Alpha psychiatry最新文献

{"title":"A Cautious Integration With AI in the Clinic: A Standardized-Patient Pilot Study of ChatGPT's Reliability in Hamilton Depression Rating Scale Scoring.","authors":"Chun-Hung Chang, Szu-Wei Cheng, Wei-Jen Chen, Chung-Wen Chang, Ting-Hui Liu, Jia-Hau Lee, Sheng-Che Lin, Kuan-Pin Su","doi":"10.31083/AP51483","DOIUrl":"10.31083/AP51483","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) integration offers significant potential to improve mental healthcare, however, the reliability of large language models (LLMs) in performing nuanced clinical tasks remains an important and largely unanswered question. This study aimed to evaluate ChatGPT's performance in scoring the Hamilton Depression Rating Scale (HAMD-21) compared with expert raters using standardized patients (SPs).</p><p><strong>Methods: </strong>Three senior mental health experts created and portrayed scenarios for ten SPs representing diverse depressive symptom profiles. Recorded interviews were transcribed and used as input for ChatGPT-4o. HAMD-21 scores generated by ChatGPT were compared with those assigned by expert raters and with predefined script-based reference scores. Inter-rater reliability was assessed using intraclass correlation coefficient (ICC), and differences between raters were evaluated using Steiger's tests.</p><p><strong>Results: </strong>ChatGPT and the expert raters achieved good-to-excellent reliability for total HAMD-21 scores (experts: ICC = 0.9921; ChatGPT: ICC = 0.9739). However, expert raters achieved perfect ICCs on 11 individual items, whereas ChatGPT achieved perfect agreement on only 2 items. Steiger's test demonstrated that experts significantly outperformed ChatGPT on 10 individual items as well as on total scores (Z = 1.931, <i>p</i> = 0.0268). Qualitative review revealed that ChatGPT tended to overestimate scores on items related to insomnia and somatic symptoms (items 4-6 and 13) and frequently miscalculated total scores.</p><p><strong>Conclusions: </strong>ChatGPT demonstrated excellent agreement on total HAMD-21 scores in structured, text-based depression assessments, supporting the potential role of LLMs as adjunctive tools for standardized depression severity evaluation. However, item-level discrepancies and systematic scoring errors indicate that human oversight remains essential for clinically nuanced interpretation.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"51483"},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Kynurenine Pathway and Cerebellar Microstructure in Bipolar Disorder With Childhood Trauma.","authors":"Ming Yin, Huifeng Zhang, Huibin Pei, Rubai Zhou, Wenxian Lu, Baichuan Wu, Tenghuan Xu, Ye Wu, Xiangdong Du, Daihui Peng","doi":"10.31083/AP52059","DOIUrl":"10.31083/AP52059","url":null,"abstract":"<p><strong>Background: </strong>Childhood trauma (CT) has been recognized as a risk factor contributing to clinical heterogeneity and adverse outcomes in bipolar disorder (BD). The neurobiological mechanisms linking CT and BD, particularly those involving the kynurenine pathway (KP) and cerebellar neuroplasticity, remain unclear.</p><p><strong>Methods: </strong>A total of 51 BD patients with CT (BD+CT), 47 BD patients without CT (BD+NCT), and 50 healthy controls (HCs) were recruited. Peripheral KP metabolites were measured, and a biophysical neurite orientation dispersion and density imaging (NODDI) model was performed to evaluate microstructural alterations in cerebellar gray matter. Mediation analysis was conducted to examine whether these biomarkers mediate the association between CT and clinical phenotypes in BD.</p><p><strong>Results: </strong>In the BD+CT group, picolinic acid (PIC) levels were significantly lower, and the gray matter orientation dispersion index (ODI) in left cerebellar lobule VIIB was significantly higher, compared to other groups. PIC levels positively correlated with age of onset but negatively with emotional neglect and sexual abuse, anxiety and somatization, and left lobule VIIB ODI. Additionally, left lobule VIIB ODI showed a positive correlation with anxiety and somatization. Exploratory path modeling indicated that sexual abuse was indirectly associated with greater anxiety/somatization severity via reduced PIC levels and increased left lobule VIIB ODI.</p><p><strong>Conclusions: </strong>In BD, CT exposure was associated with reduced PIC levels, altered gray matter microstructure in left cerebellar lobule VIIB, and more severe anxiety/somatization. These findings offer insights into mechanisms for BD with CT, though the exploratory path model could not adjust for medication and requires replication in medication-naïve samples.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"52059"},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Suicidal Self-Injury in Adolescents With Major Depressive Disorder: The Role of Beta-Endorphin, Psychological Pain, and Anhedonia.","authors":"Rabia Sevcan Karaaslan, Oğuz Bilal Karakuş, Nergis Eyüpoğlu, İbrahim Adak","doi":"10.31083/AP52361","DOIUrl":"10.31083/AP52361","url":null,"abstract":"<p><strong>Background: </strong>A substantial proportion of adolescents with major depressive disorder (MDD) engage in non-suicidal self-injury (NSSI); however, the biological and psychological factors differentiating those with and without NSSI remain poorly characterized. This study aimed to investigate whether serum beta-endorphin levels, psychological pain, and anhedonia differ between these groups and to explore their associations with the presence of NSSI.