Journal of the American Psychiatric Nurses Association最新文献

{"title":"Imprinted Arousal Pattern (IAP): A Transdiagnostic Clinical Reasoning for Compulsive Behaviors.","authors":"Raymond Zakhari","doi":"10.1177/10783903261443980","DOIUrl":"https://doi.org/10.1177/10783903261443980","url":null,"abstract":"<p><strong>Objective: </strong>Compulsive behaviors across psychiatric diagnoses often recur despite diagnostic clarity, pharmacologic stabilization, and structured psychotherapy. Substance use disorders and behavioral addictions demonstrate high relapse rates, particularly under stress, while many patients describe not a pursuit of pleasure but an inability to tolerate stillness, boredom, or emotional deadness. Although the <i>Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision</i> (DSM-5-TR) provides descriptive reliability and the Research Domain Criteria (RDoC) framework advances dimensional neurobiological insight, neither alone offers a clinically operational explanation for stress-triggered recurrence.</p><p><strong>Methods: </strong>This discussion paper proposes the Imprinted Arousal Pattern (IAP) framework, a transdiagnostic clinical reasoning model conceptualizing compulsive behaviors as conditioned arousal-affect-meaning-behavior loops consolidated through reinforcement and stress sensitization. The framework draws from addiction science, conditioning theory, attachment research, and trauma-informed neurobiology and is mapped onto RDoC domains.</p><p><strong>Results: </strong>IAP reframes compulsive behaviors as learned regulatory architectures-once adaptive solutions for managing threat, shame, or dysregulation, now rigid and self-perpetuating across contexts. The framework provides a structured explanation for intolerance of low-arousal states and predictable stress-reactive relapse and translates into practical assessment and treatment considerations for psychiatric-mental health nurse practitioners.</p><p><strong>Conclusions: </strong>By shifting focus from symptom suppression to restructuring maladaptive regulatory systems, IAP offers a coherent, dignity-preserving formulation for compulsive behaviors. As a portable explanatory framework, it provides structured language for patterns long recognized in psychiatric nursing practice but insufficiently named.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261443980"},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study of Nurses' Perceptions and Experiences in Caring for Adolescents With Self-Injurious and Suicidal Behaviors.","authors":"Mahdi Shaabani, Kourosh Amini, Farhad Ramezani-Badr, Seyed Kazem Mousavi","doi":"10.1177/10783903261427380","DOIUrl":"https://doi.org/10.1177/10783903261427380","url":null,"abstract":"<p><strong>Background: </strong>Adolescent self-injurious behaviors (SIBs) present a global public health concern. Nurses, as frontline caregivers, play a crucial role in managing these cases, where their perceptions influence care quality. However, qualitative research deeply exploring these perceptions, particularly in the Zanjan, Iran context, remains scarce.</p><p><strong>Aims: </strong>To explore the perceptions and experiences of Zanjan nurses caring for adolescents with SIB.</p><p><strong>Methods: </strong>A qualitative content analysis study. Twelve nurses from general and psychiatric hospitals in Zanjan were purposively sampled. Data from in-depth, semi-structured interviews in Farsi were analyzed using the Graneheim and Lundman approach with MAXQDA software.</p><p><strong>Results: </strong>Analysis of the data generated 449 initial codes, from which three main categories emerged: (1) Conceptualizing Self-Harm: A Spectrum from Distress to Crisis, encompassing subthemes of persistent mental rumination, perceived precipitating factors, and profound emotional impact; (2) Systemic and Clinical Challenges in Care Delivery, comprising subthemes of organizational barriers, care complexities, and limitations in available treatments; and (3) Emotional and Cognitive Responses to the Adolescent, including subthemes of attributions about the person, perceptions of psychological suffering, and recognition of familial struggles.</p><p><strong>Conclusion: </strong>Nurses' perceptions ranged from empathy to frustration. Notably, they often conceptualized non-suicidal self-injury and suicidal behaviors as interconnected expressions of distress rather than distinct phenomena. The findings highlight an urgent need for specialized nurse education, institutional support, and interdisciplinary collaboration to improve care. While insightful, the study's focus on one Zanjan province and a small sample size suggests cautious interpretation and indicates a need for broader research.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261427380"},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Eyed Seeing and Community Sovereignty: Philosophical Extensions for the Mental Health Ambassador Model.","authors":"Trae Stewart","doi":"10.1177/10783903261442945","DOIUrl":"https://doi.org/10.1177/10783903261442945","url":null,"abstract":"","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261442945"},"PeriodicalIF":1.