Psychological Medicine最新文献

{"title":"Blunted neurophysiological responses to loss feedback characterize the emotionally vulnerable type of clinical samples with gambling disorder.","authors":"Gangliang Zhong, Jingyang Liu, Xin Gao, Qiyun Xue, Chao Xue, Xiyuan Zhang, Yujie Bai, Jing Yue, Lihui Wang, Jiang Du, Min Zhao","doi":"10.1017/S0033291726105534","DOIUrl":"https://doi.org/10.1017/S0033291726105534","url":null,"abstract":"<p><strong>Background: </strong>Gambling disorder (GD) is clinically heterogeneous, with trait impulsivity and negative affect (anxiety/depression) representing key sources of variation. This study investigated whether neurophysiological responses to loss feedback differ across GD subgroups defined by these features and whether subgroup membership moderates the association between neural responses and clinical severity.</p><p><strong>Methods: </strong>Electroencephalography was recorded from 120 individuals with GD, typed via k-means clustering of impulsivity, anxiety, and depression scores, and 52 healthy controls (HC) during the Balloon Analogue Risk Task. Event-related potentials, including feedback-related negativity (FRN) and P3, were used to index feedback processing.</p><p><strong>Results: </strong>Two GD subgroups were identified: an 'impulsive type' (high impulsivity, low negative affect) and an 'emotionally vulnerable type' (high impulsivity with severe anxiety/depression), with the latter exhibiting greater gambling severity. Neurophysiologically, the emotionally vulnerable type showed blunted FRN and feedback-P3 amplitudes to loss feedback compared to HC, whereas the impulsive type did not differ from HC. Critically, subgroup membership moderated the association between feedback-P3 and gambling severity; a reduced feedback-P3 predicted higher severity only within the emotionally vulnerable type.</p><p><strong>Conclusions: </strong>These findings identify blunted neural responses to loss feedback as a specific characteristic of the emotionally vulnerable GD type. These findings resolve the inconsistent patterns of loss feedback processing in GD and highlight the potential for personalized interventions targeting this subgroup.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e294"},"PeriodicalIF":5.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031338","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":"Cerebral perfusion alterations are associated with clinical phenotypes and biotypes across the psychosis spectrum.","authors":"Dung Hoang, Victor Zeng, Jothini Sritharan, Henk J M M Mutsaerts, Jan Petr, Rebekah Trotti, Elena Ivleva, Weiying Dai, Scot Hill, Elliot Gershon, Sarah Keedy, Brett Clementz, Carol Taminga, Godfrey Pearlson, Nicolas Bolo, Matcheri Keshavan, Paulo Lizano","doi":"10.1017/S0033291726105844","DOIUrl":"https://doi.org/10.1017/S0033291726105844","url":null,"abstract":"<p><strong>Background: </strong>Cerebral perfusion abnormalities may contribute to the pathophysiology of psychosis spectrum disorders (PSD), including schizophrenia (SZ), schizoaffective disorder (SAD), and bipolar disorder with psychotic features (BP), yet large-scale investigations remain limited.</p><p><strong>Methods: </strong>Pseudo-continuous arterial spin labeling scans were acquired from 2412 SZ, 2278 SAD, 158 BP, 401 neurotypical controls (NC) and processed using ExploreASL and FreeSurfer to quantify resting-state cerebral blood flow (CBF) across total gray matter and 60 brain regions. General linear regression compared CBF between NC and diagnostic groups or biologically informed biotypes derived from neurophysiological clustering. Within patient groups, Spearman correlations assessed associations between cognitive/clinical measures and CBF. Analyses were corrected for multiple comparisons.</p><p><strong>Results: </strong>Compared to NC, patient groups showed significantly lower total gray matter CBF (PSD: Cohen's d=-0.124, p-adjusted=0.037; BP: d=-0.259, p-adjusted=0.004; the most severe biotype, Biotype 1: d=-0.222, p-adjusted=0.006). BP and Biotype 1 exhibited significant hypoperfusion in 25 regions spanning bilateral temporal, occipital, inferior frontal cortices, and subcortical structures (BP d= -0.21 to -0.33; Biotype 1 d=-0.19 to -0.26). No significant CBF-cognition associations were observed. Within PSD, higher total gray matter CBF correlated with greater psychotic symptom severity, while right superior temporal sulcus hyperperfusion was associated with greater psychotic, manic, and depressive symptoms.