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Improving refugee mental health through resilience and research 通过复原力和研究改善难民的心理健康
Pub Date : 2024-11-06 DOI: 10.1038/s44220-024-00363-6
The dramatic increase in refugees and people who have been displaced by climate-driven natural disasters, as well as by political unrest and conflict, requires broad rethinking about how aid is provided. In addition to covering basic physical needs, the mental health needs of refugees must also be considered.
难民和因气候自然灾害以及政治动荡和冲突而流离失所的人急剧增加,这要求我们对提供援助的方式进行广泛的反思。除了满足基本的物质需求外,还必须考虑难民的心理健康需求。
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引用次数: 0
A health-equity framework for tailoring digital non-pharmacological interventions in aging 老龄化数字非药物干预的健康公平框架
Pub Date : 2024-11-01 DOI: 10.1038/s44220-024-00347-6
Adam Turnbull, Michelle C. Odden, Christine E. Gould, Ehsan Adeli, Robert M. Kaplan, Feng Vankee Lin
If designed with health equity in mind, digital non-pharmacological interventions (NPIs) represent a cost-effective, scalable means of reducing health disparities associated with age-related mental health disorders in older adults in the USA. However, disparities in technological access, literacy and effectiveness can limit the impact of these interventions in older adults from disadvantaged groups. We present a health-equity-promoting framework for the development of digital NPIs for age-related mental health disorders and provide an example from the literature that highlights how interventions can be targeted at specific groups to increase technological access, literacy and effectiveness to ensure that these interventions can meet their potential of reducing health disparities. Presenting a health-equity-promoting framework, this Perspective argues for considering access to technology, health literacy and effectiveness in digital non-pharmacological interventions for older adults.
如果在设计时考虑到健康公平问题,数字化非药物干预(NPIs)就是一种具有成本效益、可扩展的手段,可用于减少美国老年人与年龄相关的心理健康疾病相关的健康差距。然而,技术普及、文化水平和有效性方面的差异会限制这些干预措施对弱势群体老年人的影响。我们提出了一个促进健康公平的框架,用于开发针对与年龄相关的心理健康障碍的数字 NPI,并提供了一个文献实例,强调如何针对特定群体采取干预措施,以提高技术普及率、文化水平和有效性,从而确保这些干预措施能够实现其减少健康差距的潜力。本视角提出了一个促进健康平等的框架,主张在针对老年人的数字化非药物干预中考虑技术的可及性、健康素养和有效性。
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引用次数: 0
Strengthening autonomy in mental health care through a relational approach 通过关系方法加强心理健康护理中的自主性
Pub Date : 2024-11-01 DOI: 10.1038/s44220-024-00337-8
Paola Buedo, Timothy Daly
Respect for autonomy is foundational to all types of clinical care, and receiving mental health care places people in a vulnerable situation that has a direct impact on their ability to live as they choose, making concerns about autonomy central. The classical understanding of personal autonomy, which still influences medical guidelines, is based on an individualistic framework and is inadequate for ethical mental health care. The goal of this Comment is to articulate why the relational autonomy model, developed in feminist bioethics, is a necessary approach for the mental health field.
尊重自主权是各类临床护理的基础,而接受心理健康护理使人们处于一种脆弱的境地, 直接影响到他们按照自己的选择生活的能力,这就使自主权成为关注的焦点。对个人自主权的传统理解仍然影响着医疗指南,但这种理解是建立在个人主义框架之上的,对于符合伦理的心理健康护理来说是不够的。本评论的目的是阐明为什么女权主义生命伦理学中提出的关系自主模式是心理健康领域所必需的方法。
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引用次数: 0
A dual-continuum framework to evaluate climate change impacts on mental health 评估气候变化对心理健康影响的双连续框架
Pub Date : 2024-10-31 DOI: 10.1038/s44220-024-00326-x
Francis Vergunst, Rachel Williamson, Alessandro Massazza, Helen L. Berry, Miranda Olff
Climate change is driving a suite of stressors that could increase the global mental health burden. In this Perspective we consider three mental health frameworks to evaluate this burden. The pathogenic framework focuses on symptom management in the presence or absence of mental disorders. The salutogenic framework emphasizes factors related to psychological wellbeing such as personal strengths, resilience and socio-environmental resources. The third approach—the dual-continuum or ‘complete state’ framework—considers mental disorders and psychological wellbeing simultaneously. Drawing on the cross-disciplinary literature, we find that the dual-continuum framework is a practical and empirically valid approach to evaluate climate-related impacts on mental health. This is because mental disorders and reduced wellbeing, though related, are conceptually and empirically distinct, and encompass different climate-related antecedents and psychosocial endpoints. Both are necessary to evaluate the full burden of climate change. In this Perspective, the authors present a framework for evaluating the burden of climate change to mental health that considers both mental disorders and psychological wellbeing.
