling, a third insurance, and a fourth pharmacy.

Each is an expert in its domain. But they all have their own distinct knowledge and objectives. Today they can exchange data, but they are not yet able to actually coordinate patient care without a human making the decisions.

“The intelligence is already there. What is missing is the connective tissue that turns four strangers into one team,” explains Vijoy Pandey, senior vice president and general manager of Outshift by Cisco.

This “connective tissue” comes from adding a semantic layer—what Outshift calls the “Internet of Cognition”—that enables agents across domains to work together and, critically, “think” together through shared intent, context, and reasoning.

This semantic layer relies on a connectivity layer beneath it called the “Internet of Agents,” which allows autonomous agents to discover one another, prove identity, and exchange messages across domains.

When used together, they enable “the next step on the road to distributed artificial superintelligence,” says Pandey.

From solo silicon savants to the ‘Internet of Cognition’

For years, the AI industry has been focused on growth. Scaling vertically has led to bigger models, trained on more data with more compute. This has produced the reasoning capabilities that can be like a “brain” for AI agents, which can perceive, reason, and act in digital environments.

While vertical scaling can produce more capable agents perpetually, to enable agentic problem solving across different systems, companies, and platforms the next axis of scale must be horizontal, says Pandey.

Multi-agent systems are already being explored in areas like software engineering, drug discovery, and scientific simulations, but their performances so far have been underwhelming. One study finds a failure rate of between 41% and around 87% when evaluating seven open-source multi-agent systems.

“Connected agents handle coordinated action well; taking a task whose shape they have seen, divided and passed around,” Pandey explains. “What they cannot do is hold a goal in common and reason toward something none of them was trained to solve.”

“The gap is architectural, not a prompting problem,” Pandey adds. “Without the right coordination layer, naive multi-agent setups can perform worse than a single agent. The step change is that team of agents converging on its own, on a new problem, with no human stitching the seams.”

To reach this goal, Pandey says Outshift has built a connectivity layer called AGNTCY, an open-source project now under the Linux Foundation. AGNTCY allows agents across different systems, companies, and platforms to find each other, prove identity, and exchange messages through open, standardized protocols.

And, as Pandey explains, this allows the Internet of Cognition thesis to take a step further. It creates a semantic layer that allows agents to align goals (share intent), pool institutional knowledge and compound memory (share context), and make collective trade-offs (share reasoning).

Pandey likens this progression to that of humans: “For hundreds of thousands of years humans got individually smarter, and the gains died with each person who made them,” he explains. “Around 70,000 years ago that changed, when humans learned to share intent, build cumulative knowledge, and reason collectively. That is when scattered individuals became civilization.

“Agents are at the same threshold. We have built the silicon geniuses and given them agency. What they lack is the layer that let humans go collective,” he says.

First steps to distributed superintelligence

Enabling agents to work collectively rests on three pillars in the tech stack:

Shared intent through cognition state protocols: Cognition state protocols are the semantic handshake that allow agents to agree on a goal before they act and then negotiate toward it. Outshift has created an open-source coordination layer called Mycelium, which organizations can clone and use against their own agents.

“We found that unstructured groups reached a decision about a third of the time across 14 scenarios,” says Pandey, speaking about internal testing. “A coordination protocol that makes agents declare a goal, surface missing information, and resolve conflicts before acting raised that to 93%.”

Shared context through cognition fabric: A cognition fabric is a shared institutional memory and communication mesh that allows agent insight to compound over time rather than resetting each session. This policy-governed context layer solves the problem of “organizational amnesia,” says Pandey, by ensuring the baseline intelligence of the systems only ever goes up.

Shared reasoning through cognitive amplifiers and guardrail technologies: Two kinds of cognition engine can be used together to enable shared reasoning. Cognitive amplifiers speed up shared reasoning and modeling, and guardrail technologies (GATs) create security, cost, and compliance frameworks. Humans are active contributors to this layer, making judgment calls the system routes to them (rather than reviewing outputs after the fact).

