Journal of psychiatric research最新文献

{"title":"Comparing self-guided and traditional crisis response planning: A pilot randomized controlled trial in US military veterans","authors":"Lauren R. Khazem ,&nbsp;Megan L. Rogers ,&nbsp;Austin G. Starkey ,&nbsp;Cameron M. Long ,&nbsp;Jarrod M. Hay ,&nbsp;Simran Bhola ,&nbsp;Craig J. Bryan","doi":"10.1016/j.jpsychires.2025.05.011","DOIUrl":"10.1016/j.jpsychires.2025.05.011","url":null,"abstract":"<div><div>US Military Veterans demonstrate a heightened prevalence of suicides when compared to the general population, but many within this population experience significant barriers to receiving efficacious suicide prevention interventions, including brief interventions such as Crisis Response Planning (CRP). We conducted a pilot randomized controlled trial comparing the relative effectiveness of traditional CRP administered by a trained individual to a self-guided version (CRP-S) in reducing suicidal ideation intensity over a one-week period following administration in 72 US military Veterans with past-month death or suicidal ideation. Results of estimated growth curve models demonstrated suicidal ideation non-significantly decreased across one-week follow-up, with results consistent across CRP and CRP-S; participants reported greater use of either version of the intervention on days when they had more severe suicidal ideation. Suicidal ideation did not significantly change as a function of any combination of administration type or CRP/-S use. These results indicted the CRP and CRP-S may perform similarly in reducing suicidal ideation over a one-week period, however, use of these interventions is limited.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 69-73"},"PeriodicalIF":3.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of post stroke depression with machine learning: A national multicenter cohort study","authors":"Yumeng Gu ,&nbsp;Juanjuan Xue ,&nbsp;Xiaoshuang Xia ,&nbsp;Xiaokun Guo ,&nbsp;Zhongyan Wang ,&nbsp;Kun Wu ,&nbsp;Wei Yue ,&nbsp;Nian Chen ,&nbsp;Lin Wang ,&nbsp;Xin Li","doi":"10.1016/j.jpsychires.2025.05.015","DOIUrl":"10.1016/j.jpsychires.2025.05.015","url":null,"abstract":"<div><h3>Objective</h3><div>Post-stroke depression (PSD) is a common psychiatric complication following stroke, with low clinical detection rates and delayed diagnosis. Most existing PSD prediction models suffer from incomplete data inclusion, which limits their clinical predictive value. This study aims to integrate multimodal data, including clinical characteristics, biomarkers, and neuroimaging variables, to validate the potential of machine learning models in efficiently identifying high-risk PSD patients.</div></div><div><h3>Methods</h3><div>This study is based on a multicenter clinical follow-up cohort of patients with acute ischemic stroke (AIS) in China, conducted from December 2020 to September 2023. Predictive factors included demographic characteristics, clinical features, and previously identified neuroimaging variables associated with PSD. The primary outcome was the occurrence of PSD within 3–6 months after stroke. The dataset was divided into a training set and a test set at a 3:1 ratio, with further validation performed using an external dataset. Four machine learning models—Adaptive Boosting, Gradient Boosting Decision Tree (GBDT), Quadratic Discriminant Analysis, and Multilayer Perceptron Classifier—were implemented using Python. Their predictive performance was compared based on accuracy metrics.</div></div><div><h3>Results</h3><div>A total of 4298 AIS patients (mean age: 68.33 ± 8.82 years, 46.4 % male) were included, among whom 1483 developed PSD. In the test dataset, the GBDT model achieved an area under the curve (AUC) of 0.8626, accuracy of 0.7833, sensitivity of 0.8085, specificity of 0.5296, and an F1-score of 0.6396, outperforming other models. In the external validation set, the GBDT model also demonstrated superior performance, with an AUC of 0.8185, accuracy of 0.8636, sensitivity of 0.8846, specificity of 0.5285, and an F1-score of 0.6689. The most important predictors of PSD included National Institutes of Health Stroke Scale (NIHSS) at discharge, left-sided lesions, lacunar infarcts (LIs), homocysteine (HCY) levels, and systolic blood pressure (SBP).