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Conflict-affected youth are at risk for poor psychological and social outcomes, yet few receive mental health services. Strategies to expand access and sustain evidence-based interventions (EBIs) across novel delivery platforms must be tested. The present study was a hybrid type II implementation-effectiveness trial using a cluster randomized design. The primary goal was to evaluate feasibility and impact of using the collaborative team approach to deliver the Youth Readiness Intervention (YRI), an EBI, integrated into a youth entrepreneurship program (ENTR) with quality control in post-conflict Sierra Leone. Youth were screened and randomly assigned to control, ENTR, or combined YRI and ENTR (YRI+ENTR). Implementation outcomes were dissemination and implementation indicators, competence, and fidelity. Effectiveness outcomes were emotion regulation, psychological distress, and interpersonal functioning. Secondary outcomes were third-party reporter assessments of youth functioning and behavior. Data were collected and analyzed from 1,151 youth participants and 528 third-party reporters. Scores on implementation constructs, competence, and fidelity demonstrated acceptable intervention response and quality. YRI+ENTR participants showed overall improvements in depression (β = −.081, 95% CI −0.124 to −0.038, d = −0.154) and anxiety (β = −.043, 95% CI −0.091 to −0.005, d = 0.082) symptoms compared with control participants. Community leaders indicated that YRI+ENTR participants demonstrated improvements in overall work or training performance compared with control participants (β = −.114, 95% CI 0.004 to 0.232, d = 0.374). Integration of EBIs such as the YRI into youth employment programs has the potential to address limited reach of EBIs in conflict and post-conflict settings. A collaborative team implementation approach can facilitate integration and fidelity. In a Hybrid Type-II Implementation-Effectiveness trial conducted in Sierra Leone, researchers tested a Collaborative Team Approach (CTA) for delivering an evidence-based mental health intervention, the Youth Readiness Intervention (YRI), within a youth entrepreneurship program. A total of 1,151 youth participated in the study, with outcomes measured on youth mental health indicators of emotional regulation, psychological distress, and interpersonal functioning, as well as implementation indicators, competence, and fidelity. Results demonstrated that the integrated YRI and entrepreneurship program led to significant improvements in depression and anxiety symptoms compared to the control group. Community leaders also noted enhanced overall performance in YRI participants, suggesting that integrating evidence-based interventions into youth employment programs can effectively address mental health challenges in low-resource regions. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper received support from a program designed to increase minority representation in science. Youth FORWARD Phase 2 YRI and EPP Study; https://clinicaltrials.gov/ ; NCT03542500. Youth Functioning and Organizational Success for West African Regional Development (Youth FORWARD): Study Protocol; https://doi.org/10.1176/appi.ps.202000009. [ABSTRACT FROM AUTHOR]

The quality of the very early emotional experiences in a child's life are recognized today as foundational in the mental health of becoming an adult. Unsurprisingly, clinicians and health authorities agree on the importance of early detection and treatment of any mental health issues experienced by the preschool child. This is even more important and challenging as young children do not yet have the language skills necessary to express their distress. But do the caregivers in charge of these populations have the best tools at their disposal to carry out that important mission in an efficient and scientifically robust manner reflecting the latest research findings and scientific literature? This is the question we try to answer in this paper. We revisited the theoretical underpinnings behind the concept of mentalization as playing a key role in the ability to understand the other's inner reality. We then carried out an extensive review of scientific papers written over the past 30 years on the subject. We examined mental representations of the adult on the child and analyzed those mentalizations as key inputs. We focused on extracting cross analyses of the mentalizations of one child by several adults with different functions in the life of the child. In this process, we used the PRISMA methodology applied to large international medical databases. We found that the qualitative approach, usually associated with a lengthy process, has been overwhelmingly used in trying to assess patients' mental states and to analyze the mentalizations on the patient, adult or child. Furthermore, cross analyses of mentalizations from more than one adult on a given child were almost nonexistent, despite having high epistemic and clinical potential. There is a dearth of reliable quantitative tools, able to capture and analyze the mentalizations on a patient, that are scientifically robust, transposable, and easy to implement in a clinical setting. The absence of such tools for medical professionals in charge of assessing preschool children contributes, in our view, the low detection and poor treatment of mental disorders in that particularly vulnerable population. We believe there is here an urgent unmet need and that such tools should be designed, validated, and deployed into the target populations as early as possible. [ABSTRACT FROM AUTHOR]

Acute and chronic operational and organizational stress dysregulate associated neuroendocrine responses and have been shown to increase health risks and occupational performance errors. The current paper addressed a research gap comparing biopsychosocial stress measures and its interaction on police lethal force errors during realistic critical incident (CI) scenarios. A combined sample (n=101) of frontline and tactical police officers completed externally valid, live-action scenarios requiring lethal force decisions paralleling field experiences. Officers provided diurnal and reactive (pre-to-post CI) salivary cortisol samples, and self-reported mental health and stress symptoms. Higher cortisol awakening response significantly predicted increased odds of committing a lethal force error by 6.45%. However, further regressions deemphasizing influential outliers via logarithmic transformations (as per Psychoneuroendocrinology expert consensus guidelines⁠—Stalder et al., 2016) revealed a no longer significant association. Reactive cortisol did not predict lethal force error across all subsamples. Consistent with previous literature, several significant relationships between mental health symptoms and cortisol were observed. The use of cortisol in field research presents a number of collection, control, and cost challenges. Furthermore, outliers are necessary to include in analyses to represent the potential cortisol dysregulation in police officers deemed 'fit for duty' by their respective organizations. The current findings suggest that diurnal cortisol is heavily influenced by outlier values, and reactive cortisol may be too subtle to predict lethal force errors during acute stress. While purposeful for predicting long-term health outcomes, pursuit of alternative measures may be more suitable for assessing acute operational errors in field research. [ABSTRACT FROM AUTHOR]

• This is the third of four papers updating standards for the care of pwCF. • Monitoring and treating lung infection is important in all people with CF. • People with more advanced CF disease need holistic individualised care. • This should balance quality of life, treatment burden and clinical outcomes. • The CF team delivers lifelong care through advanced disease and end of life. This is the third in a series of four papers updating the European Cystic Fibrosis Society (ECFS) standards for the care of people with CF. This paper focuses on recognising and addressing CF health issues. The guidance was produced with wide stakeholder engagement, including people from the CF community, using an evidence-based framework. Authors contributed sections, and summary statements which were reviewed by a Delphi consultation. Monitoring and treating airway infection, inflammation and pulmonary exacerbations remains important, despite the widespread availability of CFTR modulators and their accompanying health improvements. Extrapulmonary CF-specific health issues persist, such as diabetes, liver disease, bone disease, stones and other renal issues, and intestinal obstruction. These health issues require multidisciplinary care with input from the relevant specialists. Cancer is more common in people with CF compared to the general population, and requires regular screening. The CF life journey requires mental and emotional adaptation to psychosocial and physical challenges, with support from the CF team and the CF psychologist. This is particularly important when life gets challenging, with disease progression requiring increased treatments, breathing support and potentially transplantation. Planning for end of life remains a necessary aspect of care and should be discussed openly, honestly, with sensitivity and compassion for the person with CF and their family. CF teams should proactively recognise and address CF-specific health issues, and support mental and emotional wellbeing while accompanying people with CF and their families on their life journey. [ABSTRACT FROM AUTHOR]

