Adaptation of behavioural activation for adolescents with mild to moderate intellectual disabilities and depression

IntroductionAdolescents with intellectual disabilities are at increased risk for mental health problems and depression. Despite this, there is currently no evidence for effective psychological interventions for treating low mood and depression in this population. Behavioural activation has been identified as an effective intervention for treating depression in autistic adolescents and for adults with intellectual disabilities and may therefore also be suitable for use with adolescents with intellectual disabilities.MethodThe current paper describes an approach taken to adapting an existing behavioural activation intervention used with adults with intellectual disabilities (Beat-It) to be suitable for adolescents, named Beat-Depression (Beat-D). An iterative, three-phase approach was adopted for the adaptation process. The first phase involved review of the Beat-It manual and proposed adaptations by the project team, followed by a second phase consisting of consultations with parents of adolescents with intellectual disabilities and professionals with experience in the field.ResultsThe outcomes from phases one and two were incorporated into a final adapted manual for the Beat-D intervention. The intervention is described following the principles of the Template for Intervention Description and Replication (TIDieR) checklist.DiscussionImplications for using this adaptation approach more broadly to ensure psychological interventions used with adolescents with intellectual disabilities are suitable and accessible are discussed along with future plans for the evaluation of Beat-D.

Barriers and Facilitators in the Implementation of the Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health Digital Intervention in Rural India: Mixed Methods Process Evaluation Study

<strong>Background:</strong> An estimated 150 million people have mental health care needs in India, but only 15% are able to access care. Depression and anxiety contribute to a large proportion of mental morbidity. The Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health trial used a mobile-based clinical decision support system for primary care doctors and community health workers (CHWs) to identify and treat people at risk of depression, anxiety disorders, and self-harm. A community-based antistigma campaign was also delivered. The intervention led to improved remission rates for depression and anxiety and lower stigma scores. <strong>Objective:</strong> A process evaluation assessed (1) implementation fidelity, barriers, and facilitators; (2) perceptions of doctors and CHWs on the use of SMART Mental Health; and (3) the causal pathways that led to trial outcomes. <strong>Methods:</strong> A mixed methods evaluation combining backend program data and qualitative data was conducted. A total of 38 focus group discussions and 37 key informant interviews were conducted with primary doctors, CHWs, government officials, local community leaders, and research project staff. The data were coded and analyzed using a framework analysis approach based on the UK Medical Research Council guidance on process evaluations and the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. <strong>Results:</strong> The intervention had high implementation fidelity. Across clusters, the median proportion of participants with at least 1 CHW follow-up was 98% (IQR 96.6%-100%). The referral rate for a psychiatrist was low (224/1697, 13.2%), and only 23.6% (53/224) of those referred visited the psychiatrist. The median exposure to antistigma audiovisual content was 84% (IQR 65.7%-95.9%). At the community level, key implementation barriers included cultural inhibitions in seeking mental health care and the unavailability of patients due to competing demands. Proximity and tight social connections between CHWs and their communities were important facilitators in seeking medical help. Doctor and CHW training, mentoring, and feedback provided by program staff were important facilitators to support the use of the digital health components by the health workforce. <strong>Conclusions:</strong> A complex intervention that included both community-based antistigma and clinical digital health interventions achieved high implementation fidelity. Key areas to consider for maintenance of such interventions include (1) the need for sustained community-based strategies to address stigma and other cultural barriers; (2) health workforce strengthening policies, including supportive supervision for CHWs and doctors to increase capability in the use of mental health digital health tools; and (3) strategies to improve access to specialist care for those with more complex care needs. <strong>Trial Registration:</strong> Clinical Trial Registry India CTRI/2018/08/015355; https://tinyurl.com/5r63suxp

Autism Screening Proposed for Children with Epilepsy

Children with epilepsy are up to 10 times more likely than others to also have autism, according to research that exposes the scale of the association between the two conditions.

The findings, in more than 30,000 children, stress the importance of screening for developmental concerns among those with epilepsy, so support can be delivered as early as possible.

The study, Developmental Medicine & Child Neurology, revealed that girls with autism spectrum disorder (ASD) were more likely than boys to also have epilepsy.

Higher rates of intellectual disability were also seen in children with autism who additionally had epilepsy, and they were also diagnosed with the neurodiversity at an earlier age.

“Our findings emphasize the importance of screening for autism in this population to support earlier diagnosis and timely intervention, both of which are key to improving long-term outcomes,” said senior investigator Elaine Wirrell, MD, from the Mayo Clinic.

