<![CDATA[Psychiatrists debunk 10 common antidepressant myths—placebo claims, addiction fears, suicide risk, overuse, and withdrawal—offering evidence-based guidance.]]>

EFE-8c4, a polyamine from Elaeagnus multiflora, protects neuronal cells by regulating oxidative stress and apoptotic pathways

Neurological disorders, including depression, cognitive impairment, and neurodegenerative diseases, are closely associated with oxidative stress, apoptotic neuronal loss, and impaired neuronal differentiation. Polyamine derivatives from natural products have emerged as potential neuroprotective agents, although their mechanisms remain incompletely understood. In this study, three polyamine compounds isolated from Elaeagnus multiflora fruit were evaluated in SH-SY5Y cell models of oxidative and glucocorticoid-induced stress. Among these, EFE-8c4 exhibited the most pronounced neuroprotective activity, significantly restoring cell viability under corticosterone-induced stress and attenuating oxidative damage induced by hydrogen peroxide. Mechanistically, EFE-8c4 modulated apoptotic signaling by increasing Bcl-2 expression while suppressing Bax, caspase-8, and p53 activation, thereby restoring the balance between pro- and anti-apoptotic pathways. In addition, EFE-8c4 reduced intracellular reactive oxygen species accumulation and enhanced the expression of PCNA and βIII-tubulin, indicating improved cell survival capacity and neuronal phenotype maintenance. Furthermore, EFE-8c4 partially reduced apoptotic cell populations under corticosterone exposure. Collectively, these findings demonstrate that EFE-8c4 exerts multi-target neuroprotective effects through coordinated regulation of apoptosis, oxidative stress, and neuronal differentiation-related pathways, highlighting its potential as a candidate for the treatment of oxidative stress-associated neurological disorders.

Developing forensic patient-oriented research guidelines: a rapid review using an integrated knowledge translation approach

This paper reports findings from a rapid literature review that informed new guidelines for conducting patient-oriented research in forensic mental health settings. The project adopted an integrated knowledge translation approach at a mental health hospital in Ontario, Canada, engaging a project team that included current forensic patients, hospital staff, and members of an international community of practice. Sources were identified through nine academic databases and targeted grey literature searches, screened independently by two reviewers and extracted using a structured template guided by an a priori framework developed with patients and staff at a knowledge exchange event. Findings were iteratively refined through a patient advisory group, an implementation study, ethnographic observations, and related integrated knowledge translation activities conducted alongside the review. Together, 31 academic and grey literature sources informed a framework organized around five core dimensions: 1) Resourcing, orientation, and training; 2) Confidentiality, consent, and compensation; 3) Relationships, shared understanding, and support; 4) Levels of engagement; and 5) Evaluation and sustainability. Guided by cross-cutting principles common among participatory mental health research, such as dignity, trust, respect, and a commitment to redressing power and attending to forms of epistemic injustice, the guidelines respond to distinctive constraints of forensic environments while highlighting opportunities to promote authentic co-production and sustain patient involvement in research. Recommendations include dedicated resources and capacity-building for patients; relational, ongoing consent practices co-developed with patients; flexible patient researcher roles with fair, paid compensation; and sustained institutional support for participatory practices. We call on forensic hospitals and secure settings to adapt and evaluate these guidelines and to invest in expanding patient leadership to advance the field.

Age-stratified multimodal MRI and machine learning to explore autism-related brain characteristics in youth