气候变化带来的一系列压力可能会加重全球心理健康负担。在本视角中,我们考虑了三种心理健康框架来评估这一负担。致病框架侧重于精神障碍存在或不存在时的症状管理。致救框架强调与心理健康相关的因素,如个人力量、恢复力和社会环境资源。第三种方法--双重连续性或 "完整状态 "框架--同时考虑精神障碍和心理健康。根据跨学科文献,我们发现双重连续性框架是评估气候相关因素对心理健康影响的一种实用且经验有效的方法。这是因为,精神障碍和幸福感下降虽然相互关联,但在概念和经验上却截然不同,并且包含不同的气候相关前因和心理社会终点。要评估气候变化的全部负担,两者都是必要的。在本《视角》中,作者提出了一个评估气候变化对心理健康造成的负担的框架,该框架同时考虑了精神障碍和心理健康。
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引用次数: 0
New insights from gene expression patterns on the neurobiological basis of risky behavior 从基因表达模式揭示危险行为的神经生物学基础
Pub Date : 2024-10-30 DOI: 10.1038/s44220-024-00333-y
Gökhan Aydogan, Christian C. Ruff
The tendency to engage in risky behavior relates to genetic predispositions and brain structure, but the molecular pathways linking genes to neuroanatomical changes remain elusive. A recent study reveals how specific gene expression patterns shape brain structures associated with risk-taking, suggesting a mechanistic pathway from genes to maladaptive behavior.
从事冒险行为的倾向与遗传倾向和大脑结构有关,但将基因与神经解剖学变化联系起来的分子途径仍然难以捉摸。最近的一项研究揭示了特定基因表达模式如何塑造与冒险行为相关的大脑结构,从而提出了从基因到不适应行为的机制途径。
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引用次数: 0
Linking neuroimaging and mental health data from the ABCD Study to UrbanSat measurements of macro environmental factors 将 ABCD 研究的神经成像和心理健康数据与 UrbanSat 测量的宏观环境因素联系起来
Pub Date : 2024-10-30 DOI: 10.1038/s44220-024-00318-x
Ran Goldblatt, Nathalie Holz, Garrett W. Tate, Kari Sherman, Selamawit Ghebremicael, Soumitra S. Bhuyan, Yazan A. Al-Ajlouni, Sara Santillanes, Ghermay Araya, Shermaine Abad, Megan M. Herting, Wesley K. Thompson, Bishal Thapaliya, Ram Sapkota, Jiayuan Xu, Jingyu Liu, The environMENTAL consortium, Gunter Schumann, Vince D. Calhoun
Although numerous studies over the past decade have highlighted the influence of environmental factors on mental health, globally applicable data on physical surroundings such as land cover and urbanicity are still limited. The urban environment is complex and composed of many interacting factors. To understand how urban living affects mental health, simultaneous measures of multiple environmental factors need to be related to symptoms of mental illness, while considering the underlying brain structure and function. So far, most studies have assessed individual urban environmental factors, such as greenness, in isolation and related them to individual symptoms of mental illness. We have refined the satellite-based ‘Urban Satellite’ (UrbanSat) measures, consisting of 11 satellite-data-derived environmental indicators, and linked them through residential addresses with participants of the Adolescent Brain Cognitive Development (ABCD) Study. The ABCD Study is the largest ongoing longitudinal and observational study exploring brain development and child health, involving 11,800 children, assessed at 9–16 years of age, from 21 sites across the USA. Here we describe linking of the ABCD Study data with UrbanSat variables, including each subject’s residential address at their baseline visit, including land cover and land use, nighttime lights and population characteristics. We also highlight and discuss important links of the satellite-data variables to the default mode network clustering coefficient and cognition. This comprehensive dataset provides an important tool for advancing neurobehavioral research on urbanicity during the critical developmental periods of childhood and adolescence. In this Perspective, the authors present a model of assessing urban environmental factors’ impact on mental health by using UrbanSat measures and data from adolescents in the ABCD Study.