</p><p><strong>Methods: </strong>The study sample comprised adolescents prospectively recruited during the study period and diagnosed with MDD according to the <i>Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision</i> (DSM-5-TR) criteria. Participants were categorized into adolescents with NSSI (NSSI+) and those without NSSI (NSSI-). Assessments included the Children's Depression Inventory (CDI), Psychache Scale (PAS), and Snaith-Hamilton Pleasure Scale (SHAPS). Serum beta-endorphin levels were measured using enzyme-linked immunosorbent assay (ELISA) from blood samples collected after an overnight fast.</p><p><strong>Results: </strong>The study cohort consisted of 104 adolescents with MDD, including 52 participants in the NSSI+ group and 52 in the NSSI- group. The sample comprised 85 females (81.7%) and 19 males (18.3%). Compared with the NSSI- group, adolescents in the NSSI+ group demonstrated significantly lower serum beta-endorphin levels and significantly higher levels of depressive symptoms, psychological pain, and anhedonia (all <i>p</i> < 0.05). In multivariable analyses, greater depression severity, higher psychological pain, and lower beta-endorphin levels were independently associated with the presence of NSSI. Exploratory mediation analyses suggested an indirect association between depression severity and NSSI through psychological pain.</p><p><strong>Conclusions: </strong>These findings highlight the relevance of both psychological and neurobiological factors in NSSI among adolescents with MDD and suggest that an integrated assessment of these factors may help identify adolescents at increased risk of this form of self-harm.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"52361"},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic-Brain Functional Coupling Mechanism Underlying iTBS Treatment for Adolescent Depression.","authors":"Zeyang Zhao, Tao Leng, Peiying Li, Fangyuan Wu, Ling Sun, Bin Zhang","doi":"10.31083/AP48591","DOIUrl":"10.31083/AP48591","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with depression pose a significant public health challenge, yet individual variability in treatment response to accelerated intermittent theta-burst stimulation (iTBS) for depression remains substantial. This study aims to integrate metabolomics with multimodal neuroimaging techniques to identify objective biomarkers of response to iTBS treatment and investigate the relationship between brain and metabolism.</p><p><strong>Methods: </strong>Patients received an accelerated iTBS protocol targeting the left dorsolateral prefrontal cortex. Assessments included plasma metabolomic profiling, resting-state and naturalistic functional magnetic resonance imaging, and clinical scale evaluations conducted at baseline and post-treatment.</p><p><strong>Results: </strong>The study enrolled 85 adolescents with depression and 48 healthy controls. 53 adolescent patients with depression completed the full course of iTBS treatment and provided blood samples for biomarker detection and analysis. Seventeen differential metabolites were identified that distinguished patients from controls and changed significantly after iTBS treatment. The area under the curve (AUC) for the metabolites 3-hydroxymethylglutaric acid, malonic acid, N-acetylphenylalanine, norepinephrine and tryptophanamide exceeds 0.8. The metabolites isovalerylcarnitine, taurochenodeoxycholic acid, taurodeoxycholic acid, and valerylcarnitine were significantly correlated with the reduction in scores on the Hamilton Depression Rating scale (HAMD). Furthermore, alterations in the metabolites 3-Indolepropionic acid, N-acetylphenylalanine, 3-Methylhistidine, Norepinephrine, Ortho-hydroxyphenylacetic acid, 3-Hydroxymethylglutaric acid and Indole-3-carboxaldehyde were associated with functional changes in key prefrontal regions, specifically, the Amplitude of Low-Frequency Fluctuations (ALFF) and Regional Homogeneity (ReHo) in the left superior frontal gyrus, and ReHo in the left middle frontal gyrus.</p><p><strong>Conclusions: </strong>This study uncovers preliminary evidence of a distinct metabolic signature in adolescent depression that normalizes following iTBS treatment and correlates with both prefrontal functional recovery and clinical improvement. The identified metabolites serve as potential candidate biomarkers and shed light on the brain-metabolism relationship. These findings offer preliminary candidate biomarkers for future investigations into interindividual variability in iTBS treatment response and offer a tentative framework for developing personalized neuromodulation strategies for adolescent depression.