Margaret E. Manges, Melissa F. V. Kilicoglu, Aubrey M. Moe, Nancy B. Lundin, David M. Weiss, Anne C. Holmes, Heather M. Wastler
Introduction
Suicidal thoughts are highly prevalent among individuals with psychotic disorders and individuals at risk for psychosis. Although a growing body of literature demonstrates that this risk is greatest during the earliest stage of psychotic illness, few studies have directly compared rates of suicidal thoughts and behaviours across stages of illness.
Methods
The current study addressed this gap by using a retrospective chart review to compare rates of past 2-week suicidal thoughts and past year suicidal behaviour across individuals at clinical high risk for psychosis (CHR-P; n = 50), first-episode psychosis (FEP; n = 84) and longstanding psychosis (LP; n = 59). Chi-squared analyses were used to compare groups on past two-week suicidal thoughts and past year suicidal behaviour. Frequencies of the various methods for suicidal behaviour were computed across the entire sample and within each group.
Results
Results indicate that individuals at CHR-P had the highest rate of past two-week suicidal thoughts compared to FEP and LP. The most common method for suicidal behaviour in all groups was overdose.
Conclusion
These findings suggest that CHR-P is a particularly vulnerable period for suicide risk and highlight the continued need for research and resources for this population. These findings also underscore the importance of careful monitoring of medication use and efforts to reduce the risk of overdose.
{"title":"Rates of Suicidal Thoughts and Behaviours Across the Psychosis Continuum: A Comparison of Clinical High-Risk, First-Episode and Longstanding Psychosis Samples","authors":"Margaret E. Manges, Melissa F. V. Kilicoglu, Aubrey M. Moe, Nancy B. Lundin, David M. Weiss, Anne C. Holmes, Heather M. Wastler","doi":"10.1111/eip.70082","DOIUrl":"https://doi.org/10.1111/eip.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Suicidal thoughts are highly prevalent among individuals with psychotic disorders and individuals at risk for psychosis. Although a growing body of literature demonstrates that this risk is greatest during the earliest stage of psychotic illness, few studies have directly compared rates of suicidal thoughts and behaviours across stages of illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The current study addressed this gap by using a retrospective chart review to compare rates of past 2-week suicidal thoughts and past year suicidal behaviour across individuals at clinical high risk for psychosis (CHR-P; <i>n</i> = 50), first-episode psychosis (FEP; <i>n</i> = 84) and longstanding psychosis (LP; <i>n</i> = 59). Chi-squared analyses were used to compare groups on past two-week suicidal thoughts and past year suicidal behaviour. Frequencies of the various methods for suicidal behaviour were computed across the entire sample and within each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results indicate that individuals at CHR-P had the highest rate of past two-week suicidal thoughts compared to FEP and LP. The most common method for suicidal behaviour in all groups was overdose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest that CHR-P is a particularly vulnerable period for suicide risk and highlight the continued need for research and resources for this population. These findings also underscore the importance of careful monitoring of medication use and efforts to reduce the risk of overdose.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Barton, Mikaela K. Dimick, Vanessa Timmins, Eric A. Youngstrom, Benjamin I. Goldstein
Aim
Despite substantial evidence in adults, data on sexual behaviour in youth with bipolar disorder (BD) are limited. We therefore examined this topic in youth with BD.
Method
The study included 625 youth (n = 246 BD, n = 233 high risk for BD [BD-risk] and 146 healthy controls [HC]), ages 13–20 years. Semi-structured interviews evaluated diagnoses and treatment, as well as sexual activity, risky sexual behaviour (RSB) and reasons for RSB. Analyses compared lifetime sexual activity and RSB across the three groups and evaluated correlates of sexual activity and RSB within BD and BD-risk.
Results
Lifetime sexual activity and RSB were significantly higher amongst both BD and BD-risk youth versus HC. In univariate analyses, several overlapping clinical and suicide risk factors were associated with lifetime sexual activity amongst both BD and BD-risk youth. In multivariate analysis amongst BD youth, comorbid substance use disorder (SUD), post-traumatic stress disorder, and family history of anxiety were associated with lifetime sexual activity. In BD-risk youth, older age, lifetime depression severity, comorbid SUD and interpersonal chaos were associated with lifetime sexual activity. Affective lability and family history of suicide attempt were associated with RSB.
Conclusions
Lifetime sexual activity was two-fold greater, and RSB was over fifteen-fold greater, amongst BD and BD-risk youth versus HCs. Understanding which demographic and clinical factors are associated with lifetime sexual activity amongst BD and BD-risk youth may enable us to identify youth more likely to engage in RSB and help us develop treatments and preventative strategies to avoid RSB accordingly.