PurposeAutism is a common neurodevelopmental condition (NDC) that is characterized by restricted, repetitive behaviors and social communication differences that can impact the daily functioning of individuals. The clinical diagnosis of autism can be challenging, mainly due to its behavioral variability and frequent co-occurrence with other NDCs. This study investigates the ability of machine learning-based classification models trained using multimodal neuroimaging data combined with feature-importance analyses to identify development-specific brain characteristics associated with autism.ApproachA total of 144 participants aged 5 to 18 years with structural MRI (sMRI), diffusion MRI (dMRI), and resting-state functional MRI (rs-fMRI) data available were obtained from the Autism Brain Imaging Data Exchange (ABIDE) database. Radiomic features were extracted from each MRI data modality and used to train support vector machine (SVM) classifiers to identify neuroimaging patterns associated with autism. Single MRI modality classifiers, as well as one combining all three modalities, were trained for comparison purposes. To investigate age-specific effects, the same approach was followed for three age sub-groups: younger children (5–11 years), adolescents (12–18 years), and the entire 5–18 years age cohort. Model performance was evaluated using leave-one-out cross-validation across 30 diagnosis-balanced data splits. Feature-importance analyses were conducted to identify the most important neuroimaging features for classification.ResultsThe classification accuracies of the unimodal models ranged from 68.3% to 75.3% for sMRI, from 69.3% to 77.6% for dMRI, and from 66.3% to 69.9% for rs-fMRI data across age groups. Among all single imaging modalities and age groups, dMRI showed the highest performance with a 77.6% accuracy in younger children (5–11 years). The multimodal approach improved classification performance when compared to the unimodal models in all age groups, achieving accuracies of 78.9%, 76.7%, and 70.5% in the younger, adolescent, and entire age cohorts, respectively. Our findings indicate that multimodal classifiers integrating complementary structural, microstructural, and functional imaging features result in a more comprehensive representation of brain features that strengthens model performance. The most informative brain regions for classification differed between children and adolescents while several diffusion-derived features significantly correlated with social responsiveness scores, emphasizing the clinical importance of studying white and gray matter microstructure in autism.ConclusionsThis study demonstrates the potential of multimodal neuroimaging-based machine learning models to identify development-specific biomarkers associated with autism. The results highlight the value of integrating age-stratified analyses of multimodal neuroimaging to better capture autism-associated developmental brain characteristics. The framework adopted in this study could be extended to explore other NDCs in the future.

Enhancing psychiatry education: effectiveness of a psychodynamic psychotherapy module for borderline personality disorder for psychiatry residents

BackgroundPsychodynamic psychotherapy is the treatment of choice for borderline personality disorder (BPD); however, psychiatric residents frequently report difficulty in applying it, partly due to the lack of structured training models. This study developed and evaluated the effectiveness of psychodynamic psychotherapy learning modules for BPD among Indonesian psychiatry residents.MethodsA quasi-experimental pre-/post-test control group study using mixed methods was conducted across nine psychiatric residency programs in Indonesia. Thirty-four residents were recruited, of whom 33 completed the study. Learning outcomes were assessed using multiple-choice questions and the Psychodynamic Formulation Competency Assessment Scale (PF-CAS) and Practical Competency Assessment Scale (PC-CAS). The module program was evaluated by the participants using the Indonesian version of the Kirkpatrick Level 1 questionnaire.ResultsThe intervention group showed significantly greater improvement in psychodynamic formulation skills (PF-CAS) than the control group (p < 0.001). The multiple-choice scores improved in both groups, with no significant between-group differences. The intervention group showed a numerically greater improvement in Practical Skills (PC-CAS) than the control group, although the difference was not statistically significant. Participants’ feedback was highly positive, emphasizing the usefulness of psychodynamic formulation training, psychotherapy protocols, and supervision.ConclusionImplementation of the psychodynamic psychotherapy for BPD Learning Module enhanced competencies in the cognitive and affective domains and showed promising trends in practical skills. This positive reception highlights its feasibility and potential benefits as part of the residency training curriculum.

A Recap of the Inaugural Youth Mental Health Hub at SXSW London

In early June, SXSW London returned for its second year, gathering thousands of creatives, enthusiasts, entrepreneurs, and investors into the city to celebrate film, music, tech, and culture. As part of this year’s festival, the Child Mind Institute, in partnership with Wellcome, proudly presented the inaugural Youth Mental Health Hub – a week of programming dedicated to advancing solutions to one of the defining challenges of our time: the global youth mental health crisis. Through six thought-provoking sessions, leaders in clinical care, science, technology, policy, and media came together to explore how to strengthen prevention, improve early identification, reduce stigma, and build systems that meet young people where they are.