</p><p><strong>Clinical trial registration: </strong>The study has been registered on https://www.chictr.org.cn/ (registration number: ChiCTR2500106503 and ChiCTR2500113926; registration link: https://www.chictr.org.cn/showproj.html?proj=279390 and https://www.chictr.org.cn/showproj.html?proj=279455).</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"48591"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network Pharmacology Reveals the Potential Mechanism of Ketamine in Improving Cognitive Impairment in Patients With Depression.","authors":"Lei Yang, Qiuyu Zhang, Ying Zhang, Kaifang Yao, Ximing Chen, Hongjun Tian, Chuanjun Zhuo","doi":"10.31083/AP56752","DOIUrl":"10.31083/AP56752","url":null,"abstract":"<p><strong>Background: </strong>Ketamine may have antidepressant and anti-suicidal effects. However, the mechanism underlying ketamine-mediated improvement in cognitive impairment in patients with depression remains unclear. To improve patient cognition in depression using molecular docking and network pharmacology, we examined ketamine's key targets and identified its molecular mechanisms.</p><p><strong>Methods: </strong>To gain target information about cognitive impairment (1983) and depression (1874), we used three databases, including Online Mendelian Inheritance in Man, GeneCards, and DisGENET. Information on ketamine targets (63) was retrieved from public databases. To locate signaling pathways and core targets, we conducted bioinformatics analysis, including an enrichment analysis and protein-protein interaction (PPI) network analysis. To assess the interaction between core targets and ketamine, we carried out molecular docking.</p><p><strong>Results: </strong>We identified 20 ketamine target proteins of ketamine related to depression and cognitive impairment. Enrichment analyses revealed that ketamine influenced depression and cognitive function through multiple pathways, targets, and overall synergy. The important signaling pathways identified were \"amphetamine addiction\" and \"dopaminergic synapse\". Five core genes (monoamine oxidase (MAO)-A, <i>MAO-B</i>, <i>glycogen synthase kinase-3β</i>, <i>sirtuin-1</i>, <i>epidermal growth factor receptor</i>) were identified through PPI-network analyses. Our molecular docking results showed that binding was strong between these core genes and ketamine.</p><p><strong>Conclusions: </strong>The antidepressant and cognitive-enhancing effects of ketamine are primarily mediated through targets associated with inflammation, neural signaling, tumors, and neurodegeneration, as well as pathways such as amphetamine addiction, dopaminergic synapse, and the cyclic adenosine monophosphate (cAMP) signaling pathway. The findings provide theoretical support and guidance for optimizing clinical application strategies of ketamine and for designing new drugs.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"56752"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Comorbidity Mechanism of Internet Addiction, Insomnia, Depression, and Suicidality Among Chinese College Students Through Network Analysis.","authors":"Huayu Li, Hongyuan Lv, Jiahui Zhang, Yu Fu, Jianpeng Zhang, Hongmei Wang","doi":"10.31083/AP46397","DOIUrl":"10.31083/AP46397","url":null,"abstract":"<p><strong>Background: </strong>Internet addiction is prevalent among college students and is linked to adverse mental health outcomes such as insomnia, depression, and suicidality. However, the variability in internet addiction patterns among college students and its connection to mental disorders remains insufficiently explored. This study examined the comorbidity network of internet addiction, insomnia, depression, and suicidality in Chinese college students through latent profile analysis (LPA) and network analysis (NA).</p><p><strong>Methods: </strong>Data from 3127 Chinese college students were collected using the Internet Addiction Test (IAT), Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), and Suicidal Behavior Questionnaire-Revised (SBQ-R). LPA was applied to identify subgroups with similar internet addiction profiles. NA was conducted among addicted users to map symptom associations, and network comparison tests (NCT) were used to evaluate subgroup differences.</p><p><strong>Results: </strong>Three distinct user profiles emerged: regular users, moderate users, and addicted users. NA revealed that the central symptom of internet addiction was \"lack of self-control when online\". Furthermore, \"trouble sleeping\", \"frequency of suicidal ideation over the past year\" and \"sleep maintenance (middle)\" were identified as bridge symptoms, connecting insomnia, depression, and suicidality with internet addiction. NCT indicated no significant gender differences in overall network strength.</p><p><strong>Conclusions: </strong>Interventions focused on improving self-regulation and addressing sleep problems should be prioritized to help reduce internet addiction, insomnia, depression, and suicidality in this population.