{"title":"Sexual Activity and Risky Sexual Behaviour Amongst Canadian Youth With and at Risk for Bipolar Disorder","authors":"Jessica Barton, Mikaela K. Dimick, Vanessa Timmins, Eric A. Youngstrom, Benjamin I. Goldstein","doi":"10.1111/eip.70085","DOIUrl":"https://doi.org/10.1111/eip.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Despite substantial evidence in adults, data on sexual behaviour in youth with bipolar disorder (BD) are limited. We therefore examined this topic in youth with BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study included 625 youth (<i>n</i> = 246 BD, <i>n</i> = 233 high risk for BD [BD-risk] and 146 healthy controls [HC]), ages 13–20 years. Semi-structured interviews evaluated diagnoses and treatment, as well as sexual activity, risky sexual behaviour (RSB) and reasons for RSB. Analyses compared lifetime sexual activity and RSB across the three groups and evaluated correlates of sexual activity and RSB within BD and BD-risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Lifetime sexual activity and RSB were significantly higher amongst both BD and BD-risk youth versus HC. In univariate analyses, several overlapping clinical and suicide risk factors were associated with lifetime sexual activity amongst both BD and BD-risk youth. In multivariate analysis amongst BD youth, comorbid substance use disorder (SUD), post-traumatic stress disorder, and family history of anxiety were associated with lifetime sexual activity. In BD-risk youth, older age, lifetime depression severity, comorbid SUD and interpersonal chaos were associated with lifetime sexual activity. Affective lability and family history of suicide attempt were associated with RSB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lifetime sexual activity was two-fold greater, and RSB was over fifteen-fold greater, amongst BD and BD-risk youth versus HCs. Understanding which demographic and clinical factors are associated with lifetime sexual activity amongst BD and BD-risk youth may enable us to identify youth more likely to engage in RSB and help us develop treatments and preventative strategies to avoid RSB accordingly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Rosa Sepúlveda, Andrea Gil Gómez-Lobo, Marta Rojo, María Del Camino Del Blanco-Barredo, Óscar Luis Veiga
Introduction
Childhood obesity, a global public health issue, is associated with numerous psychological comorbidities. Identifying risk factors that could impact the psychological well-being of this population is essential. Personality traits have been linked to obesity and mental health; however, research in children remains limited. Personality traits may predict differences in mental health in children with obesity by influencing emotional, cognitive and behavioural patterns, which could affect how they cope with lifestyle habits, weight-related stigma and other psychosocial stressors associated with obesity. This study aimed to evaluate the relationship between personality traits and psychological well-being variables in children with excess weight.
Methods
A cross-sectional study was conducted with a sample of 145 children with overweight or obesity (mean age = 10.34, SD = 1.42; 43.40% female). Personality traits were assessed using the Big Five Personality Questionnaire, depressive symptomatology with the Children's Depression Inventory, anxiety with the Spence Children's Anxiety Scale and self-esteem with the Lawrence Self-Esteem Questionnaire. Principal statistical analyses included multiple hierarchical regression analyses, with personality traits as predictor variables.
Results
After controlling for sociodemographic variables and z-BMI, personality traits-particularly Neuroticism and Conscientiousness-significantly predicted depressive (β Neuroticism = 0.44), anxious symptoms (β Conscientiousness = 0.69) and self-esteem (β Neuroticism = −0.39), explaining an additional 30%, 19%, and 20% of the variance, respectively.
Conclusions
The findings suggest that certain personality traits may increase the vulnerability of children with obesity to mental health issues. Considering a child's personality profile could enhance both the prevention and treatment of obesity by developing interventions tailored to each child's behavioural patterns.