ASD and epilepsy are complex disorders of neuronal connectivity that frequently co-occur because of shared molecular and biological mechanisms.

While the increased risk of ASD in children with epilepsy is well documented, there are gaps in knowledge around its incidence and prevalence, and risk factors for their co-occurrence.

To investigate further, Wirrell and team studied the medical records of 30,490 children in Olmsted County, Minnesota, of whom 257 (0.84%) were diagnosed with epilepsy before the age of 19 years.

They found that children with epilepsy were more likely have ASD across all three research and clinical definitions compared with other children, with this likelihood increased between six and 10-fold.

The prevalence was a corresponding 21.4% versus 3.2% using broad research criteria, 14.0% versus 1.6% across stricter research criteria, and 7.9% versus 0.7% for a clinical diagnosis.

Among children with autism, those also with epilepsy were more likely to have a lower IQ on standardized testing than those in whom epilepsy was absent (56.5% versus 15.4%). Specifically, an IQ of less than 70 was observed in 57.4% of children with co-occurring epilepsy and autism compared with only 15.4% autism alone.

Those with autism and epilepsy were also more often female than those with autism alone (38.2% versus 25.8%), and were identified with autism at a younger age, at a mean of seven years and five months versus eight years and eight months).

“These insights underscore the critical need for comprehensive and early screening protocols to better address and manage the intersection of autism and epilepsy, ensuring timely interventions and tailored support for affected individuals,” the researchers concluded.

 

The post Autism Screening Proposed for Children with Epilepsy appeared first on Inside Precision Medicine.

The Download: the tech reshaping IVF and the rise of balcony solar

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

What’s next for IVF

IVF has brought millions of babies into the world over the last four decades. But the process can still be slow, painful, and expensive—and far from guaranteed to work. Now, a wave of new technologies aims to change that. 

Researchers are using AI to identify promising sperm and embryos, developing robotic systems that could automate parts of the IVF process, and even exploring controversial genetic editing techniques designed to prevent inherited disease.

The technologies could make IVF more effective and accessible. But they’re also raising difficult ethical questions about how far reproductive medicine should go.

Find out what’s next for IVF.

—Jessica Hamzelou

This story is from MIT Technology Review’s What’s Next series, which looks across industries, trends, and technologies to give you a first look at the future. You can read the rest of them here.

The balcony solar boom is coming to the US

Dozens of US states are considering legislation to allow people to install plug-in solar systems, often called balcony solar. These small arrays require little to no setup and could help cut emissions and power bills.

Proponents say the systems could make solar power more accessible, but some experts caution that there are safety concerns. 

Read the full story on balcony solar’s potentially massive impact in the US.

—Casey Crownhart

This article is from The Spark, our weekly climate newsletter. Sign up to receive it in your inbox every Wednesday.

Resistance: 10 Things That Matter in AI Right Now

Resistance against AI’s proliferation is growing. People from all walks of life are speaking out against rising electricity bills from data centers, disappearing jobs, chatbots’ impact on teen mental health, the military’s use of AI, and copyright infringement—among other concerns. 

People want to have a say in how the technology transforms their future. And they’re starting to create small cracks in AI labs’ vision for the future. Find out how.

—Michelle Kim

Resistance is on our list of the 10 Things That Matter in AI Right Now, MIT Technology Review’s guide to what’s really worth your attention in the buzzy world of AI. 

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 After years of insults, Anthropic and SpaceX have teamed up
Anthropic will tap SpaceX’s GPUs to meet surging demand. (Axios)
+ While SpaceX gets a marquee customer for its AI ambitions. (Wired $)
+ Anthropic says the deal will double Claude Code’s rate limits. (Ars Technica)
+It’s also exploring building compute capacity in space. (CNBC)
+ Musk previously called Anthropic “evil” and “misanthropic.” (Gizmodo)

2 Ex-OpenAI leaders say Sam Altman sowed “chaos” and distrust
Former CTO Mira Murati said she couldn’t trust his words. (The Verge)
+ He also bypassed OpenAI’s safety board before a model release. (Gizmodo)
+ And pitted leaders against one another. (Forbes)
+ But Elon Musk still tried to recruit Altman to lead a Tesla AI lab. (FT $)
+ Here’s why Musk and Altman are in court. (MIT Technology Review)

3 China’s humanoid robots are fueling its next export boom
Morgan Stanley says Beijing has taken an early lead in the sector. (Bloomberg $)
+ Gig workers are training humanoids at home. (MIT Technology Review)