</p><p><strong>Conclusions: </strong>Distinct perfusion patterns exist in PSD, with widespread hypoperfusion in BP and Biotype 1 and hyperperfusion associated with greater symptom severity, supporting perfusion as a potential biomarker to stratify PSD subtypes.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e297"},"PeriodicalIF":5.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031347","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":"Acceptability and efficacy of a smartphone intervention informed by interpersonal psychotherapy for perinatal mental health: A randomized controlled trial.","authors":"Yuko Toshishige, Takuya Okami, Natsumi Chatani, Shiori Kawasaki, Shinobu Goto, Yuki Yoshida, Yusaku Takahashi, Misaki Shimasaki, Yousuke Miharu, Toshiaki A Furukawa, Hiroko Mizushima, Eizaburo Tanaka, Hiroko Maekawa, Tatsuo Akechi","doi":"10.1017/S0033291726105868","DOIUrl":"10.1017/S0033291726105868","url":null,"abstract":"<p><strong>Background: </strong>Perinatal depression is a global health concern linked to adverse maternal and neonatal outcomes. Although evidence-based psychological interventions, such as interpersonal psychotherapy (IPT), are effective, women lack access to in-person perinatal care. Smartphone-based interventions may offer scalable support; however, evidence from randomized controlled trials (RCTs) evaluating IPT-informed smartphone interventions remains limited. This study assessed the acceptability and efficacy of an IPT-informed smartphone intervention for perinatal mental well-being.</p><p><strong>Methods: </strong>Participants were recruited nationwide through online advertisements and postcards. In this nonblinded RCT, 350 pregnant women were assigned to a fully self-guided smartphone application (intervention) or usual care (control). No minimum depression symptom score was required for participation. Acceptability in the intervention group at 8 weeks after enrolment was indicated by the Japanese version of the Client Satisfaction Questionnaire-8 (CSQ-8J) scores of ≥17. Efficacy was defined as the change in Patient Health Questionnaire-9 (PHQ-9) scores from baseline to 8 weeks following enrolment. Depressive symptoms were assessed at 1 month postpartum.</p><p><strong>Results: </strong>The application achieved acceptability, with 90.2% (157/174) of participants scoring ≥17 on the CSQ-8J. No significant between-group differences in depressive symptoms were observed during pregnancy (standardized mean difference (SMD) = 0.11). At 1 month postpartum, the intervention group exhibited significantly lower depressive symptom scores (SMD = 0.28).</p><p><strong>Conclusions: </strong>The smartphone application was highly acceptable. While no significant differences in depressive symptoms were observed during pregnancy, differences favoring the intervention group were observed at 1 month postpartum. An IPT-informed smartphone intervention may represent a promising approach to perinatal mental health support.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e295"},"PeriodicalIF":5.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031324","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":"Feasibility and acceptability of SOCIAbLE: A novel social cognition intervention for adults with a history of childhood trauma.","authors":"Emily Barrett, Cathal O'Curraoin, Maeve Dwan O'Reilly, Sophie Mae Harrington, Sophie Mahon, Anna O'Mahony-Sinnott, David Penn, Daniel Freeman, David Roberts, Gary Donohoe","doi":"10.1017/S0033291726105364","DOIUrl":"https://doi.org/10.1017/S0033291726105364","url":null,"abstract":"<p><strong>Background: </strong>Adults with a history of childhood trauma often experience impairments in social cognition, but these difficulties are rarely therapeutically targeted. We designed 'SOCIAbLE' as a novel virtual reality (VR)-assisted intervention to improve social cognitive functioning and real-world social function in adults with childhood trauma histories.</p><p><strong>Methods: </strong>This single-arm proof-of-concept study evaluated the feasibility, acceptability, and preliminary outcomes of the SOCIAbLE intervention. Adults with a history of early-life adversity and ongoing social difficulties completed eight weekly one-hour intervention sessions combining psychoeducation, cognitive-behavioral strategies, and immersive VR role-play, targeting social cognition. Outcome assessments were conducted at baseline, 6, 12 (end of treatment), and 18 weeks. Acceptability was assessed based on post-intervention qualitative interviews.