Here’s a look back at the inspiring conversations that took place throughout the week.

Beyond the Average: Understanding Vulnerability in the Digital Childhood Era

Beyond the Average: Understanding Vulnerability in the Digital Childhood Era

As artificial intelligence rapidly transforms the experience of childhood, experts explored how AI can both support and challenge young people’s mental health. The panelists discussed when and under what conditions young people may be most vulnerable as well as what systems we need to support them.

Moderator

Gary Wilson, Director of Research, Huo Family Foundation

Speakers
Catherine Sebastian, PhD, Head of Evidence for Mental Health, Wellcome
John Pickavance, PhD, Principal Data Scientist, Born in Bradford
Georgia Turner, Postdoctoral Research Associate, University of Cambridge
Michael Milham, MD, PhD, Chief Science Officer, Child Mind Institute

AI Is Already Shaping Childhood. Who Is Shaping AI? Balancing Innovation, Evidence, and Safety in Youth Mental Health

AI Is Already Shaping Childhood. Who Is Shaping AI? Balancing Innovation, Evidence, and Safety in Youth Mental Health

Youth are experiencing the impacts of AI earlier and more intensely than any previous generation has. This session explored the role of public leadership in anticipating harm before it becomes systemic — establishing guardrails, fostering digital resilience, and ensuring that innovation advances hand in hand with youth mental health and well-being.

Moderator
Sarah Aguiar-Borges, PhD, University of Cambridge

Speakers
Julia Gillard, former Prime Minister of Australia; Chair, Wellcome
Kanishka Narayan, UK Minister for AI and Online Safety
Giovanni Salum, MD, PhD, SVP, Global Programs, Child Mind Institute.

Youth Mental Health After Conflict: Healing, Resilience, and Rebuilding Systems

Experts shared insights on the unique mental health challenges facing children affected by war, displacement, and humanitarian crises. This session explored how societies can implement youth-centered systems grounded in prevention and use early identification to position youth mental health as a cornerstone of long-term recovery and resilience.

Moderator
Krupa Padhy, BBC Radio 4

Speakers
Dr. Mark Jordans, professor, Centre for Global Mental Health, King’s College London; Director of Research & Development, War Child
Emma Ferguson, mental health policy and advocacy specialist, UNICEF
Mohamed Ali, Director, Iftin Global

Dyslexia: Changing the Story

In a timely discussion, experts explored how dyslexia is currently understood in society, challenging current language and misperceptions that can impact a child’s confidence and mental health. Through a blend of personal experience and clinical expertise, the conversation focused on the need for evidence-based support and strengths-based approaches to help children and their families thrive.

Moderator
Kate Griggs, Founder, Made By Dyslexia

Speakers
Maggie Aderin, PhD, space scientist & educator; dyslexia advocate
Harold S. Koplewicz, MD, President and Medical Director, Child Mind Institute

Connection Continuum: Preventing Suicide and Combating Loneliness

Suicide is one of the leading causes of death among young people globally. This session gathered community, clinical, and digital leaders to explore what a more connected system of support looks like in practice. The panelists also discussed the important of recognizing warning signs, expanding access to evidence-based care, and prioritizing early intervention to help prevent youth suicide.

Moderator
Krupa Padhy, BBC Radio 4

Speakers
Victoria Hornby, CEO, Mental Health Innovations
Dean Perryman, Empty Chairs
Michael Milham, MD, PhD, Chief Science Officer, Child Mind Institute

Does Mental Health Science Funding Need a New Paradigm in the Age of AI?

With technology evolving faster than the science designed to understand it, experts examined how research, philanthropy, and clinical leaders can work together to build the evidence, safeguards, and infrastructure needed to protect children’s mental health in the digital age.