4 SpaceX’s IPO plans will give Elon Musk “virtually unchecked” authority
And erode typical shareholder protections. (Reuters $)
+ Activists and pension funds are pushing back against the IPO. (Wired $)
+ While SpaceX is shifting focus from Falcon 9 to Starship. (Ars Technica)

5 Google DeepMind will use the MMORPG Eve Online for AI model testing
It’s also bought a stake in the game’s maker. (Ars Technica)
+ DeepMind also recently built a new video-game-playing agent. (MIT Technology Review)

6 The US risks isolating its automakers by banning a Chinese EV standard
It’s prohibiting software that’s dominating global EV markets. (Rest of World)

7 Elon Musk’s proposed Texas chip factory could cost $119 billion
It would manufacture chips for Tesla, SpaceX, and xAI. (CNBC)
+ Future AI chips could be built on glass. (MIT Technology Review)

8 Why the “attention-span crisis” is misunderstood
Technology may be exhausting attention rather than shortening it. (Atlantic $)

9 Scientists are getting closer to explaining what causes lightning
New tools are revealing unexpected physics inside thunderstorms. (Quanta)

10 Kids have found an age verification loophole: fake mustaches
Resourceful children are foiling blocks on adult websites. (TechCrunch)

Quote of the day

“My concern was about Sam saying one thing to one person and completely the opposite to another person.”

—Mira Murati, the former CTO of OpenAI, testifies ‌in court that CEO Sam Altman was deceptive, Reuters reports.

One More Thing

ALAMY


A brief, weird history of brainwashing

During the Cold War, the US prepared for a psychic war with the Soviet Union and China by spending millions of dollars on research into manipulating the human brain. 

The science never exactly panned out, but residual beliefs fostered by this bizarre conflict continue to play a role in ideological and scientific debates to this day. And now, new technologies are altering how we think about mind control. 

This is how the race for mind control changed America forever.

—Annalee Newitz

We can still have nice things

A place for comfort, fun and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ Listen to the 10 bird songs of spring in this lovely compilation of American species.
+ Good Samaritans saved a 29-foot whale that had wandered too far into a river.
+ Explore the intersection of human emotion and machine learning in this look at AI’s influence on art.
+ Break down the walls between streaming services and manage all your digital music in one place with this app.

A two-decade bibliometric analysis (2004–2024) of parental factors in the context of internet gaming disorder research

ObjectiveThis is the first targeted bibliometric analysis which explores the development of scientific production on the relationship between parenting and Internet Gaming Disorder (IGD) over twenty years, emphasizing the central role of the family context in the etiology and maintenance of IGD.MethodsPapers indexed in Scopus and Web of Science databases from 2004 to December 31, 2024, were analyzed using the PRISMA guidelines, the R package Bibliometrix, and VOSviewer. A comprehensive search strategy was developed using Boolean operators to capture variations of parental and gaming-related terminology. Records were exported in BibTeX format and were merged and cleaned to remove duplicates before the analysis. A descriptive bibliometric analysis, bibliometric mapping, and content analysis were conducted to identify trends and thematic clusters. The analysis included 389 publications.ResultsThe most cited papers confirm the association of low parental warmth, family dysfunction, and comorbid psychiatric symptoms with a higher risk of IGD. Thematic mapping reveals six dominant clusters covering the conceptualization and diagnosis of IGD, parental mediation and virtual environment, psychological vulnerability and mental health, parenting and attachment, parenting styles and self-control, and problematic screen-related behaviors, and a strong concentration of publications in China, Germany, and the USA. The analysis also revealed an increase in publication output after 2013, with a notable acceleration following the inclusion of gaming disorder in the International Classification of Diseases 11th Revision (ICD-11).ConclusionThe bibliometric analysis reveals the rapid growth of research on parenting and IGD, highlighting the multifactorial nature of the disorder where dysfunctional family relationships increase risk, while supportive ones reduce it. Despite progress, longitudinal studies are needed for better understanding of causality and interventions.

At-Home Blood Test Screens for Early Dementia

A simple finger-prick blood test at home combined with online cognitive tests can reveal signs of Alzheimer’s disease, providing a convenient way to screen for early dementia.

The postal blood test, outlined in Nature Communications, is used to measure levels of two blood biomarkers linked with cognitive function: phosphorylated tau at amino acid 217 (p-tau217) and Glial Fibrillary Acidic Protein (GFAP).

