Pub Date : 2025-11-16DOI: 10.1016/j.comppsych.2025.152646
Marta Błoch, Błażej Misiak
Background
Loneliness is a public health priority due to its high prevalence and impact on various health outcomes. It might be associated with problematic internet use that is highly prevalent in young adults. However, its associations with specific problematic online behaviours (POBs) at their early stages of development remains unknown. The present study explored longitudinal associations between loneliness and various POBs in a general population sample of young adults without a history of psychiatric treatment.
Methods
Altogether, 1441 individuals were assessed at baseline (aged 29.5 ± 6.3 years, 51.4 % women). The follow-up assessment was scheduled after 6 months and was completed by 733 individuals (aged 30.5 ± 6.0 years, 49.1 % women, retention rate of 50.9 %). The data were collected using self-reports and analyzed using a cross-lagged panel network model.
Results
Higher baseline levels of loneliness predicted higher levels of problematic cybersex, depressive symptoms, and anxiety symptoms at the follow-up. In turn, higher levels of loneliness were predicted by higher baseline levels of problematic online gaming, cyberchondria, and depressive symptoms. The highest output centrality was found for problematic online gaming and shopping. Loneliness was ranked among the nodes with the lowest output centrality in the network. However, it showed the highest auto-regressive effect suggesting its high stability over time.
Conclusions
The findings indicate that loneliness is bidirectionally associated with POBs with problematic online gaming, cyberchondria, and cybersex playing the most important roles in these associations. These observations indicate the necessity to consider loneliness among therapeutic targets among individuals with POBs.
{"title":"Loneliness and the emergence of problematic online behaviours in young adults: A cross-lagged panel network analysis","authors":"Marta Błoch, Błażej Misiak","doi":"10.1016/j.comppsych.2025.152646","DOIUrl":"10.1016/j.comppsych.2025.152646","url":null,"abstract":"<div><h3>Background</h3><div>Loneliness is a public health priority due to its high prevalence and impact on various health outcomes. It might be associated with problematic internet use that is highly prevalent in young adults. However, its associations with specific problematic online behaviours (POBs) at their early stages of development remains unknown. The present study explored longitudinal associations between loneliness and various POBs in a general population sample of young adults without a history of psychiatric treatment.</div></div><div><h3>Methods</h3><div>Altogether, 1441 individuals were assessed at baseline (aged 29.5 ± 6.3 years, 51.4 % women). The follow-up assessment was scheduled after 6 months and was completed by 733 individuals (aged 30.5 ± 6.0 years, 49.1 % women, retention rate of 50.9 %). The data were collected using self-reports and analyzed using a cross-lagged panel network model.</div></div><div><h3>Results</h3><div>Higher baseline levels of loneliness predicted higher levels of problematic cybersex, depressive symptoms, and anxiety symptoms at the follow-up. In turn, higher levels of loneliness were predicted by higher baseline levels of problematic online gaming, cyberchondria, and depressive symptoms. The highest output centrality was found for problematic online gaming and shopping. Loneliness was ranked among the nodes with the lowest output centrality in the network. However, it showed the highest auto-regressive effect suggesting its high stability over time.</div></div><div><h3>Conclusions</h3><div>The findings indicate that loneliness is bidirectionally associated with POBs with problematic online gaming, cyberchondria, and cybersex playing the most important roles in these associations. These observations indicate the necessity to consider loneliness among therapeutic targets among individuals with POBs.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152646"},"PeriodicalIF":4.2,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573395","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}
Pub Date : 2025-11-16DOI: 10.1016/j.comppsych.2025.152647
Jon E. Grant , Megha Neelapu , Laurie Avila , Sophia Boutouis , Samuel R. Chamberlain
Background
Trichotillomania (hair pulling disorder) and skin picking disorder have typical age of onset around puberty, and appear more common in women than in men, suggesting the possibility that hormonal systems may relate to symptoms. Yet virtually no research has explored relationships between pregnancy (and the post-partum period) and symptom severity in people affected by these conditions.
Methods
People with trichotillomania and/or skin picking disorder were recruited from the general community if they had previously experienced at least one pregnancy during their lifetimes. Data were collected regarding perceived relationships between symptom severity, pregnancy, and the post-partum period.
Results
Whilst some women reported an exacerbation of hair pulling and/or skin picking during pregnancy or in the perinatal period, the majority of women reported no change or even reductions in such symptoms during these times.
Conclusions
These data suggest that relationships between pregnancy and hair pulling plus skin picking symptoms can vary depending on the individual. Future work could examine these relationships at the time of pregnancy and afterwards, rather than using retrospective questionnaires; and could also collect biological measures to help explore any underlying mechanisms that may account for this variation in symptoms.