</p><p><strong>Results: </strong>Of 32 participants who completed baseline, <i>n</i> = 25 completed the full 8-week intervention; <i>n</i> = 23 completed the 12-week intervention, and <i>n</i> = 24 completed the 18-week follow-up assessments. Improvements relative to baseline were observed at 12 weeks on both our primary (BLERT emotional recognition: <i>g</i> = 1.04) and secondary outcome measures, which persisted at 18 weeks. Data from qualitative interviews (<i>n</i> = 24) indicated a high level of intervention acceptability to participants, highlighting perceived gains in confidence, self-awareness, and real-world social functioning.</p><p><strong>Conclusions: </strong>In this pilot study, SOCIAbLE was observed to be feasible and acceptable and showed preliminary evidence of benefits to social cognition, clinical symptoms, and social functioning. These data suggest that immersive VR-assisted interventions warrant further investigation in a full randomized controlled trial as a potentially effective, engaging way to target social cognitive difficulties in adults with a history of CT.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e292"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012881","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":"Letter to the editor: Neural systems underlying autobiographical memory dysregulations in depression: A neuroimaging meta-analysis.","authors":"Raphaela Schöpfer, Florian Wüthrich, Jessica Peter","doi":"10.1017/S0033291726105832","DOIUrl":"10.1017/S0033291726105832","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e293"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012929","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":"Psychiatric outcomes after streptococcal upper respiratory tract infection in children.","authors":"Danish Hafeez, Katharine Lynch-Kelly, Cameron Watson, Sarah Williford, Mark Edwards, Thomas A Pollak","doi":"10.1017/S0033291726105820","DOIUrl":"https://doi.org/10.1017/S0033291726105820","url":null,"abstract":"<p><strong>Background: </strong>Associations between childhood streptococcal upper respiratory infections and subsequent psychiatric outcomes have been described for over 25 years, although clinical evidence remains limited. This study explored psychiatric outcomes after pediatric streptococcal versus non-streptococcal upper respiratory tract infections.</p><p><strong>Methods: </strong>This retrospective cohort study used TriNetX, a global federated health research network of over 150 million deidentified electronic medical records. We compared children aged 3-16 with a diagnosis of acute upper respiratory infection (ICD-10 J00-J06) and a <i>Streptococcus pyogenes</i> test result (positive or negative) within 2 weeks, propensity matched on 70 baseline variables. Main outcomes were the 1-year incidence of any psychiatric disorder, obsessive-compulsive disorder (OCD), tic disorder, anxiety, and restricted oral intake.</p><p><strong>Results: </strong>Before matching, 464,513 children were streptococcal positive and 1,023,171 children were streptococcal negative. After matching, there were 456,221 children in each cohort (48% female). The streptococcal-positive cohort had a reduced risk of any psychiatric disorder (RR 0.92 [0.90, 0.94]), restricted oral intake (0.81 [0.77, 0.86]), and anxiety disorder (0.94 [0.91, 0.97]) at 1 year. Risk of OCD (RR 0.98 [0.86, 1.12]) and tic disorder (RR 0.95 [0.87, 1.04]) was not significantly different between the two cohorts.</p><p><strong>Conclusion: </strong>This large-scale cohort study found no evidence that exposure to <i>S. pyogenes</i> is associated with increased risk of the measured psychiatric outcomes.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e282"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012855","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":"Neurobiological factors related to differential cortical abnormalities in youth-onset and adult-onset major depressive disorder.","authors":"Shuang Xu, Shunshun Cui, Xing Shi, Xinyu Duan, Xinyan Han, Jiajia Zhu, Yongqiang Yu","doi":"10.1017/S0033291726105777","DOIUrl":"https://doi.org/10.1017/S0033291726105777","url":null,"abstract":"<p><strong>Background: </strong>Age of onset is considered a key factor for the heterogeneity in major depressive disorder (MDD). Differential cortical thickness (CT) alteration patterns between youth-onset and adult-onset MDD have been evident, yet the neurobiological factors associated with such divergence remain unknown.