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"46397"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glutamatergic Modulators in Schizophrenia: Are We Ready to Move Beyond the Narrow Focus on Dopamine? A Potential Paradigm Shift in Psychopharmacology.","authors":"Renato de Filippis, Daniel Guinart, Christoph U Correll, Gaspare Liparota, Taishiro Kishimoto, Pasquale De Fazio","doi":"10.31083/AP52026","DOIUrl":"10.31083/AP52026","url":null,"abstract":"","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"52026"},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Intelligent Exercise Intervention for Enhancing Hot Executive Functions in Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.","authors":"FeiLong Zhu, Xi Zhang, DongQing Kuang, ZhuFeng Li, Li Yang, YuFeng Wang, Ming Zhang, YuanChun Ren","doi":"10.31083/AP51439","DOIUrl":"10.31083/AP51439","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Deficits in hot executive functions (EFs), including risky decision-making, delay discounting, and emotion regulation, represent important yet relatively understudied features of attention-deficit/hyperactivity disorder (ADHD). Although physical exercise has been shown to improve cool EFs, its effects on hot EFs remain uncertain. Furthermore, conventional intervention approaches are often limited by accessibility and implementation barriers, underscoring the need for intelligent, home-based alternatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this three-arm randomized controlled trial, 145 children aged 6-10 years with ADHD were randomly assigned to an intelligent exercise group (EG1; n = 53), a traditional offline exercise group (EG2; n = 45), or a wait-list control group (CG; n = 47). Both intervention groups participated in a 12-week program consisting of three sessions per week, each lasting 45-60 minutes and integrating physical and cognitive training. Participants in EG1 completed the intervention through a custom-developed WeChat mini-program (\"LeDongYing\"), which incorporates computer vision-based motor assessment, dynamically personalized exercise prescriptions, real-time feedback, an artificial intelligence (AI)-assisted guidance agent, and a tailored exercise library. Participants in EG2 received coach-led, face-to-face training sessions. Outcome measures included risky decision-making, delay discounting, and emotion regulation. Intervention effects were evaluated using generalized linear mixed models, with potential confounders included as covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For risky decision-making, EG1 demonstrated significantly greater improvements than CG in Block 3 (&lt;i&gt;β&lt;/i&gt; = 3.38, &lt;i&gt;p&lt;/i&gt; = 0.019), Block 4 (&lt;i&gt;β&lt;/i&gt; = 6.89, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and total net score (&lt;i&gt;β&lt;/i&gt; = 13.07, &lt;i&gt;p&lt;/i&gt; = 0.012). EG2 also showed significantly greater improvements than CG in Block 3 (&lt;i&gt;β&lt;/i&gt; = 3.49, &lt;i&gt;p&lt;/i&gt; = 0.019) and Block 4 (&lt;i&gt;β&lt;/i&gt; = 4.38, &lt;i&gt;p&lt;/i&gt; = 0.009). No significant differences were observed between EG1 and EG2 for any risky decision-making outcome (all &lt;i&gt;p&lt;/i&gt; &gt; 0.05). For delay discounting, both EG1 (&lt;i&gt;β&lt;/i&gt; = 0.12, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and EG2 (&lt;i&gt;β&lt;/i&gt; = 0.12, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) demonstrated significantly greater improvements than CG, with no significant difference between the two intervention groups (&lt;i&gt;β&lt;/i&gt; = 0.00, &lt;i&gt;p&lt;/i&gt; = 0.968).For emotion regulation, both EG1 (&lt;i&gt;β&lt;/i&gt; = 3.38, &lt;i&gt;p&lt;/i&gt; = 0.002) and EG2 (&lt;i&gt;β&lt;/i&gt; = 2.71, &lt;i&gt;p&lt;/i&gt; = 0.014) improved significantly more than CG, whereas no significant difference was observed between EG1 and EG2 (&lt;i&gt;β&lt;/i&gt; = 0.66, &lt;i&gt;p&lt;/i&gt; = 0.507). Adherence and participant satisfaction did not differ significantly between EG1 and EG2 (both &lt;i&gt;p&lt;/i&gt; &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The intelligent exercise intervention appears to be an effective, scalable, and accessible non-pharmacological approach for improving hot executive functions in ","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"51439"},"PeriodicalIF":2.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional Profiles in Adolescents With ADHD: A Person-Centered Analysis of Emotion Regulation, Resilience, and Internalizing Symptoms.","authors":"Zeynep Seda Albayrak, Mahmoud Mahmoudi, Reyhan Zelal Parlak, Tuba Mutluer, Herdem Aslan Genç, Gülçin Kahraman, Şafak Eray Çamlı, Merve Köksal, Gökçe Koçak Çetin, Ali Evren Tufan, Hale Yapıcı Eser","doi":"10.31083/AP50136","DOIUrl":"10.31083/AP50136","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Emotion dysregulation and internalizing symptoms are increasingly recognized as central features of attention-deficit/hyperactivity disorder (ADHD), yet substantial emotional heterogeneity exists among affected adolescents. This study aimed to identify distinct emotional profiles in adolescents with ADHD by integrating emotion regulation difficulties, resilience, and internalizing symptoms using a person-centered, data-driven approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multicenter, cross-sectional study included 