Search Results (1,378)

Objective: To identify FDA-authorized prescription or clinician-directed digital mental health products, including applications and software-enabled devices, for psychiatric treatment or diagnostic support. Methods: FDA Medical Device Databases were searched for records associated with nine product codes relevant to digital mental health. Eligible records were consolidated into distinct product families. Peer-reviewed literature and FDA documentation were reviewed to characterize indications, authorization pathways, and the quality of supporting evidence. Results: Sixteen digital mental health products and software-enabled devices authorized by the FDA met the inclusion criteria. Twelve products supported treatment for substance use disorders, insomnia, attention-deficit/hyperactivity disorder (ADHD), posttraumatic stress disorder (PTSD)-related conditions, major depressive disorder, generalized anxiety disorder, and postpartum depression. Four products provided diagnostic support for ADHD or autism spectrum disorder. Authorization was granted through either 510(k) clearance or De Novo classification, with considerable variation in the quantity, independence, and clinical relevance of supporting evidence. Conclusions: FDA marketing authorization does not uniformly indicate clinical effectiveness. Because 510(k) clearance, De Novo classification, and premarket approval (PMA) reflect distinct regulatory standards, clinicians should interpret digital mental health products in the context of the specific authorization pathway, product indication, and supporting evidence base. Full article

Research on trauma in autistic individuals has proliferated in recent years. This scoping review aims to (1) provide a comprehensive overview of the literature on trauma and autism, (2) identify and synthesize key themes, and (3) highlight gaps to inform future research. Following Arksey and O’Malley’s methodological framework and the PRISMA-ScR guideline and checklist (Tricco et al.), we included articles published after 2000 in French or English that explicitly addressed trauma in autistic individuals. Four databases were searched: PsycINFO, Medline, ERIC, and Web of Science. A two-phase selection process yielded 199 eligible studies. Descriptive analyses and collaborative theme development were conducted to map the field. Findings show that most studies were published between 2018 and 2024, with the United States contributing the largest proportion. Four major themes were identified: (1) the relationship between autism and trauma, including prevalence, vulnerability, and consequences; (2) trauma-related symptoms and clinical manifestations; (3) assessment practices; and (4) intervention strategies. This review offers a critical synthesis of current knowledge, emphasizing the need for approaches that use broader definitions of trauma and reflect the diversity and lived experiences of autistic individuals. It also identifies significant methodological and conceptual gaps, calling for future research that addresses subgroup diversity and promotes equitable, trauma-informed practices for autistic individuals. Full article

Background/Objectives: Survival rates after pediatric liver transplantation have improved substantially over recent decades, yet the psychiatric consequences for recipients remain a concern that warrants closer attention. We sought to map the psychiatric symptom burden across multiple domains in this population and to determine which symptom clusters carry the greatest impact on health-related quality of life (HRQOL). Materials and Methods: Fifty liver transplant recipients between the ages of 8 and 18 were enrolled at a single center. Children and their parents completed four psychiatric measures—the CBCL, CDI, SCARED, and CRIES-13—alongside the parent-proxy PedsQL to capture HRQOL across physical, emotional, social, and school functioning domains. Correlations between instruments were calculated, and linear regression was used to determine which psychiatric variables independently predicted PedsQL Total scores. Results: Across all psychiatric measures, higher symptom scores were associated with lower HRQOL, with school functioning recording the lowest absolute PedsQL domain score, while emotional functioning demonstrated the strongest and most consistent inverse correlations with all psychiatric symptom measures across instruments. CBCL Total (r = −0.607), SCARED Total (r = −0.557), and CRIES-13 Total (r = −0.548) scores all correlated meaningfully with overall HRQOL. When entered into multivariable analysis, anxiety symptoms measured by the SCARED (β = −0.295, p = 0.032) and post-traumatic stress symptoms measured by the CRIES-13 (β = −0.400, p = 0.004) stood out as the two independent predictors of worse PedsQL Total scores. Conclusions: Even in medically stable recipients, anxiety and post-traumatic stress symptoms were independently associated with lower daily functioning scores and overall quality of life. These findings suggest that routine psychosocial screening and trauma-informed approaches may warrant integration into post-transplant care protocols, and that prospective, adequately powered studies are needed to confirm and extend these associations. Full article

