{"title":"Sleep quality mediates the association between chronotype and mental health in young Indian adults","authors":"Satyam Chauhan, Rakesh Pandey, Krupa Vakani, Ray Norbury, Ulrich Ettinger, Veena Kumari","doi":"10.1038/s44184-024-00076-9","DOIUrl":"10.1038/s44184-024-00076-9","url":null,"abstract":"There is increasing recognition of ‘higher preference for eveningness’ as a potential independent risk factor for poor mental health. To examine the chronotype-mental health relationship while also quantifying the potential roles of poor sleep quality, relevant personality traits, and childhood trauma, we assessed 282 young adults (18–40 years; 195 females) residing in North India, between January and March 2023 (to control for seasonal variation), using self-report measures of diurnal preference, sleep patterns, mental health (depression, anxiety, and stress), personality traits (extraversion, neuroticism, schizotypy, and impulsivity), and childhood trauma. The results showed a significant association between eveningness and poor mental health but this association was fully mediated by poor sleep quality. Neuroticism, emotional abuse and cognitive disorganisation were correlated with eveningness as well as with poor mental health and sleep quality. Neuroticism and emotional abuse, but not cognitive disorganisation, also had indirect effects on mental health via sleep quality. Our findings highlight the crucial role played by sleep quality in the chronotype-mental health relationship.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00076-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447727","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}
Caitlin A. Stamatis, Deborah N. Farlow, Catherine Mercaldi, Minny Suh, Amanda Maple, Antonia Savarese, Ann Childress, Raun D. Melmed, Scott H. Kollins
{"title":"Two single arm trials of AKL-T01, a digital therapeutic for adolescents and adults with ADHD","authors":"Caitlin A. Stamatis, Deborah N. Farlow, Catherine Mercaldi, Minny Suh, Amanda Maple, Antonia Savarese, Ann Childress, Raun D. Melmed, Scott H. Kollins","doi":"10.1038/s44184-024-00075-w","DOIUrl":"10.1038/s44184-024-00075-w","url":null,"abstract":"Inattention symptoms represent a key driver of functional impairment in ADHD and often persist into adolescence and adulthood, underscoring a need for novel treatments targeting attentional control. We evaluated AKL-T01—a digital therapeutic that is FDA-cleared for children 8–12 y with ADHD—in adolescents and adults with ADHD in two independent single-arm trials: STARS-ADHD-Adolescent, a 4-week trial in adolescents 13–17 y (n = 162 enrolled), and STARS-ADHD-Adult, a 6-week trial in adults 18 and older (n = 221 enrolled). AKL-T01 was linked with improvements on the Test of Variables of Attention (TOVA®) Attention Comparison Score (ACS) of 2.6 (95% CI: 2.02, 3.26; p < 0.0001) in adolescents and 6.5 in adults (95% CI: 5.35, 7.57; p < 0.0001), along with improvements in secondary endpoints. 15 participants reported adverse device effects, all mild or moderate. Though limited by a single-arm design, results provide preliminary support for the safety and efficacy of AKL-T01 for adolescents and adults with ADHD.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428417","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}
Sumra Bari, Byoung-Woo Kim, Nicole L. Vike, Shamal Lalvani, Leandros Stefanopoulos, Nicos Maglaveras, Martin Block, Jeffrey Strawn, Aggelos K. Katsaggelos, Hans C. Breiter
{"title":"A novel approach to anxiety level prediction using small sets of judgment and survey variables","authors":"Sumra Bari, Byoung-Woo Kim, Nicole L. Vike, Shamal Lalvani, Leandros Stefanopoulos, Nicos Maglaveras, Martin Block, Jeffrey Strawn, Aggelos K. Katsaggelos, Hans C. Breiter","doi":"10.1038/s44184-024-00074-x","DOIUrl":"10.1038/s44184-024-00074-x","url":null,"abstract":"Anxiety, a condition characterized by intense fear and persistent worry, affects millions each year and, when severe, is distressing and functionally impairing. Numerous machine learning frameworks have been developed and tested to predict features of anxiety and anxiety traits. This study extended these approaches by using a small set of interpretable judgment variables (n = 15) and contextual variables (demographics, perceived loneliness, COVID-19 history) to (1) understand the relationships between these variables and (2) develop a framework to predict anxiety levels [derived from the State Trait Anxiety Inventory (STAI)]. This set of 15 judgment variables, including loss aversion and risk aversion, models biases in reward/aversion judgments extracted from an unsupervised, short (2–3 min) picture rating task (using the International Affective Picture System) that can be completed on a smartphone. The study cohort consisted of 3476 de-identified adult participants from across the United States who were recruited using an email survey database. Using a balanced Random Forest approach with these judgment and contextual variables, STAI-derived anxiety levels were predicted with up to 81% accuracy and 0.71 AUC ROC. Normalized Gini scores