It could provide a way to screen for dementia at home and act as a triage resource to identify those at risk earlier and tailor treatments more effectively, particularly in remote or unsupervised settings.

“This work raises the potential for screening people for their risk without the need for clinic visits or complex clinical assessments,” said lead researcher Anne Corbett, PhD, from the University of Exeter.

“It would ensure the people at highest risk could be prioritized for monitoring and diagnosis, unlocking the best support and treatment for those that need it most.”

While blood biomarkers are increasingly being used to diagnose Alzheimer’s disease, scalable tools are needed to reach the 99% of individuals with early cognitive impairment who are not seen in specialist healthcare services.

In an attempt to develop these further, Corbett and team conducted a study involving 174 people, of whom 146 had normal cognition and 28 had dementia.

All were participants in the PROTECT study, a larger investigation of more than 30,000 adults that aims to understand how healthy brains age and why people develop dementia.

Blood samples were collected at home using self-administered capillary blood tests, which were sent for p-tau 217 and GFAP lab testing. Venous blood samples were also available for 40 patients.

p-tau217 has previously been highly accurate at detecting Alzheimer’s disease pathology and is approved by U.S. regulators for symptomatic patients undergoing investigation for cognitive complaints.

GFAP is associated with broader cognitive decline and has been shown to be associated with Aβ deposition and progression of mild cognitive impairment to Alzheimer’s disease.

Brain performance tests were found to correlate with levels of both proteins, with p-tau217 showing the strongest association.

Capillary p-tau217 was significantly higher in people with dementia compared to those without and was significantly associated with cognitive performance and function.

A combination of an 85% specificity threshold for capillary p-tau217 85% and episodic memory performance one standard deviation (SD) below benchmarked norms identified 9% of participants who were at potentially high risk, and who also showed significantly higher impairment in cognition and function.

Importantly, this threshold for impairment of episodic memory indicated a much milder level of impairment than the 1.5 SD change required to identify people with mild cognitive impairment, revealing its potential ability to spot signs at a preclinical stage.

Unexpectedly, even though ptau217 and GFAP both identified individuals with cognitive impairment, there was only a modest overlap in individuals who were positive for both GFAP and p-tau217, with GFAP identifying a different group of at-risk individuals. GFAP biomarker appeared to be associated with vascular risk, unlike p-tau217.

Researcher Clive Ballard, MD, PhD, also at Exeter, said: “Our approach of combining our robust cognitive testing with measuring proteins via a postal blood test could provide a straightforward, efficient and cost-effective method to reach large numbers of people in the community who would not otherwise be prioritized for the next steps of diagnosis or support and to optimize the clinical pathway to enable early detection of those at highest risk.”

The post At-Home Blood Test Screens for Early Dementia appeared first on Inside Precision Medicine.

“Failure to Launch” Syndrome: How to Stop Enabling Your Grown Child

When Zeke was in high school, he struggled with anxiety and substance use problems, and he left college after the first semester. Now 25, he is living at home, and his mom Carol is frustrated. While she’s pushed him to go back to school or work, he has only held one part-time job at a local smoothie shop and quit after a few months, embarrassed that high school classmates would see him working there. Another attempt at trade school to become an electrician also didn’t take — it didn’t feel like the right fit. Now he rarely leaves the house, stays up all night playing video games or scrolling online, and sleeps most of the day.

Failure to launch syndrome, highly dependent adult children, boomerang kids — there’s no standard term or definition, but if you’re a parent in this situation you recognize it. You are worried and frustrated about your adult child’s difficulty in leaving the nest, and you don’t know what to do because everything you’ve tried so far hasn’t worked. 

“These aren’t kids who come back home because they finished school, and the first job they get doesn’t pay enough for them to afford rent on an apartment,” says Theresa Welles, the Shapiro Family Director of the Bubrick Center for Pediatric OCD at the Child Mind Institute. “We’re talking about young adults who functionally have hit a wall, so to speak. They’re caught in a loop of dependency.”

What is failure to launch syndrome?

It’s not uncommon for adult children to live with their parents: According to Pew Research Center, 18 percent of adults ages 25 to 34 lived in their parents’ home in 2023, with young men more likely than young women to do so (20 percent vs. 15 percent). Young adults might leave home for a period of time and then move back in with their parents because they can’t find a job. Or for religious or cultural reasons, some adult children expect to live in the family home until they get married. Living at home is not the main criterion for determining a “failure to launch.”