Sexual minority (SM) youth experience a greater mental health burden compared with their heterosexual peers. This study aimed to characterize mental health disparities among SM compared with non-SM youth, test main and interactive associations of SM identity and stressors targeting SM youth at the individual level (interpersonal SM discrimination) and structural level (state-level structural SM stigma) with youth mental health, and explore the contribution of interpersonal SM discrimination to the mental health burden of SM youth. Participants included 11,622 youth (ages 9-13; 47.6% assigned female at birth) from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects models tested main and interactive associations of SM identity, interpersonal SM discrimination, and structural SM stigma with mental health measures (self-reported overall psychopathology, suicidal ideation, and suicide attempts), adjusting for demographics and other interpersonal stressors not specific to SM (other discrimination types, peer victimization, and cyberbullying). Longitudinal mediation models tested whether interpersonal SM discrimination mediated the associations between SM identity and mental health measures. SM youth (n = 1,051) experienced more interpersonal SM discrimination and overall psychopathology compared with their non-SM peers (n = 10,571). Adjusting for demographics, there were significant associations (main effects) of interpersonal SM discrimination and structural SM stigma with overall psychopathology. When further adjusting for other non-SM–related stressors, the main effect of structural SM stigma was no longer significant. Interpersonal SM discrimination was also significantly associated with suicidal ideation and attempt, accounting for demographics, while structural SM stigma was not. Accounting for both demographics and other non-SM stressors, there was a significant interaction between SM identity and structural SM stigma in association with psychopathology (p =.02), such that, compared with their peers, SM youth showed a greater association between structural SM stigma and psychopathology. Longitudinal mediation revealed that interpersonal SM discrimination was a significant mediator explaining approximately 10% to 15% of the variance of the pathways between SM identity and all mental health outcomes. Results delineate contributions of interpersonal discrimination and structural stigma targeting SM youth to their heightened mental health burden in early adolescence. These findings underscore the need to address microlevel and macrolevel SM discrimination and structural stigma when caring for this population. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. [ABSTRACT FROM AUTHOR]

Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0 to 5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalization. Relevant studies published in peer-reviewed, English-language journals between the years 2000 and 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first 5 years of life and reported associations with later internalizing and/or externalizing problems. Methodological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist. Of 29,818 identified studies, 98 met inclusion criteria, with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months) and later internalizing (r = 0.14, 95% CI = 0.09, 0.20) and externalizing symptoms (r = 0.16, 95% CI = 0.11, 0.21) symptoms. For toddler/preschool irritability (13-60 months), small-to-moderate pooled associations were observed for internalizing (r = 0.21, 95% CI = 0.14, 0.28) and externalizing (r = 0.24, 95% CI = 0.18, 0.29) symptoms. These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization. Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterize irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. Early irritability as a transdiagnostic neurodevelopmental vulnerability to early onset mental health problems: A systematic review; https://www.crd.york.ac.uk/prospero/ ; CRD42020214658. [ABSTRACT FROM AUTHOR]

The prevalence of depression related to precarious employment (PE) has become a significant public health concern, given the declining trend of the standard employment relationship. Research has focused on the mental health detrimental effects of employment conditions, whereas there is scarce evidence concerning the burden of depression that could be prevented by targeting precariousness. This paper estimates the impact of PE on the risk of depression and the attributable fraction within the active and working salaried population in Spain. Observational cross-sectional on data drawn from the Spanish portion of European Health Survey 2020. After applying selection criteria and descriptives, binary logistic regression models stratified by sex are used to examine the associations between a 9-categories combination of employment precariousness and occupational social class, and depressive symptoms. There is a higher risk of depression among individuals in PE and among those who are unemployed, with a notable gradient based on occupational social class for women. Adjusting by sex, age and foreign-born origin, we estimate that approximately 15.0% (95% confidence interval [CI]: 1.0%–26.2%) of depression cases among the working population and 33.3% (95% CI: 23.2%-43.2) among the active population can be attributed to PE. These findings highlight the public health impact of PE on mental health, provide evidence to estimate the economic burden linked to employment-related mental health, and underscore the need for policy changes and interventions at the level of labour markets and workplaces to mitigate the detrimental effects of PE. [ABSTRACT FROM AUTHOR]

A prevailing view holds that the main goal of mental health promotion is to maintain and improve positive mental health, which is not merely defined by the absence of mental disorders, but by the presence of certain abilities. There are, however, challenges associated with this view that this paper aims to identify and explore. We start by highlighting three requirements for an ethically and politically justified mental health promotion scheme: (i) using a positive concept of mental health that (ii) respects the neutrality principle while (iii) not being overly permissive. Then, we argue that the WHO's positive concept of health violates (ii), and continue by exploring three philosophical accounts (i.e., Nordenfelt, 1995, 2017; Graham 2010; Wren-Lewis & Alexandrova, 2021) that could potentially provide a solution. We show that these face a dilemma of their own: they either violate (ii) or (iii), and they can rectify one issue only by violating the other. Considering the problems linked to the positive notion of health, the final section explores the alternate route of rejecting proposition (i) and instead embracing a negative concept of health. We argue that this option does not present a more advantageous solution. We conclude by highlighting the necessity for additional research to tackle the challenges we identified. [ABSTRACT FROM AUTHOR]

Although neuroimaging advances have deepened our understanding of brain health in individuals with congenital heart disease (CHD), it is less clear how neuroimaging findings relate to neurodevelopmental and mental health outcomes across the lifespan. We systematically synthesized and critically evaluated evidence on associations between neuroimaging and neurodevelopmental, neurocognitive, psychiatric, or behavioral outcomes among individuals with transposition of great arteries or single-ventricle CHD (Protocol CRD42021229617). Six databases were searched and 45 papers from 25 unique studies were identified. Structural brain injury was generally linked to poorer neurodevelopment in infancy. Brain volumes and microstructural and functional brain changes appear linked to neurocognitive outcomes, including deficits in attention, learning, memory, and executive function in children and adolescents. Fetal neuroimaging studies were limited. Four papers investigated psychiatric outcomes; none found associations with neuroimaging. Multicenter, longitudinal studies incorporating functional neuroimaging and mental health outcomes are much-needed to inform early neuroprotective and therapeutic strategies in CHD. [Display omitted] • Advances in neuroimaging have improved understanding of brain health and development in patients with CHD. • Structural, microstructural, and functional neuroimaging findings are linked to neurocognitive outcomes across the lifespan in patients with CHD. • Multicenter, longitudinal studies incorporating mental health metrics are needed to inform neuroprotective and therapeutic strategies in patients with CHD. [ABSTRACT FROM AUTHOR]

Individuals with prenatal alcohol exposure (PAE) commonly experience co-occurring diagnoses, which are often overlooked and misdiagnosed and have detrimental impacts on accessing appropriate services. The prevalence of these co-occurring diagnoses varies widely in the existing literature and has not been examined in PAE without an FASD diagnosis. A search was conducted in five databases and the reference sections of three review papers, finding a total of 2180 studies. 57 studies were included in the final analysis with a cumulative sample size of 29,644. Bayesian modeling was used to determine aggregate prevalence rates of co-occurring disorders and analyze potential moderators. 82 % of people with PAE had a co-occurring diagnosis. All disorders had a higher prevalence in individuals with PAE than the general population with attention deficit hyperactivity disorder, learning disorder, and intellectual disability (ID) being the most prevalent. Age, diagnostic status, and sex moderated the prevalence of multiple disorders. While prevalence of disorders is crucial information, it does not provide a direct representation of daily functioning and available supports. Results should be interpreted in collaboration with more individualized research to provide the most comprehensive representation of the experience of individuals with PAE. Co-occurring diagnoses are extremely prevalent in people with PAE, with older individuals, females, and those diagnosed with FASD being most at risk for having a co-occurring disorder. These findings provide a more rigorous examination of the challenges faced by individuals with PAE than has existed in the literature, providing clinicians with information to ensure early identification and effective treatment of concerns to prevent lifelong challenges. • No study has examined mental health prevalence rates in individuals with PAE but not FASD. • 57 articles including 29,644 individuals with alcohol exposure were found and analyzed. • 82 % of individuals with alcohol exposure have at least one co-occurring disorder • Older individuals, females, and those with an FASD diagnosis had higher prevalences of multiple disorders.. • These findings help inform both the diagnosis and support of individuals with alcohol exposure [ABSTRACT FROM AUTHOR]

