BackgroundIndividuals with attention-deficit/hyperactivity disorder (ADHD) and individuals with borderline personality disorder (BPD) show symptomatic overlaps. They both suffer from deficits in emotional regulation, are impulsive and have problems with their self-concept. Therefore, a precise diagnostic differentiation is of great importance. The aim of this study was to find symptom overlaps and differences in patients with ADHD and BPD.Methods80 patients with ADHD, 55 patients with BPD and 55 healthy controls were examined regarding their ADHD and BPD symptoms and their degree of emotional dysregulation using self-report instruments.ResultsPatients with ADHD and patients with BPD did not differ significantly in their expression of emotional dysregulation. However, the ADHD patients showed higher scores in impulsivity, inattention, and hyperactivity, whereas the group with BPD showed higher scores in self-concept problems and suicidal behaviour. The two clinical groups showed significantly higher scores in emotional dysregulation and all other symptom domains compared to the control group.ConclusionThe symptom overlap in emotional dysregulation yields implications for both further research and diagnosis of ADHD. Further studies should define emotional dysregulation consistently to examine the same construct. Key Practitioner Message: This article yields implications that individuals with ADHD and BPD have several symptom overlaps and in fact have no difference in their emotional dysregulation. This has a vast importance for differential diagnosis and treatment of ADHD.
Beyond aesthetic outcomes: psychodermatological benefits of botulinum toxin treatment in the upper facial third. A narrative review
BackgroundBotulinum toxin type A (BoNT-A) is widely used in aesthetic dermatology, particularly for dynamic wrinkles in the upper facial third. Beyond cosmetic effects, BoNT-A may influence emotional processing through the skin-brain axis. This narrative review synthesizes evidence on psychological and psychiatric outcomes of upper facial BoNT-A treatment, with a focus on mechanisms extending beyond aesthetics.MethodsA structured search was conducted in PubMed, Scopus, and Web of Science through January 2026. Search terms included “botulinum toxin,” “upper facial third,” “psychodermatology,” “facial feedback,” “depression,” “anxiety,” and “psychiatric disorders.” Original studies, randomized controlled trials (RCTs), observational studies, systematic reviews, and meta-analyses assessing psychological, psychiatric, or neurobiological outcomes were included.ResultsUpper facial BoNT-A is associated with clinically meaningful reductions in depressive and anxiety symptoms, and improvements in self-perception and social functioning. Inhibition of corrugator and procerus muscles modulates afferent signaling to limbic structures, supporting the facial feedback hypothesis. Neuroimaging evidence demonstrates attenuated amygdala activation after BoNT-A treatment. Psychosocial improvements may reinforce these neurobiological effects. Evidence in bipolar disorder and personality disorders remains limited and methodologically heterogeneous. Caution is advised in patients with body dysmorphic disorder.ConclusionsBoNT-A in the upper facial third provides psychodermatological benefits beyond aesthetics, improving emotional regulation and affective symptoms. It should be considered a complementary intervention within a biopsychosocial framework. Future large-scale RCTs with standardized psychiatric and neurobiological endpoints are warranted.