While there is no official clinical definition, researchers who study this group of young adults generally categorize someone as a highly dependent adult child if they are:

  • Not in school, working, or actively looking for work (though physically capable of doing so)
  • Financially dependent on their parents for housing and other necessities
  • Emotionally reliant on parents (i.e., needing constant reassurance that they are okay)  

They usually have very limited social interactions other than online. Often, they have mental health challenges such as anxiety, depression, or OCD, which is a contributing factor, Dr. Welles says.

“They’re at the developmental stage of early adulthood, they’re figuring out who they are,” Dr. Welles says. “The fancy term in psychology is ‘individuation,’ but it’s essentially who you are, both as part of your family and separate from your family.” Highly dependent adult children haven’t made much progress in this stage for several years. Many of them want to change their life path and become more independent, but they struggle with anxiety or fear of failure and don’t follow through on the necessary steps. “Reliance on parents reduces opportunities to build autonomy, which in turn maintains that reliance,” she says. So, they remain stuck.  

Dependent behaviors and parental accommodations

Young adults who are highly dependent often fall into certain patterns of behavior. They don’t do their own laundry, cook, clean, or help out around the house. They rarely leave the home and often shut themselves in their bedroom or live in the basement, avoiding talking to others in person. As a result, they rely on their parents to act as an intermediary with the outside world, such as making doctor’s appointments. They might blame their parents for their difficulties in life.

While parents may not like the situation, they struggle to get their adult child to change. So instead, they accommodate them — especially when they are concerned about their child’s mental health challenges.

“In the world of neurodiversity, accommodations are a good thing — we want accommodations for testing and sensory environments,” says Natalia Aíza, LPC, the author of the forthcoming Anxious to Launch: Parenting Strategies to Help Your Adult Child Move On. “But in the anxious-to-launch world, accommodations are actually interfering with your child becoming independent.”

Aíza gives some examples of unhelpful family accommodations: You make sure there’s food in the fridge, don’t ask them to contribute to paying bills, and may give them spending money. When they get angry or upset, you accept the behavior and feel guilty, thinking you are to blame for the situation. If they are anxious when you aren’t nearby, you don’t travel because it causes them stress. Instead of expecting them to take steps to find a therapist, you do the legwork.

“The number one behavior of the highly dependent adult child is avoidance. I cannot emphasize this enough,” Aíza says. “If your child has a full-on virtual life, that’s their social outlet. They are avoiding real-life challenges. They are avoiding working at jobs that are unpleasant. They are probably avoiding adulting tasks that should fall on them at this point. So, we swoop in and take care of those tasks for them.”

A modern version of an old problem

While adult children have lived with their parents in past generations, researchers argue that phenomenon of highly dependent adult children is on the rise, and young people today seem particularly susceptible. Adolescence is more prolonged now in many cultures, and there’s an emphasis on finding a fulfilling career, not just a job that pays the bills.

Technology contributes to the problem. Playing video games, watching videos, scrolling through social media — “these activities don’t help matters because they can do things that feel like they’re accomplishing something,” Dr. Welles says.  

How to stop enabling your grown child

In Dr. Welles’s practice, she has worked with families where she initially treated the teen for anxiety or OCD, then involved the parents more deeply when the young adult had trouble launching. In one case, the son was in the habit of playing video games late at night and would sleep through class the next day. He had anxiety and depression, and his parents didn’t want to take away video games because it was the one thing he enjoyed doing. But they started turning off the Wi-Fi in the house at a certain time at night.

“It sounds so extreme, like he’s being punished,” Dr. Welles says. “But it’s about saying to him, ‘We’re going to pull back on ways we’ve accommodated that may have unintentionally made your anxiety worse.’” It was important that the parents validated his feelings, saying things like, “You feel like you’re in danger, as if you’re standing in front of a bear, and that’s really hard. But that’s the anxiety lying to you, and it won’t go away if we keep accommodating things that allow you to avoid what you need to do in order to overcome this anxiety.”

And tactics like these made a difference over time. The son is now attending college part-time and working as a server at restaurant. He has a girlfriend and has plans to save enough to move into an apartment with a friend.

Setting boundaries with your adult child

If the adult child doesn’t seem motivated to find a job, Aíza has recommended that parents take them off the family cellphone plan, giving them warning that this will happen by the next month’s bill. “This is not necessarily the most strategic financial choice” because it’s often much cheaper per person on a family plan, she acknowledges. “But it is a perfect first accommodation to remove because it is telling your adult child, ‘This is something you can handle. You can be responsible for it financially and logistically. It is something that I control, and I want to stop controlling parts of your life.’” And it’s often the motivation they need to find a job — something that can earn them $100 for the monthly cell phone bill is small enough that it feels doable.