Dans cette communication, nous montrons que la littérature sur la prévalence des troubles psychiatriques et liés à l'usage de substances en milieu pénitentiaire est riche. Son interprétation se heurte toutefois à plusieurs difficultés : (i) une grande hétérogénéité des systèmes judiciaire et de soins de santé mentale entre les pays et (ii) des spécificités de l'environnement carcéral parfois négligées dans la méthodologie des études. Forts de ce constat, nous développons les résultats d'un certain nombre de travaux de référence sur la prévalence des troubles psychiatriques et liés à l'usage de substances dans les prisons françaises. Nous discutons enfin les perspectives en termes d'épidémiologie psychiatrique en milieu pénitentiaire. In this paper, we show that the literature on the prevalence of psychiatric and susbtance use disorders in prisons is substantial. However, there are a number of difficulties one encounters in interpreting this literature: (i) there is considerable heterogeneity between countries' judicial and mental health care systems, and (ii) the specific features of the prison environment are sometimes overlooked in the methodology used to conduct such studies. With this in mind, we discuss a number of benchmark studies on the prevalence of psychiatric and substance use disorders in French prisons. Finally, we discuss the perspectives for psychiatric epidemiology in prisons. [ABSTRACT FROM AUTHOR]

To examine profiles of distress of mothers of preterm infants in the neonatal intensive care unit (NICU) and relate profiles to maternal and child outcomes at child age 5 years. A racially and economically diverse sample of mothers (n = 94; 39% African American, 52% White) of preterm infants (≤30 weeks of gestation) completed validated questionnaires assessing depression, anxiety (state and trait), NICU stress, and life stress at NICU discharge of their infant. Mothers reported on their own and their children's symptomatology at child age 5. A latent profile analysis was conducted to categorize maternal symptomatology. Latent profile analysis yielded 4 distinct maternal profiles: low symptomatology, high NICU stress, high depression and anxiety, and high state anxiety. Social determinants of health factors including age, education, neighborhood deprivation, and infant clinical risk distinguished the profiles. Mothers in the high depression and anxiety profile reported more anxiety and life stress at follow-up and reported their children experienced more anxious/depressed symptoms. Existing literature has gaps related to examining multiple dimensions of NICU distress and understanding how patterns of mood/affective symptoms, life stressors, and related social determinants of health factors vary across mothers. In this study, one specific profile of maternal NICU distress demonstrated enduring risks for poorer maternal and child mental health outcomes. This new knowledge underscores sources of disparate health outcomes for mothers of preterm infants and the infants themselves. Universal screening is needed to identify at-risk dyads for poor health outcomes in need of individualized interventions that address both maternal and child well-being. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this study was to examine the reliability, equivalence and respondent preference of a computerized version of the General Health Questionnaire (GHQ-12), Symptom Checklist (SCL-90-R), Medical Outcomes Study Social Support Survey (MOSSSS), Perceived Stress Scale (PSS) and Utrecht Coping List (UCL) in comparison with the original version in a general adult population. Internal consistency, equivalence and preference between both administration modes was assessed in a group of participants (n =130) who first completed the computerized questionnaire, followed by the traditional questionnaire and a post-assessment evaluation measure. Test–retest reliability was measured in a second group of participants (n =115), who completed the computerized questionnaire twice. In both groups, the interval between first and second administration was set at one week. Reliability of the PC versions was acceptable to excellent; internal consistency ranged from α =0.52–0.98, ICC’s for test–retest reliability ranged from 0.58–0.92. Equivalence was fair to excellent with ICC’s ranging from 0.54–0.91. Interestingly, more subjects preferred the computerized instead of the traditional questionnaires (computerized: 39.2%, traditional: 21.6%, no preference: 39.2%). These results support the use of computerized assessment for these five instruments in a general population of adults. [Copyright &y& Elsevier]

Abstract: Healthcare facilities from a number of countries have or are in the process of implementing smoke-free policies as part of their public health agenda and tobacco control strategy. Their main intent is to prevent the harmful effects of environmental tobacco smoke on employees and patients. However, these protection policies are often implemented before taking into account the specific needs of patients in psychiatric facilities and are clouded by a lack of knowledge, myths and misconceptions held by a variety of stakeholders. Consequently, the implementation of smoke-free policies tends to result in unintended and unfavourable consequences for this aggregate. Patients are forced to abstain from tobacco use during their hospitalization but have few options to address their dependence upon discharge. The development and implementation of such policies should not occur in isolation. It requires thoughtful consideration of the needs of the affected population. Recommendations are presented on the role of nurses in lobbying for policy changes. As well as strategies for policy makers and administrators that should accompany such a policy in psychiatry. [Copyright &y& Elsevier]

Digital mental health interventions (DMHIs) offer potential solutions for addressing mental health care gaps, but often suffer from low engagement. Text messaging is one promising medium for increasing access and sustaining user engagement with DMHIs. This paper examines the Small Steps SMS program, an 8-week, automated, adaptive text message-based intervention for depression and anxiety. We conducted an 8-week longitudinal usability test of the Small Steps SMS program, recruiting 20 participants who met criteria for major depressive disorder and/or generalized anxiety disorder. Participants used the automated intervention for 8 weeks and completed symptom severity and usability self-report surveys after 4 and 8 weeks of intervention use. Participants also completed individual interviews to provide feedback on the intervention. Participants responded to automated messages on 70 % of study days and with 85 % of participants sending responses to messages in the 8th week of use. Usability surpassed established cutoffs for software that is considered acceptable. Depression symptom severity decreased significantly over the usability test, but reductions in anxiety symptoms were not significant. Participants noted key areas for improvement including addressing message volume, aligning message scheduling to individuals' availability, and increasing the customizability of content. This study does not contain a control group. An 8-week automated interactive text messaging intervention, Small Steps SMS, demonstrates promise with regard to being a feasible, usable, and engaging method to deliver daily mental health support to individuals with symptoms of anxiety and depression. • Daily interactive SMS is acceptable for supporting affective self-management skills. • A personalized automated SMS intervention supports sustained engagement (8 weeks). • An SMS-based mental health intervention is associated with reductions in depression. [ABSTRACT FROM AUTHOR]

Peut-on raisonnablement défendre la suppression de l'évaluation du discernement dans l'appréciation de la responsabilité pénale des infracteurs ? Si une telle question peut à première vue sembler purement rhétorique, de récentes propositions de réforme de l'article 122-1 du Code pénal suggèrent qu'il n'en est rien. Une recommandation, publiée dans les Annales Médico-Psychologiques (Bouchard, 2018), de réécriture dudit article s'appuie même explicitement sur une argumentation en faveur de l'abandon des concepts – légitimement jugés insuffisamment précis – d' abolition et d' altération du discernement, auxquels devrait se substituer l'idée, supposément moins équivoque, d'un lien de causalité nouant (de façon « exclusive » ou non) la présence d'un trouble mental et la commission des faits. Nous nous proposons ici de démontrer en quoi le raisonnement censé justifier l'évacuation de l'examen de la qualité du discernement – remplacé par une estimation de type causal particulièrement ambitieuse – repose sur des prémisses éminemment controversables et nous achemine en outre vers d'insurmontables difficultés évitées par le texte actuel. Can one reasonably defend the suppression of the investigation of discernment in the assessment of the criminal responsibility of offenders? While such a question may at first glance seem purely rhetorical, recent proposals for reform of article 122-1 of the Penal Code suggest that this is not the case. A recommendation, published in the Annales Médico-Psychologiques (Bouchard, 2018), to rewrite this article is in fact explicitly based on an argument insisting on the desirable removal of the concepts – legitimately judged insufficiently precise – of abolition and alteration of discernment , which should be replaced by the idea, supposedly less equivocal, of a causal link ("exclusive" or not) between the presence of a mental disorder and the commission of the offence. In this paper, we propose to demonstrate how such an evacuation of the examination of the quality of discernment – intended to be replaced by a particularly ambitious causal type analysis – is incoherent and moreover produces insurmountable difficulties avoided by the current text. [ABSTRACT FROM AUTHOR]

