Conditions: Body Dysmorhpic Disorder
Interventions: Other: Questionnaire and Physical Exam
Sponsors: Sohag University
Not yet recruiting
Interventions: Other: Questionnaire and Physical Exam
Sponsors: Sohag University
Not yet recruiting
Trial Phase: Syndemic Adapted Medly Uganda
Conditions: Mental Health
Interventions: Device: Syndemic-Adapted Medly Uganda (SAMU)
Sponsors: Yale University; National Institute of Mental Health (NIMH)
Not yet recruiting
Interventions: Device: Syndemic-Adapted Medly Uganda (SAMU)
Sponsors: Yale University; National Institute of Mental Health (NIMH)
Not yet recruiting
Designing Psychologically Grounded Artificial Intelligence for Supporting Bystander-Based Cyberaggression Intervention: Mixed Methods Exploratory Study
Background: Cyberaggression poses a growing threat to mental health, contributing to increased distress, reduced self-esteem, and other adverse psychosocial outcomes. Although bystander intervention can mitigate the escalation and impact of cyberaggression, individuals often lack the confidence, strategies, or language to respond effectively in these high-stakes online interactions. Advances in generative artificial intelligence (AI) present a novel opportunity to facilitate digital behavior change by assisting bystanders with contextually appropriate, theory-informed intervention messages that promote safer online environments and support mental well-being. Objective: This mixed methods design study aimed to explore the feasibility of using generative AI to support bystander intervention in cyberaggression on social media. Specifically, we examined whether AI can generate effective responses aligned with established intervention strategies and how these responses are perceived in terms of their potential to de-escalate online harm and foster behavior change. Methods: We collected 1000 real-world cyberaggression examples from public social media datasets and generated bystander intervention responses using 3 distinct prompt strategies: a generic policy reminder, a baseline GPT prompt, and a theory-driven GPT prompt (AllyGPT). To evaluate the responses, we conducted computational linguistic analyses to assess their psycholinguistic features and carried out a mixed methods evaluation. Three trained coders rated each message on favorability, conversational impact, and potential to change behavior and later participated in semistructured interviews to reflect on their evaluation process and perceptions of intervention effectiveness. Results: Linguistic analyses revealed that baseline GPT responses exhibited more emotionally positive and authentic language compared to AllyGPT responses, which showed a more analytical and assertive tone. Policy reminder messages were linguistically rigid and lacked emotional nuance. Human evaluation results showed that AllyGPT responses received the highest effectiveness ratings for low-incivil cyberaggression cases in 2 dimensions (favorability and changing behavior), and baseline GPT works better for mid and high levels for all effectiveness dimensions. For medium- and high-incivility aggressions, baseline GPT responses received the highest ratings across all 3 dimensions of effectiveness (favorability, discussion-shifting potential, and likelihood of changing bullying behavior), followed by AllyGPT, with policy reminders rated lowest. Qualitative feedback further emphasized that baseline GPT responses were perceived as natural and inclusive, while AllyGPT responses, although grounded in psychological theory, were sometimes viewed as overly direct. Policy reminders were considered clear but lacked persuasive impact. Conclusions: Our work showed that designing effective AI-generated bystander interventions requires a deep sensitivity to platform culture, social context, and user expectations. By combining psychological theory with adaptive, conversational design and ongoing feedback loops, future systems can better support bystanders, delivering interventions that are not only contextually appropriate but also socially resonant and behaviorally impactful. As such, this work serves as a foundation for scalable, human-centered AI systems that promote safer online spaces and users’ mental well-being.
