Digital Mental Health Research Priorities, Revisited for the AI and Large Language Model Era

Digital mental health has become an established part of mental health care, but the rapid arrival of large language models and other artificial intelligence tools has refocused attention on the evidence needed to guide the field. This editorial updates the research priorities articulated by JMIR Mental Health in 2023, while reaffirming their emphasis on equity, replicability, privacy, efficacy, and engagement. What has changed is not the importance of these priorities, but the urgency with which they must now be applied. As digital tools become more clinically consequential, research must move beyond demonstrating that a technology is feasible, usable, or novel. The field needs studies that clarify how these tools work, for whom they are beneficial, under what conditions they may cause harm, and how they can be responsibly integrated into care. We call for research that is transparent about the technologies being studied, grounded in meaningful clinical questions, attentive to safety and accountability, and designed to produce knowledge that remains useful as specific products and models change. The promise of digital mental health will depend less on the sophistication of emerging tools than on the quality of the evidence used to shape their role in care.
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Nominee for key federal health role has a history of questioning vaccines

WASHINGTON — The Trump administration’s pick to oversee preparedness and response to public health emergencies and disasters has questioned the use of the hepatitis B vaccine in infants and raised the disproven link between vaccines and autism in past comments reviewed by STAT.

Those comments by Sean Kaufman, nominated to be Assistant Secretary for Preparedness and Response, are part of an undercurrent of vaccine skepticism among some high-ranking Department of Health and Human Services officials under Secretary Robert F. Kennedy Jr. — despite efforts from White House officials to steer the conversation away from vaccines.

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Maintaining Emotional Boundaries as a Parent

Parents often emphasize to children the importance of respecting others’ boundaries — don’t tickle another kid if they say they don’t like it, for example. Don’t kiss someone unless they welcome it. But within the family, we can fail to notice our own difficulty setting and respecting boundaries with our children, especially emotional boundaries.

What are emotional boundaries

Emotional boundaries refer to an individual’s sense of autonomy and ability to control how they think, feel, and engage with others. Those boundaries are crossed either when you try to control someone else’s thoughts or feelings or they try to control yours.   

Difficulty setting your own and respecting others’ emotional boundaries often comes from a place of care and concern. Parents are usually concerned that their child is not going to make safe choices or are trying to protect their child from distressing emotions. But the intrusion can have a negative impact on children’s emotional development as well as parents’ mental health, especially when it’s done repeatedly. Everyone has boundaries, even parents, and it’s important for kids to learn that.  

How parents overstep their child’s emotional boundaries

Parents can inadvertently encroach on their child’s right to their own thoughts and feelings through:

  • Over-involvement in children’s academic and social life: Your child has a whole life outside the home, and it can be anxiety-provoking to trust them to manage their homework, advocate for themselves with teachers, and navigate conflicts with peers. It can alleviate your anxiety to get involved, but that can feel highly intrusive to your child. For example, if your kid feels snubbed by a friend, you might feel the urge to contact that friend’s parent to try to smooth things over. However, over-involvement in these tasks can prevent your kid from developing the skills they need to manage challenging situations successfully and can impact their confidence in their ability to cope independently.
  • Overconcern to protect your child’s safety: Fears that something negative will happen to your child are understandable, but aggressive monitoring can backfire. This can include strict control over the ingredients in your teen’s food, the information they consume online, or what activities they do. This may temporarily alleviate anxiety about the child’s health and safety but it can lead to resentment and rebellion. 
  • Ignoring or rejecting children’s requests for privacy: It is normal for children and adolescents to want more privacy as they mature, from showering alone to keeping a private diary.Unless your child engages in an activity that suggests they are being unsafe, it is important to trust your child and let them decide what to share with you.
  • Sharing private information without the child’s permission: Parents telling anecdotes about their children, much to their kids’ embarrassment, is hardly new. However, that sharing now includes photographs and videos posted on social media that is broadcast far beyond close friends.It is important to include your child in decisions about what information is shared with others (excluding, of course, medical professionals). When in doubt, consider what information you would feel comfortable with them sharing about you.
  • Telling children what is or isn’t acceptable to value, think, or feel: Many parents, in an effort to help their child feel better, say things like, “Don’t worry about that” or “You can’t think that way.” These seemingly innocuous phrases can come across as attempts to control how the child feels. We can forget that kids are real people just like adults. And if they’re mad or upset about something, they want to be able to feel those feelings, not be told that that their feelings are wrong.