Moderator
Chelsea Clinton, Vice Chair, Clinton Global Initiative

Speakers
Miranda Wolpert, Director of Mental Health, Wellcome
Margaret Laws, President & CEO, HopeLab
Daria Bukhman, Co-Founder and Chair, Bukhman Philanthropies
Harold S. Koplewicz, MD, President & Medical Director, Child Mind Institute

The post A Recap of the Inaugural Youth Mental Health Hub at SXSW London appeared first on Child Mind Institute.

Boys, Masculinity, and the Looksmaxxing Trend  

By now, you’ve probably heard of the term looksmaxxing. Think pieces about the trend have popped up all over the internet. And in a recent episode of Saturday Night Live, comedians poked fun at lookmaxxing influencers obsessed with having the perfect male physique.

While this new social media craze may seem silly, it’s impacting more boys than you might think. In a study conducted last year that surveyed over 3,000 young men (ages 16–25) from the United States, United Kingdom, and Australia, nearly two-thirds of participants were regularly engaging with masculinity influencers.

Teen boys are being encouraged to change the way they look in order to fit a certain standard of attraction. The growing amount of looksmaxxing content they see online can have real effects on their self-esteem and mental health.   

What is looksmaxxing?  

Looksmaxxing originated nearly a decade ago in incel forums where men blamed their lack of romantic partners on the belief that female sexual selection is primarily based on physical qualities. So men who aren’t born with traits desirable to women are doomed to fail romantically. While traditional incels wallow in this fate, looksmaxxers seek to enhance their appearance to become more attractive. Their community claims that there is a universal standard for what the ideal man (and woman) should look like.

This is determined by a rating system called the PSL scale — the name being an amalgamation of three prominent misogynistic incel forums of the 2010s. There are many factors that go into the scaling, such as eye shape, jaw size, nose angle, and body fat percentage. Along this scale, you can land in four categories: subhuman, normie, Chadlite, and Chad (the ultimate catch).

During the pandemic, looksmaxxing went mainstream, merging with “manosphere” content on social media platforms like TikTok and Instagram. The trend became less about the ability to attract women and more of a competition among boys and men as they engaged in mog-offs — online contests where people have their faces analyzed and compared by facial recognition software to determine who’s better looking.

Self-improvement practices have gained popularity among boys. Some are considered to be softmaxxing, like developing skincare routines or eating high-protein diets, and others to be hardmaxxing, like using growth hormones or getting cosmetic surgery.

Prominent young influencers like Clavicular represent the extreme side of looksmaxxing. He practices bonesmashing (using a hammer on facial bones to try to form more angular features), injects himself with testosterone, and takes meth to maintain a low body fat percentage while still having a muscular physique.

Looksmaxxing and new beauty standards

The rise of looksmaxxing seems to have a caused a ripple effect among teen boys. While the ideal look has centered on big muscles and washboard abs for decades, there’s now an added pressure on facial beauty that’s typically been reserved for girls.

“With some of the teen boys I work with, most of whom already have self-esteem issues, I think there is a lot more concern about how they look,” observes Alnardo Martinez, LMHC, director of the Pediatric OCD Intensive Program and a mental health counselor at the Child Mind Institute. “They want to have the strong jaw, really big muscles, clear skin, and a perfect haircut.”

However, Martinez notes that it sometimes take a while for boys  to admit that they feel this pressure. They may insist that they don’t really care about that stuff. “But then, maybe a few months later, it comes out that there is a lot of comparison. They’re spending a lot of time in front of the mirror or in the bathroom trying to create this perfect image,” he observes.

What teen boys think about looksmaxxing and self-improvement

We talked to young men who were critical of Clavicular and the impact looksmaxxing can have on teens but were positive about engaging in some form of physical self-improvement.

Wyatt, now 19, remembers comparing his jawline to his peers’ when he was in 7th grade. “I just felt like they had really sharp jawlines. And I was just like, ‘Oh, I want to get closer to that.’” He would also come across TikToks advertising rubber chewing blocks and chin exercises meant to strengthen the jawline.