Cognition sharing in multi-agent systems can create new risks, including unintended delegations, malicious prompt injections or memory poisoning, or over-privileged agents with access to permissions and data far beyond what their tasks require. Environment-specific controls are therefore needed to protect against unintended actions or consequences.

“Agents have human-like attributes but operate at machine speed and scale,” says Pandey. “Everything we built for twenty years—access control, identity, compliance—was built for humans or machines, not both.”

Continuous Agent Semantic Authorization (CASA)—an open-source reference implementation developed by Outshift—is a GAT that works to ensure agent actions remain securely aligned with the user’s original goal through a process of continuous authorization. It does this by reading what the agent is trying to accomplish then checking each tool request against that task.

In the case of a healthcare system, for example, an agent told to summarize a patient record may start by querying a whole database. This could lead to CASA denying the call, because the request no longer matches the task it was authorized for.

“Today’s controls are scoped to a role or a session not to the task so an agent granted a tool can use it for anything,” explains Pandey. “Roughly 90% of the time, an agent has no way to confirm it is even cleared for the job it was handed.”

Experimentation for cross-domain innovation

When horizontally scaling intelligence in the enterprise, businesses should begin by experimenting with one cross-functional workflow that spans three or four teams and currently needs a human authorizing the handoffs, Pandey advises.

“Stand it up as a small multi-agent system on open, interoperable infrastructure, with a measurable baseline,” he says. “Keep building bigger models, add the horizontal axis on top of them, and change what you measure. Track where one agent’s insight made another agent better—that is the signal the horizontal axis is working.”

By starting to experiment now with intent, context, and reasoning layers, organizations can get ahead of the curve. “The problems are open, and the infrastructure is still being written,” says Pandey. “This is the moment to build it.”

For more information on the Internet of Cognition, visit Outshift.com.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

Research progress on the α-synuclein-lysosome axis in Parkinson’s disease: molecular mechanisms of protein aggregation, autophagy dysfunction, and therapeutic targeting

Parkinson’s disease (PD) is the second most prevalent neurodegenerative disorder worldwide, characterized pathologically by the loss of dopaminergic neurons in the substantia nigra and the formation of Lewy bodies, which predominantly consist of misfolded α-synuclein (α-Syn) aggregates. Recent advances have highlighted the critical role of the interplay between α-Syn and lysosomal function, termed the α-Syn-lysosome axis, as a central mechanism underlying PD pathogenesis. This review systematically summarizes the molecular mechanisms driving α-Syn aggregation and the lysosomal dysfunction contributing to impaired autophagy-lysosome pathway (ALP) activity. We further discuss emerging therapeutic strategies targeting this axis to restore lysosomal function and mitigate α-Syn toxicity. By integrating the latest findings from molecular biology, cell biology, and preclinical studies, this article aims to elucidate the complex regulatory network of the α-Syn-lysosome axis and provide a theoretical foundation for the development of novel therapeutic interventions for PD.

International OCD Foundation Responds to OCD Representation in TLC’s “90 Day Fiancé”

Recent conversations about the portrayal of OCD on TLC’s 90 Day Fiancé underscore an important truth: how OCD is portrayed in television, film, and other media matters.

OCD is a serious, often debilitating mental health disorder affecting millions of people. It is characterized by unwanted, intrusive thoughts, images, or urges (obsessions) and repetitive behaviors or mental acts (compulsions) performed in an attempt to reduce distress. While OCD can look different from person to person, it is highly treatable. Yet today, nearly 95% of people with OCD are not receiving the most effective treatment. Misunderstanding OCD makes it harder for people to recognize their symptoms, receive an accurate diagnosis, and get the care they need to reclaim their lives.

Each episode of 90 Day Fiancé is watched by more than one million viewers. With that kind of reach comes an extraordinary opportunity to shape public understanding of mental health for the better. Accurate portrayals of OCD have the power to transform lives. They replace myths with understanding, reduce stigma, help people recognize the signs of OCD sooner, inspire individuals to seek effective treatment, and let those living with OCD know they are not alone—and that recovery is possible.

The entertainment industry has a responsibility to get it right, and doing so requires thoughtful decisions at every stage of the creative process. The International OCD Foundation encourages TLC to engage clinical experts and people with lived experience to better inform their editorial decisions. We stand ready to serve as a resource for future portrayals of OCD and related disorders.