</p><p><strong>Methods: </strong>CT alteration patterns in youth-onset and adult-onset MDD were derived from the Enhancing NeuroImaging Genetics through Meta-Analysis. We interrogated whether the structural connectome constrains MDD-related CT alterations, followed by identifying likely epicentre regions and examining the hub vulnerability hypothesis. Using the neurotransmitter, transcriptome, and mitochondria atlases, we further explored the neurochemical basis, genetic architecture, and molecular energetic landscape related to the CT alterations.</p><p><strong>Results: </strong>The structural connectome constrained CT alterations in both youth-onset and adult-onset MDD, but the constraint effect was greater in adult-onset MDD. The epicentres were divergent for youth-onset (lateral prefrontal cortex) and adult-onset (orbitofrontal cortex, anterior and middle cingulate gyrus) MDD. The association between CT alterations and connectome degree centrality confirmed the hub vulnerability hypothesis in youth-onset MDD. Moreover, we found common and distinct neurotransmitter systems linked to CT alterations in youth-onset and adult-onset MDD. Transcriptomic contextualization demonstrated that CT alterations in adult-onset MDD were related to gene categories primarily involving synapse, neuron, synaptic transmission, and ion channel activity, yet those in youth-onset MDD were not related to gene expression. Additionally, associations between mitochondrial features and CT alterations were found in adult-onset MDD but not in its youth-onset counterpart.</p><p><strong>Conclusions: </strong>Our findings may illuminate the neurobiological factors related to the spatial patterning of cortical abnormalities in youth-onset and adult-onset MDD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e288"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012947","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":"Comparing lithium and valproate in reducing suicide risk: A territory-wide retrospective cohort study with pairwise and network meta-analysis.","authors":"Cuiling Wei, Jessie Ching Yan Su, Paco Chun Yeung Wong, Zijie Xu, Francisco Tsz Tsun Lai","doi":"10.1017/S0033291726105881","DOIUrl":"10.1017/S0033291726105881","url":null,"abstract":"<p><p>Direct clinical comparisons between lithium and valproate for suicide prevention remain limited and inconclusive. We aimed to evaluate their effectiveness of suicide prevention using a retrospective cohort study and meta-analysis. We conducted a retrospective cohort study using electronic health records from the Hong Kong Hospital Authority, including patients with bipolar disorder who initiated lithium or valproate monotherapy between 2003 and 2023. Inverse probability of treatment weighting was applied to balance baseline characteristics, and weighted Cox proportional hazards regression estimated hazard ratios (HRs) for suicide risk. We also searched electronic databases for randomized controlled trials (RCTs) and observational studies comparing lithium, valproate, and nontreatment controls. Pairwise meta-analyses and network meta-analyses were performed to synthesize direct and indirect evidence. The cohort study included 1,379 lithium users and 5,556 valproate users, with no significant difference in suicide risk between groups (weighted HR = 0.76, 95% confidence interval [CI]: 0.54-1.08). The meta-analysis identified 3 RCTs and 12 observational studies. Meta-analysis of RCTs was precluded due to methodological incompatibilities. Pairwise meta-analysis of eight observational studies showed no significant difference between lithium and valproate (pooled HR = 0.87, 95% CI: 0.69-1.09). Network meta-analysis showed that both lithium (network HR = 0.46, 95% CI: 0.33-0.64) and valproate (network HR = 0.63, 95% CI: 0.45-0.88) were associated with lower suicide risk than no treatment, with no significant difference between the two agents (network HR = 0.73, 95% CI: 0.52-1.02). Lithium and valproate showed comparable effectiveness in reducing suicide risk, while both were associated with lower risk than no treatment. The choice between these two mood stabilizers should be guided by individual patient characteristics and safety considerations.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e289"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012905","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":"Dynamics of childhood adversity and poor physical and mental health in children experiencing high adversity: Findings from the DANLIFE cohort.","authors":"Tjeerd Rudmer de Vries, Leonie K Elsenburg, Signe Kær Bennetsen, Adrian G Zucco, Naja Hulvej Rod","doi":"10.1017/S0033291726105613","DOIUrl":"https://doi.org/10.1017/S0033291726105613","url":null,"abstract":"<p><strong>Background: </strong>Children in families navigating significant adversity often face co-occurring physical and mental health problems, which together can contribute to substantial marginalization across the life course. These children and their families may greatly benefit from targeted interventions to disrupt accumulating vulnerability, which requires empirical evidence on the underlying dynamics of adversity and health problems throughout childhood.