showed that the most important predictors (age, loneliness, household income, employment status) contributed a total of 29–31% of the cumulative relative importance and up to 61% was contributed by judgment variables. Mediation/moderation statistics revealed that the interactions between judgment and contextual variables appears to be important for accurately predicting anxiety levels. Median shifts in judgment variables described a behavioral profile for individuals with higher anxiety levels that was characterized by less resilience, more avoidance, and more indifference behavior. This study supports the hypothesis that distinct constellations of 15 interpretable judgment variables, along with contextual variables, could yield an efficient and highly scalable system for mental health assessment. These results contribute to our understanding of underlying psychological processes that are necessary to characterize what causes variance in anxiety conditions and its behaviors, which can impact treatment development and efficacy.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422124","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":"Advancing mental health parity to ensure children’s access to care","authors":"Nathaniel Z. Counts, Ashwin Vasan","doi":"10.1038/s44184-024-00070-1","DOIUrl":"10.1038/s44184-024-00070-1","url":null,"abstract":"Mental health and substance use parity provides a rhetorical device and policy strategy for achieving more equitable financing of mental health and substance use services, which the U.S. has pursued as a lead policy approach for improving access to mental healthcare. Parity implementation in the U.S. has improved access to care for children, but implementation challenges remain, leading to persistent treatment gaps and disparities, workforce shortages, and variable care quality. In the U.S., a recent policy change required health insurers to make available all of the data on their coverage and reimbursement practices for all health conditions. This new data enables a more detailed conceptualization of what parity means in children’s mental health and how it should be implemented and overseen. Researchers, clinicians, and advocates across the globe can use this data to build the case and the policy approach for parity, supporting more equitable financing of children’s mental health and substance use care and promoting families’ access to evidence-based care.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00070-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141315523","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}
Aada Ståhl, Milla Salonen, Emma Hakanen, Salla Mikkola, Sini Sulkama, Jari Lahti, Hannes Lohi
{"title":"Development and validation of the puppy blues scale measuring temporary affective disturbance resembling baby blues","authors":"Aada Ståhl, Milla Salonen, Emma Hakanen, Salla Mikkola, Sini Sulkama, Jari Lahti, Hannes Lohi","doi":"10.1038/s44184-024-00072-z","DOIUrl":"10.1038/s44184-024-00072-z","url":null,"abstract":"It has been described that many puppy owners experience a state called puppy blues involving stress, worry, anxiety, strain, frustration, or regret. While puppy blues is a commonly used term among dog owners, the term is nearly nonexistent in scientific literature. In turn, analogous phenomenon, postpartum affective disturbance of infant caregivers, is well described in the literature. This study aimed to develop and validate the first questionnaire to evaluate puppy blues. The methodology involved generating scale items based on a qualitative review of 135 pilot survey responses from people who had experienced distress during the puppy period, conducting exploratory factor analysis for the final scale items from a dataset of 1801 answers from Finnish dog owners (92% women), and collecting test-retest data from 265 individuals to assess the consistency of the measurement of items and factor structure across time. In addition, we collected an independent sample of 326 owners of 1–2-year-old dogs who answered the survey both regarding puppy period and current moment. The results indicate that the scale is a valid and reliable tool for measuring dog owners’ negative experiences and feelings related to puppyhood. We discovered three factors that describe different aspects of puppy blues: Frustration, Anxiety, and Weariness, which accounted for a significant proportion of the variance in puppy blues. The study demonstrated good internal consistency and consistency across two independent samples for the three identified factors. The test-retest reliability of the factors was good. Responses for the current timeframe compared to puppyhood experiences revealed significantly lower current scores across all factors for the current period, validating that the scale captures distress during puppyhood that diminishes over time. Interestingly, we found a fading affect bias where recollections of the experiences in the puppy period became more positive with time. Our findings shed light on the characteristics of puppy blues and provide a useful retrospective tool for measuring it.