Bulletin of the Menninger Clinic最新文献

Acceptance and commitment therapy (ACT) combined with exposure and response prevention (ERP) is an effective treatment for obsessive-compulsive disorder (OCD). Due to the influence of sociocultural factors on OCD symptomatology, it is crucial to customize and assess ACT within diverse cultural settings. We present an online group protocol for ACT-ERP, tailored for Brazilian adults with OCD, based on a prior pilot study and the work of Twohig and colleagues. The protocol adaptations for online use in a group format included technical arrangements, adjusted session frequency, and cultural adaptations with appropriate translations. These modifications addressed cultural analogies and socioeconomic challenges, enhancing accessibility and relevance for Brazilians. Adapting this intervention to the Brazilian context aims to optimize OCD treatment, offering a culturally sensitive approach for Brazilian patients.

Obsessive-compulsive disorder (OCD) is one of the most popular health-related topics on TikTok but is often misrepresented. This study analyzed the accuracy (i.e., accurate, overgeneralizing, or inaccurate), reach (i.e., views, likes, comments, and shares), and content quality (i.e., understandability and actionability) of 117 informational TikTok videos about OCD. Content creator type (health care professionals [HCPs], individuals with lived experiences, and others) was determined. Of the 117 analyzed videos, 64 (54.7%) were accurate, 31 (26.5%) overgeneralizing, and 22 (18.8%) inaccurate. HCP-created videos were significantly more accurate (82.1% accurate) than non-HCP-created ones (individuals with lived experiences: 63.6% accurate; others: 35.7%). Reach metrics did not vary significantly across accuracy levels and creator types. Videos analyzed were moderately understandable, and accurate videos were significantly more understandable. However, actionability was low overall. Results suggest that misinformation about OCD on TikTok is common and is being disseminated almost as widely as accurate information. Clinical implications are discussed.

The Obsessive-Compulsive Inventory-Child Version (OCI-CV), which was developed to assess OCD symptoms in children and adolescents, was recently revised (OCI-CV-R) after hoarding was removed as an OCD symptom dimension in the DSM-5. The study aimed to examine the validity of the OCI-CV-R for assessing OCD symptoms in Turkish culture. A total of 1,062 youths, aged 9 to 18 years, participated in this study to assess the OCI-CV-R's psychometric properties in the Turkish culture. Analysis included factor analyses and assessments of validity and reliability. Results demonstrated that the Turkish version of the OCI-CV-R had good model fit values for the five-factor structure of the scale. The revised scale also revealed measurement invariance between two age groups: children (ages 9-11) and adolescents (ages 12-18). The findings indicate that the OCI-CV-R is a valid and reliable instrument for assessing OCD symptoms among Turkish-speaking populations and thus can replace the previous version.

This study assessed the validity and reliability of the Youth and Parent Forms of the Work and Social Adjustment Scale (WSAS) in the Turkish population. The patient group comprised 298 young patients aged 8 to 18 with any anxiety disorder, while 107 healthy young people formed the control group. Participants completed assessments, including the Screen for Child Anxiety-Related Disorders and the Pediatric Quality of Life Inventory (PedsQL), alongside the WSAS, while parents also completed the PedsQL and the WSAS. After 2 weeks, 100 individuals from the patient group were reevaluated for test-retest reliability. Results showed satisfactory validity and reliability, supported by statistical analyses, including Rasch analysis and Cronbach's alpha coefficient. The WSAS demonstrated validity across all evaluations and reliable internal consistency (Cronbach's alpha: parent form = .755, youth form = .750), test-retest reliability (correlation coefficients: parent form = 0.934, youth form = 0.937). Overall, the WSAS proved valid and reliable in the Turkish language.

The Texas Child Health Access Through Telemedicine (TCHATT) program addresses the growing mental health crisis among children and adolescents by providing accessible, school-based telehealth services. With over 18 million youth in t he U.S. experiencing mental health issues, exacerbated by the COVID-19 pandemic, TCHATT offers free, short-term therapy, medication management, and case management to students in Texas public schools. The program serves a diverse population, with 53% Hispanic, 28% non-Hispanic White, 12% Black, and 5% Asian students, reflecting the state's demographics. Strengths include universal access, reduced school absences, and educational outreach to school staff and families. However, challenges remain, such as ensuring culturally responsive care, recruiting a diverse workforce, and addressing broadband access disparities in rural areas. TCHATT exemplifies a scalable program for increasing mental health access, particularly for underserved populations, while highlighting the need for systemic investments in telehealth infrastructure and workforce diversity.