When families take steps like these, the adult child will likely get angry or upset. “That’s hard. But think about when your kids were toddlers, and they wanted to touch a hot stove,” Dr. Welles says. “They were mad when you said, ‘No, you can’t touch that stove,’ but that didn’t mean you let them do it.”

“The good news is, generally speaking, even if there’s unhappiness in the beginning,” she continues, “pretty quickly, once they start to feel better and are doing the things that they actually care about, it can really help.”

Supporting without enabling adult children

Highly dependent adult children might accuse parents of not being supportive when they pull back on accommodations. Dr. Welles suggests communicating that you hear them and validate their feelings: “You can say things like, ‘Hey, I know this is tough or ‘I know that this makes you really nervous.’ But you combine it with the confidence that they can do it, like ‘I also know you can do it, as hard as it is.’”

Sometimes, you might think you are being supportive when you are actually enabling — like filling out a job application on behalf of the child. “Even if it works and they get an interview, you’re accommodating their anxiety,” Dr. Welles says. “But also, there’s going to be a point when you can’t do something for the child — the interview or the job itself — so the earlier that you can pull back the better.”

If your adult child has both ADHD and anxiety, you can support their executive functioning skills without accommodating the anxiety. “Maybe you sit down with them on Mondays and look at their schedule to help them determine if there’s a way you can help them organize, as opposed to you stepping in and letting them avoid things they need to do because they’re anxious about it,” Dr. Welles says.

Aíza encourages giving the adult child the minimum amount of help needed, to avoid creating another form of dependency. “It’s about noticing, ‘Am I working harder at this than they are?’” she says. “A lot of times the answer is ‘yes,’ and that’s a signal to back off and put more expectations on the child.”

Treatment for highly dependent adult children

While there is no standard treatment for highly dependent adult children, early evidence has shown a form of therapy called SPACE-FTL (Supportive Parenting for Anxious Childhood Emotions – Failure to Launch) to be promising. A variation on an effective treatment for anxiety and OCD, SPACE-FTL involves only the parents, since the adult child is often resistant to seeking help. The program helps parents reduce accommodations step by step and engage extended family and friends to help de-escalate conflict. 

One tactic is to make a plan to deliver a change in accommodation in writing — for instance, explaining that you will stop paying the cellphone bill at the end of the month and why. Doing it in writing (on paper or in a text) makes the message clear and helps you remain calm and non-reactive. If you are expecting an angry or violent response, they can ask a grandparent, uncle, or family friend be in the house when you deliver the letter, since that might make the response less extreme. The relative or friend may even spend the night if the adult child is more likely to cool off when others are present.

Asking for others’ help also helps you stop blaming yourself for the situation. “A lot of parents of highly dependent adults feel shame, but this is not something happening to only one family,” Aíza says. “We need to build on our social supports and get other people on our team so that we don’t feel so isolated in this process. Your adult child may be resisting change, but you don’t have to. It might sound cruel, but our central mandate as parents is making sure our child is okay after we’re gone. We brought them on earth to survive us — that is the design.”

Frequently Asked Questions

What is “failure to launch syndrome”?

“Failure to launch” isn’t a formal diagnosis but describes young adults who are stuck in a pattern of dependence. They’re typically not working or in school, rely on parents financially and emotionally, and struggle to move forward with adult responsibilities.

How can I motivate my adult child to become independent?

Change often starts with parents gradually pulling back on accommodations while staying supportive and calm. Set clear expectations, validate their feelings, and shift responsibility back to them in manageable steps so they can build confidence and autonomy.

The post “Failure to Launch” Syndrome: How to Stop Enabling Your Grown Child appeared first on Child Mind Institute.

Opinion: Trump’s executive order on psychedelics is the right move. But is my field ready for it?

I have spent the last 10 years of my life investigating psychedelics as novel treatments for mental health conditions. When President Trump signed his executive order on psychedelic medicines, my first thought was: He got this one right. My second thought: My field may not be ready for it.

The order itself is sweeping. It directs the Food and Drug Administration to issue priority review vouchers to accelerate approval timelines, expands right-to-try pathways for ibogaine, dedicates $50 million in ARPA-H funding to psychedelic research, authorizes the Drug Enforcement Administration to speed scheduling of FDA-approved psychedelics, and launches collaboration with Veterans Affairs on therapies for veterans.