</p><p><strong>Methods: </strong>We investigated associations between childhood adversities (material deprivation, experiences of loss or threat of loss, and family dynamics) and hospitalizations for mental and physical health problems across four developmental periods among 11,978 children who experienced high rates of family adversity. We used data from the Danish Life Course (DANLIFE) register-based cohort study and applied cross-lagged networks models. Hospitalizations were identified through inpatient, outpatient, and emergency hospital contacts.</p><p><strong>Results: </strong>We found clear evidence of reciprocal associations between childhood adversities and physical and mental health problems across childhood, alongside strong autoregressive effects within adversity and health domains, indicating vicious circles of reinforcing vulnerability. Conditional on high health problems in infancy, childhood adversity was not found to be associated with additional health problems throughout the rest of childhood. Child health problems were, however, positively associated with subsequent adversity across childhood.</p><p><strong>Conclusions: </strong>Dynamics of childhood adversity and poor health give rise to complex reinforcing patterns of vulnerability over time. Our findings contribute to a better understanding of the emergence of vulnerability resulting from childhood adversity and poor health in children, highlighting the importance of embracing the complex nature of these emergent phenomena, both in research and intervention.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e290"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012875","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 dynamics of affect, screen time, and step count in individuals at risk for mood disorders.","authors":"Fleur Helmink, Eeske van Roekel, Manon Hillegers, Esther Mesman, Sarah Sperry","doi":"10.1017/S0033291726105297","DOIUrl":"https://doi.org/10.1017/S0033291726105297","url":null,"abstract":"<p><strong>Background: </strong>Identifying how affect and daily behaviors influence each other is central to understanding mood disorder development. This study investigated how negative affect (NA), positive affect (PA), physical activity, and smartphone use influence one another in daily life, and whether familial risk or mood disorder history shapes these relationships.</p><p><strong>Methods: </strong>In a 14-day experience sampling protocol, we measured NA and PA five times a day along with passive sensing of step count and screen-on time. We examined the effect of familial high risk and history of mood disorders on within-person affect-behavior dynamics using Dynamic Structural Equation Modeling.</p><p><strong>Results: </strong>The sample included offspring of parents with bipolar disorder (<i>n</i> = 82) and control participants (total <i>n</i> = 128, <i>M</i>_age = 37.8, 57% female), of which 32 had a history of mood disorders (recurrent: <i>n</i> = 3, single: <i>n</i> = 29). Results showed a credible bidirectional relationship between step count and PA (step count → PA: <i>β</i> = 0.06; 95% credibility interval [CrI], 0.02-0.09; PA → step count: <i>β</i> = .07; 95% CrI, 0.03-0.11), while NA exhibited no credible associations. Higher PA predicted decreased screen-on time (<i>β</i> = -.05; 95% CrI, -0.08 to -0.02), while increased screen-on time was associated with subsequent elevated NA (<i>β</i> = .03; 95% CrI, 0.01-0.06). Familial risk status and recurrent mood disorders did not alter these bidirectional effects, but were associated with lower PA and higher NA on average (all <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Findings highlight PA as a key driver in the interplay between behavior and affect. Supporting PA through increased activity may help improve daily emotional experiences, even in those with elevated mood disorder risk.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"56 ","pages":"e291"},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012893","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}