{"title":"Relationship Between Personality Traits and Psychological Well-Being in Childhood Obesity: A Cross-Sectional Study Following the Five-Factor Model","authors":"Ana Rosa Sepúlveda, Andrea Gil Gómez-Lobo, Marta Rojo, María Del Camino Del Blanco-Barredo, Óscar Luis Veiga","doi":"10.1111/eip.70080","DOIUrl":"https://doi.org/10.1111/eip.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Childhood obesity, a global public health issue, is associated with numerous psychological comorbidities. Identifying risk factors that could impact the psychological well-being of this population is essential. Personality traits have been linked to obesity and mental health; however, research in children remains limited. Personality traits may predict differences in mental health in children with obesity by influencing emotional, cognitive and behavioural patterns, which could affect how they cope with lifestyle habits, weight-related stigma and other psychosocial stressors associated with obesity. This study aimed to evaluate the relationship between personality traits and psychological well-being variables in children with excess weight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted with a sample of 145 children with overweight or obesity (mean age = 10.34, SD = 1.42; 43.40% female). Personality traits were assessed using the Big Five Personality Questionnaire, depressive symptomatology with the Children's Depression Inventory, anxiety with the Spence Children's Anxiety Scale and self-esteem with the Lawrence Self-Esteem Questionnaire. Principal statistical analyses included multiple hierarchical regression analyses, with personality traits as predictor variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After controlling for sociodemographic variables and <i>z</i>-BMI, personality traits-particularly Neuroticism and Conscientiousness-significantly predicted depressive (<i>β Neuroticism</i> = 0.44), anxious symptoms (<i>β Conscientiousness</i> = 0.69) and self-esteem (<i>β Neuroticism</i> = −0.39), explaining an additional 30%, 19%, and 20% of the variance, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest that certain personality traits may increase the vulnerability of children with obesity to mental health issues. Considering a child's personality profile could enhance both the prevention and treatment of obesity by developing interventions tailored to each child's behavioural patterns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yamit Sol-Nottes, Sujoud Saqer, David Roe, Shlomo Mendlovic, Ayat Nasser, Danny Koren
Background and Aims
Recent studies have shown that communicating and psycho-educating young individuals and their families about high-risk psychosis can offer benefits, like validation and access to specialised care. However, it can also negatively impact self-perception, distress and help-seeking behaviour. In a recent study (Sol-Nottes et al.), we demonstrated that clinicians view positive reframing as a way to mitigate these concerns. This study aimed to extend those findings to community-dwelling adolescents with high versus low levels of distressing ‘prodromal’ experiences. An additional goal was to explore the moderating role of sex and culture.
Methods
The study replicated the design from Sol-Nottes et al. Exactly 108 adolescents were randomly assigned to view either negatively or positively framed simulated feedback sessions, followed by questions about the session's impact. Prior to viewing the simulated session, all participants completed the brief version of the Prodromal Questionnaire (PQ-B).
Results
As hypothesised, positive framing significantly reduced fear and stigma. However, contrary to our secondary hypothesis, these effects were not moderated by the level of prodromal symptoms. Finally, exploratory analyses revealed a moderating effect of sex and culture, with a stronger effect of positive reframing on stigma, mobilisation to seek help and hopefulness, among male and Arab adolescents.
Conclusions
These findings provide further support for the potential beneficial effect of positive reframing in the context of at-risk mental states and highlight the importance of cultural factors. Together, these results lay the groundwork for clinical trials on positive framing in real-world settings.
{"title":"Positive Reframing of Psychosis Risk is Perceived as Less Frightening and Stigmatising Than Negative Framing by Adolescents With and Without Prodromal Symptoms: An Experimental Simulated Feedback Study","authors":"Yamit Sol-Nottes, Sujoud Saqer, David Roe, Shlomo Mendlovic, Ayat Nasser, Danny Koren","doi":"10.1111/eip.70083","DOIUrl":"https://doi.org/10.1111/eip.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Recent studies have shown that communicating and psycho-educating young individuals and their families about high-risk psychosis can offer benefits, like validation and access to specialised care. However, it can also negatively impact self-perception, distress and help-seeking behaviour. In a recent study (Sol-Nottes et al.), we demonstrated that clinicians view positive reframing as a way to mitigate these concerns. This study aimed to extend those findings to community-dwelling adolescents with high versus low levels of distressing ‘prodromal’ experiences. An additional goal was to explore the moderating role of sex and culture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study replicated the design from Sol-Nottes et al. Exactly 108 adolescents were randomly assigned to view either negatively or positively framed simulated feedback sessions, followed by questions about the session's impact. Prior to viewing the simulated session, all participants completed the brief version of the Prodromal Questionnaire (PQ-B).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>As hypothesised, positive framing significantly reduced fear and stigma. However, contrary to our secondary hypothesis, these effects were not moderated by the level of prodromal symptoms. Finally, exploratory analyses revealed a moderating effect of sex and culture, with a stronger effect of positive reframing on stigma, mobilisation to seek help and hopefulness, among male and Arab adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide further support for the potential beneficial effect of positive reframing in the context of at-risk mental states and highlight the importance of cultural factors. Together, these results lay the groundwork for clinical trials on positive framing in real-world settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The mental health of college students has become a critical concern, with depression, anxiety and stress (DAS) reaching alarming levels. Despite the vital role of societal attitudes in shaping mental health outcomes, the factors and mechanisms influencing college students' community attitudes towards mental illness (CAMI) remain underexplored.