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00072-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287018","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":"Behavioral health and generative AI: a perspective on future of therapies and patient care","authors":"Emre Sezgin, Ian McKay","doi":"10.1038/s44184-024-00067-w","DOIUrl":"10.1038/s44184-024-00067-w","url":null,"abstract":"There have been considerable advancements in artificial intelligence (AI), specifically with generative AI (GAI) models. GAI is a class of algorithms designed to create new data, such as text, images, and audio, that resembles the data on which they have been trained. These models have been recently investigated in medicine, yet the opportunity and utility of GAI in behavioral health are relatively underexplored. In this commentary, we explore the potential uses of GAI in the field of behavioral health, specifically focusing on image generation. We propose the application of GAI for creating personalized and contextually relevant therapeutic interventions and emphasize the need to integrate human feedback into the AI-assisted therapeutics and decision-making process. We report the use of GAI with a case study of behavioral therapy on emotional recognition and management with a three-step process. We illustrate image generation-specific GAI to recognize, express, and manage emotions, featuring personalized content and interactive experiences. Furthermore, we highlighted limitations, challenges, and considerations, including the elements of human emotions, the need for human-AI collaboration, transparency and accountability, potential bias, security, privacy and ethical issues, and operational considerations. Our commentary serves as a guide for practitioners and developers to envision the future of behavioral therapies and consider the benefits and limitations of GAI in improving behavioral health practices and patient outcomes.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00067-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287024","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}
Mathew Varidel, Ian B. Hickie, Ante Prodan, Adam Skinner, Roman Marchant, Sally Cripps, Rafael Oliveria, Min K. Chong, Elizabeth Scott, Jan Scott, Frank Iorfino
{"title":"Dynamic learning of individual-level suicidal ideation trajectories to enhance mental health care","authors":"Mathew Varidel, Ian B. Hickie, Ante Prodan, Adam Skinner, Roman Marchant, Sally Cripps, Rafael Oliveria, Min K. Chong, Elizabeth Scott, Jan Scott, Frank Iorfino","doi":"10.1038/s44184-024-00071-0","DOIUrl":"10.1038/s44184-024-00071-0","url":null,"abstract":"There has recently been an increase in ongoing patient-report routine outcome monitoring for individuals within clinical care, which has corresponded to increased longitudinal information about an individual. However, many models that are aimed at clinical practice have difficulty fully incorporating this information. This is in part due to the difficulty in dealing with the irregularly time-spaced observations that are common in clinical data. Consequently, we built individual-level continuous-time trajectory models of suicidal ideation for a clinical population (N = 585) with data collected via a digital platform. We demonstrate how such models predict an individual’s level and variability of future suicide ideation, with implications for the frequency that individuals may need to be observed. These individual-level predictions provide a more personalised understanding than other predictive methods and have implications for enhanced measurement-based care.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00071-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287022","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}
Benjamin Selaskowski, Annika Wiebe, Kyra Kannen, Laura Asché, Julian Pakos, Alexandra Philipsen, Niclas Braun
{"title":"Clinical adoption of virtual reality in mental health is challenged by lack of high-quality research","authors":"Benjamin Selaskowski, Annika Wiebe, Kyra Kannen, Laura Asché, Julian Pakos, Alexandra Philipsen, Niclas Braun","doi":"10.1038/s44184-024-00069-8","DOIUrl":"10.1038/s44184-024-00069-8","url":null,"abstract":"Virtual reality has been found effective for some mental disorders, while for many others weak methodology prevents conclusive evidence. Similar to other digital technologies, the field has particular demands for conducting clinical research which currently remain poorly addressed. In this commentary, we discuss the unique issues associated with the incorporation of virtual reality in clinical research. In addition, we elaborate on the possibility that these challenges may also be consequences of current funding and publication schemes, and speculate on specific improvement approaches that might be more compatible with the characteristics of clinical virtual reality research.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00069-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140949333","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}