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saving Lives in Crisis: A Literature Review for Adolescent Crisis Response.","authors":"Faith Carini-Graves","doi":"10.1177/10783903261429446","DOIUrl":"https://doi.org/10.1177/10783903261429446","url":null,"abstract":"<p><strong>Introduction: </strong>Only 50% of children with mental illnesses receive the appropriate mental health care, leading to an increase in acute hospitalizations for crisis events. Community-based psychiatric care programs, such as the Youth Assertive Community Treatment (Youth ACT) programs, offer a novel, community-based crisis intervention for adolescents with complex psychiatric needs. However, many times these programs experience capacity limitations due to staff burnout, stress, and low levels of competence as reported by staff.</p><p><strong>Methods: </strong>Fifty-seven articles were screened for relevance, with 31 meeting inclusion criteria based on predefined appropriateness and exclusion standards.</p><p><strong>Results: </strong>Despite many advances in pediatric psychiatry, crisis management remains a persistent challenge. This review found themes of crisis management guidelines for best practices, crisis management education, crisis management debriefing, crisis management tools, and the role of nursing in crisis management. Multiple trials found reduced hospitalizations and improved psychiatric symptoms with evidence-based guidelines and strategies. Education and debriefing opportunities improved staff self-perceived resilience and self-confidence ratings.</p><p><strong>Conclusion: </strong>Many programs struggle to provide crisis management that reduces psychiatric emergency department visits and hospitalizations. This review highlights how nurses can support crisis care staff by facilitating the recognition of guidelines, providing targeted education, designing crisis management tools, and offering structured debriefings.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261429446"},"PeriodicalIF":1.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Solution-Focused Approach on Psychosocial Adjustment and Treatment Adherence in Individuals Diagnosed With Schizophrenia: A Randomized Controlled Trial.","authors":"Fatih Şahin, Özlem Ulaşoğlu","doi":"10.1177/10783903261427421","DOIUrl":"https://doi.org/10.1177/10783903261427421","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a chronic psychiatric disorder characterized by persistent impairments in psychosocial functioning and treatment adherence. Community-based mental health services require nursing interventions that support recovery-oriented, person-centered care.</p><p><strong>Aim: </strong>This study aimed to examine the effects of a solution-focused approach (SFA) on psychosocial adjustment and treatment adherence in individuals diagnosed with schizophrenia.</p><p><strong>Method: </strong>This randomized controlled pretest-posttest study, conducted at a community mental health center in Türkiye, assigned participants to an experimental (initial <i>n</i> = 30; completers <i>n</i> = 27; mean age = 48.4 ± 13.47; 66.7% male) or a control group (initial <i>n</i> = 30; completers <i>n</i> = 26; mean age = 55.0 ± 7.03; 87.6% male) via gender-stratified, computer-assisted randomization. The experimental group received six weeks of individual, face-to-face solution-focused sessions led by a psychiatric nurse, while the control group continued routine care. Psychosocial adjustment and treatment adherence were assessed pre- and post-intervention using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) and the Morisky-Green-Levine Adherence Scale (MGL).</p><p><strong>Results: </strong>Groups were similar at baseline. Post-intervention, the experimental group showed a significant reduction in PAIS-SR scores, indicating improved psychosocial adjustment, with notable gains in occupational functioning, family environment, social relationships, and psychological distress. No significant change occurred in the control group. Delta and mixed ANOVA analyses confirmed significantly greater improvement in psychosocial adjustment for the experimental group (<i>p</i> < .001). Treatment adherence also increased significantly in the experimental group, with a statistically significant between-group difference (<i>p</i> = .002).</p><p><strong>Conclusion: </strong>A 6-week, nurse-led solution-focused intervention significantly enhanced psychosocial adjustment and treatment adherence in individuals with schizophrenia. This approach can substantially contribute to recovery-oriented, person-centered psychiatric nursing practices in community-based mental health services.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261427421"},"PeriodicalIF":1.