Aim
This study aims to investigate the CAMI, mental health problems and mental health literacy (MHL) among Chinese college students and to analyse the relationships between them.
Methods
A total of 600 college students from Jinan City, Shandong Province, China, completed the Community Attitudes towards the Mentally Ill Scale, the Depression–Anxiety–Stress Scale and the Mental Health Literacy Scale. Data were analysed using structural equation modelling (SEM).
Results
The findings showed that DAS significantly negatively predicted positive CAMI, while MHL significantly positively predicted more favourable CAMI. Notably, MHL, as a moderating variable, attenuated the negative predictive effect of DAS on positive CAMI.
Discussion
The results of this study highlight the crucial role of the government, universities, and families in guiding college students to develop more positive CAMI, particularly in the post-pandemic era. Efforts should focus on creating a supportive mental health environment within universities. Additionally, the direction of mental health education should shift from merely imparting knowledge to a more contextualised and interactive educational approach, aiming to enhance understanding and acceptance of mental illness.
{"title":"College Students' Community Attitudes Towards Mental Illness: Do Mental Health Problems and Literacy Matter?","authors":"Shushan Liu, Lei Wang","doi":"10.1111/eip.70075","DOIUrl":"https://doi.org/10.1111/eip.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The mental health of college students has become a critical concern, with depression, anxiety and stress (DAS) reaching alarming levels. Despite the vital role of societal attitudes in shaping mental health outcomes, the factors and mechanisms influencing college students' community attitudes towards mental illness (CAMI) remain underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to investigate the CAMI, mental health problems and mental health literacy (MHL) among Chinese college students and to analyse the relationships between them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 600 college students from Jinan City, Shandong Province, China, completed the Community Attitudes towards the Mentally Ill Scale, the Depression–Anxiety–Stress Scale and the Mental Health Literacy Scale. Data were analysed using structural equation modelling (SEM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings showed that DAS significantly negatively predicted positive CAMI, while MHL significantly positively predicted more favourable CAMI. Notably, MHL, as a moderating variable, attenuated the negative predictive effect of DAS on positive CAMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The results of this study highlight the crucial role of the government, universities, and families in guiding college students to develop more positive CAMI, particularly in the post-pandemic era. Efforts should focus on creating a supportive mental health environment within universities. Additionally, the direction of mental health education should shift from merely imparting knowledge to a more contextualised and interactive educational approach, aiming to enhance understanding and acceptance of mental illness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jara Bouws, Lotte Uyttebroek, Joanne R. Beames, Mariken de Koning, Frederike Schirmbeck, An Henrard, Ulrich Reininghaus, Lieuwe de Haan, Inez Myin-Germeys
Introduction
Individuals with early psychosis received Acceptance and Commitment Therapy in daily life (ACT-DL), consisting of 8 face-to-face sessions and use of a mobile app at home, as part of a randomised controlled trial (INTERACT). Those receiving ACT-DL showed improvement in negative symptoms and global functioning compared to the control condition. The current study qualitatively explores patients' perspectives on the ACT-DL app and perceived areas for improvement.
Methods
The ACT-DL app prompted individuals randomly multiple times a day between therapy sessions to complete questionnaires (Ecological Momentary Assessments, EMA) and ACT metaphors or exercises (Ecological Momentary Interventions, EMI). User experiences with the ACT-DL app were explored in 17 semi-structured interviews within 6 months after the intervention and analysed using template thematic analysis.
Results
Three themes were formed: 1. App functionalities and usability; consisting mainly of perceived practical obstacles. 2. Additional value of the app; on how the EMAs raised levels of awareness for feelings, thoughts, and behaviour, and the positive evaluation of the ACT exercises in the EMI part of the app. 3. Improving applicability and effect of the ACT-DL app; with practical feedback from participants.
Conclusions
Individuals with early psychosis were generally positive about the effects of the ACT-DL app, attributing benefits to increased awareness via EMAs and to the ACT exercises. However, they experienced difficulties using the app during work and social activities. Participants provided valuable suggestions to improve the app's effectiveness and applicability.