</div></div><div><h3>Conclusion</h3><div>The machine learning model performs well in predicting PSD. Clinicians should focus on stroke patients with high NIHSS scores, left-sided lesions, LIs, elevated HCY level, and high SBP to develop personalized and precise management and treatment strategies for high-risk PSD patients, aiming to prevent or delay PSD onset.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 123-133"},"PeriodicalIF":3.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial rescue of schizophrenia-related phenotypes in young adult Sp4 hypomorphic mice","authors":"Joris Kamp ,&nbsp;Megan E. Sikkink ,&nbsp;Mahalah R. Buell ,&nbsp;Susan B. Powell ,&nbsp;Xianjin Zhou","doi":"10.1016/j.jpsychires.2025.05.002","DOIUrl":"10.1016/j.jpsychires.2025.05.002","url":null,"abstract":"<div><div>The Schizophrenia Exome Sequencing Meta-Analysis (SCHEMA) Consortium found that truncation of one copy of the SP4 gene has an odds ratio of 9.37 (3.38–29.7) for schizophrenia (SCZ). Human SP4 gene is also one of the 69 schizophrenia-risk genes prioritized by parallel genome-wide association studies (GWAS) and one of the two schizophrenia-risk genes shared between the SCHEMA and the GWAS, suggesting that more subtle common variants of the SP4 gene with a partial loss-of-function are likely involved in the pathogenesis of schizophrenia in the general population of patients. SP4 may also act as a hub of network in the regulation of many other schizophrenia-risk genes. Sp4 hypomorphic mice that have reduced Sp4 expression recapitulate several behavioral phenotypes related to schizophrenia such as deficient prepulse inhibition (PPI), hypersensitivity to ketamine in locomotion, and deficient context memory. We previously demonstrated cell-specific rescue of ketamine hypersensitivity by restoring Sp4 expression in forebrain GABAergic inhibitory neurons during embryogenesis. However, it is unknown whether restoration of Sp4 expression in young adult Sp4 hypomorphic mice may rescue these schizophrenia-related phenotypes when these phenotypes are still emerging. Such studies are critical for evaluation of SP4 as a potential target gene for schizophrenia drug development. Here, we use AAV.PHP.eB virus carrying Cre recombinase to restore Sp4 expression in the whole brains of young adult Sp4 hypomorphic mice. Our preliminary studies suggested that Sp4 partial restoration attenuated PPI deficits and ketamine locomotor hypersensitivity in adult male Sp4 hypomorphic mice but did not improve deficient context memory in Sp4 hypomorphic mice transduced with AAV/PHP.eB virus carrying the Cre gene. A large cohort of Sp4 hypomorphic mice is needed for the rescue experiments to validate our findings.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 44-52"},"PeriodicalIF":3.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Brain network communication in remission: a comparative study of bipolar and unipolar depression\" [J. Psychiatr. Res. 186 (2025) 1-8].","authors":"Haiyan Liu, Yi Xia, Lingling Hua, Hao Sun, Rui Yan, Zhijian Yao, Jiaolong Qin","doi":"10.1016/j.jpsychires.2025.04.048","DOIUrl":"https://doi.org/10.1016/j.jpsychires.2025.04.048","url":null,"abstract":"","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating natural language processing derived linguistic features associated with current suicidal ideation, past attempts, and future suicidal behavior","authors":"Lauren McBride ,&nbsp;Varsha D. Badal ,&nbsp;Philip D. Harvey ,&nbsp;Amy Pinkham ,&nbsp;Ankit Aich ,&nbsp;Natalie Parde ,&nbsp;Colin Depp","doi":"10.1016/j.jpsychires.2025.05.004","DOIUrl":"10.1016/j.jpsychires.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>People with psychosis have a higher suicide risk than the general population. Natural language processing (NLP) has been used to understand communication in psychosis and suicide risk prediction, but not to predict future suicidal behavior in people with psychosis. We utilized NLP-derived linguistic features from a dyadic task among people with psychotic disorders to predict current suicide ideation, past suicide attempts, and future suicidal behavior.