Despite the growing interest on the Russian-Ukrainian war and its repercussion on the children's health, there is no previous systematic review compiling the current evidence on this topic. This study conducted a rapid systematic review to investigate the current findings concerning the impact of the Ukraine war on the social and health aspects of the Ukrainian pediatric population. A rapid systematic review was conducted. PubMed, Scopus, CINAHL, PsycINFO, Web of Science, and Virtual Health Library (BVS Spain) were searched between February and April 2023. In addition, high-impact journals and institutions focused on pediatric health and human rights were also consulted. All relevant original articles, letters, editorials, and policy papers assessing the health and social repercussions of the war on Ukrainian children were included. From 134 publications matching the search criteria, 23 were included. These publications were categorized into three distinct domains: 'Public health challenges for the physical and mental health of children and adolescents', 'Lack of Healthcare resources and initiatives to mitigate suffering', and 'Policies, Government, and Children's rights'. Our findings revealed that the war is seriously impacting the life and the health of Ukrainian children, resulting in worse physical and mental health outcomes and perpetrating a deprived situation. To overcome such problems, several initiatives have been proposed by European and non-European countries, relying mostly on receiving refugees, providing mental health support, complementing lack of resources, and establishing policies to improve health care. It could help health professionals, policy makers, and governments to plan preventive, promotive, and therapeutic strategies for Ukrainian children. [ABSTRACT FROM AUTHOR]

Les notions de crise et d'urgence sont fréquemment confondues autant par les familles que par bon nombre de professionnels bien qu'elles ne soient pas synonymes. L'urgence en pédopsychiatrie correspond à une situation pathologique aiguë à laquelle s'associe la notion de risque vital pour le jeune. Alors que l'urgence exige une prise en charge immédiate du jeune, la crise nécessite, quant à elle, le développement de nouvelles manières de voir et de faire ainsi que de nouveaux mécanismes adaptatifs pour faire face aux changements. Suite à la nouvelle politique en santé mentale enfants-adolescents développée par le ministère de la Santé publique belge en 2015, l'unité thérapeutique adolescents destinée aux 10–18 ans de l'hôpital Vincent Van Gogh, a dédié 2 de ses 15 lits pour la prise en charge spécifique de la crise pédopsychiatrique. L'objectif de cet article est de présenter le fonctionnement du dispositif « lits de crise » au sein de l'unité. Seront définis tout d'abord la notion de crise ainsi que les modèles théoriques d'intervention proposés en clinique. Ensuite, le contexte historique de l'implémentation des lits de crises de l'hôpital VVG ainsi que leur fonctionnement seront évoqués. Enfin, 3 cas cliniques illustreront non seulement toute la prise en charge réalisée en unité de crise mais aussi les différentes issues possibles au terme du séjour. À travers ceux-ci, sera mis en évidence également l'impact qu'ont les facteurs individuels intrapsychiques et systémiques sur la crise et son devenir. The notions of crisis and emergency are frequently mixed up by family members, as well as by many professionals, although they are not synonymous. In child psychiatry, an emergency is an acute pathological situation which is associated with the idea that the child's life is in danger. While an emergency requires immediate care, a crisis requires the development of new ways of seeing and navigating the world, as well as new adaptive mechanisms to deal with these changes. Following the new child-adolescent mental health policy developed by the Belgian Ministry of Public Health in 2015, the therapeutic unit for adolescents (10 to 18-year-old) at the Vincent Van Gogh Hospital dedicated two of its fifteen beds to the treatment of child psychiatric crises. The objective of this paper is to present the functioning of the "crisis beds" device within the hospital unit. We will begin with a definition of the notion of crisis and of the theoretical models of intervention offered in clinics. This will be followed by an explanation of the historical context behind the implementation of the crisis beds in the Vincent Van Gogh hospital and a description of how this device works. We will conclude with an overview of three clinical cases which illustrate the extent of the treatment provided in the crisis unit and the different possible outcomes at the end of the stay. The influence of individual intrapsychic and systemic factors on the crisis and its aftermath will be highlighted through these cases. [ABSTRACT FROM AUTHOR]

The current staffing shortage across all disciplines of post-acute and long-term care (PALTC) settings is affecting the health and safety of residents, as well as the well-being of the current staff. The need to retain and recruit new talent to this challenging but fulfilling setting demands that we look to existing evidence-based strategies and identify ways to implement them quickly, effectively, and in a sustainable way. Using the 4 Ms Framework of the Age-Friendly Health System developed by the Institute for Healthcare Improvement and the John A. Hartford Foundation (What Matters, Medication, Mentation, and Mobility), we can build on successful strategies to address what matters to staff, mental health, career mobility, and the overall safety and wellness of our nation's careforce. This paper summarizes "More of a Good Thing: A Framework to Grow and Strengthen the PALTC Careforce," a series of 6 roundtable discussions held in 2022 that brought together clinicians, industry leaders, and change-makers to share strategies that have been researched and successfully implemented and discuss ways to scale and disseminate them to a broader audience. The role of PALTC leadership is highlighted, with key points from the final roundtable discussion outlined, and challenging leadership to think about what they can begin doing immediately to build trust with existing staff and lay the foundation for a stronger nursing home careforce. Next steps for "More of a Good Thing" include a survey of participants about what they have tried, what has been successful, and what barriers they face; a series of focused interviews with leaders; and potential collaboration with quality improvement organizations to help facilities build on and implement the strategies presented. [ABSTRACT FROM AUTHOR]

Objectives: A new patient-reported outcome (PRO) instrument to measure fatigue symptoms and impacts in relapsing multiple sclerosis (RMS) was developed in a qualitative stage, followed by psychometric validation and migration from paper to an electronic format.Methods: Adult patients with relapsing-remitting multiple sclerosis (RRMS) were interviewed to elicit fatigue-related symptoms and impacts. A draft questionnaire was debriefed in cognitive interviews with further RRMS patients, and revised. Content confirmation interviews were conducted with patients with progressive-relapsing multiple sclerosis (PRMS) and relapsing secondary-progressive multiple sclerosis (RSPMS). Psychometric analyses used data from adult patients with different RMS subtypes and matched non-RMS controls in a multicenter, observational study. After item reduction, the final instrument was migrated to a smartphone (eDiary) and usability was confirmed in interviews with additional adult RMS patients.Results: The qualitative stage included 37 RRMS, 5 PRMS, and 5 RSPMS patients. Saturation of concepts was reached during concept elicitation. Cognitive interviews confirmed that participants understood the instructions, items, and response options of the instrument-named FSIQ-RMS-as intended. Psychometric validation included 164 RMS and 74 control patients. Internal consistency and test-retest reliability were demonstrated. The symptoms domain discriminated along the RMS symptom-severity continuum and between patients and controls. Patients were able to attribute fatigue-related symptoms to RMS. Usability and conceptual equivalence of the eDiary were confirmed (n = 10 participants).Conclusions: With 7 symptom items and 13 impact items (in 3 impacts subdomains: physical, cognitive and emotional, and coping) after item reduction, the FSIQ-RMS is a comprehensive, valid, and reliable measure of fatigue-related symptoms and impacts in RMS patients. [ABSTRACT FROM AUTHOR]

Common mental disorders (CMDs) are prevalent throughout the population. Psychological therapy is often sought via primary care; however, equitable access is not commonplace. This review aims to investigate the barriers and facilitators adults experiencing CMDs perceive when accessing evidence-based psychological treatment in England. A qualitative systematic review with meta-synthesis was conducted (PROSPERO CRD42020227039). Seven electronic databases were searched for papers from 2008 to October 2022. Searches identified 30 studies from which three themes were developed with seven subthemes. Stigma and patients' perceptions and understandings of CMDs impacted their help-seeking decision-making and engagement with services. This meant that services were not used as a first resort for help-seeking. Upon reaching services, patients appeared to perceive primary care as not prioritising mental health problems, nor as being the place where they would be supported, particularly as healthcare professionals did not appear to know about CMDs and therapy was seen as difficult to access. The interaction between healthcare professional and patients was seen as pivotal to whether patients accessed support or not. The review is limited to research conducted within England. Additionally, it only explores access barriers prior to treatment experiences. Knowledge, attitudinal, systemic and relational barriers and facilitators were identified. Future research should focus on developing stigma reduction initiatives. Clinical implications include provision of standardised training across primary care HCP (healthcare professionals). • Barriers, such as stigma, are experienced by patients before engaging with services. • Primary care is not viewed as where common mental health disorders are supported. • The patient-healthcare professional relationship is pivotal to accessing support. [ABSTRACT FROM AUTHOR]