This study examined discrepancies between child and parent reports of pediatric anxiety, depression, and anger, as well as how parental anxiety differentially influenced these reports across clinical manifestations. Participants were recruited from clinical centers in Brazil specializing in anxiety disorders, comprising 47 children aged 7 to 17 years and their parents. Parent-child agreement was moderate to high for anxiety and depression symptoms but nonsignificant for anger. Parental anxiety was significantly associated with child anxiety and depression in parent-reported measures, while child-reported measures showed significant associations only between parental anxiety and child anxiety. Multivariate analyses identified parental anxiety as a significant predictor for child anxiety but not for child depression. These findings emphasize the influence of parental anxiety on parental perceptions of pediatric anxiety, highlighting the need to account for this potential bias in clinical assessments and treatment planning.

Behavioral health research is guided by ethical principles that seek to improve the well-being of individuals and communities. Traditional research approaches, however, may fall short when they fail to account for the sociocultural and structural contexts shaping mental health outcomes, particularly for historically underserved populations. Community-based participatory research (CBPR) offers a promising framework for addressing these gaps by fostering equitable academic-community partnerships, co-developing research questions, and emphasizing shared ownership of findings. This commentary presents an overview of CBPR and its associated benefits and challenges, and illustrates the application of CBPR in the Standing Up for Mental Health study, a targeted, cross-age peer mentoring intervention designed to support racially and ethnically minoritized youth. Our experience demonstrates how CBPR enhances cultural responsiveness, ecological validity, and translational potential, aligning research processes with the goal of advancing health equity.

Social anxiety disorder (SAD) is characterized by significant distress and avoidance surrounding social and performance situations, with marked interpersonal and academic impairment. This review article highlights cultural considerations relevant to the conceptualization, identification, and treatment of SAD in Black youth. Research evaluating the utility of evidence-based measures to assess SAD suggests they are culturally relevant; however, gaps in knowledge regarding the psychometric properties of even the most widely used instruments are evident. In regard to intervention, cognitive behavioral therapy (CBT) approaches hold promise, yet there is a lack of research on the use of CBT with Black adolescents. Recommendations to incorporate cultural factors into CBT are provided, and future work investigating culturally adapted interventions is needed. Finally, given significant disparities in access and utilization of mental health services among Black youth, strategies to increase treatment engagement, such as school-based services, are important to consider.

The aim of this study was to examine worsening of OCD symptoms after childbirth in individuals seeking assessment or treatment of OCD. The postpartum period may make parents biologically and psychologically vulnerable to OCD symptoms. Participants included 222 parents with OCD who completed surveys through a self-help website. Most women and almost half of men with self-reported OCD reported an increase in OCD symptoms following childbirth. Retrospective report of perceived worsening of OCD symptoms after childbirth was associated with more aggressive obsessions for both men and women, in comparison to individuals whose OCD symptoms did not worsen around childbirth. Women whose OCD symptoms worsened after childbirth reported more impairment in social functioning than individuals whose symptoms did not worsen. These results highlight the need to develop a better understanding of aggressive obsessions in parents, and improve education about prevalence, content, assessment, and intervention for aggression-focused intrusive thoughts.

Research specific to obsessive-compulsive disorder (OCD) among individuals of Hispanic and Latin American (H/L) ancestry is limited, as are culturally relevant assessment and treatment recommendations. This article discusses the implications of underrepresentation of H/L populations in OCD research and emphasizes the need to consider issues related to assessment, treatment, and structural barriers that hinder delivery of culturally appropriate first-line psychotherapy. Recommendations for assessment and treatment are provided to aid clinicians in distinguishing culturally normative thoughts and behaviors from OCD, as well as to inform the implementation of psychotherapeutic interventions with cultural humility. This manuscript offers recommendations for future research to tackle health equity concerns with respect to assessment and treatment and structural factors limiting access to culturally appropriate psychotherapy. Wide-scale efforts are needed to comprehensively understand how H/L cultures intersect with various OCD presentations and to further disseminate treatments to populations that have historically lacked access to mental health care.