{"title":"Perspectives of Patients With Early Psychosis on the Use of an App in Acceptance and Commitment Therapy: A Qualitative Study","authors":"Jara Bouws, Lotte Uyttebroek, Joanne R. Beames, Mariken de Koning, Frederike Schirmbeck, An Henrard, Ulrich Reininghaus, Lieuwe de Haan, Inez Myin-Germeys","doi":"10.1111/eip.70073","DOIUrl":"https://doi.org/10.1111/eip.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Individuals with early psychosis received Acceptance and Commitment Therapy in daily life (ACT-DL), consisting of 8 face-to-face sessions and use of a mobile app at home, as part of a randomised controlled trial (INTERACT). Those receiving ACT-DL showed improvement in negative symptoms and global functioning compared to the control condition. The current study qualitatively explores patients' perspectives on the ACT-DL app and perceived areas for improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The ACT-DL app prompted individuals randomly multiple times a day between therapy sessions to complete questionnaires (Ecological Momentary Assessments, EMA) and ACT metaphors or exercises (Ecological Momentary Interventions, EMI). User experiences with the ACT-DL app were explored in 17 semi-structured interviews within 6 months after the intervention and analysed using template thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three themes were formed: 1. App functionalities and usability; consisting mainly of perceived practical obstacles. 2. Additional value of the app; on how the EMAs raised levels of awareness for feelings, thoughts, and behaviour, and the positive evaluation of the ACT exercises in the EMI part of the app. 3. Improving applicability and effect of the ACT-DL app; with practical feedback from participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Individuals with early psychosis were generally positive about the effects of the ACT-DL app, attributing benefits to increased awareness via EMAs and to the ACT exercises. However, they experienced difficulties using the app during work and social activities. Participants provided valuable suggestions to improve the app's effectiveness and applicability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xuan Wang, Bingna Xu, Yifan Zhang, Xiangting Zhang, Huolian Li, Dongfang Wang, Fang Fan
Objectives
School climate may influence psychotic-like experiences (PLEs). The study aimed to explore the association between school climate and PLEs among adolescents and to investigate whether resilience mediates this association.
Methods
A total of 11 860 Chinese junior high school students were involved in a two-wave longitudinal study. The baseline survey (time 1, T1) was conducted from 21 April to 12 May 2021, and the follow-up survey (time 2, T2) was carried out between December 17 and 26, 2021. At T1, adolescents completed questionnaires assessing their school climate, resilience, and sociodemographic characteristics. PLEs were evaluated at both T1 and T2.
Results
The prevalence of PLEs in adolescents was 15.8% at T1 and 13.2% at T2. The correlation analyses indicated that school climate (T1) was positively correlated with resilience (T1) and negatively correlated with PLEs (T1 and T2). After controlling for confounding variables, the final model showed that the impact of school climate on PLEs at T1 (indirect effect = −0.09, 95% CI = −0.22, −0.20) and T2 (indirect effect = −0.01, 95% CI = −0.06, −0.02) was mediated by resilience.
Conclusions
These findings offer new insights into the mechanisms linking school climate and PLEs, highlighting the importance of resilience in the effective prevention and intervention of PLEs among adolescents.
{"title":"Resilience as a Mediator Between School Climate and Psychotic-Like Experiences Among Adolescents: Cross-Sectional and Prospective Analyses","authors":"Xuan Wang, Bingna Xu, Yifan Zhang, Xiangting Zhang, Huolian Li, Dongfang Wang, Fang Fan","doi":"10.1111/eip.70074","DOIUrl":"https://doi.org/10.1111/eip.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>School climate may influence psychotic-like experiences (PLEs). The study aimed to explore the association between school climate and PLEs among adolescents and to investigate whether resilience mediates this association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 11 860 Chinese junior high school students were involved in a two-wave longitudinal study. The baseline survey (time 1, T1) was conducted from 21 April to 12 May 2021, and the follow-up survey (time 2, T2) was carried out between December 17 and 26, 2021. At T1, adolescents completed questionnaires assessing their school climate, resilience, and sociodemographic characteristics. PLEs were evaluated at both T1 and T2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of PLEs in adolescents was 15.8% at T1 and 13.2% at T2. The correlation analyses indicated that school climate (T1) was positively correlated with resilience (T1) and negatively correlated with PLEs (T1 and T2). After controlling for confounding variables, the final model showed that the impact of school climate on PLEs at T1 (indirect effect = −0.09, 95% CI <i>=</i> −0.22, −0.20) and T2 (indirect effect = −0.01, 95% CI <i>=</i> −0.06, −0.02) was mediated by resilience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings offer new insights into the mechanisms linking school climate and PLEs, highlighting the importance of resilience in the effective prevention and intervention of PLEs among adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phuong Mi Nguyen, Sandra Abrantes-Diaz, Sören Friedrich, Karen Krause, Silvia Schneider, Mar Rus-Calafell
Introduction
Psychotic-like experiences (PLEs) occur transdiagnostically in young people and are linked to an increased risk of severe psychopathology in adulthood. However, the psychosocial factors influencing PLEs severity and their distribution across diagnoses remain under-researched. Updated knowledge of these aspects is crucial for clinical understanding and treatment. This study aims to expand existing research by investigating the prevalence and psychosocial factors associated with PLEs in help-seeking adolescents, examining differences in their severity across diagnoses and multimorbidity, and exploring preliminary changes following routine cognitive behavioural therapy (CBT).