• First study to examine paramedic psychological injury through EMS data linkage. • Fatality and cardiac arrest cases increase the odds of psychological injury. • Lower patient age is associated with paramedic psychological injury. • Findings may help facilitate the provision of early interventions to those at risk. Introduction : In comparison to the general population and other emergency services workers, paramedics experience high rates of work-related psychological injury. However, there is limited understanding of the case and practitioner-related factors that increase the risk of psychological injury among these workers. This paper aims to identify case and practitioner-related factors associated with paramedic work-related psychological injury in Victoria, Australia, through data linkage. Methods : Data linkage of 7,223 paramedic injury reports with electronic patient care records, and paramedic demographic data from the single state-wide ambulance service in Victoria, Australia – Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Factors associated with paramedic psychological injury were assessed using multivariable logistic regression analysis. Results : A total of 4,641 (64%) injury reports were successfully linked, of which, 244 (5%) were psychological injuries. Shift hours between 0401 and 0800 (AOR 1.83; 95%CI: 1.12–2.97), cardiac arrest or deceased patient attendances (AOR 2.15; 95%CI: 1.06–4.34), hospital or medical center case locations (AOR 2.44; 95%CI: 1.22–4.91), and Priority 0 (AOR 2.27; 95%CI: 1.26–4.09), Priority 2 (AOR 1.56; 95%CI: 1.04–2.33), and Priority 3 (AOR 1.95; 95%CI: 1.15–3.32) dispatch codes were associated with increased odds of psychological injury. Increasing patient age (AOR 0.98; 95%CI: 0.97–0.99), and the absence of other emergency services on scene (AOR 0.50; 95%CI: 0.34–0.72) were associated with decreased odds of paramedic psychological injury. Conclusions: This is the first study to collectively examine and identify EMS case and practitioner-related characteristics associated with paramedic psychological injury through data linkage of EMS agency-level data sources. Practical application: The findings of this study highlight the dispatch case characteristics that may increase the risk of a paramedic sustaining a work-related psychological injury, and consequently facilitate the early identification, intervention, and support of the individuals most at risk. [ABSTRACT FROM AUTHOR]

• Mental Health Concerns (MHC) index is constructed using Google Trends data. • We study if economic uncertainty raises concerns about mental health in the U.S. • A positive shock to uncertainty is shown to raise MHC index. This paper investigates if heightened economic uncertainty raises concerns about mental health in the U.S. We first quantify such concerns by constructing a composite Mental Health Concerns index, using time series of the intensity of Google search queries related to mental disorders and distress. This index i) rises significantly during the three recessionary episodes and ii) comoves negatively with survey responses that reflect views on current consumer sentiment or on future economic conditions. We find that the concerns regarding mental health substantially increase after an unexpected hike in economic uncertainty; uncertainty not only channels through its negative impacts on economic activity, but also directly affects the level of concerns. Our findings suggest that an uncertainty shock can have a far-reaching impact on overall welfare of economic agents by leaving them more concerned about mental health. [ABSTRACT FROM AUTHOR]

Major health shocks can have far-reaching implications for the welfare of an individual's support and emotional network. This paper investigates both long-term and short-term spillover effects of a major non-communicable health shock, namely a cancer diagnosis (CD), on the health and well-being of an individual's partner. We rely on data from a longitudinal sample of individuals over fifty from 19 European countries. Our estimates provide economically relevant evidence of the spillovers of a CD on the partner's mental health and well-being. We document a robust and time persisting negative relationship between a partner's CD and several measures of well-being, which is not driven by changes in health behaviors. These findings suggest that focusing solely on the individual economic impact of a CD will likely underestimate its long-term welfare effects unless the external effects on the emotional support network are considered. [ABSTRACT FROM AUTHOR]

Adolescents' mental health was severely compromised during the COVID-19 pandemic. Longitudinal real-world studies on changes in the mental health of adolescents during the later phase of the pandemic are limited. We aimed to quantify the effect of COVID-19 pandemic on adolescents' mental health outcomes based on electronic health records. This was a retrospective cohort study using the computerized database of a 2.5 million members, state-mandated health organization in Israel. Rates of mental health diagnoses and psychiatric drug dispensations were measured among adolescents 12 to 17 years of age with and without pre-existing mental history, for the years 2017 to 2021. Relative risks were computed between the years, and interrupted time series (ITS) analyses evaluated changes in monthly incidence rates of psychiatric outcomes. The average population size was 218,146 in 2021. During the COVID-19 period, a 36% increase was observed in the incidence of depression (95% CI = 25-47), 31% in anxiety (95% CI = 23-39), 20% in stress (95% CI = 13-27), 50% in eating disorders (95% CI = 35-67), 25% in antidepressant use (95% CI = 25-33), and 28% in antipsychotic use (95% CI = 18-40). A decreased rate of 26% (95% CI = 0.80-0.88) was observed in ADHD diagnoses. The increase of the examined outcomes was most prominent among youth without psychiatric history, female youth, general secular Jewish population, youth with medium−high socioeconomic status, and those 14 to 15 years of age. ITS analysis confirmed a significantly higher growth in the incidence of psychiatric outcomes during the COVID-19 period, compared to those in previous years. This real-world study highlights the deterioration of adolescents' mental health during the COVID-19 pandemic and suggests that youth mental health should be considered during health policy decision making. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. [ABSTRACT FROM AUTHOR]

• This paper uses data from the Australian Journeys Home survey, a sample of disadvantaged Australians. • It studies the relationship between early mental health episodes and early homelessness, focusing on depression and anxiety. • We find that a person's first episode of depression makes a transition to homelessness more likely for both men and women. • Men's first experience of homelessness increases the likelihood of anxiety disorders. • - Anxiety disorders have no effect on homelessness and homelessness has no effect on the likelihood of developing depression. This paper studies the relationship between early mental health episodes and early homelessness, focusing on depression and anxiety amongst disadvantaged Australians. Using data from the Australian Journeys Home survey, we investigate whether the early onset of mental health conditions make a first transition into homelessness more likely. Similarly, we analyze whether early experiences of homelessness increase the likelihood of early onset of depression or anxiety. We perform our analysis separately for men and women since there are gender differences in rates of both mental health diagnosis and homelessness. After accounting for the effects of joint observed and unobserved determinants, we find that a person's first episode of depression makes a transition to homelessness more likely for both men and women. In contrast, anxiety disorders have no effect on the likelihood of experiencing homelessness. In addition, people's first experience of homelessness has no effect on the likelihood of developing depression, but does increase the likelihood of anxiety disorders for men only. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [ABSTRACT FROM AUTHOR]

Obstetric patients are at increased risk for psychological distress and the development or exacerbation of mental illness, particularly in the setting of pregnancy or delivery complications. Inpatient antepartum, labor and delivery, and postpartum hospitalization is an important opportunity for psychiatric support and intervention. The aims of this paper are to review the unmet mental health needs in obstetric inpatient care, examine the current state of obstetric consultation-liaison (OB CL) psychiatry services, present one existing model of such a service at the authors' institution, provide broad recommendations for the structure and implementation of this service, and detail areas of future research within the area of OB CL psychiatry. We argue that the inpatient obstetric setting is a critical space for mental health evaluation, education and intervention, and that dedicated OB CL psychiatry services are a potentially valuable tool in addressing the perinatal mental health crisis. [ABSTRACT FROM AUTHOR]

Abstract: People with serious mental illness have higher morbidity and mortality rates of chronic diseases than the general population. This discussion paper explores the complex reasons for these disparities in health, such as limitations of health services, the effects of having a serious mental illness, health behaviours and the effects of psychotropic medication. Physical health can be enhanced by improved monitoring and lifestyle interventions initiated at the start of treatment. There are opportunities for mental health nurses to play a significant role in improving both the physical and mental health of people with serious mental illness. [Copyright &y& Elsevier]