How parents fail to set their own emotional boundaries

Letting kids change your own values, thoughts, and feelings can also be unhealthy. Here are some common ways in which parents fail to set their own boundaries:

  • Allowing your child’s thoughts and feelings to influence your own too much:  Your child may act like it will be the end of the world if they don’t get into the right college. If their anxiety becomes your anxiety, then it’s going to be very hard for you to encourage your kid to have fun on the weekend or to go to bed with work left undone. What they need you to do is validate their feelings but challenge those worry thoughts and help them to relax.
  • Implying that your child is responsible for how you feel:  As a parent, your child’s well-being is your priority, and your emotional state is affected by your child’s behavior. But phrases like, “You are making me crazy” or “I cannot cope with one more word from you” unintentionally suggest that the child has control over your feelings. It’s not healthy for children to feel that they are responsible for your well-being.
  • Depending on your child for emotional support: If you’re a parent under stress and you’re not getting support elsewhere, it makes sense that you’re going to vent to a child. It’s not necessarily meant to burden a kid with financial stressors or relationship drama, and the child might be a sympathetic ear. But it blurs the boundaries between the parent role and the kid role, and that often causes difficulties for the kid in accepting parental authority in other domains. If they see themselves as equals in terms of emotional support, then they might think, why can you tell me what to do?
  • Sharing age-inappropriate information: Many children want to be treated as older than they are (at least in certain ways). So they might requestinformation about finances, romantic relationships, or family stressors that are inappropriate for their age. Although it can be tempting to share, it is not helpful long-term. It may alleviate the child’s current anxiety (and stop the nagging), but it will impair their ability to respect boundaries as well as interfere with them just being a kid.
  • Difficulty saying no: If you’re exhausted, the last thing you want is an argument. One way to avoid an argument is to say yes to your kid’s requests to buy a toy, stay up 15 more minutes, or have a different dinner. If you have boundaries around what you will spend, how much sleep you need, or what you will cook, you are still a good parent. Sticking to your limits teaches your child to accept other people’s boundaries without whining or threats. 
  • Allowing your child to treat you unkindly: Many parents allow their children to treat them in ways they would never tolerate from another person. This includes calling the parent mean or profane names, hitting them, or disregarding their needs (for money, sleep, leisure time, etc.).  Allowing this kind of behavior prevents the child from learning how to respect boundaries and tolerate the emotions they experience when they face them.

Factors that contribute to boundary concerns

There are specific circumstances that can make it difficult for a parent to know where the appropriate boundaries are. They include a child’s late development, psychiatric challenges, and history of unsafe choices. For example, a child may have delays in language, executive functioning, or social or emotional skills. These things can make it challenging to determine how involved you need to be in your child’s daily life and how much independence they can handle.

  • Poor risk assessment and impulsivity: Many disorders can impact children’s ability to think clearly, regulate emotionally, and act safely. For example, a teen experiencing a manic episode may overestimate their abilities, underestimate risk, and act impulsively. Or a child with ADHD might hard to control on crowded city streets or in restaurants, so you avoid taking them out or letting them do activities on their own with friends.  
  • Lack of confidence: Anxious children may underestimate their abilities and request continued support past when they are capable of independence. For example, a socially anxious child may ask their parent to order for them at a restaurant or keep track of their homework assignments.  When a parent accommodates these requests, it confirms their belief that they still need help.
  • Executive functioning deficits: Children who struggle with executive functioning may need more scaffolding to complete daily self-care tasks than other kids their age. This can look like parents providing frequent reminders of assignments, events, or even hygiene tasks — as well as cleaning their room for them long past when an child with ADHD should be doing it themselves. Consider how you can scaffold the skills (packing their bookbag!) without doing tasks for them, and gradually remove the supports over time.
  • History of not successfully navigating tasks: A child’s history of poorly handling a responsibility (safe use of technology, completion of homework, brushing their teeth) often reduces parents’ confidence in the child’s abilities and increases their inclination to step in. Although extra supervision and support may be needed initially, it is important to reassess your child’s abilities over time as they can learn and grow if you let them!