{"title":"Trichotillomania, skin picking disorder, and pregnancy","authors":"Jon E. Grant , Megha Neelapu , Laurie Avila , Sophia Boutouis , Samuel R. Chamberlain","doi":"10.1016/j.comppsych.2025.152647","DOIUrl":"10.1016/j.comppsych.2025.152647","url":null,"abstract":"<div><h3>Background</h3><div>Trichotillomania (hair pulling disorder) and skin picking disorder have typical age of onset around puberty, and appear more common in women than in men, suggesting the possibility that hormonal systems may relate to symptoms. Yet virtually no research has explored relationships between pregnancy (and the post-partum period) and symptom severity in people affected by these conditions.</div></div><div><h3>Methods</h3><div>People with trichotillomania and/or skin picking disorder were recruited from the general community if they had previously experienced at least one pregnancy during their lifetimes. Data were collected regarding perceived relationships between symptom severity, pregnancy, and the post-partum period.</div></div><div><h3>Results</h3><div>Whilst some women reported an exacerbation of hair pulling and/or skin picking during pregnancy or in the perinatal period, the majority of women reported no change or even reductions in such symptoms during these times.</div></div><div><h3>Conclusions</h3><div>These data suggest that relationships between pregnancy and hair pulling plus skin picking symptoms can vary depending on the individual. Future work could examine these relationships at the time of pregnancy and afterwards, rather than using retrospective questionnaires; and could also collect biological measures to help explore any underlying mechanisms that may account for this variation in symptoms.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152647"},"PeriodicalIF":4.2,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548623","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}
Pub Date : 2025-11-16DOI: 10.1016/j.comppsych.2025.152648
Shiau-Shian Huang , Ying-Ting Chao , Yu-Ning Chen , Mei-Hsin Su , Chiao-Erh Chang , Shih-Jen Tsai , Po-Hsiu Kuo
Introduction
Antidepressant-induced mania (AIM) is a significant clinical concern, primarily studied in bipolar disorder patients. Limited research exists on AIM in unipolar depression, with reported incidence rates of 3.0–8.2 %.
Methods
Using data from the Taiwan's National Health Insurance Research Database merged with Taiwan Biobank (2001–2017), we analyzed 772 depression patients who were prescribed antidepressants and had available genotype data. A genome-wide association study (GWAS) was performed to investigate potential genetic factors associated with AIM. Single-marker association analysis and polygenic risk scores were calculated using PLINK.
Results
AIM developed in 145 (19.65 %) of depressive patients within 28 days of medication use or discontinuation. Significant associated clinical characteristics included female gender, postpartum depression, comorbid obsessive-compulsive disorder, severe depression, substance use disorders, and other non-organic psychosis. Eight single nucleotide polymorphisms were identified as potential genetic markers associated with AIM in this GWAS, and higher polygenic risk scores for bipolar disorder were associated with increased AIM risk.
Conclusion
AIM was observed in one-fifth of depressive patients of the Han Chinese origin, with female gender and psychiatric comorbidities as significant clinical characteristics. This GWAS of AIM in depressive patients identified potential genetic markers and suggested that a genetic predisposition to bipolar disorder may increase the likelihood of developing AIM, although this association did not reach statistical significance. Future research should aim to increase sample size and further investigate genotype-AIM associations.
{"title":"Genetic and clinical characteristics associated with antidepressant-induced mania in depression patients","authors":"Shiau-Shian Huang , Ying-Ting Chao , Yu-Ning Chen , Mei-Hsin Su , Chiao-Erh Chang , Shih-Jen Tsai , Po-Hsiu Kuo","doi":"10.1016/j.comppsych.2025.152648","DOIUrl":"10.1016/j.comppsych.2025.152648","url":null,"abstract":"<div><h3>Introduction</h3><div>Antidepressant-induced mania (AIM) is a significant clinical concern, primarily studied in bipolar disorder patients. Limited research exists on AIM in unipolar depression, with reported incidence rates of 3.0–8.2 %.</div></div><div><h3>Methods</h3><div>Using data from the Taiwan's National Health Insurance Research Database merged with Taiwan Biobank (2001–2017), we analyzed 772 depression patients who were prescribed antidepressants and had available genotype data. A genome-wide association study (GWAS) was performed to investigate potential genetic factors associated with AIM. Single-marker association analysis and polygenic risk scores were calculated using PLINK.</div></div><div><h3>Results</h3><div>AIM developed in 145 (19.65 %) of depressive patients within 28 days of medication use or discontinuation. Significant associated clinical characteristics included female gender, postpartum depression, comorbid obsessive-compulsive disorder, severe depression, substance use disorders, and other non-organic psychosis. Eight single nucleotide polymorphisms were identified as potential genetic markers associated with AIM in this GWAS, and higher polygenic risk scores for bipolar disorder were associated with increased AIM risk.</div></div><div><h3>Conclusion</h3><div>AIM was observed in one-fifth of depressive patients of the Han Chinese origin, with female gender and psychiatric comorbidities as significant clinical characteristics. This GWAS of AIM in depressive patients identified potential genetic markers and suggested that a genetic predisposition to bipolar disorder may increase the likelihood of developing AIM, although this association did not reach statistical significance. Future research should aim to increase sample size and further investigate genotype-AIM associations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152648"},"PeriodicalIF":4.2,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577144","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}
Depressive symptoms are prevalent among young adults, with cognitive theories suggesting that impaired cognitive control contributes to sustained negative mood and depressive symptoms. This study investigated the feasibility and efficacy of a remotely-applied, tablet-based cognitive control video game, Legends of Hoa'manu (LoH), for reducing depressive symptoms in subclinical adults.