The COVID-19 pandemic, which is a global health emergency, has potentiality had a serious impact on students' mental health. An online cross-sectional survey design that included 534 senior year college students from South India revealed a significant and direct positive effect of the fear of a third wave of COVID-19 on academic anxiety which in turn showed a significant and direct positive effect on COVID-19 burnout. Academic anxiety was also found to mediate the relationship between the fear of a third wave of COVID-19 and subsequent cases of burnout. The study suggested measures to be taken by policy makers for the broader interest and wellbeing of student communities. Managerial implications, limitations and future studies were also examined in the paper. [ABSTRACT FROM AUTHOR]

• To overview Transformer models used for text-based mental health issue identification. • To characterize the methods based on Transformers developed in the past few years. • To highlight opportunities and challenges of the methods in addressing mental issues. Early identification and prevention of mental health stresses and their outcomes has become of urgent importance worldwide. To this purpose, artificial intelligence provides a body of advanced computational tools that can effectively support decision-making clinical processes by modeling and analyzing the presence of a variety of mental health issues, particularly when these can be detected in text data. In this regard, Transformer-based language models (TLMs) have demonstrated exceptional efficacy in a number of NLP tasks also in the health domain. To the best of our knowledge, the use of TLMs for specifically addressing mental health issues has not been deeply investigated so far. In this paper, we aim to fill this gap in the literature by providing the first survey of methods using TLMs for text-based identification of mental health issues. [ABSTRACT FROM AUTHOR]

Youth in the United States are experiencing mental health concerns at alarming rates. Considering the nation's legacy of racism and growing recognition of the impact of social determinants of health on educational and mental health inequities, it is imperative to re-envision how we approach mental health screening in schools to center equity. A focus on mental health screening for the sole purpose of identifying individual at-risk students ignores key contextual considerations, is ineffective in addressing health and educational inequities, and has the potential to perpetuate oppressive practices in schools. Equity-focused mental health screening requires a shift from individual- and deficit-focused approaches to systems- and holistic-focused approaches that (a) identify strengths and stressors among individuals, groups, and communities; (b) dismantle structural forms of oppression; and (c) promote positive mental health outcomes for minoritized youth. Integrating recommendations from the educational equity literature and critical school mental health frameworks, this paper identifies core considerations for equitable school mental health screening and provides guiding principles for each phase of the screening process, from screening readiness to execution to follow up. To implement these recommendations and transform school-based mental health care, schools should (a) incorporate multiple perspectives; (b) prioritize student, family, and community voices; and (c) build collaborative partnerships to co-construct a vision for equitable school mental health. [ABSTRACT FROM AUTHOR]

• The tsunami increased household out-of-pocket health expenses by 35% in heavy damage areas in the short run. • Worsened mental wellbeing was associated with a 4% fall in wage earnings among men two years after the tsunami struck. • Worsened physical wellbeing was associated with a 34% fall in wage earnings among men three years after the tsunami struck. • Although the direct health costs of the tsunami were seen only in the short term, indirect costs were apparent in the medium term. This paper looks at the direct and indirect health-related monetary costs that households incurred in the short and medium terms because of the 2004 Indian Ocean Tsunami. The paper uses three rounds of a longitudinal household survey of Aceh and North Sumatra where data were collected 5–17, 18–30, and 31–40 months after the event. The results show that direct costs, measured by out-of-pocket health expenses, increased significantly by a third (35%) compared to pre-tsunami spending, for households living in heavily damaged areas. This effect, however, was seen only in the short-term, 5–17 months after the tsunami struck, and did not persist to the later years. The tsunami had significant effects on mental wellbeing as measured using the post-traumatic stress reaction score (PTSR). Among men, these changes to mental wellbeing were associated with a 4% fall in wage earnings two years after the tsunami. Physical health also worsened according to self-reported measures, and this was associated with a 34% fall in men's earnings three years after the tsunami. Thus, although the direct costs of the tsunami in terms of increasing household out-of-pocket health spending were seen only in the short term, the indirect costs via effects on mental and physical health were apparent two to three years after the event. [ABSTRACT FROM AUTHOR]

Autistic adolescents are at increased risk of developing mental health problems. Improving psychological well-being could reduce the likelihood of such problems developing. Research has tended to prioritise the voices of non-autistic people and has neglected to consult autistic young people themselves. Our meta-synthesis aimed to systematically review qualitative research on the perspectives of autistic young people and their parents on the lived experience of psychological well-being. We conducted a pre-planned systematic search which identified 2552 papers, with 37 of those meeting full inclusion criteria. Included papers were published between 2008 and 2023, with three-quarters published since 2018. We extracted qualitative data from each paper pertaining to the lived experience of psychological well-being in autistic young people and conducted a thematic synthesis. We identified three themes; Walking a tightrope: the need for growth versus recharging through rest and familiarity; Developing a positive sense of self in the social world; Internally driven sources of happiness. Psychological interventions aiming to improve well-being in autistic young people should respect their autonomy and need for rest whilst encouraging growth and skills development, provide opportunities to understand social needs and differences, and promote opportunities to enjoy special interests. • A systematic review of the lived experience of well-being in autistic adolescents. • 37 papers published between 2008 and 2023 were included in a thematic synthesis. • Results give new insights into factors contributing to psychological well-being. • Psychological interventions should be designed based on lived experience. [ABSTRACT FROM AUTHOR]

Existing research has documented various determinants of mental health related to individuals' social connections, but less is known about the role of the structural features of interpersonal networks. This is especially true in the case of bridging , which refers to ties to people who are otherwise disconnected from each other. By intersecting theories of social networks and gerontology, this study employs within- and between-person analysis with data from the National Social Life, Health, and Aging Project (NSHAP) to examine the association between social network bridging and depression in later life. The study finds that bridging, particularly between kin and non-kin members in the network, is associated with increased depressive symptoms in later life. This association is contingent on social support and strain respondents experienced, and it exhibits variations within individuals over time, especially among older adults in the youngest age cohort (57–64 years old included in NSHAP in 2005). In closing, the paper discusses the extent to which heterogeneous network structures may be one mechanism that shapes mental health trajectories in the context of later life-course experiences. • The paper discusses how bridging disparate network members produces strain that elevates depression risks in later life. • Older adults' bridging potential in personal networks is classified into three distinct types. • The association between bridging and elevated depressive symptoms is unique to bridging unconnected kin and non-kin. • The effect of bridging is more so for the youngest age cohort than older cohorts. [ABSTRACT FROM AUTHOR]

Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6–24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well. • This review included 145 randomised controlled studies on applied and casual games for youth mental health. • In clinical samples, games were effective for social skills, verbal memory, anxiety, depression and ADHD. • In healthy samples, games were promising in medical settings and for improving affect. • Future work on harmonising outcome measures, positive outcomes and nonspecific factors is needed. [ABSTRACT FROM AUTHOR]

This paper examines the conflicts and challenges faced by women managers in Japan following the introduction of a new law in 2020 which merely obliges employers to take preventive measures against workplace bullying and pawahara (power harassment), but does not stipulate any criminal punishment for corporations or individuals responsible for workplace harassment, or the specific grounds for victims to have the right to claim damages. Cases are left to be disputed and decided in a costly and complicated process of arbitration, which could further exacerbate the precarious position of vulnerable workers, including women managers who are not only a small minority, but many are also marginal players in the workplace where job promotions do not enhance their participation in corporate decision-making. This paper elucidates how the new law ironically enables employers to legitimize discriminatory practices and acts of harassment against women, with serious, long-term ramifications on the emotional and mental health of these workers, as well as on the gendered workforce in Japan amidst global trends towards improving gender equality. [ABSTRACT FROM AUTHOR]

The aim of this FEPSAC Position Statement is to summarize current knowledge about athletes' dual careers (DCs) in the European context and propose recommendations for future DC research, practice, and policy. Inspired by the European Union's Guidelines on Dual Careers of Athletes (European Commission, 2012), researchers, practitioners, and policy makers collaborated over the last decade to create the European DC discourse as a context-informed and negotiated body of DC knowledge. In this paper, we proceed from analyzing this body of knowledge using recent review papers and European DC psychological research projects to formulating seven postulates summarizing DC research findings on factors influencing athletes in their striving for DC excellence. These factors include (1) context, (2) pathways and transitions, (3) challenges, (4) resources and coping, (5) support and empowerment, (6) student–athletes' mental health, and (7) DC development environments. In the final section, we acknowledge the contributions of European DC discourse in serving athletes in their pursuit of DC excellence and European DC culture. We also provide a critical discussion on DC knowledge gaps and, on behalf of FEPSAC, offer recommendations for DC research, practice, and policy in Europe. • Role of FEPSAC and European Commission in promoting dual career topic is stressed. • Current knowledge on athletes' dual careers in the European context is summarized. • Pursuit of dual career excellence is supported by seven research-based postulates. • Recommendations for future dual career research, practice, and policy are provided. [ABSTRACT FROM AUTHOR]