Background: Mental illness constitutes one of the greatest worldwide health burdens. The use of artificial intelligence (AI) and virtual reality (VR) is becoming increasingly relevant in mental health. Nevertheless, evidence regarding their integrated application remains sparse. This scoping review identified existing evidence on AI-integrated VR in mental health care, including clinical applications, reported outcomes, and future research directions. Methods: The Population, Concept, and Context framework was used as the eligibility criteria. The mental health-related studies considered were original studies that addressed explicit AI integration using VR systems or workflows and had at least one outcome or clinical or implementation finding. PubMed, Scopus, Web of Science, and PsycINFO were searched to retrieve English-language studies published between January 2020 and February 2026. Results: The available evidence is heterogeneous, generally small, and primarily focused on feasibility or predictive modeling. The focus of applications is on the assessment or prediction of anxiety spectrum conditions, trauma and post-traumatic stress disorders, stress, and panic disorder/agoraphobia. Most of the research examines immersive VR with multimodal inputs and machine-learning-based prediction models. However, the field remains largely in an early stage, with a lack of standardization, implementation readiness, safety reporting, and real-world validation. Conclusions: AI-integrated VR can be considered as a promising but emerging field, and further development requires stricter, more clinically based, and implementation-focused studies that can help establish safe, effective, and scalable implementation in mental health care. Furthermore, pragmatic, multicenter research directly investigates whether AI-integrated VR has additional clinical value compared to regular VR or regular care in mental health care. Full article

Background/Objectives: Given that post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are separate constructs that can co-occur following adversity, we examined how prior adversity and current functioning difficulties may relate to the likelihood of meeting criteria for PTSD and scoring above the cutoff for PTG among individuals who reported being impacted by their prior adversity. Methods: Participants (n = 2112) in this international sample completed online measures assessing their adversity history, current functioning difficulties (i.e., negative world assumptions and autonomic reactivity), PTSD symptomatology, and PTG. Results: Chi square analyses suggested a trend toward an association between meeting criteria for PTSD and scoring above the cutoff for PTG, although not statistically significant (p = 0.061). Multivariable logistic regression analysis found that individuals most impacted by caregiver abuse and certain specific adversities (i.e., parent with a mental health problem, caregiver and non-caregiver sexual abuse, and being held captive) were more likely to meet the criteria for PTSD. Whereas those most impacted by life-threatening situations and the specific adversities of being impacted by a life-threatening illnesses or injury, were more likely to meet the criteria for PTG. However, the strongest predictor of the likelihood of PTSD was increased autonomic reactivity, and the strongest predictor of the likelihood of PTG was fewer negative world assumptions. Conclusions: Our research suggests the need to assess the perceived impact of adversity history, as well as the potential negative consequences of autonomic reactivity and negative world assumptions, as these may be associated with PTSD symptomatology and PTG. Full article

This study examines the relationship between Sudanese audiences’ exposure to digital media coverage of the civil war and their psychological immunity and post-traumatic stress disorder (PTSD) symptoms while also investigating the mediating role of psychological immunity. Data were collected through an online survey from a sample of 774 Sudanese respondents residing both inside and outside Sudan. The findings indicate a relatively high level of exposure to digital news coverage, particularly through social media platforms such as Facebook, reflecting the growing centrality of digitally mediated news environments in conflict reporting. The results also reveal moderate levels of psychological immunity and relatively high levels of PTSD symptoms, especially in the hyperarousal dimension. Statistical analysis shows a negative association between media exposure and psychological immunity, and a positive association between exposure and PTSD symptoms, with psychological immunity partially mediating this relationship. Beyond these findings, this study highlights important implications for journalism practice and media responsibility. The intensity and emotional nature of digital war coverage raise critical concerns regarding ethical news production, the circulation of distressing content, and the potential psychological impact on audiences. These findings underscore the need for more responsible digital journalism practices, including content moderation, trauma-sensitive reporting, and the promotion of media literacy, in order to mitigate the potential harm associated with repeated exposure to crisis-related news content. Full article