How to get better at boundaries

Once you have recognized the challenges in respecting your child’s boundaries and protecting your own, the next step is to figure out what those boundaries are.

  • Identify your boundaries: What things are most important to support your child’s growing independence and sense of autonomy? What boundaries do you need to set to protect your own mental health? Consider what level of involvement you want to have in their academics, friendships, emotion regulation, and appearance and what you want to disclose to them about your own relationship, emotions, or work.  
  • Practice setting these boundaries: It is much easier to set a boundary when you are not forced to make the choice with a child’s puppy dog eyes looking at you. Rehearsing how you will say no, decline to share certain information, or respond to an anxiety-provoking situation can prepare you to respond more effectively and in line with your values in a moment of conflict.
  • Share your reasons for boundaries: Children can be quick to interpret lack of boundaries as “more caring,” but being consistent in language around why boundaries are being set can help prevent this. When setting a boundary, it is helpful to couch it in care. For example, “I care about you enjoying your childhood, so I do not feel comfortable sharing with you about our family’s finances.”

When kids want more independence than you are sure they are ready to handle, identifying steps toward their goal can be effective. Giving them opportunities to show maturity, with success at one step leading to more responsibility, can help you trust your child with greater independence. What can your kids show you that will help you feel confident in their ability to manage their emotions themselves or make well thought-out decisions?

Kids also need to recognize that they sometimes overestimate their own abilities, that there are times they have not assessed risk accurately and still need their parents. It is important to teach your child that you should be alerted if they are experiencing something that is unsafe or concerning (such as a friend talking about suicide or sharing an inappropriate photo). Discussions with your kid can sort out how to work toward new milestones and help everybody feel confident that they have the skills to do it.

Modeling a healthy respect for boundaries will set your child up to establish their own and respect others’ boundaries throughout their life.

Frequently Asked Questions

What are emotional boundaries between parents and children?

Emotional boundaries are the limits that protect each person’s right to their own thoughts, feelings, values, and decisions. In families, healthy boundaries allow children to develop independence while helping parents avoid taking responsibility for emotions or choices that belong to their child.

Why are emotional boundaries important in parenting?

Healthy emotional boundaries support children’s confidence, autonomy, and ability to solve problems on their own. They also protect parents’ well-being by preventing them from becoming overly responsible for their child’s feelings, worries, or decisions.

What are signs a parent is overstepping a child’s emotional boundaries?

Common signs include getting overly involved in a child’s friendships or school life, refusing age-appropriate privacy, sharing personal information without permission, or telling a child what they should think or feel. While these behaviors often come from a place of love and concern, they can undermine a child’s confidence and independence.

How can parents determine appropriate emotional boundaries?

Parents can start by considering where their child is developmentally and what level of support versus independence is appropriate. A good guideline is to provide enough structure to keep children safe while gradually giving them more responsibility and privacy as they demonstrate readiness.

The post Maintaining Emotional Boundaries as a Parent appeared first on Child Mind Institute.

STAT+: Roche ends Huntington’s gene-silencing programs

Want to stay on top of the science and politics driving biotech today? Sign up to get our biotech newsletter in your inbox.

ARPA-H has unveiled a $160 million effort to speed bespoke gene-editing therapies for rare diseases into the clinic. Meanwhile, Roche has abandoned two Huntington’s gene-silencing drugs after disappointing data, and drugmakers have stepped in to promote Medicare’s new obesity drug discount program.

I got coffee with my cousin this morning here in SF. Before leaving for his job at an AI behemoth, he said the bone-chilling July gloom is perfect “working weather.” 