Cognitive and neuropsychological correlates of the attention training technique: a systematic review and evidence synthesis
IntroductionThe Attention Training Technique (ATT) is a brief metacognitive intervention recognised as a possibly efficacious standalone transdiagnostic treatment for emotional disorders. The cognitive and neuropsychological mechanisms underlying its clinical effects are of particular interest in understanding and developing the technique. The aim of the systematic review was to synthesise and evaluate the cognitive-attentional task performance and neurocognitive correlates of ATT in the context of theoretical mechanisms from which ATT is derived.MethodsFive electronic databases (PsycINFO, MEDLINE, PubMed, Web of Science and EMBASE) were searched from January 1990 to November 2025. Studies that used ATT as part of a metacognitive multi-component treatment package or combined with other therapy/technique(s) were excluded. Sample inclusion was diverse to capture effects on non-clinical and clinical individuals and across age groups for potential sub-group analyses.ResultsIn total, 20 studies with 1, 230 participants met the inclusion criteria. Four studies included clinical samples, four studies included non-clinical participants, two studies used experimental induction of pain or mind wandering, and 10 used healthy samples of which two used school children. Study quality varied from strong to weak with the majority receiving ‘moderate’ ratings. Across 14 cognitive-attentional tasks and three neural methodologies (EEG, fNIRS, fMRI), the review found small to large cognitive and neural effects associated with ATT. Nine cognitive tasks showed significant ATT-dependent effects in at least one study, with the most consistency shown on the emotional dot-probe. Neural findings across all methodologies converged, suggesting that ATT modulates cognitive control, frontoparietal, dorsal attention networks and reduces default mode network connectivity.DiscussionInterpretation and synthesis of findings based on the S-REF model are consistent with cognitive and neural effects involving reduced threat monitoring, improved executive control, and enhanced disengagement from self-referential processing; central theoretical mechanisms and design parameters of ATT. Where inconsistencies across study effects emerged, they may be due to heterogeneity in cognitive task and measurement factors and ATT protocol deviations. Future research on individual differences in neurocognitive effects associated with ATT across clinical and sub-clinical populations is needed. Studies must safeguard fidelity and adherence to the ATT protocol and improve reporting of these important factors.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024483053.
Editorial: Loneliness among youth and young adults
Gaming-based program for internet gaming disorder: feasibility and preliminary outcomes of a structured camp program
BackgroundAlthough controlled trials support several psychosocial interventions for adolescent internet gaming disorder (IGD), short, highly structured residential camp formats remain underreported, particularly regarding feasibility, safety, and process data from routine service settings.ObjectiveTo evaluate the feasibility, safety, and short-term entry-to-exit signals of a structured gaming-based camp program using retrospective, de-identified routinely collected service data, with a focus on implementation evidence for a brief, highly structured residential format.MethodsWe conducted a single-group entry-to-exit evaluation of a 7-day structured camp in 12 adolescents aged 11–16 years clinically diagnosed with IGD by psychiatrists using DSM-5 criteria. Entry and exit assessments were organized hierarchically, with the Gaming Disorder Screening Scale (GDSS), the Game Addiction Scale–7 (GAS-7), and the Visual Analog Scale (VAS) craving score as primary outcomes; the Barratt Impulsiveness Scale–11 (BIS-11), Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), Social Avoidance and Distress Scale (SADS), and Chinese version of the Interpersonal Reactivity Index (IRI-C) as supportive secondary outcomes; and camp residential counselor–rated Conners scores and the Stroop task as exploratory external-rating and objective complementary indicators, respectively. Wilcoxon signed-rank tests reported effect size r and Hodges–Lehmann (HL) median difference with 95% CI. Exploratory Spearman correlations examined baseline characteristics and change.ResultsCompletion was 100% (12/12) and attendance 98.6% (142/144), with no serious adverse events; two participants had a brief single-session interruption (coded as non-attendance for that session-person) but completed subsequent sessions and exit assessment. Primary outcomes decreased at exit: GDSS 50.00 (SD 8.32) to 28.67 (SD 8.98), p<0.001, r=0.88, HL −20.5 (95% CI −27.0 to −16.5); GAS-7 21.50 (SD 6.57) to 13.33 (SD 4.44), p=0.003, r=0.89, HL −8.5 (95% CI −12.5 to −6.0); VAS 4.25 (SD 2.63) to 2.75 (SD 2.05), p=0.012, r=0.85, HL −2.0 (95% CI −3.0 to −1.0). High-risk GDSS decreased from 66.7% to 0%, GAS-7 positivity from 58.3% to 8.3%, and moderate-to-severe craving from 58.3% to 25.0%. BIS-11, SDS, and IRI-C showed supportive short-term changes, and counselor-rated Conners scores showed exploratory external-rating changes, whereas SAS and SADS did not. Stroop reaction time decreased and accuracy increased in both conditions, while interference effects did not change significantly. Baseline PSQI correlated with change in VAS craving (ρ=0.767, p=0.004).ConclusionsThis pilot program evaluation suggests that a short, highly structured gaming-based residential camp can be delivered feasibly and safely and may be associated with short-term reductions in IGD symptom severity and craving. Its main value is to provide early implementation and short-term signal data for a service-based camp format that should be tested in subsequent controlled studies with follow-up.