A randomized controlled trial (NCT05447091) was conducted with 173 participants (mean age 33 ± 11.6 years; 75.1 % female) exhibiting at least a minimal level of depressive symptoms (PHQ-8 ≥ 5). Participants were randomized into three groups: high-dose experimental game (HD_EG; N = 58), low-dose experimental game (LD_EG; N = 61), and high-dose control game (HD_CG; N = 54), with interventions spanning three weeks.
The intervention demonstrated high feasibility and adherence (69.5–76.5 % of sessions completed) without direct study contact. Overall depressive symptoms (BDI-II total score) improved across all groups, with a significant main effect of time, but no significant group differences. Still, group differences were found for the cognitive-affective BDI-II subscale, where the HD_EG group showed the largest reduction (4.5 points vs. 2.3 and 2.1 in the LD_EG and HD_CG, respectively). These improvements were maintained at 3-week and 3-month follow-ups. Secondary outcomes, including anxiety and rumination, also improved across all groups. Overall cognitive control performance did not differ between groups; however, significant improvements in inhibitory control emerged exclusively in the HD_EG group.
The results highlight the feasibility of this novel, cost-effective, and remotely-applied cognitive control-based intervention. These findings underscore the potential of LoH as a scalable solution for addressing depressive symptoms in subclinical populations.
抑郁症状在年轻人中很普遍，认知理论表明认知控制受损会导致持续的负面情绪和抑郁症状。本研究调查了远程应用、基于平板电脑的认知控制视频游戏《Hoa’manu Legends》（LoH）减轻亚临床成人抑郁症状的可行性和有效性。一项随机对照试验（NCT05447091）对173名参与者（平均年龄33±11.6岁；75.1%为女性）进行了研究，这些参与者至少表现出最低程度的抑郁症状（PHQ-8≥5）。参与者被随机分为三组：高剂量实验游戏（HD_EG, N = 58）、低剂量实验游戏（LD_EG, N = 61）和高剂量控制游戏（HD_CG, N = 54），干预时间为三周。在没有直接研究接触的情况下，干预显示出很高的可行性和依从性（69.5- 76.5%的疗程完成）。总体抑郁症状（BDI-II总分）在所有组间均有改善，主要受时间影响，但组间无显著差异。然而，在认知情感BDI-II子量表上发现了组间差异，其中HD_EG组表现出最大的下降（4.5分，LD_EG和HD_CG分别为2.3和2.1分）。这些改善在3周和3个月的随访中保持不变。包括焦虑和反刍在内的次要结果在所有组中也有所改善。整体认知控制表现在两组之间没有差异；然而，抑制控制的显著改善仅出现在HD_EG组。结果强调了这种新颖、经济、远程应用的基于认知控制的干预措施的可行性。这些发现强调了LoH作为解决亚临床人群抑郁症状的可扩展解决方案的潜力。
{"title":"A remotely-applied, cognitive control-based video game intervention to reduce depressive symptoms in a sub-clinical population: A randomized controlled trial (RCT)","authors":"Noa Givon Schacham , Angela Pasqualotto , Naamah Lerner , Marios Fanourakis , Zeno Menestrina , Daphne Bavelier , Mor Nahum","doi":"10.1016/j.comppsych.2025.152645","DOIUrl":"10.1016/j.comppsych.2025.152645","url":null,"abstract":"<div><div>Depressive symptoms are prevalent among young adults, with cognitive theories suggesting that impaired cognitive control contributes to sustained negative mood and depressive symptoms. This study investigated the feasibility and efficacy of a remotely-applied, tablet-based cognitive control video game, <em>Legends of Hoa'manu</em> (LoH), for reducing depressive symptoms in subclinical adults.</div><div>A randomized controlled trial (<span><span>NCT05447091</span><svg><path></path></svg></span>) was conducted with 173 participants (mean age 33 ± 11.6 years; 75.1 % female) exhibiting at least a minimal level of depressive symptoms (PHQ-8 ≥ 5). Participants were randomized into three groups: high-dose experimental game (HD_EG; <em>N</em> = 58), low-dose experimental game (LD_EG; <em>N</em> = 61), and high-dose control game (HD_CG; <em>N</em> = 54), with interventions spanning three weeks.</div><div>The intervention demonstrated high feasibility and adherence (69.5–76.5 % of sessions completed) without direct study contact. Overall depressive symptoms (BDI-II total score) improved across all groups, with a significant main effect of time, but no significant group differences. Still, group differences were found for the cognitive-affective BDI-II subscale, where the HD_EG group showed the largest reduction (4.5 points vs. 2.3 and 2.1 in the LD_EG and HD_CG, respectively). These improvements were maintained at 3-week and 3-month follow-ups. Secondary outcomes, including anxiety and rumination, also improved across all groups. Overall cognitive control performance did not differ between groups; however, significant improvements in inhibitory control emerged exclusively in the HD_EG group.</div><div>The results highlight the feasibility of this novel, cost-effective, and remotely-applied cognitive control-based intervention. These findings underscore the potential of LoH as a scalable solution for addressing depressive symptoms in subclinical populations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152645"},"PeriodicalIF":4.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444367","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}
Pub Date : 2025-10-30DOI: 10.1016/j.comppsych.2025.152644
Tegan Cruwys , Olivia Evans , Michael J. Platow , Iain Walker , Katherine J. Reynolds , Christienne Javier , Catherine Haslam , S. Alexander Haslam , Hema Preya Selvanathan
Background
There has been a tendency for the academic literature, media, and practitioners to attribute prejudice — particularly extreme beliefs and the violence they can engender — to mental ill-health. Meta-analyses have found relationships (albeit weak) among these variables, but they rely primarily on correlational evidence. The reverse pathway, from holding prejudice to mental ill-health, has rarely been considered. Moreover, a third, unexplored, variable might cause both. To address these gaps, we investigate reciprocal relationships between holding racist beliefs – one form of prejudice – and mental ill-health over time. We further consider the possible operation of a third variable: social connectedness (or lack thereof, in the form of ostracism, alienation, etc).