尽管过去十年间的许多研究都强调了环境因素对心理健康的影响,但全球适用的物理环境数据(如土地覆被和城市化程度)仍然有限。城市环境十分复杂,由许多相互作用的因素组成。要了解城市生活如何影响心理健康,需要同时测量多种环境因素与精神疾病的症状之间的关系,同时考虑潜在的大脑结构和功能。迄今为止,大多数研究都是孤立地评估绿化等单个城市环境因素,并将其与单个精神疾病症状联系起来。我们改进了基于卫星的 "城市卫星"(UrbanSat)测量方法,该方法由 11 个卫星数据衍生的环境指标组成,并通过居住地址将这些指标与青少年大脑认知发展(ABCD)研究的参与者联系起来。ABCD 研究是目前最大的探索大脑发育和儿童健康的纵向观察研究,涉及美国 21 个地点的 11,800 名 9-16 岁儿童。我们在此介绍 ABCD 研究数据与 UrbanSat 变量的联系,包括每个受试者基线访问时的居住地址,包括土地覆盖和土地利用、夜间灯光和人口特征。我们还强调并讨论了卫星数据变量与默认模式网络聚类系数和认知的重要联系。这一全面的数据集为推进儿童和青少年关键发育期的城市性神经行为研究提供了重要工具。在本《视角》中,作者提出了一个评估城市环境因素对心理健康影响的模型,该模型采用 UrbanSat 测量方法和 ABCD 研究中的青少年数据。
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引用次数: 0
Enhancing brain health in the global south through a sex and gender lens 从性和性别角度加强全球南部的大脑健康
Pub Date : 2024-10-28 DOI: 10.1038/s44220-024-00339-6
Sandra Baez, Laura Castro-Aldrete, Gabrielle B. Britton, Agustin Ibañez, Antonella Santuccione-Chadha
Gender inequality substantially impacts society, disproportionately disadvantaging women, especially in the global south. This inequality correlates with brain health outcomes for women, including a higher risk of cognitive decline and dementia. Here we highlight how sex-linked biology and gender disparities affect women’s brain health in the global south through various pathways, such as a differential exposomes, health behaviors and gender biases in research and healthcare systems. Alzheimer’s disease and other brain health conditions exemplify how sex-specific risk factors and gender-related health barriers interact to influence brain health. We advocate for incorporating sex/gender considerations in research, policy and clinical practice to improve brain health interventions in the global south. Additionally, we propose using the patient and public involvement framework to effectively tailor health strategies that address these factors. This Perspective discusses how gender disparities affect women’s brain health in the global south and proposes strategies to improve brain health outcomes by incorporating sex and gender considerations in research, policy and clinical practice and using the patient and public involvement framework.
性别不平等对社会产生了重大影响,尤其是在全球南部地区,妇女处于不成比例的不利地位。这种不平等与女性的大脑健康结果相关,包括认知能力下降和痴呆症的风险较高。在此,我们将重点介绍与性别相关的生物学和性别差异如何通过各种途径影响全球南部女性的大脑健康,例如不同的暴露体、健康行为以及研究和医疗保健系统中的性别偏见。阿尔茨海默氏症和其他脑部健康问题体现了特定性别的风险因素和与性别相关的健康障碍是如何相互作用影响脑部健康的。我们主张将性/性别因素纳入研究、政策和临床实践,以改善全球南部的脑健康干预措施。此外,我们还建议使用患者和公众参与框架来有效地定制解决这些因素的健康策略。本视角讨论了性别差异如何影响全球南部女性的大脑健康,并提出了通过将性和性别因素纳入研究、政策和临床实践以及利用患者和公众参与框架来改善大脑健康结果的策略。
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引用次数: 0
Advancing computational psychiatry through a social lens 从社会视角推进计算精神病学的发展
Pub Date : 2024-10-28 DOI: 10.1038/s44220-024-00343-w
Shawn A. Rhoads, Xiaosi Gu, Joseph M. Barnby
Social factors have an outsized role in the progression and treatment of psychiatric conditions, but existing computational models often neglect social context. We propose that integrating social features into computational frameworks will shed light into the complexity of mental health, and provide guidelines for model design.
社会因素在精神疾病的发展和治疗中发挥着重要作用,但现有的计算模型往往忽视了社会背景。我们提出,将社会特征纳入计算框架将揭示心理健康的复杂性,并为模型设计提供指导。
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引用次数: 0
Advancing a consent-forward paradigm for digital mental health data 推进数字心理健康数据的 "征得同意 "模式
Pub Date : 2024-10-25 DOI: 10.1038/s44220-024-00330-1
Sachin R. Pendse, Logan Stapleton, Neha Kumar, Munmun De Choudhury, Stevie Chancellor
The field of digital mental health is advancing at a rapid pace. Passively collected data from user engagements with digital tools and services continue to contribute insights into mental health and illness. As the field of digital mental health grows, a concerning norm has been established—digital service users are given little say over how their data are collected, shared or used to generate revenue for private companies. Given a long history of service-user exclusion from data collection practices, we propose an alternative approach that is attentive to this history: the consent-forward paradigm. This paradigm embeds principles of affirmative consent in the design of digital mental health tools and services, which may strengthen trust around individual choices and needs, and proactively protect users from unexpected harm. In this Perspective, we outline practical steps to implement this paradigm, toward ensuring that people searching for care have the safest experiences possible. In this Perspective, the authors discuss a consent-forward paradigm that embeds principles of affirmative consent in the design of digital mental health tools and services and protects users from unexpected harm.