Hybrid solid−liquid optics enable scalable, high-resolution light-sheet microscopy across diverse immersion media
Nature Biotechnology, Published online: 09 June 2026; doi:10.1038/s41587-026-03172-7
Hybrid solid–liquid optics improve light-sheet imaging of intact biological samples.
Bundibugyo Ebola without vaccines or therapeutics: why public health fundamentals matter more than border closures
Nature Medicine, Published online: 09 June 2026; doi:10.1038/s41591-026-04482-8
Bundibugyo Ebola without vaccines or therapeutics: why public health fundamentals matter more than border closures
Adjuvanted inactivated rabies virus-vectored Lassa virus vaccine in healthy adults: a phase 1 trial
Nature Medicine, Published online: 09 June 2026; doi:10.1038/s41591-026-04429-z
An interim report of a first-in-human phase 1 trial found an adjuvanted, combination inactivated rabies-vectored, Lassa fever vaccine (LASSARAB + 3D-6-acyl PHAD-SE) to be safe and induced immunogenicity to both Lassa and rabies viruses in healthy participants.
Human learning of noninvasive brain–computer interfaces via manifold geometry
Nature Neuroscience, Published online: 09 June 2026; doi:10.1038/s41593-026-02311-2
Busch et al. use nonlinear neural manifolds to help humans gain rapid control over a noninvasive brain–computer interface, allowing them to learn how to play a video game with real-time fMRI neurofeedback from cognitive brain regions.
Optimizing Digital Cardiac Rehabilitation Using the Multiphase Optimization Strategy: Mixed Methods Feasibility Study
<strong>Background:</strong> Cardiac rehabilitation (CR) is an evidence-based, multicomponent intervention. However, participation in and reach of CR remain suboptimal globally. Digital CR is a promising alternative to traditional center-based CR, with the potential to increase intervention reach and efficiency. However, efforts to increase the efficiency of digital CR require an understanding of the relative effectiveness of the components of CR, which is currently lacking. The Multiphase Optimization Strategy provides a framework to evaluate the effects of individual components within complex interventions. <strong>Objective:</strong> This mixed methods study explored the feasibility and acceptability of implementing the procedures of a factorial design and delivering multiple intervention components in preparation for an optimization randomized controlled trial of a digital CR intervention. <strong>Methods:</strong> Patients attending CR in a community setting were randomized to 1 of 8 experimental conditions in a 2 × 2 × 2 (2<sup>3</sup>) factorial trial design. Each condition received a different combination of three intervention components over a 6-week study period (1) goal setting and self-monitoring, (2) education, and (3) feedback messages. Feasibility was assessed through intervention fidelity (eg, usage statistics) and outcome measure data completeness. Acceptability was measured using the System Usability Scale, a questionnaire, and semistructured interviews based on the Theoretical Framework of Acceptability. <strong>Results:</strong> A total of 8 participants were recruited and retained in the study. The mean age was 75 (SD 5.6) years, and the majority were female (5/8, 62.5%). The digital CR intervention demonstrated good usability (System Usability Scale score 72.1, SD 19.1), and 83.3% (5/6) of participants found the digital technology acceptable. However, only half (2/4, 50%) found the feedback messages acceptable. Fidelity was high for goal setting/self-monitoring and feedback but lower for education. Qualitative findings indicated that participants held positive attitudes toward the intervention and reported improvements in physical activity, although many expressed a preference for more tailored feedback and 2-way communication. Of the 3 prespecified progression criteria, usability met the “Go” criterion, whereas intervention fidelity, acceptability, and outcome measure data completeness met the “Amend” threshold. <strong>Conclusions:</strong> This study demonstrated the feasibility of implementing a factorial design and delivering multiple intervention components within a digital CR intervention. While the intervention was generally acceptable, modifications to the education and feedback components are necessary prior to conducting a pilot optimization randomized controlled trial.