Methods
The bidirectional link between racism and mental ill-health (operationalised as psychological distress) was assessed in three longitudinal Australian studies, each with over 2000 participants and three timepoints spanning approximately six months.
Results
The cross-sectional associations between racism and psychological distress were small and unreliable. However, longitudinally, an increase in racist beliefs consistently preceded and predicted increased psychological distress. Social connectedness strongly predicted less racism and less psychological distress.
Conclusions
These findings suggest that people who hold prejudiced beliefs are at increased risk of psychological distress over time. This challenges common claims that it is mental ill-health that leads to prejudiced beliefs. Implications are discussed with an emphasis on the potentially undervalued contribution of positive social connection as a counterforce to both prejudice and mental ill-health.
{"title":"What goes around comes around? Holding racist attitudes predicts increased psychological distress over time","authors":"Tegan Cruwys , Olivia Evans , Michael J. Platow , Iain Walker , Katherine J. Reynolds , Christienne Javier , Catherine Haslam , S. Alexander Haslam , Hema Preya Selvanathan","doi":"10.1016/j.comppsych.2025.152644","DOIUrl":"10.1016/j.comppsych.2025.152644","url":null,"abstract":"<div><h3>Background</h3><div>There has been a tendency for the academic literature, media, and practitioners to attribute prejudice — particularly extreme beliefs and the violence they can engender — to mental ill-health. Meta-analyses have found relationships (albeit weak) among these variables, but they rely primarily on correlational evidence. The reverse pathway, from holding prejudice to mental ill-health, has rarely been considered. Moreover, a third, unexplored, variable might cause both. To address these gaps, we investigate reciprocal relationships between holding racist beliefs – one form of prejudice – and mental ill-health over time. We further consider the possible operation of a third variable: social connectedness (or lack thereof, in the form of ostracism, alienation, etc).</div></div><div><h3>Methods</h3><div>The bidirectional link between racism and mental ill-health (operationalised as psychological distress) was assessed in three longitudinal Australian studies, each with over 2000 participants and three timepoints spanning approximately six months.</div></div><div><h3>Results</h3><div>The cross-sectional associations between racism and psychological distress were small and unreliable. However, longitudinally, an increase in racist beliefs consistently preceded and predicted increased psychological distress. Social connectedness strongly predicted less racism and less psychological distress.</div></div><div><h3>Conclusions</h3><div>These findings suggest that people who hold prejudiced beliefs are at increased risk of psychological distress over time. This challenges common claims that it is mental ill-health that leads to prejudiced beliefs. Implications are discussed with an emphasis on the potentially undervalued contribution of positive social connection as a counterforce to both prejudice and mental ill-health.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152644"},"PeriodicalIF":4.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444334","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}
Pub Date : 2025-10-24DOI: 10.1016/j.comppsych.2025.152643
Joy C. MacDermid , Shannon C. Killip , Amanda Brazil , Margaret Lomotan , Steve Fraser , Dianne Bryant , Heidi Cramm , R. Nicholas Carleton
Purpose
The study was designed to assess the adaptation, implementation, and delivery of the Resilient Minds program for volunteer firefighters in Prince Edward Island.
Methods
A concurrent triangulation mixed-methods approach was used. Survey data were collected from firefighters who participated in the training, and semi-structured interviews were performed with peer trainers, members of leadership, and firefighters who participated in the implementation. Summary statistics were performed to summarize the survey data, and thematic analysis was performed to analyze the qualitative data following interpretive description methods. We followed the Consolidated Framework for Implementation Research to guide our data collection and analyses.