If you are creating content that includes OCD or related disorders, we encourage you to connect with us at media@iocdf.org. Together, we can improve public understanding of OCD, reduce stigma, and help more people find the treatment that can change their lives.

The post International OCD Foundation Responds to OCD Representation in TLC’s “90 Day Fiancé” appeared first on International OCD Foundation.

Art therapy for depression: a systematic review and meta-analysis

IntroductionDepression is among the leading causes of disability globally. Therefore, exploring the various non-medical treatment options for this condition is particularly important. The aim of the review was to assess the effect of art therapy on depressive symptoms.MethodsThe foundation of this review is a pre-planned, explorative, secondary analysis of a previously published umbrella review, encompassing the databases Cochrane Library, Embase, MEDLINE, CINAHL, ERIC, American Psychological Association PsycArticles, American Psychological Association PsycInfo, PSYNDEX, the German Clinical Trials Register, and ClinicalTrials.gov. Included were all randomized trials with any patient population receiving active visual art therapy. The outcome was depressive symptoms measured by depression assessment instruments. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted a bias assessment using a modified Cochrane risk of bias tool. Data was pooled using a random-effects model and visualized in forest plots. A pooled standardized mean difference (SMD) with hedges g was calculated to measure the reduction of depressive symptoms.ResultsOf 3,100 identified reports we included 26 studies. Of these, 19 studies with 997 patients were eligible for inclusion in the meta-analysis. Overall, we found a standardized mean difference of 0.53 (95% CI: 0.30 to 0.76) for depressive symptoms, favoring the intervention group. Main sources of variation were different types of control groups, methodological quality, and patient populations.ConclusionOur results suggest that art therapy is associated with improved depressive symptoms. Therefore, art therapy should be accessible as complementary treatment for patients suffering from depressive symptoms.

Multilingual Voice AI for Postoperative Cataract Follow-Up in Turkish Speaking Patients in the United Kingdom: Patient and Public Involvement Focus Group Study

Background: Conversational voice AI assistants can automate postoperative follow-up calls in high-volume, low-complexity pathways such as cataract surgery but may widen health inequalities if language access and inclusive design are not built in. This patient and public involvement focus group was conducted to inform the Turkish-language adaptation of Dora ahead of a forthcoming multilingual clinical trial at Moorfields Eye Hospital. Objective: This study aims to inform the Turkish-language adaptation of Dora by gathering input from Turkish speaking community contributors about their experiences with UK ophthalmic care, language-related barriers, and design requirements for an equitable voice AI. Methods: We conducted a 1-time, 2-hour patient and public involvement focus group with 7 Turkish speaking adults recruited via the Derman community charity. The session ran in 2 phases: contributors first discussed their experiences with UK ophthalmic care, then evaluated a prerecorded Turkish-language telephone call from a voice AI to a Turkish speaking volunteer. The session was delivered bilingually, recorded with consent, and synthesized using an approach informed by the principles of reflexive thematic analysis. The voice AI uses automatic speech recognition and neural text-to-speech, with a large language model–based dialog manager for open-ended conversation within a postoperative review protocol. Results: Contributors described how pathway delays and limited language support shape their care, including reliance on family members for translation and concerns about privacy and autonomy. A language-concordant voice AI was conditionally acceptable for standardized postoperative follow-up, provided specific safeguards were met. Priorities included advance notice of calls, caller verification, privacy assurances, a clear standard Turkish accent at a slower pace, tolerance for regional dialects, interpersonal warmth, interactivity, accessibility for low vision and low literacy, and clinician escalation for complex issues. These priorities were synthesized into a 10-point checklist: preparation, verification, confidentiality, clarity and pace, voice, empathy, interactivity, dialect handling, accessibility, and efficiency. Conclusions: For patients facing language barriers, conversational voice AI may complement existing services when implemented with clear verification, privacy protections, and a defined scope under clinician oversight. The 10-item checklist will guide the Turkish-language adaptation of Dora and will be tested alongside similar consultations with other language communities in the forthcoming multilingual cataract follow-up trial.
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Child Mind Institute Launches Research Initiative To Inform Safer AI Systems for Youth

New project will develop tools to study youth mental health during AI chatbot use

New York, NY — Today, the Child Mind Institute announced a new research initiative, launched with support from the OpenAI Foundation, to build the research infrastructure needed to measure and better understand youth mental health while using AI chatbots and over time. The effort aims to identify valid markers that can inform the design and testing of safer AI systems.