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Sensory Room Interventions on Vagal Function in Individuals With Depression: A Randomized Crossover Trial.","authors":"Hikari Otsuka, Keisuke Irie, Riku Takebuchi, Hiroyuki Inadomi","doi":"10.1177/10783903261433565","DOIUrl":"https://doi.org/10.1177/10783903261433565","url":null,"abstract":"<p><p><b>BACKGROUND:</b> Sensory rooms, widely used in psychiatric care, offer customizable environments designed to enhance comfort and reduce distress. Although our previous research demonstrated that sensory room use was associated with increased vagal activity in healthy individuals, its physiological effects in individuals with depression remain unclear. <b>AIM:</b> This study aimed to examine the effects of a sensory room intervention on autonomic function and psychological outcomes in adults with depression. <b>METHODS:</b> Twenty adults with depression participated in a randomized crossover trial. Each participant completed two 30-min sessions-sensory room use and static seated activities-in a counterbalanced order. Resting vagal activity, vagal reactivity to auditory stimulation, subjective discomfort, mood states, and interoceptive awareness were assessed before and after each session. Vagal indices were derived from respiratory sinus arrhythmia, a heart rate variability measure reflecting parasympathetic cardiac control. Mood was assessed with the Profile of Mood States, Second Edition, and interoceptive awareness with the Multidimensional Assessment of Interoceptive Awareness. <b>RESULTS:</b> Compared to static activities, the sensory room significantly increased resting vagal activity and reduced vagal reactivity to auditory stimuli, indicating enhanced autonomic stability. Although no significant differences were found in subjective discomfort or negative mood states, several aspects of interoceptive awareness, including the Not-Worrying subscale, showed significant improvement following sensory room use. <b>CONCLUSIONS:</b> These findings suggest that sensory rooms may help regulate vagal function and support sensory modulation in individuals with depression, providing a non-pharmacological approach to enhance autonomic regulation and body awareness in psychiatric care.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261433565"},"PeriodicalIF":1.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Canada's National Suicide Prevention Plan: Key Recommendations.","authors":"Rosina Mete","doi":"10.1177/10783903261436315","DOIUrl":"https://doi.org/10.1177/10783903261436315","url":null,"abstract":"<p><strong>Objective: </strong>Suicide is a significant public health crisis in Canada, claiming approximately 4,500 lives annually. Despite decades of localized efforts, Canada remains one of the few G7 nations without a national suicide prevention strategy until 2024. This discussion paper examines Canada's newly launched National Suicide Prevention Action Plan (2024-2027) and provides a critique of its structural framework, collaborative mechanisms, and evidence-based approaches.</p><p><strong>Methods: </strong>The article outlines a brief historical overview of Canada's development of the current National Suicide Prevention Action Plan. A review of the Plan's four strategic pillars, specifically, data and monitoring, research and evaluation, support and services, and governance, reveals both progress and ongoing issues. The plan's equity-focused approach, multisectoral collaboration, and integration of Indigenous perspectives mark notable achievements, whereas data infrastructure gaps, funding uncertainties, and implementation dependencies present ongoing concerns.</p><p><strong>Results: </strong>Drawing on successful Canadian and international policy models and provincial innovations, this paper provides concrete recommendations to strengthen implementation and ensure sustained impact on Canada's persistent suicide rates.</p><p><strong>Conclusion: </strong>Canada's National Suicide Prevention Action Plan (2024-2027) constitutes a significant federal milestone in addressing a persistent public health concern. However, to further enhance the current plan, specific details on evaluation, assessments, and outcome measures should be included. In addition, collaboration with provincial and territorial organizations that are currently involved in suicide prevention initiatives would strengthen the plan. More tailored approaches to support diverse groups within Canada and Indigenous populations are additional suggested improvements.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261436315"},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacogenetic Testing in Patients With Depression: A Quality Improvement Project.","authors":"Jeremy Tyler Rockwell, Amy Y Spurlock, Kerri L Outlaw","doi":"10.1177/10783903261431278","DOIUrl":"https://doi.org/10.1177/10783903261431278","url":null,"abstract":"<p><strong>Background: </strong>First-line treatment for major depressive disorders (MDDs) is often antidepressants. These medications are commonly trialed and discontinued due to side effects. Pharmacogenetic testing (PGx) allows psychiatric-mental health nurse practitioners to assess patient drug metabolism with the goal of reducing medication trials.</p><p><strong>Aims: </strong>The purpose of this quality improvement project was to examine the impact of PGx on remission rates and clinical outcomes for MDD compared with the standard of care (SOC) in psychiatry.</p><p><strong>Method: </strong>Outcomes were measured using a problem status system within the site's electronic health record based on patient self-reports and clinician interpretation. No validated scale was used which represents a methodological limitation to the study.