Continue to STAT+ to read the full story…

STAT+: Pharmalittle: We’re reading about bigger drug discounts in Germany, drugmakers embracing secrecy, and more

Good morning, everyone. Damian Garde here, filling in for Ed Silverman at Pharmalot’s satellite campus along the East River, where today’s cup of stimulation is filled not with coffee but rather a smoothie of curious color and questionable contents (what exactly is an “adaptogen”?). Anyway it’s Friday, as you’re almost certainly aware, and here are some tidbits to help you through the waning hours of another working week. …

German lawmakers passed a bill that would more than double the discount on branded medicines drugmakers must provide to the government, Reuters reports. The policy, part of an effort to plug a sizable budget gap in the country’s health insurance system, would increase the mandatory rebate from 7% to 15.5%. Industry groups have said the bill, if it clears Germany’s upper chamber, would deter investment and imperil the country’s access to new medicines.

The rapid rise of China’s biotech industry has led some American drug developers to do their work in near total secrecy, the Wall Street Journal observes. U.S. startups are increasingly loath to publish early data, disclose their scientific ambitions, or even publicize which diseases they hope to treat, all in fear that nimble Chinese firms will use that information to whip up competing drugs and beat them to the punch of starting clinical trials.

Continue to STAT+ to read the full story…

The Download: Claude’s inner workings and OpenAI’s “super app”

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.

Anthropic found a hidden space where Claude puzzles over concepts

The AI firm Anthropic has got the clearest glimpse yet at what’s really going on inside large language models as they answer questions or carry out tasks. What they found ranges from the mundane to the unnerving. 

Researchers at the company built a tool called the Jacobian lens (or J-lens) and used it to uncover a hidden area, which they named the J-space, inside its flagship LLM, Claude.

The J-space contains words related to the response a model is working on but may not ultimately produce. If Claude were a person (which it is not), you might say these hidden words reveal what’s on its mind before it actually speaks. 

Read the full story on what they found.

—Will Douglas Heaven

The must-reads

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

1 OpenAI has unveiled its long-awaited “super app” 
ChatGPT Work blends its chatbot, coding tool, and new models. (Reuters $)
+ It’s designed to do your work for you and with you. (Ars Technica)
+ And arrived the same day as OpenAI’s GPT 5.6 models. (NYT $)
+ It’s also developing a fully automated researcher. (MIT Technology Review)

2  Humanoids have performed teleoperated surgery on living animals
In the world-first, they removed gallbladders from pigs. (Ars Technica)
+ The human work behind humanoids is hidden. (MIT Technology Review)
 
3 SK Hynix has landed the largest US listing by a foreign company
The South Korean chip giant raised $26.5 billion. (CNN)
+ Demand for AI data centres has led its profits to skyrocket. (Guardian)
+ But its jumbo share sale may be a sign of overheated times. (FT $)
+ South Korea’s hottest bachelors are chip workers. (MIT Technology Review)
 
4 Tencent is leading a deal to unwind Meta’s $2 billion Manus acquisition
It’s in talks to become the Chinese AI startup’s largest shareholder. (FT $)
+ Tencent will reportedly buy Manus for no less ​than $2 billion. (Reuters $)
+ Beijing had ordered Meta to unwind the acquisition. (Bloomberg $)
 
5 Resuscitated human retinas responded to light 10 hours after death
It’s a big step towards eye transplants that restore vision. (New Scientist $)
+ As is a new device that revives dead eyeballs. (MIT Technology Review)
 
6 Meta has started charging for AI access
A new version of Muse Spark has a paid tier for developers. (Quartz) 
+ Meta also plans to start producing an AI chip in September. (Reuters $)
 
7 OpenAI and Google have sold AI models to blacklisted China groups
Via Singapore-based subsidiaries of Alibaba, Baidu and Tencent. (FT $)

8 A daughter tested an AI “death bot” of her father
The technology provided both comfort and unease. (New Yorker $)

9 An astronomer says the hunt for alien life needs more statistics
He wants to replace speculation with mathematical frameworks. (Quanta)

10 Pokémon Go players turned Times Square into a giant battlefield
More than 1,500 fans finally fulfilled the game’s 2016 launch promise. (Wired $)
+ Pokémon Go is also training world models. (MIT Technology Review)

Quote of the day

“When we’re talking about AI, we love the hype, we get excited about it. The damn thing never actually lands in practice.”