Millions of children in the United States are struggling with mental health or learning challenges, yet there continues to be a dire shortage of qualified mental health professionals. That, along with stigma and misinformation about mental health, is pushing young people to explore using readily available, often free AI tools for support, including general-purpose chatbots, digital companions, or “therapy bots.”

Novel and emerging digital technologies are shaping mental health faster than the pace of science and the development of evidence-based care can keep up. This new initiative will help advance research studying the impact of these tools and better support youth mental health.

“As the leading nonprofit dedicated to improving youth mental health through science, education, and care, the Child Mind Institute is well positioned to help tackle the key issues affecting the well-being of young people, including technology and the proliferation of AI. It is our belief that with appropriate safeguards and evidence, digital tools may complement care from trained clinicians,” said Harold S. Koplewicz, MD, president and medical director at the Child Mind Institute. “We are excited about filling a gap that currently exists in the research of AI tools and to work toward creating a safer online experience for youth around the globe.”

Using clinical assessments, digital journals, de-identified AI chat histories, real-time behavioral measures, and existing youth mental health datasets, the Child Mind Institute will build an infrastructure to better understand interactions between youth users and AI conversational platforms. With the goal of strengthening our understanding of the mental state in AI chatbot interactions, this initial one-year project will enable the research team to identify and begin scaling the signals needed to meaningfully assess and monitor youth mental health alongside their use of AI tools.

The Child Mind Institute has long been committed to advancing technologies that make mental health research and care more precise, measurable, and connected to real-world settings. Grounded in science and focused on impact, the organization brings together scientific rigor, clinical expertise, and product development experience to build digital tools that accelerate research, improve care, and expand access without compromising safety, quality, or accountability.

“Many of our youth are turning to AI chatbots for important areas of their lives — and mental health is no exception. It is our responsibility to more holistically comprehend the impact of these tools on mental health, both in the long and short term,” said Michael P. Milham, MD, PhD, chief science officer at the Child Mind Institute. “Digital platforms provide an opportunity to rethink the way we conduct mental health research, but they also introduce new challenges and risks. It is critical to better understand the relationship between AI use and youth mental health, and to examine whether, and under what conditions, AI tools can strengthen evidence-based care, support clinician training, and expand access to high-quality mental health services.”

This research initiative is being independently developed and solely executed by the Child Mind Institute. To ensure the safety and security of all study participants, it will be conducted with strong privacy protections, informed consent, ethical oversight, and careful data governance. The project will be co-designed by its principal investigators, Gregory Kiar, PhD, Arno Klein, PhD, and Dr. Milham, who bring expertise in computational methods, digital measurement, clinical science, and youth mental health. Consistent with the Child Mind Institute’s open science philosophy, all data will be shared to help fuel discovery across the field.


About the Child Mind Institute

The Child Mind Institute is an independent nonprofit organization dedicated to transforming the lives of children and families struggling with mental health and learning disorders. Through cutting-edge research, evidence-based clinical care, and public education, the Child Mind Institute builds open science platforms and digital tools to accelerate discovery and improve youth mental health worldwide.

For press questions, contact cmiscience@ssmandl.com or mediaoffice@childmind.org.

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Governing the social production of care: the hidden foundation of health systems

Nature Medicine, Published online: 22 July 2026; doi:10.1038/s41591-026-04535-y

Health systems rely on unpaid care that is poorly measured and governed. We argue that unpaid care, and the wider social production system behind it, is a productive input whose breakdown drives avoidable admissions, delayed discharge, and labor-force exit. We propose a national accounting framework, a diagnostic lens, and five policy priorities.