</p><p><strong>Results: </strong>The SOC group had higher remission rates of MDD (38%) compared with PGx (9.8%). The PGx group had a higher occurrence of moderate (24.4%) and severe (17.1%) diagnosis of MDD compared with the SOC group (16% and 8%), respectively. The SOC group had a stable problem status (70%) compared with the PGx group (43.9%). The improving status of PGx was 12.2% compared with SOC at 8%, and the worsening problem status of standard care was 10% compared with PGx at 4.9%. Age did not significantly differ by problem status in the PGx group, <i>F</i>_{(3, 37)} = 0.592, <i>p</i> = .624.</p><p><strong>Conclusions: </strong>PGx may offer clinical value for patients with severe depression. Results should be interpreted cautiously, and further studies using validated scales and controlled designs are needed.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261431278"},"PeriodicalIF":1.7,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco Treatment Competencies: A Brief Review of Advanced Practice Psychiatric Nursing Education.","authors":"Sara B Adams, Alice Geis, Jenna Wasserman","doi":"10.1177/10783903261427387","DOIUrl":"https://doi.org/10.1177/10783903261427387","url":null,"abstract":"<p><strong>Objectives: </strong>Tobacco use increases morbidity and mortality among its users. The rate of tobacco use is declining in the general adult population yet is two to three times higher for those experiencing mental health disorders, specifically those with serious mental illness (SMI). Psychiatric mental health nurse practitioners (PMHNPs) are well-positioned to treat tobacco use in patients with SMI, yet tobacco training during nursing education, both in amount of time spent and content delivered, is not well understood and can leave PMHNPs ill-prepared to intervene.</p><p><strong>Methods: </strong>A cross-sectional descriptive survey design was used to assess PMHNP programs nationwide to determine where tobacco treatment is located in the curriculum, the amount of time spent on tobacco treatment throughout the program, and program directors' general attitude and beliefs about the importance of tobacco treatment related to the scope of practice and impact.</p><p><strong>Results: </strong>Program directors or their representatives responded (<i>N</i> = 34) across all program types. Respondents reported either agreement or strong agreement with the importance of tobacco treatment in PMHNP programs. Most spent less than 1 hour or between 1 and 3 hours on tobacco treatment, primarily in psychiatric assessment and psychopharmacology courses. Most agreed or strongly agreed that this was within the scope of practice, yet agreement was less when asked about impact on outcomes.</p><p><strong>Conclusion: </strong>PMHNP programs have an opportunity to improve perspectives on the impact psychiatric nurse practitioners can have on tobacco treatment outcomes and integrate curricular strategies to robustly integrate tobacco competencies.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261427387"},"PeriodicalIF":1.7,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing High School Students' Attitudes Toward Seeking Professional Psychological Help.","authors":"Chun-Lin Chen, Yu-Hsuan Chu, Yi-Ju Pan, Mu-Shan Ho, Hsiu-Ju Chang","doi":"10.1177/10783903261422670","DOIUrl":"https://doi.org/10.1177/10783903261422670","url":null,"abstract":"<p><strong>Background: </strong>Enhancing adolescents' willingness to seek professional psychological help is essential for improving mental health service utilization. Previous research suggests that depression literacy, stigma, depressive symptoms, and family factors-particularly caregivers' perspectives-play important roles in shaping help-seeking attitudes. However, few studies have simultaneously examined these factors from both adolescents' and caregivers' viewpoints.</p><p><strong>Aims: </strong>This study aimed to examine how depression literacy, stigma, depressive symptoms, and caregivers' attitudes toward professional psychological help influence adolescents' help-seeking attitudes, while controlling for relevant sociodemographic variables.</p><p><strong>Method: </strong>A cross-sectional study was conducted with adolescents and their primary caregivers recruited from public and private high schools in northern Taiwan. Participants completed questionnaires on demographics, depression literacy, stigma, depressive symptoms, and attitudes toward professional psychological help. Hierarchical regression analyses were performed, adjusting for key sociodemographic variables.</p><p><strong>Results: </strong>After controlling for caregivers' religious beliefs, marital status, and education, as well as adolescents' prior use of mental health services, academic satisfaction, and interpersonal difficulties, the strongest predictors of adolescents' help-seeking attitudes were their depressive symptoms, personal stigma, and caregivers' attitudes toward professional psychological help.</p><p><strong>Conclusion: </strong>Adolescents' help-seeking attitudes are shaped by both their own psychological experiences and their caregivers' perspectives. Targeted interventions should prioritize stigma reduction, symptom recognition and management, and caregiver engagement to foster timely and effective help-seeking among adolescents.</p>","PeriodicalId":17229,"journal":{"name":"Journal of the American Psychiatric Nurses Association","volume":" ","pages":"10783903261422670"},"PeriodicalIF":1.7,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}