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Co-Design of a Depression Self-Management Tool for Adolescent and Young Adult Cancer Survivors: Rapid Qualitative Analysis of Interview Feedback on a Prototype
<strong>Background:</strong> Over 2.1 million adolescent and young adult cancer survivors (AYACS) live in the United States. Recent estimates suggest that up to one-third of AYACS experience major depressive disorder. Although several efficacious evidence-based interventions are available to manage symptoms of depression, these interventions are often inaccessible to AYACS who have many competing commitments. Digital mental health tools hold promise for this population; however, only a few have been tailored to meet the unique needs of AYACS, and findings to date have yielded mixed results. <strong>Objective:</strong> This study aims to obtain feedback from AYACS on a mid-fidelity prototype of a depression self-management tool being tailored for AYACS. <strong>Methods:</strong> Individuals with a history of cancer diagnosed at age 12 or older who were between the ages of 15 and 39 and had completed primary treatment were identified through a review of medical records from a comprehensive cancer center in the Southeastern United States. Potentially eligible participants were contacted by study staff to conduct additional screening and obtain informed consent via REDCap (Research Electronic Data Capture; Vanderbilt University). Upon enrollment, participants provided demographic and clinical information, as well as their availability for an interview. The principal investigator (KMI) conducted semistructured individual interviews with consented AYACS. Most of the interview was dedicated to showing participants the mid-fidelity prototype of the tool, explaining how the prototype might work, and requesting targeted feedback. Demographic and clinical characteristics, as well as some aspects of feedback on the prototype, were summarized using descriptive statistics. Interviews were audio- and video-recorded and transcribed. The transcriptions underwent rapid qualitative analysis guided by the Rigorous and Accelerated Data Reduction technique. <strong>Results:</strong> A total of 14 AYACS (n=9, 64%, female; n=9, 64%, white; ages 15-38) completed an individual interview. Participant preferences for mood tracking, content presentation, user input, and duration of use were captured qualitatively but analyzed quantitatively. For example, most participants (n=10, 71%) indicated that they preferred a mood-tracking option that included emojis and would be willing to track their mood at least once per day (n=11, 79%). Participant preferences captured qualitatively fell into 4 themes: (1) features to promote user engagement (eg, the use of gamification); (2) tailored content presentation (eg, authenticity in the portrayal of the cancer experience); (3) perceived usability (eg, simplifying user input); and (4) interface design (eg, implementing a coherent design theme and color scheme). <strong>Conclusions:</strong> Findings indicated that AYACS highly value personalization, flexibility, and peer support in digital interventions. Based on insights obtained during individual interviews, a working prototype was developed by reprogramming an existing digital tool. Qualitative and quantitative findings informed modifications to the existing digital tool. The working prototype will next undergo evaluation as part of a pilot full-factorial trial.
STAT+: Access granted: CMS greenlights more than 150 participants for chronic care experiment
More than 150 companies and providers have been provisionally approved to participate in an experimental Medicare program meant to expand access to technology-supported chronic care. They include popular mental health apps, wearable device makers, a life sciences company tied to Google, and startups that help large health systems manage heart failure patients.
Announced late last year by the Center for Medicare and Medicaid Innovation, the ACCESS model will pay participants set rates to treat chronic conditions like diabetes, hypertension, high cholesterol, musculoskeletal pain, anxiety, and depression. The payments are tied to measurable health outcomes; the model is meant as an alternative to paying for individual technology services. The initial deadline to participate in the first ACCESS cohort was April 1, but CMMI Monday announced it will extend the deadline to allow more to join.
CMS officials say the large number of applications to participate in ACCESS exceeded their expectations and that the enthusiasm suggests modest payment rates and restrictions did not discourage digital health companies from applying. According to officials, most of the participants had not previously served Medicare patients.
<![CDATA[New youth-focused substance use guidelines spotlight prevention, brain development, and coordinated mental health support to improve outcomes early.]]>
In silico exploration of electric field distribution in tDCS: integrating white matter anisotropy and subject-specific structural connectivity
Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique with promising application in the treatment of neurological and psychiatric disorders. However, its effectiveness is often limited by the high inter-subject variability of the induced effects, mainly attributable to individual anatomical differences, which are not considered in the design of the stimulation protocols. Among these, structural connectivity plays a crucial role but remains often overlooked in tDCS research. Objective—This study aims to evaluate how variations in structural connectivity influence the distribution of the electric field (EF) during tDCS session. In particular, we analyse how the inclusion of white matter anisotropy affects the EF distribution and spread compared to classical isotropic models, and how the strength of connection across cortical parcels affects the EF spread. Approach—The study proposes an advancement in the computational modelling of tDCS through the integration of white matter anisotropy into finite element method (FEM) simulations. By combining advanced computational approaches, we explore the relationship between EF strength and cortical connectivity. Main results—Neglecting white matter anisotropy in electromagnetic simulations lead to a relative error in EF magnitude greater than 10% and to an orientation error of the EF vector of almost 20 degrees. The DTI-informed simulations lead to a more focalized EF distribution, moreover it was found a positive and significant (p < 0.05) correlation between EF focality and the strength of connectivity between cortical areas below P2 and P1 electrodes. Significance—These findings highlight the importance of including white matter anisotropy into tDCS simulation to prevent distortions in EF distribution and suggest the need to integrate structural connectivity information into the definition of subject-specific dose in tDCS protocols.