Results
The relative advantage of Resilient Minds (i.e., created for firefighters) and the high-priority need for mental health training promoted buy-in from stakeholders and facilitated program implementation. Most participants described the training as helpful (84 %), and reported high intention to use the information (86 %). At three-month follow-up, most reported being able to recall the training (83 %), and reported increased support from colleagues (59 %) and leadership (50 %). Our qualitative data identified improvements in coping and awareness of mental health issues, and decreases in mental health stigma. Suggestions were provided to improve the adaptation and implementation (e.g., simplifying the content, obtaining funding).
Conclusion
Our results support the adaptation, implementation, and delivery of Resilient Minds among Canadian volunteer firefighters. Scaled delivery of the training across Canada will require collaborations among the developers, local implementation leads, and other stakeholders in the local fire services to adapt the course content and implementation procedures for the needs of each fire department.
{"title":"Adaptation, implementation, and evaluation of a protective mental health intervention (Resilient minds) for Canadian volunteer firefighters","authors":"Joy C. MacDermid , Shannon C. Killip , Amanda Brazil , Margaret Lomotan , Steve Fraser , Dianne Bryant , Heidi Cramm , R. Nicholas Carleton","doi":"10.1016/j.comppsych.2025.152643","DOIUrl":"10.1016/j.comppsych.2025.152643","url":null,"abstract":"<div><h3>Purpose</h3><div>The study was designed to assess the adaptation, implementation, and delivery of the Resilient Minds program for volunteer firefighters in Prince Edward Island.</div></div><div><h3>Methods</h3><div>A concurrent triangulation mixed-methods approach was used. Survey data were collected from firefighters who participated in the training, and semi-structured interviews were performed with peer trainers, members of leadership, and firefighters who participated in the implementation. Summary statistics were performed to summarize the survey data, and thematic analysis was performed to analyze the qualitative data following interpretive description methods. We followed the Consolidated Framework for Implementation Research to guide our data collection and analyses.</div></div><div><h3>Results</h3><div>The relative advantage of Resilient Minds (i.e., created for firefighters) and the high-priority need for mental health training promoted buy-in from stakeholders and facilitated program implementation. Most participants described the training as helpful (84 %), and reported high intention to use the information (86 %). At three-month follow-up, most reported being able to recall the training (83 %), and reported increased support from colleagues (59 %) and leadership (50 %). Our qualitative data identified improvements in coping and awareness of mental health issues, and decreases in mental health stigma. Suggestions were provided to improve the adaptation and implementation (e.g., simplifying the content, obtaining funding).</div></div><div><h3>Conclusion</h3><div>Our results support the adaptation, implementation, and delivery of Resilient Minds among Canadian volunteer firefighters. Scaled delivery of the training across Canada will require collaborations among the developers, local implementation leads, and other stakeholders in the local fire services to adapt the course content and implementation procedures for the needs of each fire department.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152643"},"PeriodicalIF":4.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398061","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}
Pub Date : 2025-10-10DOI: 10.1016/j.comppsych.2025.152636
Michelle O'Toole , Brian Doyle , Walter Eppich , Brett Williams , Alan M. Batt
Background
First responders such as paramedics and firefighters increasingly rely on their family and friends for psychosocial support due to workplace barriers such as culture and stigma. Despite many benefits, such support is often perceived as placing a burden on family and friends. The ability to provide Psychological First Aid (PFA) has not yet been explored in the context of family members and friends providing support to first responders. In this study, we explored the impacts of PFA on first responders and family members/friends.
Methods
This pre-post study design was informed by a wider programme of research adopting a Community Based Participatory Research approach. We co-designed a simulation enhanced PFA training intervention -the HUGS@Home programme. We collected survey data over three time points from family member/friend participants and their corresponding first responders. We analysed the data using descriptive and comparative statistical analysis. External evaluation of the intervention occurred simultaneously.
Findings
Ten family member/friend cohorts (n = 82) completed the training in Ireland and the United Kingdom. Results indicate they experienced increased quality of life, improved social support, maintenance of high resilience scores, a slight increase in anxiety levels and most notably, enhanced post traumatic growth. Their related first responders (n = 33) noted similar results, in addition to demonstrating improved help-seeking and post-traumatic growth, specifically in the ‘improved relationships’ subdomain. Both groups found the intervention significant, meaningful, and valuable. External evaluation considered the programme mature and ready for wider implementation.
Conclusions
HUGS@Home contributes significantly to the international PFA evidence base as the first evaluation of a PFA intervention in Ireland. This is the first study to demonstrate that family members and friends can effectively provide PFA to first responders. Further planned and ongoing work will explore our findings in detail and evaluate programme implementation in volunteer first responder populations.