109 clinically referred adolescents aged 11-18 years with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis of ADHD. Adolescents completed self-report measures of emotion regulation difficulties (Difficulties in Emotion Regulation Scale-16; DERS-16), resilience (Connor-Davidson Resilience Scale; CD-RISC-25), and internalizing symptoms (Revised Child Anxiety and Depression Scale; RCADS). Parents completed parent-report measures of their child's ADHD symptom severity (Swanson, Nolan, and Pelham Rating Scale; SNAP-IV) and perceived competence, as well as self-report measures of their own emotion regulation difficulties and resilience. Clinicians rated global severity using the Clinical Global Impression-Severity scale (CGI-S). K-means clustering was applied to standardized adolescent emotional variables to identify distinct profiles, which were evaluated using internal validation indices and clinical correlates. Between-cluster comparisons were conducted across demographic, clinical, and psychosocial variables. Correlation and mediation analyses were performed to examine associations among resilience, emotion regulation difficulties, and internalizing symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four distinct emotional profiles were identified: (1) Low Emotion Dysregulation / High Resilience / Low Internalizing, (2) Moderate Emotion Dysregulation / Moderate Resilience / Moderate Internalizing, (3) Low-to-Moderate Emotion Dysregulation / Low Resilience / Low-to-Moderate Internalizing (descriptively labeled as \"Low-resilience silent\" profile), and (4) High Emotion Dysregulation / Low Resilience / High Internalizing. Emotional profiles differed significantly in emotion regulation difficulties, resilience, and internalizing symptom severity (all &lt;i&gt;p&lt;/i&gt; &lt; 0.001), but not in parent-reported ADHD symptom dimensions or clinician-rated severity. Perceived social competence, gender distribution, internalizing comorbidity, and medication patterns varied across profiles, whereas parental emotion regulation difficulties and resilience did not. Emotion regulation difficulties showed a significant indirect effect in the association between resilience and internalizing symptoms, such that lower resilience was associated with greater emotion regulation difficulties, which in turn were associated with higher internalizing symptom severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Adolescents ","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"50136"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Intranasal Oxytocin on Social Interaction in Adults and Children With Autism Spectrum Disorders: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Gengjing Fang, Wuyuan Pan, Guokai Li, Le Ma, Jinbao Wei","doi":"10.31083/AP45322","DOIUrl":"10.31083/AP45322","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by marked heterogeneity in cognitive, behavioral, and social functioning. Although oxytocin has been extensively investigated as a potential therapeutic agent for ASD, evidence regarding its clinical efficacy remains inconsistent and inconclusive. This systematic review and meta-analysis aimed to evaluate the therapeutic efficacy of intranasal oxytocin in improving core behavioral and social symptoms in individuals diagnosed with ASD by synthesizing evidence from randomized controlled trials.</p><p><strong>Methods: </strong>A systematic search of PubMed, Web of Science, and the Cochrane Library was conducted to identify peer-reviewed studies published up to February 16, 2025. Two independent reviewers performed study screening, data extraction, and critical appraisal of methodological quality and strength of evidence. Autism-related behavioral symptom scores were used as outcome measures. Meta-analyses were conducted using random-effects models.</p><p><strong>Results: </strong>Twelve randomized controlled trials encompassing a total of 733 participants met the inclusion criteria. Pooled results from the random-effects model indicated no statistically significant effect of oxytocin on social functioning outcomes (standardized mean difference [SMD] = -0.05, 95% confidence interval [CI]: -0.20 to 0.10; <i>p</i> = 0.54). Between-study heterogeneity was low (I² = 4%; τ² = 0.00). Exploratory subgroup analyses showed no significant differences across pre-specified moderators (all <i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>The current body of evidence does not support a significant therapeutic effect of intranasal oxytocin on core behavioral symptoms in individuals with ASD. However, methodological limitations of the existing literature-including small sample sizes and heterogeneity in study design-limit the strength of conclusions that can be drawn regarding its potential clinical utility.</p><p><strong>Registration: </strong>The study has been registered on https://www.crd.york.ac.uk/prospero/ (registration number: CRD42024500088; registration link: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024500088).</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 4","pages":"45322"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}