Jakob Mechler, Karin Lindqvist, Kristoffer Magnusson, Adrián Ringström, Johan Daun Krafman, Pär Alvinzi, Love Kassius, Josefine Sowa, Gerhard Andersson, Per Carlbring
{"title":"Guided and unguided internet-delivered psychodynamic therapy for social anxiety disorder: A randomized controlled trial","authors":"Jakob Mechler, Karin Lindqvist, Kristoffer Magnusson, Adrián Ringström, Johan Daun Krafman, Pär Alvinzi, Love Kassius, Josefine Sowa, Gerhard Andersson, Per Carlbring","doi":"10.1038/s44184-024-00063-0","DOIUrl":"10.1038/s44184-024-00063-0","url":null,"abstract":"Social Anxiety Disorder (SAD) is highly prevalent and debilitating disorder. Treatments exist but are not accessible and/or helpful for all patients, indicating a need for accessible treatment alternatives. The aim of the present trial was to evaluate internet-delivered psychodynamic therapy (IPDT) with and without therapist guidance, compared to a waitlist control condition, in the treatment of adults with SAD. In this randomized, clinical trial, we tested whether IPDT was superior to a waitlist control, and whether IPDT with therapeutic guidance was superior to unguided IPDT. Participants were recruited nationwide in Sweden. Eligible participants were ≥ 18 years old and scoring ≥ 60 on the Liebowitz Social Anxiety Scale self-report (LSAS-SR) whilst not fulfilling any of the exclusion criteria. Included participants were randomly assigned to IPDT with guidance (n = 60), IPDT without guidance (n = 61), or waitlist (n = 60). The IPDT intervention comprised eight self-help modules based on affect-focused dynamic therapy, delivered over 8 weeks on a secure online platform. The primary outcome was SAD symptoms severity measured weekly by the LSAS-SR. Primary analyses were calculated on an intention-to-treat sample including all participants randomly assigned. Secondary outcomes were depressive symptoms, generalized anxiety, quality of life, emotion regulation and defensive functioning. At post-treatment, both active treatments were superior to the waitlist condition with guided treatment exhibiting larger between group effects than unguided treatment (d = 1.07 95% CI [0.72, 1.43], p < .001 and d = 0.61, 95% CI [0.25, 0.98], p = .0018) on the LSAS-SR respectively. Guided IPDT lead to larger improvements than unguided IPDT (d = 0.46, 95% CI [0.11, 0.80], p < .01). At post-treatment, guided IPDT was superior to waitlist on all secondary outcome measures. Unguided IPDT was superior to waitlist on depressive symptoms and general anxiety, but not on emotion regulation, self-compassion or quality of life. Guided IPDT was superior to unguided PDT on depressive symptoms, with a trend towards superiority on a measure of generalized anxiety. At six and twelve month follow-up there were no significant differences between guided and unguided IPDT. In conclusion, IPDT shows promising effects in the treatment of SAD, with larger benefits from guided IPDT compared to non-guided, at least at post-treatment. This finding increases the range of accessible and effective treatment alternatives for adults suffering from SAD. The study was prospectively registered at ClinicalTrials (NCT05015166).","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00063-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902816","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}
J. M. Armitage, R. E. Wootton, O. S. P. Davis, C. M. A. Haworth
{"title":"An exploration into the causal relationships between educational attainment, intelligence, and wellbeing: an observational and two-sample Mendelian randomisation study","authors":"J. M. Armitage, R. E. Wootton, O. S. P. Davis, C. M. A. Haworth","doi":"10.1038/s44184-024-00066-x","DOIUrl":"10.1038/s44184-024-00066-x","url":null,"abstract":"Educational attainment is associated with a range of positive outcomes, yet its impact on wellbeing is unclear, and complicated by high correlations with intelligence. We use genetic and observational data to investigate for the first time, whether educational attainment and intelligence are causally and independently related to wellbeing. Results from our multivariable Mendelian randomisation demonstrated a positive causal impact of a genetic predisposition to higher educational attainment on wellbeing that remained after accounting for intelligence, and a negative impact of intelligence that was independent of educational attainment. Observational analyses suggested that these associations may be subject to sex differences, with benefits to wellbeing greater for females who attend higher education compared to males. For intelligence, males scoring more highly on measures related to happiness were those with lower intelligence. Our findings demonstrate a unique benefit for wellbeing of staying in school, over and above improving cognitive abilities, with benefits likely to be greater for females compared to males.","PeriodicalId":74321,"journal":{"name":"Npj mental health research","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44184-024-00066-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900496","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}