{"title":"HUGS@Home - An initial evaluation of a psychological first aid programme for families and friends of first responders","authors":"Michelle O'Toole , Brian Doyle , Walter Eppich , Brett Williams , Alan M. Batt","doi":"10.1016/j.comppsych.2025.152636","DOIUrl":"10.1016/j.comppsych.2025.152636","url":null,"abstract":"<div><h3>Background</h3><div>First responders such as paramedics and firefighters increasingly rely on their family and friends for psychosocial support due to workplace barriers such as culture and stigma. Despite many benefits, such support is often perceived as placing a burden on family and friends. The ability to provide Psychological First Aid (PFA) has not yet been explored in the context of family members and friends providing support to first responders. In this study, we explored the impacts of PFA on first responders and family members/friends.</div></div><div><h3>Methods</h3><div>This pre-post study design was informed by a wider programme of research adopting a Community Based Participatory Research approach. We co-designed a simulation enhanced PFA training intervention -the HUGS@Home programme. We collected survey data over three time points from family member/friend participants and their corresponding first responders. We analysed the data using descriptive and comparative statistical analysis. External evaluation of the intervention occurred simultaneously.</div></div><div><h3>Findings</h3><div>Ten family member/friend cohorts (<em>n</em> = 82) completed the training in Ireland and the United Kingdom. Results indicate they experienced increased quality of life, improved social support, maintenance of high resilience scores, a slight increase in anxiety levels and most notably, enhanced post traumatic growth. Their related first responders (<em>n</em> = 33) noted similar results, in addition to demonstrating improved help-seeking and post-traumatic growth, specifically in the ‘improved relationships’ subdomain. Both groups found the intervention significant, meaningful, and valuable. External evaluation considered the programme mature and ready for wider implementation.</div></div><div><h3>Conclusions</h3><div>HUGS@Home contributes significantly to the international PFA evidence base as the first evaluation of a PFA intervention in Ireland. This is the first study to demonstrate that family members and friends can effectively provide PFA to first responders. Further planned and ongoing work will explore our findings in detail and evaluate programme implementation in volunteer first responder populations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152636"},"PeriodicalIF":4.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291348","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}
Pub Date : 2025-10-06DOI: 10.1016/j.comppsych.2025.152640
Jannis Engel , Maria Veit , Laura Budnik , Stephanie Antons , Christopher Sinke , Tillmann H.C. Kruger
Background
Compulsive Sexual Behavior Disorder (CSBD) is a new category in the 11th version of the International Classification of Diseases and has neuropsychological similarities with those disorders due to addictive behaviors. Initial automatic approach tendencies and an attentional bias towards preferred stimuli may be crucial to the maintenance of addictive behavior disorders.
Aims
This experimental study aims to further our knowledge on approach-avoidance tendencies by examining a clinical sample with compulsive sexual behavior CSBD compared to a control-group.
Methods
Participants completed the approach avoidance task (AAT) modified with pornographic pictures.
Outcomes
We collected data on approach-avoidance tendencies from 43 heterosexual men with CSBD (age, M = 36.26, SD = 11.47) and a control group of 37 men without CSBD (age: M = 38.24, SD = 12.33).
Results
Reaction times of the onset of cue presentation to initial hand movement show significantly more approach tendencies towards pornographic stimuli in men with CSBD vs. men without CSBD. Negative values of movement times (MT) suggested longer viewing times when enlarging the stimulus compared to shrinking the image for pornographic and neutral material with a larger difference in the CSBD group. The overall effect scores for RT show a faster reaction time in men without CSBD towards pornographic material, while the MT scores indicates that men with CSBD show longer viewing times for pornographic material.
Conclusion
Our results emphasize previous findings in subclinical samples and show that CSBD is associated with approach tendencies at the time of stimulus presentation. These approach tendencies can be addressed therapeutically.
{"title":"Approach tendencies towards pornographic material in compulsive sexual behavior disorder: insights from the sex@brain study","authors":"Jannis Engel , Maria Veit , Laura Budnik , Stephanie Antons , Christopher Sinke , Tillmann H.C. Kruger","doi":"10.1016/j.comppsych.2025.152640","DOIUrl":"10.1016/j.comppsych.2025.152640","url":null,"abstract":"<div><h3>Background</h3><div>Compulsive Sexual Behavior Disorder (CSBD) is a new category in the 11th version of the International Classification of Diseases and has neuropsychological similarities with those disorders due to addictive behaviors. Initial automatic approach tendencies and an attentional bias towards preferred stimuli may be crucial to the maintenance of addictive behavior disorders.</div></div><div><h3>Aims</h3><div>This experimental study aims to further our knowledge on approach-avoidance tendencies by examining a clinical sample with compulsive sexual behavior CSBD compared to a control-group.</div></div><div><h3>Methods</h3><div>Participants completed the approach avoidance task (AAT) modified with pornographic pictures.</div></div><div><h3>Outcomes</h3><div>We collected data on approach-avoidance tendencies from 43 heterosexual men with CSBD (age, M = 36.26, SD = 11.47) and a control group of 37 men without CSBD (age: M = 38.24, SD = 12.33).</div></div><div><h3>Results</h3><div>Reaction times of the onset of cue presentation to initial hand movement show significantly more approach tendencies towards pornographic stimuli in men with CSBD vs. men without CSBD. Negative values of movement times (MT) suggested longer viewing times when enlarging the stimulus compared to shrinking the image for pornographic and neutral material with a larger difference in the CSBD group. The overall effect scores for RT show a faster reaction time in men without CSBD towards pornographic material, while the MT scores indicates that men with CSBD show longer viewing times for pornographic material.</div></div><div><h3>Conclusion</h3><div>Our results emphasize previous findings in subclinical samples and show that CSBD is associated with approach tendencies at the time of stimulus presentation. These approach tendencies can be addressed therapeutically.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152640"},"PeriodicalIF":4.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312539","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}
HIV-associated neurocognitive disorders (HAND) remain a significant public health concern among people living with HIV (PWH) in Africa, despite the widespread implementation of highly active antiretroviral therapy (HAART). While HAART has been effective in reducing the incidence of severe neurocognitive disorder, milder forms of neurocognitive impairment continue to be observed even among individuals receiving active antiretroviral therapy. These subtle deficits, particularly prevalent in low-resource and low-literacy contexts, are associated with adverse outcomes such as diminished functional capacity, poor adherence to antiretroviral therapy, and reduced quality of life. This systematic review and meta-analysis aims to synthesize the current evidence on the effectiveness of HAART on neurocognitive outcomes among HIV-positive individuals in Africa.