数字心理健康领域正在飞速发展。从用户使用数字工具和服务的过程中被动收集到的数据,将继续有助于人们深入了解心理健康和疾病。随着数字心理健康领域的发展,一个令人担忧的常态已经形成--数字服务用户对其数据如何被收集、共享或用于为私营公司创收几乎没有发言权。鉴于服务用户被排除在数据收集实践之外的历史由来已久,我们提出了一种关注这一历史的替代方法:"同意向前 "范式。这种范式在数字心理健康工具和服务的设计中体现了肯定同意的原则,可以加强对个人选择和需求的信任,并主动保护用户免受意外伤害。在本《视角》中,我们概述了实施这一范例的实际步骤,以确保人们在寻求护理时获得最安全的体验。在本《视角》中,作者讨论了 "征得同意 "范式,该范式将 "肯定性同意 "原则纳入数字心理健康工具和服务的设计中,并保护用户免受意外伤害。
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引用次数: 0
Building personalized machine learning models using real-time monitoring data to predict idiographic suicidal thoughts 利用实时监控数据建立个性化机器学习模型,预测特发性自杀想法
Pub Date : 2024-10-24 DOI: 10.1038/s44220-024-00335-w
Shirley B. Wang, Ruben D. I. Van Genugten, Yaniv Yacoby, Weiwei Pan, Kate H. Bentley, Suzanne A. Bird, Ralph J. Buonopane, Alexis Christie, Merryn Daniel, Dylan DeMarco, Adam Haim, Lia Follet, Rebecca G. Fortgang, Flynn Kelly-Brunyak, Evan M. Kleiman, Alexander J. Millner, Onyinye Obi-Obasi, J. P. Onnela, Narise Ramlal, Jordyn R. Ricard, Jordan W. Smoller, Tida Tambedou, Kelly L. Zuromski, Matthew K. Nock
Suicide risk is highest immediately after psychiatric hospitalization, but the field lacks methods for identifying which patients are at greatest risk, and when. We built personalized models predicting suicidal thoughts after psychiatric hospital visits (N = 89 patients), using ecological momentary assessment (EMA; average EMA responses per participant = 311). We built several idiographic models, including baseline autoregressive and elastic net models (using single train/test split) and Gaussian process (GP) models (using an iterative rolling-forward prediction method). Simple GP models provided the best prediction of suicidal urges (R2average = 0.17), outperforming baseline autoregressive (R2average = 0.10) and elastic net (R2average = 0.06) models. Similarly, simple GP models provided the best prediction of suicidal intent (R2average = 0.12) compared to autoregressive (R2average = 0.08) and elastic net (R2average = 0.04). Here we show that idiographic prediction of suicidal thoughts is possible, although the accuracy is currently modest. Building GP models that iteratively update and learn symptom dynamics over time could provide important information to inform the development of just-in-time adaptive interventions. Using ecological monetary assessment, this study presents findings from idiographic models built to predict suicidal ideation in individuals after psychiatric hospitalization.
精神病患者住院后立即自杀的风险最高,但该领域缺乏识别哪些患者以及何时自杀风险最高的方法。我们利用生态瞬间评估(EMA;每位参与者的平均 EMA 反应 = 311)建立了预测精神病院就诊后自杀想法的个性化模型(N = 89 名患者)。我们建立了多个特异性模型,包括基线自回归模型和弹性网模型(使用单一训练/测试分割)以及高斯过程(GP)模型(使用迭代滚动前向预测方法)。简单的 GP 模型对自杀冲动的预测效果最好(R2average = 0.17),优于基线自回归模型(R2average = 0.10)和弹性网模型(R2average = 0.06)。同样,与自回归模型(R2 平均值 = 0.08)和弹性网模型(R2 平均值 = 0.04)相比,简单的 GP 模型对自杀意向的预测效果最好(R2 平均值 = 0.12)。我们在此表明,对自杀意念进行特异性预测是可能的,尽管其准确性目前并不高。建立能随着时间推移迭代更新和学习症状动态的 GP 模型,可为及时适应性干预措施的开发提供重要信息。本研究采用生态货币评估方法,介绍了为预测精神病患者住院后的自杀意念而建立的特异性模型的研究结果。
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引用次数: 0
期刊
Nature mental health
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