Patient safety incidents in mental health residential services: a multicenter, crosssectional, survey-based study
IntroductionWhile patient safety in general hospitals is well-researched, residential mental health services have received less attention. Psychiatric patients and staff working in such facilities face unique and complex risks. This study aims to explore and describe the frequency and characteristics of patient safety incidents (PSIs) experienced by professionals working in a cohort of Italian mental health residential services.MethodsA multicenter, cross-sectional, questionnaire-based observational study was conducted involving workers from 68 psychiatric mental health services from seven different Italian provinces. A total of 159 respondents, including both healthcare and non-healthcare professionals, took part in the study. Participants reported incidents personally experienced (FHE) or reported by colleagues (CRE) over the previous 12 months, using a taxonomy adapted from the World Health Organization’s Conceptual Framework for the International Classification for Patient Safety. Data was analyzed using descriptive statistics and zero-inflated models to identify associations between respondent characteristics and reporting behaviors.ResultsA total of 4,432 FHE and 4,807 CRE were reported. The behavior-related events were the most frequently reported, followed by incidents related to organizational or infrastructure issues, and medication errors. Secondary analyses suggested that facilities with more than ten employees had significantly higher rates of both FHE and CRE. Furthermore, residential facilities showed a higher incidence rate of CRE compared to non-residential ones, and non-healthcare workers reported witnessing fewer incidents to colleagues (28%) compared to healthcare workers. Significant variability was also observed across different provinces.ConclusionResidential mental health services experience a high incidence of PSIs, suggesting a risk profile distinct from general hospital settings. The predominance of behavior-related incidents corroborates the hypothesis that primary risks are mainly driven by relational dynamics. The findings highlight that both healthcare and non-healthcare staff are exposed to significant risks, suggesting the need of inclusive and comprehensive safety interventions. Consequently, specific training programs focused on relational risk management, de-escalation, and empathic communication are essential for all workers employed in these settings.
Evaluation of anxiety levels and stress coping methods of pregnant women after the Kahramanmaraş earthquake
ObjectiveNatural disasters can cause serious psychological pressures on women during pregnancy. How the mental health of pregnant women is affected after major disasters such as earthquakes and what coping methods come into play in this process is an important research topic. This study aimed to evaluate the anxiety levels and stress coping strategies of pregnant women who experienced the February 6, 2023 Kahramanmaraş earthquake.MethodsThis cross-sectional descriptive study was carried out within four months after the earthquake. A total of 118 pregnant women were included. Participants were grouped according to pregnancy trimester. Anxiety level was assessed with the Beck Anxiety Inventory and coping strategies with the Brief COPE Scale. Earthquake exposure data, including building damage and loss of relatives, were collected via structured survey.ResultsThe mean Beck Anxiety score was 15.9 ± 12.8. A significant difference was observed between trimesters (H = 19.09, p < 0.001), with anxiety declining from the first to the third trimester. Religious coping (ρ = 0.42, p < 0.001), acceptance (ρ = 0.36, p < 0.001), and behavioral avoidance (ρ = 0.36, p < 0.001) were positively correlated with anxiety. Positive reinterpretation and development showed a significant negative correlation with anxiety (ρ = −0.32, p < 0.001). Building damage category was not significantly associated with anxiety (p = 0.80).ConclusionAnxiety in post-earthquake pregnant women differs according to trimester, and individual coping styles are associated with anxiety levels. Within the scope of the variables measured in this study, positive reinterpretation showed the strongest negative association with anxiety. Approaches supporting cognitive flexibility should be prioritized in perinatal mental health interventions.
Epigenetics at Birth Links Microbiome to Neurodevelopment, Potentially ASD and ADHD
The results of a study headed by researchers at Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, indicate that the gut microbiome and epigenetics are intertwined, and that both contribute to neurodevelopment.
The researchers showed that epigenetic changes present at birth can impact how an infant’s gut microbiome develops during their first year. They also identified specific epigenetic changes and gut microbes that were associated with signs of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) when the children were three years old.
“Certain bacteria seem to offer protection, which is exciting because it suggests there could be ways to support a child’s development through diet or probiotics in the future,” said research lead and gastroenterologist Francis Ka Leung Chan, MD. Chan is co-senior author of the team’s published paper in Cell Press Blue, titled “Epigenome-microbiome interplay in early life associates with infants’ neurodevelopmental outcomes,” in which they stated, “We showed that epigenetic alterations at birth were associated with early-life microbiome development and that they determine the risks of neurodevelopmental consequences in children.”