The relationship between stress and Parkinson’s disease is regarded as complex and multifaceted, although a direct causal link has not yet been conclusively proven. One prevailing hypothesis is based on the activation of the hypothalamic–pituitary–adrenal (HPA) axis and the consequent elevation of glucocorticoid levels. Prolonged exposure to these hormones may exacerbate oxidative stress, thereby rendering the dopaminergic neurons within the brain’s subcortical structures more susceptible to degeneration. Furthermore, stress may intensify neuroinflammation through the activation of microglia—a mechanism that could constitute a significant factor in the pathogenesis of Parkinson’s disease. Another important concept concerns the direct interaction of stressors with the dopaminergic system. Physiological and psychological stress can alter dopaminergic transmission by affecting both the synthesis and release of dopamine, as well as the sensitivity of dopamine receptors. Severe or chronic stress may contribute to the disruption of dopaminergic mechanisms and accelerate the onset of clinical symptoms in predisposed individuals. Furthermore, many researchers draw attention to the role of stress-induced aggregation of α-synuclein—a key protein implicated in the pathogenesis of Parkinson’s disease. Clinical data suggest a highly probable link between post-traumatic stress disorder and an increased risk of developing Parkinson’s disease, although these findings remain inconclusive. It is possible that stress acts not as a primary cause, but rather as a modifying factor that interacts with genetic predisposition, accelerating or triggering neurodegenerative processes. The aim of our narrative review was to examine these concepts and discuss possible directions for future research into the interaction between stress and Parkinson’s disease. Full article

Trauma-related autobiographical memories can manifest as involuntary, vivid, emotionally charged intrusions that perpetuate avoidance, negative emotions, and functional impairment. While these memories are central to post-traumatic stress disorder (PTSD), they also occur across diagnoses and are often reported in depressive disorders, including treatment-resistant depression (TRD). Although trauma-focused psychotherapies are effective, their routine implementation can be limited by dropout, residual symptoms, and difficulty engaging patients with severe depression, dissociation, or complex comorbidities. Intranasal esketamine is an approved rapid-acting treatment for TRD and has been hypothesized to create transient conditions that may facilitate psychotherapeutic work on traumatic memories. This narrative review synthesizes clinical and translational evidence on ketamine and esketamine for PTSD and trauma-related symptoms, with particular attention to the distinction between intravenous ketamine studies, intranasal esketamine data, and studies combining these compounds with psychotherapy. Currently, the most robust evidence in this area comes from three randomised trials of intravenous ketamine for PTSD. In contrast, data on intranasal esketamine and psychotherapy-combination approaches are mainly from pilot studies, retrospective analyses, or case reports. We additionally propose a pragmatic, feasibility-oriented protocol integrating intranasal esketamine with a structured traumatic-memory intervention for TRD patients with clinically relevant trauma-memory symptoms. The novelty of the proposal does not lie in claiming efficacy, but in specifying a standardised imagery rescripting module and predefining two timing hypotheses. The proposal targets patients with TRD with relevant trauma-memory symptoms, and it embeds the intervention within existing esketamine-care infrastructure. Overall, the available literature supports mechanistic plausibility and preliminary feasibility more than clinical efficacy. The evidence base remains small, heterogeneous, and largely uncontrolled, and controlled studies are needed before efficacy claims can be made. Full article