Methods
A comprehensive systematic search was conducted across multiple electronic databases—including PubMed/MEDLINE, Scopus, African Journals Online, PsycINFO, EMBASE, CINAHL, and the Cochrane Library—to identify primary research studies that examined the prevalence and clinical impact of HIV-associated neurocognitive disorders (HAND) among HIV-infected populations in Africa. Study selection and data extraction were performed independently by two reviewers using predefined standardized protocols to ensure methodological rigor and minimize the risk of bias. The review protocol was prospectively registered with PROSPERO (CRD420251017353).
Results
This meta-analysis, which included 62 primary studies with a combined sample of 19,831 individuals living with HIV, estimated a pooled prevalence of HIV-associated neurocognitive disorders was 47.18% (95% CI: 39.94%–54.42%). In contrast, among 2,176 HIV-negative individuals in the control group, the prevalence of neurocognitive disorder was 13.48% (95% CI: 10.9%–15.32%). Sub-regional stratification revealed the highest HAND prevalence in Eastern Africa (50.85%), followed by Southern Africa (48.12%) and Western Africa (43.67%), while Central Africa reported the lowest prevalence at 34.68%. Among individuals receiving antiretroviral therapy (ART), the prevalence of HAND was 46.96%, compared to 50.22% in ART-naïve participants, indicating only a modest reduction in neurocognitive impairment associated with ART exposure. Meta-regression analyses identified several independent predictors significantly associated with increased odds of HAND, including advanced HIV disease stage (odds ratio [OR] 3.59; 95% CI: 2.81–4.59), lower educational attainment (3.13, 2.19–4.48), older age (2.05, 1.51–2.78), being female (2.18, 1.79-2.64), history of substance use (2.70, 2.65–2.75), reduced CD4+ T-cell counts (2.49, 1.42–4.36) and comorbid medical illness (2.05, 1.57-2.67).
Conclusion
HIV-associated neurocognitive disorders affect nearly half of people living with
{"title":"The role of HAART in mitigating neurocognitive decline among HIV-positive Africans: Systematic review and meta-analysis","authors":"Mulualem Kelebie , Getasew Kibralew , Gebresilassie Tadesse , Girum Nakie , Mulu Muche , Dawed Ali , Birtukan Fasil , Gidey Rtbey , Biruk Fanta , Nega Gedefaw Agmase , Girmaw Medfu Takelle , Melese Gobezie , Mequanente Dagnaw , Setegn Fentahun","doi":"10.1016/j.comppsych.2025.152639","DOIUrl":"10.1016/j.comppsych.2025.152639","url":null,"abstract":"<div><h3>Background</h3><div>HIV-associated neurocognitive disorders (HAND) remain a significant public health concern among people living with HIV (PWH) in Africa, despite the widespread implementation of highly active antiretroviral therapy (HAART). While HAART has been effective in reducing the incidence of severe neurocognitive disorder, milder forms of neurocognitive impairment continue to be observed even among individuals receiving active antiretroviral therapy. These subtle deficits, particularly prevalent in low-resource and low-literacy contexts, are associated with adverse outcomes such as diminished functional capacity, poor adherence to antiretroviral therapy, and reduced quality of life. This systematic review and meta-analysis aims to synthesize the current evidence on the effectiveness of HAART on neurocognitive outcomes among HIV-positive individuals in Africa.</div></div><div><h3>Methods</h3><div>A comprehensive systematic search was conducted across multiple electronic databases—including PubMed/MEDLINE, Scopus, African Journals Online, PsycINFO, EMBASE, CINAHL, and the Cochrane Library—to identify primary research studies that examined the prevalence and clinical impact of HIV-associated neurocognitive disorders (HAND) among HIV-infected populations in Africa. Study selection and data extraction were performed independently by two reviewers using predefined standardized protocols to ensure methodological rigor and minimize the risk of bias. The review protocol was prospectively registered with PROSPERO (CRD420251017353).</div></div><div><h3>Results</h3><div>This meta-analysis, which included 62 primary studies with a combined sample of 19,831 individuals living with HIV, estimated a pooled prevalence of HIV-associated neurocognitive disorders was 47.18% (95% CI: 39.94%–54.42%). In contrast, among 2,176 HIV-negative individuals in the control group, the prevalence of neurocognitive disorder was 13.48% (95% CI: 10.9%–15.32%). Sub-regional stratification revealed the highest HAND prevalence in Eastern Africa (50.85%), followed by Southern Africa (48.12%) and Western Africa (43.67%), while Central Africa reported the lowest prevalence at 34.68%. Among individuals receiving antiretroviral therapy (ART), the prevalence of HAND was 46.96%, compared to 50.22% in ART-naïve participants, indicating only a modest reduction in neurocognitive impairment associated with ART exposure. Meta-regression analyses identified several independent predictors significantly associated with increased odds of HAND, including advanced HIV disease stage (odds ratio [OR] 3.59; 95% CI: 2.81–4.59), lower educational attainment (3.13, 2.19–4.48), older age (2.05, 1.51–2.78), being female (2.18, 1.79-2.64), history of substance use (2.70, 2.65–2.75), reduced CD4+ T-cell counts (2.49, 1.42–4.36) and comorbid medical illness (2.05, 1.57-2.67).