The first years of life are critical for brain development and immune system maturation. Though previous studies have shown that both early epigenetic changes and gut microbiome development can impact health in later life, little is known about how these two systems interact. “Recent data suggest that epigenetic programming of gene expression profiles is sensitive to the early-life environment and can impact health outcomes in children,” the authors wrote. “One environmental cue known to trigger host epigenetic modifications is the genes of bacteria, fungi, and viruses inside the human body, collectively known as the microbiome.”
Co-senior author and public health researcher Hein Min Tun, PhD, of The Chinese University of Hong Kong, commented, “We wanted to see how the epigenome and microbiome interact in early life and if their interaction could influence a child’s risk of developing neurodevelopmental conditions like ASD and ADHD.” The authors added, “New understanding of host-microbe-epigenome interactions and mechanisms of epigenetic changes in early life can be leveraged for the prevention, early detection, and novel interventions of common childhood diseases.”
For their study the researchers characterized DNA methylation patterns from the umbilical cord blood of 571 infants. They paired this information with gut microbiome data collected from 969 infants at two, six, and 12 months of age, and from their parents during the third trimester of pregnancy. When the children reached 36 months of age, the researchers used a behavioral questionnaire to assess their neurodevelopment and investigate links between the microbiome, epigenome, and early signs of ASD and ADHD.
“This, to our knowledge, represents the first longitudinal study with multiple sample types to depict the intimate interplay between perinatal exposures, epigenetic hallmarks, and gut microbiome development and neurodevelopmental outcomes within the first three years of life,” the authors stated.
They found that an infant’s epigenome at birth was associated with birth mode, length of gestation, having older siblings, and maternal allergies, but it was not affected by their parents’ gut microbiomes. Microbiome development, on the other hand, was associated with birth mode, antibiotics, having older siblings, and breastfeeding. Infants who were born by Caesarean section (CS) showed different patterns of DNA methylation for several genes involved in immune responses and brain development. “Some of the changes in methylations of immune- and nervous-system-related genes, associated with CS delivery, are linked to neurodevelopmental outcomes,” they noted.
Their reported findings, the team suggested, “… resonate with studies linking CS to increased risks of immune-mediated and neurodevelopmental disorders, providing mechanistic plausibility through epigenomic and microbial dysbiosis.” The team also showed that an infant’s epigenome at birth impacted how their microbiome developed during their first year. Specifically, infants developed less diverse gut microbiomes at 12 months of age when they showed higher rates of DNA methylation in immune genes involved in recognizing pathogens. “We found that methylation rates in the major histocompatibility complex (MHC) region of infants at birth were linked to differences in the diversity of the infant gut microbiome at 12 months,” they commented.
The behavioral survey revealed that signs of ASD and ADHD in three-year-olds were associated with specific epigenetic patterns and the presence of certain gut microbes. “Importantly, we reported that epigenetic modifications were associated with an increased susceptibility to neurodevelopmental conditions in children, and these effects were in part mediated by microbial colonization.”
However, other microbial species seemed to mitigate these effects: infants with epigenetic patterns associated with ASD or ADHD were less likely to show signs of the disorders if they acquired Lachnospira pectinoschiza and Parabacteroides distasonis, respectively, during their first year. “We discovered a kind of conversation happening: a baby’s epigenetic setting at birth can influence their risk for neurodevelopmental disorders, but the presence of certain ‘good’ bacteria in their gut can step in and modify the risk,” Tun reported. “The foundations for brain health are laid very early, even before birth. However, we don’t want people to think this means a child’s developmental path is fixed at birth. These are complex conditions with many causes, and we’ve only uncovered a small piece of a very large puzzle.”
The researchers are continuing to follow the children who participated in the study to see how these early-life factors relate to their health as they grow. They note that laboratory experiments are needed to confirm the associations between gut microbes and neurodevelopment. In their discussion, the team wrote, “In conclusion, our findings revealed dual alterations to the neonatal epigenome and gut microbiome by perinatal factors and highlight the role of the ‘holo-epigenome’—the integrated host epigenome and microbiome—as a key mediator of neuro-immune outcomes. Interventions targeting microbial restoration or epigenetic modulation during critical developmental windows may mitigate risks of neurodevelopmental disorders.”
First author and gastroenterologist Siew Chien Ng, MD, PhD, added, “The ultimate goal is to develop safe, non-intrusive early interventions such as specific probiotics or live biotherapeutics, that could help nurture a healthy gut microbiome and potentially reduce the risk of neurodevelopmental challenges.”
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