Daylight Saving Time (DST) creates abrupt, externally imposed circadian disruptions that can impair sleep regulation, hormonal balance, cognitive performance, and emotional stability. Although these effects are known in the general population, individuals with chronic mental illness, whose circadian systems are often intrinsically dysregulated, may face increased neuropsychological consequences. This comprehensive review synthesizes evidence from chronobiology, psychiatry, neuroscience, and population health to examine how DST-related circadian misalignment impacts cognitive functioning, mood regulation, suicidality risk, and symptom exacerbation across psychological disorders such as depression, anxiety disorders, bipolar disorder, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, and psychotic disorders. Following the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines, a search of PubMed, PsycINFO, Scopus, and Google Scholar was conducted to identify studies published from 2000–2026 examining DST, circadian rhythm disruption, neuropsychological outcomes, and chronic mental illness. Empirical, theoretical, and mechanistic studies were included to ensure comprehensive synthesis. Across conditions, DST, particularly spring forward transitions, is associated with increased sleep disturbance, impaired executive functioning, reduced attention and working memory, heightened emotional reactivity, increased depressive symptoms, elevated risk of manic episodes, and short-term increases in suicidality. Neurobiological mechanisms include altered melatonin secretion, cortisol dysregulation, Hypothalamus Pituitary Axis (HPA-axis) activation, and clock-gene desynchrony. DST may function as a modifiable negative environmental influence capable of affecting neuropsychological functioning in vulnerable populations. These findings underscore the need for clinical awareness, preventive strategies, and policy reconsiderations, including calls to eliminate seasonal time changes. Standardizing DST-related research outcomes and expanding longitudinal, multi-site studies will be essential for advancing this emerging field. Full article

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition that impairs psychological functioning and increases susceptibility to various chronic illnesses, including inflammatory, metabolic, and cognitive disorders. Recent advances in neuroscience and microbiology have identified the brain–gut–microbiota axis as a key mediator of neuroimmune and neuroendocrine regulations, providing new insight into the pathophysiology of PTSD. This review synthesizes current findings from preclinical and clinical studies on gut microbiome alterations in PTSD, highlighting the underlying mechanistic pathways. Dysbiosis in PTSD is associated with immune dysregulation, altered neuroendocrine signaling, and neurotransmitter imbalances. Animal models, particularly those using the single prolonged stress paradigm, have demonstrated behavioral and microbial changes that mirror the characteristics of human PTSD. Human studies have revealed reduced abundance of beneficial bacterial taxa and increased inflammation-associated genera in patients with PTSD. Although emerging evidence supports the role of gut microbiota in PTSD, further research is needed to establish causal relationships and optimize microbiome-targeted therapies. Overall, the gut microbiome offers a novel and potentially modifiable target for the prevention and treatment of PTSD. Full article

Background: Posttraumatic stress disorder (PTSD) in ages 3–18 is associated with disturbances in attention, working memory, processing speed, and executive control, as well as persistent difficulties in affect regulation. These neuropsychological vulnerabilities might interfere with learning, peer relationships, and the consolidation of age-appropriate developmental skills. Methods: We conducted a narrative review informed by a structured literature search in PubMed, Scopus, PsycINFO, Embase, EBSCOhost, Web of Science, and Google Scholar. English-language publications from 1990 to 2025 were considered if they examined (1) neuropsychological outcomes of trauma exposure or PTSD in youth and/or (2) interventions with potential to modify neurocognitive or affective functioning, including trauma-focused cognitive behavioral therapy (TF-CBT), mindfulness-based interventions, cognitive rehabilitation strategies, and biofeedback/neurofeedback. Results: Across study designs, trauma exposure and PTSD in youth are consistently linked to impairments in attentional control and executive functioning, with downstream effects on everyday memory and academic performance. Neurobiological studies commonly implicate altered reactivity within amygdala-centered threat circuits and reduced top-down modulation by prefrontal networks, although findings vary with trauma type, developmental stage, and comorbidity. TF-CBT remains the best-supported intervention for pediatric PTSD symptoms; however, neurocognitive outcomes are measured less frequently. Mindfulness-based programs show promise for strengthening attention and emotion regulation when carefully adapted for trauma-exposed youth. Neurofeedback and targeted cognitive rehabilitation represent emerging approaches with preliminary evidence, but the literature remains heterogeneous. Conclusions: An intervention strategy that combines symptom-focused trauma therapy with explicit targeting of executive control, memory processes, and affect regulation may represent a developmentally informed clinical framework for trauma-exposed youth. Future trials need to incorporate standardized neuropsychological endpoints and examine moderators that inform treatment matching. Full article

