Npj mental health research最新文献

Psychedelic substances are increasingly recognized for their potential to catalyse transformative shifts in worldviews. Central to these transformations may be the integration of self-transcendent states. This mixed-methods study explored transformative psychedelic experiences, focussing on subsequent epistemic shifts. Ninety participants completed the Awe Experience Scale (AWE-S), and the Inclusion of Other in Self Scale (IOS) and open-ended questions exploring epistemic changes. The vastness and connectedness components of awe recalled from the acute psychedelic experience were significantly positively associated with perceived self-other overlap post-experience. Thematic Network Analysis revealed three epistemic shift clusters: (1) expanded awareness and openness to complexity, (2) dissolution of societal and natural boundaries, (3) increased prosociality, compassion and acceptance of difference. Together, these patterns suggest that boundary-expanding experiences can promote reflective meaning-making towards more holistic, interconnected frameworks of understanding self, others, and the world. We discuss the potential of psychedelic experiences to foster prosocial and ecologically aware worldviews, and highlight the need for further research to identify culturally attuned resources for supporting the integration of transformative psychedelic experiences.

Substance use disorder (SUD) is characterized by behaviors of impaired control, physical dependence, social impairments, and risky use, regardless of the substance used-yet no prior work has predicted these behaviors directly. This study of 3476 adults used 15 judgment variables, derived from a picture rating task, with contextual variables to predict the SUD-defining behaviors, recency of four categories of substances being used, and SUD severity. This study achieved up to 83% accuracy and 0.74 AUC ROC for SUD behavior and moderate-high prediction for substance use with a balanced random forest approach, and 84% accuracy for predicting SUD severity. Judgment variable profiles revealed that participants with higher SUD severity are more risk-seeking, less resilient to losses, have more approach behavior, and have less variance in preference. This study argues that distinct constellations of 15 judgment variables yield a scalable system for addiction assessment, which can support research across a broad range of addictions.

In this preregistered longitudinal study with nationally representative samples from 23 countries in the Global Flourishing Study (N = 207,919), we examine associations between dispositional forgivingness and multidimensional well-being outcomes approximately one year later. Following the analytic template for outcome-wide designs, we conducted a series of country-specific weighted multivariate regression analyses where each Wave 2 outcome was regressed on Wave 1 forgivingness (controlling for Wave 1 sociodemographic and retrospectively recalled childhood variables). Random effects meta-analyses were used to pool country-specific estimates of association for the 56 main outcomes covering psychological, social, physical, volitional, and material dimensions of well-being. We found some evidence of association between forgivingness and higher well-being for both composite well-being indicators and numerous specific indicators across different domains of functioning (observed associations were mostly very small in magnitude). Associations were generally stronger and more consistent for some domains (e.g., psychological well-being) compared to others (e.g., physical health & health behavior). Meta-analyzed estimates of association generally attenuated after using a more conservative analytic approach that additionally adjusted for principal components extracted from the Wave 1 outcomes treated as covariates. Country-specific results showed some cross-national variation. Our findings contribute novel population-level evidence on the potential benefits of forgivingness for different aspects of well-being.

Skilled trades workers, including electricians, face unique occupational stressors and a persistent labour shortage that may contribute to burnout, job dissatisfaction, and heightened intention to leave (ITL). This cross-sectional study of 73 electricians aimed to assess the prevalence of burnout, job satisfaction, and ITL and to explore the relationships between these factors while accounting for sociodemographic and occupational characteristics. Burnout (measured using the Copenhagen Burnout Inventory), was prevalent (31.8%) but not independently associated with ITL. Higher job satisfaction (measured using an adapted NIOSH Generic Job Stress Questionnaire) was linked to lower ITL (OR = 0.58, 95% CI [0.34, 0.96]). Apprentice status significantly increased the odds of ITL (OR = 6.59, 95% CI [1.48, 38.47]). Findings suggest that job satisfaction is a protective factor against turnover intention, while apprentices are at a greater risk of ITL - underscoring the need for targeted retention and mental health strategies in the skilled trades.

