Journal of psychiatric research最新文献

Trichotillomania (TTM) and excoriation disorder (skin picking) disorder (SPD) are common yet undertreated conditions. Although evidence-based cognitive behavioral treatments exist, therapy access is often limited by insufficient provider availability, cost, and stigma. Several technology-based interventions have emerged as a scalable and accessible alternative, but their overall effectiveness for TTM and SPD remains unclear. This systematic review and meta-analysis evaluated the efficacy of digitally-delivered interventions for TTM and SPD. The review protocol was pre-registered on PROSPERO. PsycINFO, MEDLINE, and Embase were searched for studies testing digital interventions for TTM/SPD grounded in cognitive and/or behavioral therapies, including both therapist-assisted and self-guided formats and both controlled and uncontrolled study designs. Random-effects meta-analyses estimated within-group effect sizes for all included studies and between-group effects for randomized controlled trials. Subgroup analyses examined study, sample, and intervention characteristics. Fourteen studies (N = 5468) met inclusion criteria. Large within-group effect sizes were found for symptom reduction from pre- to post-treatment (g = 1.01), with sustained follow-up effects (1-3 months: g = 1.22; 6 months: g = 1.15). Between-group analyses of randomized controlled trials showed a medium effect favoring digital interventions over control (g = 0.63). Subgroup analyses showed trends toward stronger effects in interventions that explicitly incorporated ACT-based therapeutic content and included accountability features (e.g., reminders, therapist messaging). Effects for secondary outcomes (quality of life, depression, anxiety) were minimal. Overall, digitally-delivered interventions are associated with meaningful reductions in TTM and SPD symptom severity. Although heterogeneity and variability in study design warrant cautious interpretation, these findings support digital interventions as a promising option for improving access to care.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects normal brain development and results in impaired brain function. Most studies have focused on connectivity changes within the traditional low-frequency range, whereas the frequency-dependent nature of brain dynamics remains largely unexplored. This study employed whole-brain co-activation pattern (CAP) analysis to investigate the frequency-dependent spatiotemporal dynamics of spontaneous brain activity in ASD across three frequency bands: LFO (0.01-0.1 Hz), slow-5 (0.01-0.027 Hz), and slow-4 (0.027-0.073 Hz). Resting-state fMRI data were obtained from the NYU site of the ABIDE I database, comprising 52 individuals with ASD and 52 typical controls (TCs). Six CAPs were identified within each frequency band using k-means clustering. We then calculated and compared CAP dynamics, including the appearance frequency, duration, entry rate, and transition probability. Our results revealed that (1) CAPs across different frequency bands exhibited overall similar spatial patterns but showed significant differences in temporal evolution, with the slow-5 band demonstrating lower dynamic variability; (2) compared to the TC group, individuals with ASD exhibited abnormal brain dynamics in both the LFO and slow-4 bands, whereas no significant differences were observed in the slow-5 band; and (3) significant correlations were found between the dynamic metrics of CAPs in the LFO and slow-5 bands and the severity of restricted and repetitive behaviors (RRB) in individuals with ASD. These findings reveal frequency-specific abnormalities in brain dynamics in ASD, providing new insights into its time-varying neural mechanisms.