—Vijay Janapa Reddi, an engineering professor at Harvard University, tells Wired why he’s skeptical about grand plans for AI.

One More Thing

a hand putting a pigeon into hatch in a missile

B.F. SKINNER FOUNDATION


Why we should thank pigeons for our AI breakthroughs

In 1943, psychologist B.F. Skinner led a secret government project to make bombs more precise. His idea: teach pigeons to guide missiles by pecking at targets on a screen inside a warhead. To train them, Skinner rewarded the birds with food when they made the right decisions, using trial and error to shape their behavior.

Unsurprisingly, the military never deployed Skinner’s kamikaze pigeons. Yet his experiments convinced him that pigeons were “an extremely reliable instrument” for studying learning.  

Decades later, those same principles would help power reinforcement learning, the technology behind some of today’s most advanced AI systems.

Discover how pigeons inspired one of AI’s most powerful techniques.

—Ben Crair

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.)

+ Here’s a splendid selection of this year’s NSW architecture award winners.
+ Photographers have captured the Strawberry Moon’s golden glow in stunning detail.
+ Idiocracy is the film that best exemplifies the “American experience,” according to a new poll. Look back at the prescient comedy with this Screen Junkies trailer.
+ Get ready for the weekend with this psychedelic house journey from Jamie xx b2b Caribou.

How diet therapy affects obesity-associated depressive symptoms: from mechanism to therapeutics

Obesity stands as a formidable 21st-century public health crisis, with its capacity to aggravate depressive symptoms gaining increasing clinical attention. Traditional treatment models often treat these two conditions separately. However, recent research evidence suggests a complex network linking obesity and depressive symptoms across metabolism, behavior, and mental health, with dietary patterns proposed as a key upstream modulator of both metabolic and psychological pathways. The specific mechanisms by which diet influences obesity and depressive symptoms remain unclear. Therefore, this narrative review focuses on analyzing molecular connections between diet, obesity, and depressive symptoms, including adipose tissue inflammation, the gut-brain axis, the hypothalamus-pituitary–adrenal axis, insulin and brain-derived neurotrophic factor levels, and neuroplasticity. We discuss the possible pathways and effects of different diet therapies in regulating metabolism and simultaneously impacting mental health, including calorie restriction diet, intermittent fasting, ketogenic diet, low glycemic index diet, plant-based diet, Mediterranean diet, Dietary Approaches to Stop Hypertension, among others. This review aims to provide a scientific basis for precision nutrition and personalized, sustainable diet therapies in clinical practice, promoting awareness and improving treatment strategies for depressive symptoms in obese patients.

Silent Twiddler syndrome despite dual-anchor fixation in deep brain stimulation: two case reports

BackgroundTwiddler syndrome (TS) is a rare hardware-related complication in which manipulation or excessive mobility of an implanted pacemaker or implantable pulse generator (IPG) results in device malfunction. Traditionally, TS is diagnosed only after lead coiling, fracture, displacement, or loss of therapeutic efficacy, suggesting that it represents a late-stage manifestation of the condition.CasesWe report 2 patients with deep brain stimulation (DBS) systems who presented with a subjective sensation of increased IPG mobility during changes in body position. Neither patient demonstrated mechanical failure, lead displacement, or deterioration of DBS clinical benefit, and both IPGs had been implanted with two anchoring sutures fixed to the fascia. Furthermore, neither patient reported intentional manipulation of the device. Because of persistent discomfort and abnormal mobility, revision surgery was performed. Intraoperative findings confirmed early-stage TS in both cases. The IPGs were reimplanted into tailored subpectoral pockets and firmly secured to the fascia. Following revision, both patients experienced complete resolution of symptoms and maintained sustained therapeutic benefit from DBS.ConclusionThese cases suggest that a subjective perception of increased IPG mobility may represent a distinct pre-Twiddler clinical syndrome that precedes the development of classic TS and overt hardware failure. Early recognition of this underrecognized presentation and timely surgical intervention through pocket revision and device immobilization may prevent progression to lead damage, device malfunction, and serious neurological adverse events, while ensuring uninterrupted neuromodulation therapy.