Methods
This observational, non-controlled study included 275 adolescents attending a routine mental health service for young people in Germany. Of the full sample, 161 participants completed a full course of CBT.
Results
At baseline, 87% reported at least one PLE, and 54.91% reported three or more. The most distressing experiences included thought broadcasting, paranoia, mind reading, and auditory hallucinations. The number of diagnoses did not affect PLEs severity, but the presence of self-reported childhood physical neglect and jumping to conclusions did. Among those who completed CBT, results showed reductions in PLEs severity over time across diagnostic groups.
Discussion
This study highlights the high prevalence of transdiagnostic PLEs in help-seeking adolescents. Among psychosocial predictors, trauma and cognitive biases were particularly relevant and should be addressed in psychotherapy. The observed improvements in PLEs severity following CBT, irrespective of the primary presenting problem, suggest promising avenues for transdiagnostic therapeutic strategies.
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B. A. Hamilton, S. L. Berry, S. Barakat, S. Horsfield, R. Simeone, S. Maguire, A. L. Burton
Background
headspace is Australia's National Youth Mental Health Foundation. There are over 165 youth-friendly multidisciplinary services located in every state and territory across Australia. Considerable Government funds are allocated to headspace centres with the aim of targeting mild-to-moderate mental health disorders for young people aged 12–25 years. Young people present for help for a wide range of concerns including mood disorders, anxiety disorders, peer difficulties and substance use issues. Recent research has demonstrated that a high percentage of young people accessing care at headspace centres are experiencing significant body image concerns and are engaging in disordered eating behaviours. These include dietary restriction, binge eating and purging behaviours such as self-induced vomiting. The headspace centre model includes both general practitioners and mental health clinicians as part of the clinical team. This multi-disciplinary model enables centres to have the basic staffing needed to provide effective interventions for emerging and mild-to-moderate eating disorder presentations. While offering early intervention for eating disorders is within the scope of headspace centres, full integration of eating disorders care into the core business of headspace centres is still ongoing.
Aims
This paper aims to highlight the potential of headspace centres to support the early identification and treatment of eating disorders and outlines feasible strategies for embedding evidence-based care within their existing service framework.
Conclusion
We will argue that headspace centres are well placed with existing resources to provide effective and accessible early intervention for eating disorders to young Australians at risk.
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Gili Hoter Ishay, Michal Mashiach-Eizenberg, David Roe
Background
Psychiatric diagnosis often generates controversy regarding its necessity, validity and utility. While it can help determine service eligibility and guide clinical decision-making, a formal diagnosis can also reinforce negative stereotypes and self-stigma, particularly among adolescents and young adults in critical stages of identity formation.
Aim
In this article, we argue that a policy shift from a national, free-to-all funding to HMO-based coverage—with mandatory diagnostic documentation—might contradict the principles of early-intervention services for youth.
Method
Between 2016 and 2018, we collected routine data for an evaluation study of youth early-intervention services in Israel. During this period, eligibility changed from open access to a requirement of receiving a formal DSM diagnosis.
Results
Our secondary analysis shows no significant differences in demographic characteristics, psychological distress or social and occupational functioning before and after the policy change. However, clinicians reported a significantly higher proportion of youth meeting full diagnostic criteria for DSM diagnosis and expressed greater certainty in their assessments.
Discussion
These findings underscore the potential influence of policy on clinical judgement—or at least its documentation—demonstrating a paradox: a system intended to broaden early intervention may inadvertently hinge on a stigmatising label, potentially deterring help-seeking among youth. Financial and policy structures can challenge the low-barrier, youth-friendly framework that characterises early intervention in psychiatry. Further investigation is needed to understand the fragile dynamics of mental health coverage policy and the principles youth-oriented early-intervention services.
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