</div></div><div><h3>Conclusion</h3><div>HIV-associated neurocognitive disorders affect nearly half of people living with","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152639"},"PeriodicalIF":4.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262340","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}
Pub Date : 2025-10-06DOI: 10.1016/j.comppsych.2025.152641
Youna McGowan , Bilikis Banire , Hailey Burns , Dawson Sutherland , Sherry H. Stewart , Raymond M. Klein , Sandra Meier
Social media's highly visual and interactive nature fosters social comparisons and can thereby exacerbate feelings of inadequacy, especially among youth with anxiety. Compared to their non-anxious peers, anxious youth are more likely to use social media and may be more susceptible to engaging in social comparison, as suggested by prior literature. Anxious youth are also more attentive to indicators of social status and threats. Thus, this study explored the attention bias mechanisms underlying anxiety in response to social media status cues (e.g., follower counts, likes). We predicted that with increasing anxiety symptoms, youth would avoid allocating their attention to these cues. We recruited 69 shy or anxious young females with anxiety symptoms to view Instagram profiles [Mage = 20.44 years, SDage = 1.84 years]. We recorded participants' eye movements with a high degree of spatial and temporal resolution while participants freely engaged with these profiles. Results showed that with increasing anxiety symptoms, youths' first fixation latency was significantly longer and their fixation duration shorter for social media status cues compared to the overall profile, representing an attentional avoidance pattern. This pattern was observed for both popular and less-popular profiles. These findings add to evidence that anxiety symptoms are linked to differences in visual attention to social media status cues. Further research is needed to examine these effects across genders, platforms, and in relation to other psychological constructs.
{"title":"Attention to Instagram features in female youth with anxiety symptoms","authors":"Youna McGowan , Bilikis Banire , Hailey Burns , Dawson Sutherland , Sherry H. Stewart , Raymond M. Klein , Sandra Meier","doi":"10.1016/j.comppsych.2025.152641","DOIUrl":"10.1016/j.comppsych.2025.152641","url":null,"abstract":"<div><div>Social media's highly visual and interactive nature fosters social comparisons and can thereby exacerbate feelings of inadequacy, especially among youth with anxiety. Compared to their non-anxious peers, anxious youth are more likely to use social media and may be more susceptible to engaging in social comparison, as suggested by prior literature. Anxious youth are also more attentive to indicators of social status and threats. Thus, this study explored the attention bias mechanisms underlying anxiety in response to social media status cues (e.g., follower counts, likes). We predicted that with increasing anxiety symptoms, youth would avoid allocating their attention to these cues. We recruited 69 shy or anxious young females with anxiety symptoms to view Instagram profiles [<em>M</em><sub>age</sub> = 20.44 years, <em>SD</em><sub>age</sub> = 1.84 years]. We recorded participants' eye movements with a high degree of spatial and temporal resolution while participants freely engaged with these profiles. Results showed that with increasing anxiety symptoms, youths' first fixation latency was significantly longer and their fixation duration shorter for social media status cues compared to the overall profile, representing an attentional avoidance pattern. This pattern was observed for both popular and less-popular profiles. These findings add to evidence that anxiety symptoms are linked to differences in visual attention to social media status cues. Further research is needed to examine these effects across genders, platforms, and in relation to other psychological constructs.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152641"},"PeriodicalIF":4.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262341","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号