Evolution of brain-computer interface technologies for stroke rehabilitation: a bibliometric integration of neural decoding and functional recovery (2016–2025)

IntroductionBrain-computer interface (BCI) technology represents a critical frontier in neurorehabilitation. This study aims to systematically analyze the global research landscape, hotspot distribution, and evolving trends of BCI interventions for upper limb rehabilitation in stroke survivors between 2016 and 2025.MethodsBibliometric analysis and systematic mapping were conducted using data from the Web of Science Core Collection and PubMed. Literature was retrieved using terms related to “stroke,” “brain-computer interface,” and “upper limb rehabilitation.” Screening followed the PRISMA guidelines. Visualization and quantitative mapping were performed using CiteSpace (v.6.4.R2) and VOSviewer (v.1.6.20) to evaluate publication volume, international collaboration, and keyword co-occurrence clusters.ResultsAnnual publications increased steadily from 37 in 2016 to 104 in 2025, with 65.6% published since 2020. The United States (n = 144), China (n = 83), and Italy were the most productive countries. Keyword analysis revealed a paradigm shift from functional electrical stimulation toward robotics-assisted therapy, motor imagery, and AI-driven decoding. Significant burst strengths were observed for “closed-loop systems,” “generative AI,” and “multi-modal feedback,” indicating these as the current primary frontiers.DiscussionBCI research for post-stroke recovery is transitioning from experimental signal processing to intelligent, multi-modal, and personalized clinical systems. Bibliometric evidence confirms that integrating BCI with robotic-assisted rehabilitation or functional electrical stimulation (FES) has become the mainstream clinical trend. Future efforts must focus on improving EEG signal stability and developing user-friendly hardware to facilitate the transition of BCI from research settings to daily clinical practice. China has emerged as the second most productive country, though international cooperation with European institutions remains an area for further growth.

Latent profile analysis and associated factors of alexithymia among patients with chronic obstructive pulmonary disease

BackgroundAlexithymia is one of the most common psychological characteristics observed in patients with chronic obstructive pulmonary disease (COPD) and is associated with poorer health outcomes. The negative impact of alexithymia on physical illness is reflected in more severe clinical symptoms and poorer quality of life, which adversely affect clinical outcomes and further increase disease burden, potentially contributing to a cycle of worsening health status. Therefore, timely identification of the psychological characteristics of patients with COPD, along with early psychological support, may help improve the quality of life of patients with COPD.ObjectivesTo explore the latent profiles of alexithymia among patients with COPD and to analyze their associated factors.MethodsThis cross-sectional study recruited 312 patients with COPD using convenience sampling between October 2024 and March 2025. Sociodemographic characteristics, physiological and disease-related information, psychospiritual information, environmental factors, and alexithymia scores were collected. Latent profile analysis, univariate analysis, and multinomial logistic regression were conducted to identify alexithymia profiles and examine factors associated with profile membership.ResultsThe results of this study showed that patients with COPD were categorized into three alexithymia profiles: high (28.85%), moderate (63.46%), and low (7.69%). COPD duration, depression, activity intensity, self-perceived social support, psychological resilience, and anxiety were associated with different alexithymia profiles among patients with COPD.ConclusionThis single-center cross-sectional study identified three preliminary alexithymia profiles (high, moderate, and low) among patients with COPD. Due to potential selection bias resulting from convenience sampling, these findings require validation in multicenter studies before generalization. The observed associations among COPD duration, depression, activity intensity, social support, resilience, and anxiety provide empirical evidence to inform the development of tailored patient classification and targeted support strategies for early identification, with the goal of improving quality of life in this population.