Antidepressant efficacy for major depressive disorder (MDD) remains limited, with the neural mechanisms underlying treatment response poorly understood. The default mode network (DMN), particularly the connectivity between the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC), has been implicated in MDD pathophysiology and may be linked to treatment outcomes. However, its potential as a biomarker for antidepressant response has not been validated. Here, we investigate the relationship between DMN connectivity and antidepressant treatment response in MDD. Resting-state fMRI data from four large MDD cohorts (n = 4271) were analyzed using Granger causality to examine directional effective connectivity (EC) within the DMN. Linear mixed-effects models compared EC between recurrent MDD patients, first-episode drug-naïve patients, and healthy controls. We also examined associations between EC, medication use, illness duration, depressive symptoms, and treatment outcomes. Additionally, Support Vector Machine (SVM) classifiers and support vector regression (SVR) were trained using EC from mPFC to PCC to predict treatment response. Our results revealed that recurrent MDD patients exhibited significantly reduced EC from mPFC to PCC compared to healthy controls and first-episode patients, with this reduction correlating with antidepressant medication use and illness duration. Importantly, DMN connectivity was associated with treatment improvement rather than core depressive symptoms, including suicide, anhedonia, or emotional blunting. Crucially, EC from mPFC to PCC predicted antidepressant treatment response, and SVM classifiers demonstrated high predictive accuracy for therapeutic outcomes. In conclusion, reduced EC from mPFC to PCC may serve as a biomarker for antidepressant treatment response in MDD, offering insights into MDD neurobiology and supporting the clinical potential of DMN connectivity measures for guiding treatment decisions. The SAINT, Xijing_QG, and Xijing_KG datasets were approved by the Ethics Committee of the First Affiliated Hospital, Fourth Military Medical University (approval numbers: KY20202066-F-1, XJLL-KY20222111, and KY20222165-F-1, respectively) and registered with clinicaltrials.gov (identifiers: NCT04653337, NCT05577481, and NCT05544071, respectively).

Telemedicine became a vital tool during the COVID-19 pandemic, a time marked by increased social isolation and mental health challenges among adolescents. Using data from 7,998 U.S. adolescents collected in early 2021 via the Adolescent Behavior Experience Survey, this study examined intersectional disparities in telemental health use. Stratified multivariable logistic regression models revealed significantly lower odds of telemedicine use for mental health care among marginalized groups who experienced suicidal thoughts or behaviors. These included Black, Hispanic/Latino, and multi-racial Latino female adolescents; Black heterosexual adolescents; and sexual minority multi-racial non-Latino adolescents. Notably, sexual minority multi-racial non-Latino adolescents showed higher odds of telemental health care use in some cases. The findings highlight critical gaps in access and underscore the need for targeted strategies to improve equitable mental health service delivery, particularly for racially diverse sexual and gender minority youth navigating intersecting structural and identity-based inequities.

This pragmatic randomized controlled trial examined the effectiveness of reviga, a self-guided digital intervention based on cognitive behavioral therapy, in reducing work-related stress symptoms. A total of 290 adults experiencing significant stress and burnout were assigned to the intervention group (reviga + treatment as usual [TAU]; n = 147) or the control group (TAU only; n = 143). Intent-to-treat analyses showed that 3 months post-randomization, participants in the intervention group experienced significant positive effects on the primary outcome, perceived stress (Cohen's d = 0.36), as well as on the secondary outcomes anxiety (d = 0.28), burnout (d = 0.31), occupational and social functioning (d = 0.31) and health-related quality of life (d = 0.35) compared to TAU. No effect was found for absenteeism quantified as the number of sick days. Effect sizes increased at 6 month follow-up. This study demonstrates that reviga represents a promising and scalable tool for workplace mental health support.

Clinical trials in digital mental health have grown rapidly, yet little research has examined their informativeness. This study assessed the proportions of recent trials that met indicators of informativeness and explored related factors. Using stratified sampling from five trial registries, we randomly selected 25% (N = 152) of recent trials for depression, anxiety, and psychosis in high-income and low- and middle-income countries. Each trial was evaluated against 17 established indicators. On average, trials met only half of these (M = 8.9, SD = 4.57, range 2-17). Just 5.3% (n = 8) met all indicators, with methodological criteria more often satisfied than those related to ethical, equitable, or open research practices. Informativeness did not differ by disorder or region but was higher where trial documentation and reporting were more accessible, with notable variation across registries. Findings highlight that many digital mental health trials may lack value for stakeholders, underscoring the need to prioritise informativeness and improve registry reporting.