</div></div><div><h3>Methods</h3><div>N = 112 adults with psychotic disorders completed the Columbia-Suicide Severity Rating Scale at baseline and one-year follow-up to capture lifetime suicide attempts, current suicidal ideation, and suicidal behavior during the follow-up period. At baseline, participants completed a dyadic role-play task called the Social Skills Performance Assessment. Lexical features, lexical diversity, and sentiment features were extracted from task transcripts. Models for each outcome were generated using a 70 %–30 % train-test split with MLPRegressor. SHapley Additive exPlanations (SHAP) was utilized for feature analysis.</div></div><div><h3>Results</h3><div>A total of 42.9 % of participants had baseline suicidal ideation, 67.9 % had at least one past suicide attempt, and 13.3 % had at least one reported new suicidal behavior at one-year follow-up. The models had strong predictive performance for past attempts (F1 = 0.75) and current ideation (F1 = 0.74–0.79), with future suicide behavior models showing the strongest predictive performance (F1 = 0.86–0.93). The top features varied across suicide ideation, past attempts, and future behavior.</div></div><div><h3>Discussion</h3><div>NLP-derived features from a dyadic task were associated with high predictive accuracy for future suicidal behavior. Pending replication, these findings suggest that NLP-derived linguistic features from dyadic tasks could contribute to understanding suicide risk among people with psychosis.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 25-33"},"PeriodicalIF":3.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The complex relationship between NSSI exposure and suicidal risk: Insights from a short-term longitudinal study","authors":"Zhenhai Wang ,&nbsp;Zhiyuan Tao ,&nbsp;Yijin Xiong ,&nbsp;Yanrong Chen ,&nbsp;Ge Jin ,&nbsp;Wei Zhang ,&nbsp;Herui Shang","doi":"10.1016/j.jpsychires.2025.04.052","DOIUrl":"10.1016/j.jpsychires.2025.04.052","url":null,"abstract":"<div><h3>Objective</h3><div>Adolescent suicide has become a critical global public health issue. While non-suicidal self-injury (NSSI) is closely associated with suicide, the role of NSSI exposure remains unclear. This study aims to explore possible mechanisms among NSSI exposure, NSSI engagement, and future suicidal risk.</div></div><div><h3>Method</h3><div>A total of 2,155 Chinese middle school students (47.9 % girls; M = 13.38 years, SD = 0.66) participated in the study. During the first survey, they reported demographic information, NSSI exposure, and NSSI engagement. Three months later, they completed follow-up assessments on suicidal risk and depressive symptoms.</div></div><div><h3>Results</h3><div>Our results revealed three distinct relational patterns between NSSI exposure, NSSI engagement, and future suicidal risk: (1) NSSI exposure is associated with future suicidal risk through the mediating role of NSSI engagement (indirect effect = 0.145, SE = 0.02, 95 % CI [0.107, 0.183]); (2) NSSI exposure independently impact suicidal risk without NSSI engagement (<em>β</em> = 0.046, SE = 0.018, <em>t</em> = 2.299, <em>p</em> &lt; 0.05); (3) NSSI exposure amplifies the predictive effect of NSSI engagement (<em>β</em> = 0.053, <em>SE</em> = 0.014, <em>t</em> = 3.844, <em>p</em> &lt; 0.001, 95 % CI [0.023, 0.010]).</div></div><div><h3>Conclusions</h3><div>Our findings highlight the importance of interpersonal exposure, rather than media exposure, in these pathways. This study uncovers multiple pathways through which NSSI exposure influences suicidal risk, offering preliminary evidence for targeted prevention strategies.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 1-9"},"PeriodicalIF":3.