• Violence against older people is one of the least known forms of violence, despite being significantly represented worldwide. • Nowadays, the most common types of violence are neglect and psychological or emotional abuse. • The keywords "elderly abuse" led to a low number of results, showing low interest in this topic. • This type of abuse is little reported and not adequately addressed. Social and structural changes are of primary importance. • This paper is a call to the scientific community to study epidemiological and medico-legal aspects of older people abuse. The World Health Organization (WHO) describes gender violence as a real global health problem with a major impact not only on the victims' physical and mental health, but also on the economics of the National Health System. Gender-based violence has been also extended to all types of subjects defined as fragile: children, elderly, women, men and disabled people. Older people abuse, more frequent in women, is a far less socially debated issue, with many forms: physical, sexual, psychological, abandonment, neglect, economic-financial, pharmaceutical, discriminatory, institutional. An electronic literature research was carried out search using the keywords "elderly abuse" on various online sources. The research showed low number of results and little attention to this topic in the scientific literature. The paper highlights how the theme of older people abuse is little reported and not adequately addressed in scientific literature and in real life, being a form of violence certainly underestimated by the public. [ABSTRACT FROM AUTHOR]

Mental stress persisting for long can cause severe health issues. There are various approaches available in the literature for investigating stress through speech utterances. The available procedure to obtain speech under stress dataset requires the speakers to undergo the actual stress situations in a real environment with limited control or inducing stress with a mental task in a lab environment. These approaches either suffer from ethical issues or unreliable labeling of the obtained speech samples. In this paper, we attempt to overcome these limitations with I nduced mental S tress based speech production A nd labeling P rocedure (ISAP), for obtaining speech utterances under mental stress along with labeling the samples simultaneously. The proposed ISAP can be incorporated by future studies as per their need to create a speech under stress dataset. We also present the obtained dataset, the baseline experiments, and classification results with various machine learning models. A total of 1260 speech utterances are obtained, with ISAP able to induce stress in 54.4% of the cases. The accuracy of the SVM classifier in recognizing three stress classes, namely, No Stress , Low Stress , and High Stress is found to be 57.1%. • A procedure for recording speech under stress is presented which overcomes the limitations of the existing procedures. • The obtained dataset (MATSS) is also presented. • A baseline work with stress recognition accuracy using popular machine learning models on MATSS is presented. [ABSTRACT FROM AUTHOR]

About a quarter of the adults living in England have been diagnosed with a mental health condition (for example, anxiety and depression). The purpose of this paper is to discuss the difficulties faced by these people when they travel, and ways in which policy interventions could be used to encourage them to travel more. The main evidence in the paper comes from a weighted sample of 363 people with mental health conditions who completed an on-line survey. The paper concentrates on anxiety issues. The anxieties are considered under five headings: interacting with fellow travellers, interacting with staff and purchasing tickets, wayfinding, needing support, and needing to take urgent action. Policy interventions to improve access to infrastructure and services to help address the anxieties are discussed under these headings. The number of respondents who say that they would travel more if some of the interventions were introduced is then considered. The paper concludes that there are ways in which some of the anxieties that people have when travelling can be addressed and that introducing these types of intervention would increase travel by people with mental health conditions. • Psychological barriers to travel are revealed in an on-line survey. • 99% of the respondents identified aspects of travel that caused them anxiety. • The largest cause of anxiety was interacting with other people when travelling. • Other causes of anxiety included wayfinding and needing to find public toilets. • Policy interventions would encourage the respondents to travel more. [ABSTRACT FROM AUTHOR]

La spiritualité et la religion sont des domaines importants de la vie humaine qui suscitent l'intérêt des chercheurs en psychologie et en médecine à propos de leurs possibles effets sur la santé mentale. Depuis près de quarante ans, un nombre croissant de recherches ont montré les effets positifs du couple spiritualité/religion sur la santé mentale par l'intermédiaire de différents processus comme le coping, l'optimisation du lien social, le pouvoir des croyances et les bienfaits de certaines approches thérapeutiques utilisant la spiritualité. Cependant, au niveau des thérapies complémentaires et alternatives qui utilisent la spiritualité comme vecteur de soins ou qui s'inscrivent dans le champ de la spiritualité, on retrouve beaucoup de recherches qui se caractérisent par des biais méthodologiques importants ne permettant pas de valider la pertinence et l'efficacité systématique de ces thérapies. De ce fait, cette recherche a pour objectif d'étudier l'impact des approches thérapeutiques basées sur la spiritualité, sur la santé mentale au niveau de l'anxiété en suivant une démarche méthodologique rigoureuse de sélection des travaux de recherche. Nous avons effectué une revue de la littérature sur le sujet, de recherches contrôlées et randomisées. Quinze recherches ont été sélectionnées et ont montré des effets positifs des approches psycho-spirituelles sur la santé mentale, qu'il convient toutefois de nuancer en raison de limites méthodologiques importantes qui seront développées. Les approches de types TCC (Thérapies Comportementales et Cognitives) ayant la spiritualité comme thématique de base ressortent nettement de cette étude. Cela souligne la pertinence d'utilisation de la spiritualité dans une optique comportementale et cognitive dans le traitement de la relation entretenue avec les pensées et les émotions dans une optique de changements adaptatifs et de style de vie permettant une meilleure gestion de l'anxiété. La dimension de la spiritualité est riche en perspective d'accompagnement thérapeutique et les approches cognitives et comportementales de la 3e vague des TCC travaillant sur les relations entretenues avec les cognitions, les valeurs de vie et les émotions sont une piste sérieuse à exploiter dans le cadre de traitements psychothérapeutiques complémentaires pour le soin de l'anxiété. Spirituality and religion are important areas of human life that have aroused the interest of researchers in psychology and medicine with respect to their potential effects on mental health. A growing body of research for nearly 40 years has demonstrated the positive effects of spirituality/religion on mental health through different processes such as coping, optimization of social bonding, the power of beliefs, and the benefits of certain therapeutic approaches using spirituality. However, at the level of complementary and alternative therapies which use spirituality as a vector of care or which fall within the field of spirituality, we find considerable research which is characterized by significant methodological biases that do not allow us to validate the relevance and the systematic effectiveness of these approaches. Therefore, the objective of this study is to examine the effectiveness of therapeutic approaches based on spirituality in treating anxiety. We carried out a review of the literature on the subject that used randomized controlled trials. Fifteen studies that demonstrated positive effects of psycho-spiritual approaches on mental health were selected. These studies should, however, be put into perspective because of significant methodological limitations. Cognitive Based Therapies (CBT)-type approaches with spirituality as a basic theme clearly stand out from this study and underline the relevance of using spirituality from a behavioral and cognitive perspective in the treatment of the relationship maintained with thoughts and emotions in a context of adaptive and lifestyle changes, allowing for better management of the pathologies studied. The dimension of spirituality is rich with respect to therapeutic support, and the cognitive and behavioral approaches of the 3rd wave of CBT relying on the relationships maintained with cognition, life values and emotions are a serious avenue to be exploited within the framework of complementary psychotherapeutic treatments for anxiety. [ABSTRACT FROM AUTHOR]

Given the global secular declining trends of the age at puberty and its relevant mechanisms, as illustrated in the first part of this series, the present part will discuss the public health implications of early puberty and potential clinical and public health measures. Although the major effect of earlier maturation impacts adolescents' mental health and likelihood of engaging in risky behaviors, there are also effects in adulthood on cardiometabolic health, especially type 2 diabetes, and an increased risk of certain cancers, especially hormone-related cancers such as breast cancer. The paper ends with recommendations for clinical management, especially for girls who should receive further evaluation, as well as recommendations for the patient and her family and public health considerations. [ABSTRACT FROM AUTHOR]

