The relationship between impulsivity and non-suicidal self-injury in adolescents: the chain-mediated effects of parenting style and distress tolerance

ObjectiveThe purpose of this study is to explore the related risk factors and protective factors of adolescent non suicidal self injury (NSSI).MethodsUtilizing the experience sampling method, we recruited 311 adolescents engaging in NSSI, all without other mental disorders, from five public high schools in a specific city. Questionnaire surveys were administered, employing the Chinese version of the Short-Form Egna Minnen av Barndoms Uppfostran (s-EMBU-C), Distress Tolerance Scale-Revised (DTS-CR), Adolescent Self-harm Behavior Questionnaire, Barratt Impulsiveness Scale version 11 (BIS-11).Results1) The findings indicate that NSSI in adolescents is positively correlated with impulsivity and negative parenting styles (P < 0.01), while it is negatively correlated with distress tolerance and positive parenting styles (P<0.01). Impulsivity is negatively correlated with distress tolerance and positive parenting styles (P < 0.01) and positively correlated with negative parenting styles (P < 0.01). Furthermore, distress tolerance is negatively correlated with negative parenting styles (P < 0.01) and positively correlated with positive parenting styles (P < 0.01). 2) This study reveals that both negative and positive parenting styles serve as complete mediators in the relationship between impulsivity and NSSI behavior in adolescents, with distress tolerance as a significant factor.ConclusionImpulsivity significantly influences NSSI behavior in adolescents through the mediation of parenting styles (both negative and positive) and distress tolerance.

Research progress on social participation of young and middle-aged stroke survivors: a narrative review

Stroke is characterized by high morbidity, disability, and mortality, and has become the third leading cause of death worldwide. In China, stroke accounts for 39.9% of all cerebrovascular diseases, with young and middle-aged survivors (aged 40–60 years) comprising 33% of global stroke survivors in this age group and over 51.51% of all stroke cases in China. Despite significant improvements in treatment, 70–80% of survivors still lose the ability to live independently, and social participation declines to varying degrees. Social participation plays an important role in rehabilitation outcome indicators, which can reflect the overall recovery of survivors and is closely related to quality of life. Guided by the International Classification of Functioning, Disability and Health (ICF) framework, this review aims to examine the current status, assessment tools, and influencing factors of social participation among young and middle-aged stroke survivors, with the goal of informing future research and guiding clinical practice.

A qualitative study on the participation experience in a mental health recovery program based on WHO QualityRights in South Korea

IntroductionThe World Health Organization’s QualityRights initiative offers a practical framework for developing rights-based, person-centered, and recovery-oriented mental health systems. In Korea, the face-to-face WHO QualityRights specialized training module, Recovery practices for mental health and well-being, was culturally and clinically adapted for local use, incorporating Open Dialogue principles. This adaptation led to the development of the group-based “QualityRights Recovery Program.” This study examines the experiences and perspectives of individuals with lived experience of mental health challenges, their family caregivers, and mental health practitioners who participated in this program to inform the local implementation of recovery-oriented mental health practices.MethodsEighteen participants were recruited from two mental health facilities in Suwon, Republic of Korea. Researchers conducted semi-structured interviews and used thematic analysis to examine participants’ experiences with the 13-week QualityRights Recovery Program, which was adapted for the Korean clinical context.ResultsFour major themes emerged: (1) participation and engagement in recovery, (2) changes in communication and decision-making, (3) mutual understanding and shifts in perception, and (4) redefining recovery concepts and therapeutic aims.ConclusionParticipants’ perspectives on the QualityRights Recovery Program indicate its potential to restore the autonomy and well-being of individuals with lived experience, while also positively influencing the perspectives of their caregivers and practitioners. These findings provide guidance for expanding rights-based, recovery-oriented mental health interventions in Korea.

Protocol for a randomized trial to predict the efficacy of cognitive and behavioral interventions for symptoms of depression

IntroductionCognitive behavioral therapy (CBT) is one of the most common interventions for depression and has two key components: Cognitive Restructuring (CR) and Behavioral Activation (BA). However, no evidence-based guidelines exist to help clients and clinicians decide whether CBT would be a good first-line treatment for a given individual based on their personal characteristics, and which CBT intervention would benefit them more. We propose that specific capacities to learn from new information and experiences are prerequisites for response to CBT and that BA and CR require different learning capacities. In this study, we aim to develop predictive models of symptom change based on computationally-derived variables from behavioral tasks, in addition to clinical and demographic self-report data, to identify parameters and variables that can determine which individuals with depressive symptoms would benefit from CBT-based interventions and, ideally, which specific interventions they would benefit from more.Methods and analysisWe plan to recruit at least 1,500 adult participants who report having symptoms of depression and reside in U.S. After completing a series of questionnaires and behavioral tasks to assess their learning propensities, participants will be randomly assigned to a BA or a CR group. Using an online self-help tool, participants will then engage with designated modules according to their assigned group for five weeks. We will assess symptoms 1 week post-intervention (main end point of study) and follow up at 6, 18, and 42 weeks post-intervention. Upon enrolling and consenting into the main study, participants will be randomly assigned to either the training dataset or the held-out test dataset at a ratio of 2:1. This enables a clean separation of training and test datasets and prevent data leakage. We plan to build cross-validated predictive algorithms on the training dataset, and preregister our analysis plan before we validate our models and hypotheses in the held-out, unseen, test dataset. Enrollment of the study started 23rd January, 2024.Study protocol registrationClinicalTrials.gov, identifier (NCT06631183). The protocol follows the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. Numbers in brackets follow subsection numbers in the guidelines.

Empathy and alexithymia in essential tremor

BackgroundSocial cognition is increasingly recognized as part of the non-motor phenotype of essential tremor (ET). Available ET evidence suggests selective alterations in some socio-cognitive domains, whereas findings on self-reported empathy and alexithymia remain limited and inconsistent.ObjectivesThis cross-sectional study aimed to evaluate empathy and alexithymia in patients with ET compared with healthy controls (HC), and to explore their associations with global cognition and with each other.MethodsForty ET patients and 40 HC underwent the Italian versions of the Montreal Cognitive Assessment (MoCA), the short Empathy Quotient (EQ-short), and the Toronto Alexithymia Scale (TAS-20).ResultsET patients had significantly lower MoCA scores than HC (22.1 ± 4.1 vs. 25.3 ± 3.2, p<0.001), whereas no between-group differences emerged for EQ-short or TAS-20 scores. In ET, MoCA was not significantly associated with empathy or alexithymia measures. In HC, higher MoCA scores were associated with greater emotional reactivity. Exploratory bivariate analyses suggested inverse associations between social skills and alexithymia in ET, but only the adjusted ET models remained significant.ConclusionOur findings do not support a group-level deficit in self-reported empathy or alexithymia in ET. Rather, they suggest that socio-emotional functioning may be largely preserved at the group level, while the relationship between social skills and emotional self-description may differ in ET.