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of brain localization using task-based fMRI for late-life depression with suicidal risk","authors":"Ai-Ling Hsu ,&nbsp;Changwei W. Wu ,&nbsp;Chih-Mao Huang ,&nbsp;Chemin Lin ,&nbsp;Cheng Hong Toh ,&nbsp;Ho-Ling Liu ,&nbsp;Tatia M.C. Lee ,&nbsp;Shwu-Hua Lee","doi":"10.1016/j.jpsychires.2025.04.053","DOIUrl":"10.1016/j.jpsychires.2025.04.053","url":null,"abstract":"<div><div>Late-life depression (LLD) is a heterogeneous mental disorder with a high risk of suicide, often linked to abnormalities in brain networks, particularly the prefrontal cortex. While transcranial magnetic stimulation targeting the dorsal and ventral lateral prefrontal cortex (DLPFC and VLPFC) has shown promise, its treatment efficacy may be compromised by the imprecise group-level standard methods. Although a personalized localization approach using fMRI is available, no study has yet systematically evaluated its reliability in LLD. This study evaluated the reliability of functional magnetic resonance imaging (fMRI) for targeting DLPFC and VLPFC using numerical Stroop and face/shape matching tasks in LLD patients with varying degrees of suicidality, the disorder's most devastating consequence. A total of 103 LLD patients, including 42 with non-suicidal risk (NS), 37 with suicidal ideation or plans (IP), and 24 with past suicide attempts (SA), underwent task-based fMRI. We performed both voxel-wise statistical analyses and the success rate of DLFPC/VLPFC localization in each subgroup by detecting significant brain activity within predefined masks. The numerical Stroop task reliably localized the bilateral DLPFC in all subgroups and the VLPFC in two-thirds. Success rates for localizing DLPFC were 98 % (41 out of 42 NS), 100 % (IP), and 100 % (SA), while VLPFC localization rates were 95 %, 97 %, and 88 %, respectively. Conversely, the face/shape matching task localized bilateral DLPFC in two-thirds and failed to detect the VLPFC in any subgroup. These findings underscore the potential of task-based fMRI, particularly the numerical Stroop task, as a reliable method for personalized targeting in LLD patients with different suicidality degrees.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 10-17"},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal variability-based alternations in dynamic functional networks in internet gaming disorder","authors":"Jiejie Fu ,&nbsp;Shuaiyu Chen ,&nbsp;Min Wang ,&nbsp;Debo Dong ,&nbsp;Guang-Heng Dong","doi":"10.1016/j.jpsychires.2025.04.050","DOIUrl":"10.1016/j.jpsychires.2025.04.050","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies on resting-state functional connectivity (FC) in internet gaming disorder (IGD) have typically assumed that FC is static during the entire scan, neglecting the dynamic reorganization of brain networks. However, understanding the dynamic changes in functional networks is crucial for a comprehensive understanding of IGD, a complex and evolving disorder.</div></div><div><h3>Methods</h3><div>Resting-state fMRI data were collected from 269 participants (132 IGD subjects, male/female: 72/60, and 137 recreational game users (RGUs), male/female: 85/52). At the network level (within-network and between-network), temporal variability indices were calculated for each group and subjected to independent samples t-tests.</div></div><div><h3>Results</h3><div>Compared to RGUs, IGD individuals exhibited decreased within-network variability in the default mode network (DMN), increased within-network temporal variability in the ventral attention network (VAN), and increased between-network temporal variability in sensorimotor network (SMN) and VAN, SMN and limbic network (LN), VAN and LN.</div></div><div><h3>Conclusions</h3><div>Changes in temporal variability at the network level occur in participants with IGD, indicating impaired executive inhibitory functions and attention, as well as imbalances between sensory-attention, sensory-emotion, and emotion-motivation functions. These findings provide new insights into the dynamic functional organization of the brain in IGD, contributing to our understanding the neural basis of pathological gaming behaviors.