This study reviews findings for the first randomized controlled trial (RCT) on the Interconnected Systems Framework (ISF) for school mental health (SMH) and Positive Behavioral Interventions and Supports (PBIS). Since its development in the late 2000s, the ISF has been supported by federally funded centers for SMH and PBIS, and, guided by a national workgroup, is being implemented in >50 communities in the United States. This experimental evaluation of the ISF involved an RCT implemented in 24 schools in two southeastern states, with the ISF implemented in eight schools, PBIS alone implemented in eight schools, and typically co-located PBIS+SMH implemented in eight schools. Related to very poor implementation, documented by two sources of fidelity data, two ISF schools were dropped from major analyses; hence, the study used a treatment on the treated (ToT; Rubin, 1974) as compared to a more traditional Intent-to-Treat approach (ITT; Lachin, 2000). This is the first paper from this large study, with emphasis here on proximal variables and school discipline. Within schools' multi-tiered systems of support (MTSS), ISF schools delivered more Tier 2 (early intervention) and Tier 3 (treatment) interventions to a greater proportion of students than the other two conditions by the second year of the intervention. There was also a dramatic difference in the provision of interventions by community mental health clinicians in ISF schools (almost half of interventions delivered) as compared to PBIS+SMH schools (around 3% of interventions delivered), underscoring the critical role of the ISF in integrating clinicians into MTSS teams and core school functions in SMH. As compared to the other two conditions, ISF schools also had reduced office discipline referrals (ODRs) and in-school suspensions, as well as reduced ODRs and out-of-school suspensions for African American students. Findings are discussed in relation to future directions of education-mental health system partnerships in improving the delivery and impact of SMH programs and services, demonstrated in the ISF. [ABSTRACT FROM AUTHOR]

Background: Rumination and worry represent two types of repetitive negative thinking (RNT), and their predictive and maintaining roles are well-established in depression and anxiety, respectively. Furthermore, there is an emerging literature on the link between RNT and psychological wellbeing in the perinatal period.Methods: We conducted a scoping review of studies that have investigated the relationship between RNT and perinatal depression and anxiety. We identified 87 papers eligible for inclusion in the review; they included cross-sectional and longitudinal studies, as well as treatment evaluations (pilot trials and randomised controlled trials).Results: Cross-sectional studies provided evidence of an association between RNT (i.e., rumination and worry) and depression and anxiety, in both pregnancy and postpartum. Longitudinal findings were mixed. Whilst antenatal worry consistently predicted subsequent depression and anxiety (both later in pregnancy and postpartum), rumination did not consistently predict depression. However, there was some evidence that rumination interacted with other processes to predict later psychopathology. Three randomised controlled trials evaluated whether psychological treatments reduce RNT in the perinatal period, only one of which included a clinical sample.Limitations: No experimental investigations were eligible for inclusion in the review.Conclusions: Further studies are needed to further our understanding of the nature and role of RNT in pregnancy and postpartum, and its consequences for maternal mental health. These include (but are not limited to) experimental investigations, studies with large clinical samples, and RCTs evaluating the effectiveness of psychological interventions targeting RNT to prevent and treat perinatal depression and anxiety. [ABSTRACT FROM AUTHOR]

• Motor Vehicle Accidents (MVA) may increase the risk for psychological problems. • Results indicated negative MVA's consequences in at least one psychopathology. • Untreated MVA-related psychological consequences could have long-term effects. • Trauma-related MVA injuries are associated with elevated psychological distress. • Frequently effects were PTSD, depression, anxiety, phobia, and emotional distress. People involved in motor vehicle accidents (MVA) are at increased risk for psychological problems. Although the existing literature states that MVAs cause substantial negative mental health effects, summarizing and comparing these effects to understand their consequences could be more explored. This systematic literature review provides an overview of the literature surrounding the psychological consequences of MVAs to summarize and quantify their effects on mental health. The studies published in an English-language journal in the last 20 years (2001–2021) that present psychological consequences of MVAs were included. Web of Science, Scopus, and PubMed databases were used for the literature search. The systematic literature search found 23 eligible studies. After identifying all relevant studies on the topic, we synthesized the applied psychological assessment methods and the psychological consequences of MVAs. Current gaps in the reviewed papers and what future research are needed are also discussed. Results indicated that negative psychological consequences following an MVA are substantial, with all studies pointing to negative consequences in at least one psychopathology. Trauma-related MVA injuries are associated with elevated psychological distress, and MVA-related psychological consequences could have long-term effects if left untreated. [ABSTRACT FROM AUTHOR]

• Reducing modifiable risk factors could prevent the onset of cognitive decline. • Physical multimorbidity–cognitive function association was mediated by depression. • Routine screening for depression in multimorbidity patient may delay dementia onset. This paper explores the role of depressive symptoms (mediator/moderator) in the association between physical multimorbidity (exposure) and cognitive function (outcome) among older adults in the three most populous middle-income countries. This study used cross-sectional data from China (2015 China Health and Retirement Longitudinal Study), India (2017/2018 Longitudinal Ageing Study in India), and Indonesia (2014/2015 Indonesian Family Life Survey), with a total sample of 73,199 respondents aged ≥ 45 years. Three domains of cognitive tests were harmonised across surveys, including time orientation, word recall, and numeracy. The four-way decomposition analysis assessed the mediation and interaction effects between exposure, mediator/moderator, and outcome, adjusted for covariates. The mean age of the respondents (in years) was slightly younger in Indonesia (56.0, SD = 8.8) than in China (59.5, SD = 9.3) and India (60.0, SD = 10.5). The proportion of male respondents was 49.3 % in China, 47.3 % in India, and 47.5 % in Indonesia. Respondents in China had the highest mean cognitive function z scores (54.7, SD = 19.9), followed by India (51.1, SD = 20.0) and Indonesia (51.0, SD = 18.4). Physical multimorbidity was associated with lower cognitive function in China and India (p < 0.0001), with 48.4 % and 40.0 % of the association explained by the mediating effect of depressive symptoms ('overall proportion due to mediation'). The association was not found in Indonesia. Cognitive functions were lower among individuals with physical multimorbidity, and depressive symptoms mainly explained the association. Addressing depressive symptoms among persons with physical multimorbidity is likely to have not only an impact on their mental health but could prevent cognitive decline. [ABSTRACT FROM AUTHOR]

Gentrification, growing income inequality, urban development, and the affordable housing crisis necessitate understanding the impact of the concern of displacement on health — prior to or even in the absence of a displacement event. In this paper, I use the term "exclusionary displacement pressure" to unify the literature on exclusionary displacement and displacement pressure, highlighting the disproportionate and inequitable impacts of displacement pressure among communities of color. Through following 35 residents over 2.5-years (2019–2022) in one predominantly low-income Hispanic/Latinx immigrant neighborhood in Denver, Colorado, I examine how exclusionary displacement pressure shapes their health and wellbeing over time. Through paying attention to how participants' lived experience is shaped by structural vulnerability (e.g. lack of documentation status, inadequate work, limited access to safety net systems), I identify how exclusionary displacement pressure is constantly internalized and responded to as a unique embodied health experience, wearing on individuals over time and reproducing population health inequities. The framework of embodied health experiences captures the wide range of health-related impacts, from diagnosable health conditions to idioms of distress, using participant's own language of suffering to express how they were feeling , battling , and enduring the pressure. Theorizing on structural vulnerability within specific subpopulations with intersecting identities, such as low-income immigrant Hispanic/Latinx communities, provides a bottom-up refinement to existing theories of embodied health. Understanding the place-health experiences of individuals in changing neighborhoods over time is also critically important to define time points at which context-specific supports and interventions are appropriate. • Gentrification impacts health through exclusionary displacement pressure. • Embodied health experiences highlight residents' structural vulnerability. • Stabilizing interventions are needed in advance of physical displacement. [ABSTRACT FROM AUTHOR]