And so, Wyatt began to do jaw exercises he’d found online, reciting the alphabet while stretching out the muscles. “I would go through my Zoom classes throughout the day and then after that was done, I’d just go into the bathroom and go through the whole exercise. It would take like an hour sometimes,” he recalls. “It turned into more like a self-care, self-improvement session. I would do that every day after my classes. I didn’t feel like I was done with school until I finished my jawline routine.” He took photos to document his progress.  

Wyatt feels like the routine had a positive effect, because he was able to see an improvement. “I felt more satisfied with myself, a little more confident.”

Lev, now 19, remembers wanting to have some control over his body when going through puberty in high school. “Puberty is not a straightforward process. It’s not all peaches and cream. Your body changes, and it can be uncomfortable,” he explains. “But with lifting and strength training, it was very exciting to see this, you know, man energy that came out of it. I wanted to harness that and really take it by the reins. Have some agency as a man.”

And while he rejects the extreme parts of looksmaxxing, Lev does regularly practice self-improvement through weight lifting, skin care routines, and taking GLP-1 weight loss medication.

How looksmaxxing can impact boys’ mental health

Since looksmaxxing places such a strong emphasis on achieving a very specific look, clinicians are concerned about its influence on teens. “Self-esteem is pretty fragile during puberty,” Martinez says. “There’s already a ton of comparison and perceived flaws that teens don’t love about themselves.”

These insecurities can be exacerbated by the type of content teens engage with online, Martinez explains. Along with ChatGPT bots specifically designed to judge aesthetics, Reddit threads such as r/Mewing and websites like Looksmaxxing Forum encourage boys to post pictures of their faces and bodies to get rated by their peers. Boys as young as 13 visit these forums, posting pictures and asking for tips on how to improve their looks.

“These are generally places where people are already pretty harsh and critical. These boys are receiving a lot more ‘confirmation’ around the perceived things that are wrong with them or that they need to change,” Martinez says. “And it just feeds into the already present negative self-image and self-talk.”

He explains that this type of social media engagement can also compound underlying mental health issues like depression and social anxiety. “They might be less likely to go out and talk to people because they’re thinking, ‘Everyone is going to see this one thing that everyone else has told me is wrong with me. So now I can’t go out,’”he says.

Martinez is also concerned that online content can negatively affect teens with body dysmorphic disorder (BDD). “If they think they have a big nose, for example, they might go on these Reddits and ask, ‘What does my nose look like? Is it too big?’ There are trolls out there. Someone is going to say yes and then that’s going to make the BDD symptoms even worse.”

When behaviors might be concerning

In some ways, teen boys taking part in more self-improvement practices could be seen as a good thing. They’re exercising, taking care of their skin, and eating more balanced diets. The issues begin when these types of practices turn into obsession. And given the underlying ideology of looksmaxxing and the nature of social media, things can become unhealthy.

According to Martinez, there are some changes in behavior to look out for that indicate you might want to step in.

One clear change, he says, is a noticeable shift in the amount of time they’re spending on grooming themselves. “Maybe they were someone who would typically just get up and run out the door without washing their face,” he says. “But now they’re spending a lot more time in the bathroom and asking a lot of questions about how they look.”

Another warning sign can be a big change in personality. “Irritability is a big one that we’ll see a lot,” he says. “They’re unhappy with how they look, so this increases a general level of irritation.”

These behaviors paired with an unusual uptick in time spent on social media, Martinez explains, can be a sign that something’s wrong and support is needed.

How to support your child

If you’re worried that your child might be engaging in looksmaxxing-related behaviors to an unhealthy degree, says Martinez, there are a few things you can do:

  • Open communication. Martinez suggests approaching your child with curiosity. “You could start the conversation by saying something like, ‘So have you heard about this? What do you think about it? Have you ever had any thoughts yourself about how you look or desires to change your body or face?’ And then give them some space to be open and vulnerable about it. Validate their experience.” 
  • Find out where your child is getting their information. “Read it together, talk about it, and see what your child thinks about it,” Martinez advises. “And if it’s promoting something dangerous, then you can talk to them about how those practices can be harmful and what could actually happen if they do some of those things.”
  • Encourage male role models. “There’s a patient I work with now who doesn’t have a present dad,” Martinez explains. “His mom tries to talk to him about things like body image, but he feels like she doesn’t understand and can’t relate. So having someone that he can talk to and be open about this stuff with, especially someone who can also share their own struggles, can be really helpful.”
  • Seek help from a mental health professional. This is especially important if you find out that your child has been engaging in extreme forms of looksmaxxing such as bonesmashing or starvemaxxing. Martinez recommends looking for a clinician who specializes in body image or body dysmorphic disorder.