Read the rest…

Anxiety and Depression Associated With the Dependent Use of Generative AI in Medical Students: Cross-Sectional Study

Background: The growing integration of artificial intelligence (AI) in higher education has transformed learning processes but also raised concerns about potential mental health risks. Medical students represent a particularly vulnerable group due to high academic stress and increasing reliance on generative AI tools for study and decision-making tasks. Despite this, the relationship between AI dependence and psychological distress remains underexplored in Latin American contexts. Objective: This study aimed to evaluate the association between generative AI dependence and levels of stress, anxiety, and depression among medical students. Methods: A cross-sectional study was conducted with 187 human medicine students from a Peruvian university during the first academic semester of 2025. The Dependence on Artificial Intelligence Scale and the Depression, Anxiety, and Stress Scale–21 were applied. Negative binomial regression models, both crude and adjusted for sex, age, income, and year of study, were used to assess associations, reporting rate ratios (RRs) and 95% CIs. Results: Participants had a median age of 22 (IQR 19‐24) years, and 58.8% (110/187) were female. The median Dependence on Artificial Intelligence Scale score was 10 (IQR 7‐14). Generative AI dependence showed significant correlations with anxiety (ρ=0.336, 95% CI 0.22‐0.44) and depression (ρ=0.316, 95% CI 0.20‐0.43) and a smaller correlation with stress (ρ=0.277, 95% CI 0.16‐0.39). In the adjusted regression models, each 1-point increase in generative AI dependence was associated with a 5% higher expected anxiety score (RR 1.05, 95% CI 1.01‐1.09; =.01) and a 4% higher depression score (RR 1.04, 95% CI 1.01‐1.08; =.03), whereas the association with stress was positive but nonsignificant (RR 1.03, 95% CI 1.00‐1.07; =.08). Fifth-year students had significantly greater anxiety levels than their sixth-year peers (RR 1.82, 95% CI 1.09‐3.01; =.02). No significant effects were observed for sex, age, or income. Conclusions: This study empirically examined generative AI dependence as a distinct behavioral construct and its association with mental health symptoms in medical students. Unlike prior research, this study evaluated psychological dependence on generative AI and modeled its relationship with anxiety and depression using appropriate count-based regression techniques. By providing early evidence from a Latin American context, it contributes to the emerging field of digital mental health and medical education research. These findings underscore the need for universities to promote balanced and responsible AI use, integrate digital literacy with mental health support strategies, and develop preventive policies that mitigate potential maladaptive reliance on generative AI tools.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/63c5cab6261231002a3eb9a11707995f" />

Psilocybin-Induced Brain Changes May Explain Therapeutic Effects

Researchers at University of California, San Francisco and Imperial College London have shown that a single dose of psilocybin, the psychedelic compound found in magic mushrooms, causes likely anatomical brain changes that last for up to a month after the experience.

The study, involving healthy volunteers who had never taken a psychedelic, links temporary shifts in brain “entropy”—which is the diversity of neural activity occurring in the brain—to insight. This suggests the psychedelic trip itself is important to the drug’s longer term therapeutic effects.

The researchers found that a high dose of psilocybin led to increased entropy in the minutes and hours after taking the drug. The degree of entropy predicted how much insight, or emotional self-awareness, the participants felt the next day; and this, in turn, forecasted improvements in their sense of wellbeing a month later.

The findings may help to explain psilocybin’s therapeutic effects on conditions such as depression, anxiety, and addiction. “Psychedelic means ‘psyche-revealing,’ or making the psyche visible,” said senior author Robin Carhart-Harris, PhD, the Ralph Metzner distinguished professor of neurology at UCSF. “Our data shows that such experiences of psychological insight relate to an entropic quality of brain activity and how both are involved in causing subsequent improvements in mental health. It suggests that the trip—and its correlates in the brain—is a key component of how psychedelic therapy works.”  Carhart-Harris is senior and corresponding author of the team’s published paper in Nature Communications, titled “Human brain changes after first psilocybin use.”

“Psychedelics have robust effects on acute brain function and long-term behavior but whether they also cause enduring functional and anatomical brain changes is largely unknown,” the authors wrote. Psilocybin is the precursor of the compound psilocin, a serotonin receptor agonist. “Converging evidence supports a role for serotonin 2A receptor  (5-HT2AR) agonism in eliciting the characteristic brain and subjective effects of this and related psychedelics in humans,” the team continued.