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 34-43"},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation and comparison of traumatic brain injury data sources within the VA Million Veteran Program: A descriptive epidemiological study","authors":"Adam X. Maihofer ,&nbsp;Catherine Chanfreau-Coffinier ,&nbsp;Marissa A. Kellogg ,&nbsp;Victoria C. Merritt","doi":"10.1016/j.jpsychires.2025.04.038","DOIUrl":"10.1016/j.jpsychires.2025.04.038","url":null,"abstract":"<div><div>With the increased use and availability of electronic health record (EHR) data, population-based traumatic brain injury (TBI) research has received growing attention. However, a key challenge emerging from this research has been accurate ascertainment of TBI case/control status. While International Classification of Diseases (ICD) diagnosis codes constitute a widely used source of data, their validity may vary by clinic and provider. Examining other TBI data sources from epidemiological databases may help ascertain the value of ICD codes. Within the VA Million Veteran Program (MVP), TBI data is available from several data sources. The purpose of this study was to provide an overview of TBI data sources available within MVP and to evaluate the performance characteristics of these variables. Analyses included up to 657,790 MVP-enrolled Veterans. TBI status (i.e., “TBI” vs. “No TBI”) was examined using several different variables: two variables from the MVP Baseline Survey; one variable from the MVP Lifestyle Survey; TBI ICD codes; and two variables from the VA TBI Screening and Evaluation Program. Several key findings emerged: (1) the availability of TBI data varied across data sources; (2) there were significant differences in TBI prevalence by sex, ancestry, and military service era for all TBI variables; (3) sensitivity and specificity varied considerably across TBI variables; and (4) combining TBI data sources (e.g., defining a TBI case using ICD codes <em>and</em> survey data) resulted in variables with stronger performance characteristics. Findings speak to the power of combining multiple data sources when retrospectively assessing TBI in the EHR.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 85-94"},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of cybersickness and presence on treatment satisfaction and clinical outcomes in virtual reality-based biofeedback for depression and anxiety","authors":"Daa Un Moon ,&nbsp;Alva Lütt ,&nbsp;Hyewon Kim ,&nbsp;Sisu Seong ,&nbsp;Ka Ram Park ,&nbsp;Jooeun Choi ,&nbsp;Min-Ji Kim ,&nbsp;Hong Jin Jeon","doi":"10.1016/j.jpsychires.2025.04.047","DOIUrl":"10.1016/j.jpsychires.2025.04.047","url":null,"abstract":"<div><div>Virtual Reality-Biofeedback (VR-BF) has emerged as a novel digital intervention for reducing anxiety and depressive symptoms. This study aimed to assess the relationship between cybersickness, presence, treatment satisfaction, and symptom change following VR-BF. In this prospective clinical study, 80 drug-naive adults were enrolled and classified into two groups: those with subclinical depressive and anxiety symptoms (n = 40) and healthy controls (n = 40). All participants completed three sessions of a self-developed VR-BF intervention over four weeks. Clinical outcomes related to depression and anxiety symptoms were assessed using established psychological scales, along with post-intervention evaluations of presence, cybersickness, and treatment satisfaction. Higher presence was associated with greater reductions in anxiety (ΔSTAI: β = −0.24, SE = 0.06, P &lt; 0.001), stress (ΔVAS: β = −0.37, SE = 0.13, P = 0.008), and depressive symptoms (ΔPHQ-9: β = −0.07, SE = 0.02, P = 0.008), and with greater treatment satisfaction (β = 0.07, SE = 0.01, P &lt; 0.001). Cybersickness was inversely correlated with presence (ρ = −0.38, P &lt; 0.001) and satisfaction (β = −0.11, SE = 0.04, P = 0.013) and was associated with smaller improvements in anxiety (ΔSTAI: β = 0.62, SE = 0.30, P = 0.044) and depressive symptoms (ΔPHQ-9: β = 0.28, SE = 0.12, P = 0.019). Female sex and older age were associated with greater clinical improvement and higher satisfaction. These findings underscore the relevance of experiential process factors in VR-BF and support further development of user-centered, tolerable, and clinically effective VR-based interventions.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 53-61"},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}