A lot of parenting comes down to open communication around what your kids are seeing and what they’re feeling. We all have things about our bodies that we might not like and wish we could change, says Martinez, and it can help to normalize those feelings. “And then you can discuss how they can make changes in healthy ways,” he suggests. “Go over what’s a realistic change and what’s a dangerous change.”

The post Boys, Masculinity, and the Looksmaxxing Trend   appeared first on Child Mind Institute.

<![CDATA[Explore how to manage mood and substance use disorders together, boost engagement, and expand addiction medications.]]>

The relationship between intracranial artery hemodynamics and subjective cognitive decline in patients with cerebral small vessel disease: a 4D flow study

BackgroundRecent studies link disrupted intracranial artery hemodynamics, including pulsatility index (PI), resistance index (RI), and wall shear stress (WSS), to neuroimaging features of cerebral small vessel disease (CSVD). Cognitive dysfunction is a key clinical manifestation of CSVD. Subjective cognitive decline (SCD), considered a pre-mild cognitive impairment stage, enables early identification and intervention to control cognitive decline. Nevertheless, scholarly investigation on SCD in CSVD and its underlying hemodynamic mechanisms remains limited.ObjectiveThis study aims to utilize 4D flow magnetic resonance imaging (MRI) to explore the effects of intracranial artery hemodynamics on SCD in patients with CSVD.MethodsThis study enrolled 40 patients with CSVD, comprising 20 individuals with SCD and 20 with normal cognition. SCD was evaluated according to established diagnostic criteria using the 9-item Subjective Cognitive Decline Questionnaire (SCD-Q9). Hemodynamic parameters, including PI-flow, PI-area, RI and WSS, were measured in nine major intracranial arteries via 4D flow MRI. Associations between these parameters and cognitive status were examined using logistic regression analysis.ResultsCompared to the cognitively normal group, patients with CSVD and concomitant SCD showed lower arterial elasticity at the C7 segment and the basilar artery (BA), and lower WSS at the C2 segment. Logistic regression analysis further identified abnormal RI-BA was independently associated with SCD in the CSVD cohort.ConclusionAltered intracranial artery hemodynamics in patients with CSVD are associated with the presence of SCD. These findings offer mechanistic insight into early cognitive impairment in CSVD and suggest that hemodynamic abnormalities may serve as potential indicators of early cognitive dysfunction in this population.

Burned aggression: the relationship between burnout and aggressive behaviour among young adults in Czechia

IntroductionDespite stress being a critical component of burnout, few studies have investigated the relationship between burnout and aggressive behaviour. Therefore, the current study aims to verify whether states of exhaustion are associated with aggression.MethodsStructural equation models were constructed using data from a representative sample of 1027 young adults (Mage = 24.53), almost half of whom were men (n = 507). The models revealed the relationships between burnout, aggressive behaviour, emotion regulation strategies, risky alcohol consumption, stress, and adverse childhood experiences. ResultsAlthough there were minor differences in the pathways between men and women, both models showed a good fit for the data. Furthermore, among both men and women, the positive relationship between burnout and aggressive behaviour was mediated by maladaptive coping strategies and risky alcohol consumption. Interestingly, reliance on maladaptive emotion regulation strategies was also associated with increased depressive symptoms among women but not among men.ConclusionThe findings of this study reveal that aggressive behaviour is another negative consequence of burnout among young adults and highlight the importance of skills applied in responses to chronic stress. The implications of these findings and further results are discussed in relation to the existing literature.