For their newly reported study, Carhart-Harris and colleagues carried out an exploratory, placebo-controlled, within-patient study in 28 psychedelic-naïve participants who each received a single, high-dose (25 mg) of psilocybin. The researchers used an assortment of brain imaging and brain measurement techniques, some of which were carried out during the peak of the psychedelic experience, as well as before and one-month after drug administration. “This was an exploratory, hypothesis-generating mechanistic study in healthy volunteers,” the authors noted. None of the 28 people in the study had a diagnosed mental health condition, which gave the scientists greater freedom to do more testing.

In the first part of the experiment the subjects were given a 1 mg dose of psilocybin, which the researchers regarded as a placebo, and were then monitored with EEG, which records brain activity from electrodes on the scalp.  Over the next few weeks, the researchers measured their subjects’ psychological insight, wellbeing, and cognitive ability. They examined brain activity with functional MRI (fMRI) and brain connectivity with diffusion tensor imaging (DTI).

One month after the placebo, the subjects were given 25 mg of psilocybin, a dose capable of eliciting a strong psychedelic trip. During the experience, researchers again measured the subjects’ brain activity with EEG, and in the following weeks they repeated the same tests they had given after the 1 mg dose.

This enabled the scientists to compare the effects of the psychedelic trip on the brain and mind to the effects of the placebo. “The multimodal neuroimaging design allowed us to observe changes in brain function and (potential) anatomy from 1-h (EEG) to 1-month (DTI) after high-dose psilocybin,” they explained.

The investigators found that within 60 minutes of taking the 25 mg dose of psilocybin, EEG revealed higher entropy, suggesting that the brain was processing a richer body of information under the psychedelic. A month later, the researchers looked at their subjects’ brains using DTI, which measures the diffusion of water along neural tracts in the brain, and found that they were denser and had more integrity. This is the opposite of what happens in aging, which makes these tracts more diffuse.

The researchers cautioned that more work needs to be done to better understand the meaning of this finding, but the result is a never-before-seen sign of how psychedelics can change the brain. ”The inclusion of DTI enabled us to test for long-term changes in the integrity of white matter tracts post psilocybin,” the authors stated. “Results revealed decreased axial diffusivity in prefrontal-subcortical tracts 1-month post 25mg psilocybin.”

The day after the 25 mg dose, all but one of the 28 subjects rated the trip as the “single most” unusual state of consciousness they had ever experienced. The remaining person rated it as among their top five. The study participants said they had experienced more psychological insight after taking the 25 mg of psilocybin than they had after the 1 mg placebo.  The subjects also reported increased wellbeing two and four weeks after the study. This was measured from responses to statements such as, “I’ve been feeling optimistic about the future,” and “I’ve been dealing with problems well.”

As the scientists noted in their paper, “A predictive relationship was also found between brain entropy and longer-term mental-health changes—namely, improved wellbeing. Improved wellbeing could be predicted directly from acute increases in brain entropy as early as 1-h post dosing.”

A month after the study the study individuals also scored better on a test of cognitive flexibility.  “Psilocybin seems to loosen up stereotyped patterns of brain activity and give people the ability to revise entrenched patterns of thought,” said first author Taylor Lyons, PhD, a research associate at Imperial College London. “The fact that these changes track with insight and improved well‑being is especially exciting.”

The scientists found that the subjects who had experienced the largest increases in brain entropy in the minutes to hours after taking psilocybin were the most likely to have increased insight the next day and increased wellbeing a month later. The researchers concluded that improved wellbeing was driven by the experience of insight.

The authors suggest that the study findings could improve treatment for people with mental illness using psilocybin, for example, by ensuring that the right dosage is used to produce the right amount of brain entropy to promote insight. “We already knew psilocybin could be helpful for treating mental illness,” Carhart-Harris said. “But now we have a much better understanding of how.”

In their paper the team concluded, “The present multi-modal neuroimaging study in healthy participants sheds light on the brain effects of first-time high-dose psychedelic use and the therapeutic action of psilocybin-therapy, suggesting that therapeutically relevant changes—i.e., improved wellbeing—can be forecast via an acute human brain action, i.e., an entropic brain effect, that is well-known to relate to the psychedelic experience … Results support a role for psychological insight in mediating the causal association between the entropic brain effect and potentially enduring improvements in wellbeing.”

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