Background: Poor mental health is prevalent among veterans who suffer from post-traumatic stress disorder (PTSD) and other psychiatric conditions. Canine-assisted interventions may improve psychological and social health in veterans. The parent study, a randomized controlled trial, revealed improvements in PTSD following both a service dog training program and an active control condition consisting of virtual dog training lessons. Thus, in the present post hoc secondary analysis, we analyzed both groups together (pooled arms) to examine gender-based differences in the effects of the altruistic service dog training programs on psychosocial outcomes. Methods: Veterans (N = 59) participated either in hands-on (with a dog and trainer) or virtual (no dog present) dog training programs over eight weeks and completed self-reported psychosocial measures before and after the program. Mixed-effect linear models were used to assess the interaction between time and gender on a series of psychosocial outcomes in the pooled sample. Results: The findings supported greater psychosocial improvements for female participants compared to male participants, including significant improvements in PTSD, perceived stress, and perceived physical health, and feeling greater closeness and lower avoidance in close relationships (ps < 0.05). The results revealed moderate to large effect sizes among female participants, suggesting meaningful clinical effects of the interventions (ds = 0.47–0.70). Conclusions: While the secondary analysis and small sample size limit causal inferences, the exploratory evidence suggests greater improvements in psychosocial health in female veterans after participating in the service dog training programs. Future research should tailor interventions to optimize the therapeutic effects for male and female veterans and identify other individual characteristics involved, such as combat exposure or post-traumatic stress symptom severity. Full article

Although recent studies report elevated rates of post-traumatic stress disorder (PTSD) among Ukrainian refugees, data from military hospitals and rehabilitation centers within Ukraine remain scarce. Numerous studies have described that interactions with therapy dogs help mitigate PTSD symptoms by providing emotional support, reducing hypervigilance, encouraging social engagement, and facilitating physiological de-arousal. However, the potential role of dog-assisted interventions (DAIs) in therapeutic settings during ongoing conflict has not yet been investigated. In this study, saliva samples pre- and post- a 20 min DAI were gathered from soldiers and other military service personnel with diagnosed PTSD in Kyiv, Ukraine. Salivary cortisol was assessed as a biomarker to parallel acute physiological strain. The findings revealed a decrease in salivary cortisol from pre- to post-DAIs in both men and women. Of note, men exhibited higher salivary cortisol levels than women both pre- and post-DAIs. The present findings suggest that people with PTSD benefit from canine support due to reduced acute arousal in a war environment. Limitations include the small sample size and the lack of a control group. In order to mitigate against the high prevalence of psychophysiological distress in at-risk populations such as military personnel, further research is warranted. Full article

Posttraumatic stress disorder (PTSD) has been associated with a range of cognitive alterations; however, the relationship between PTSD and intelligence remains unclear. The aim of this systematic review was to examine potential differences in intelligence associated with exposure to traumatic events and/or a diagnosis of PTSD in adults aged 18 years and older. A systematic search was conducted across three major academic databases—PsycINFO, MEDLINE, and Web of Science—to identify empirical studies assessing intelligence or closely related cognitive constructs in individuals with PTSD or a history of trauma exposure. After applying predefined inclusion criteria, 12 studies were included in the review. Intelligence was assessed using various psychometric instruments, encompassing both global intelligence measures and specific domains such as verbal intelligence and vocabulary. Overall, the findings consistently indicated a negative association between intelligence and PTSD, with lower intelligence scores more frequently observed among individuals with PTSD or significant traumatic exposure. Due to the correlational design of the studies included, causal relationships cannot be established. Consequently, it remains unclear whether intelligence is affected by PTSD or whether higher intelligence may serve as a protective factor against the development or severity of the disorder. From an intelligence research perspective, these findings highlight cognitive ability as a key factor associated with vulnerability and resilience in trauma-related psychopathology. Full article

First responders are routinely exposed to potentially traumatic events and occupational stress, placing them at heightened risk for mental health difficulties. Despite the prominence of psychological resilience in first responder research, insufficient attention has been given to gender differences in how resilience functions within male-dominated occupations. The present study investigated gender differences in the relationships between perceived stress, resilience, and mental health outcomes among South African first responders (n = 429). Participants completed the Perceived Stress Scale-10, the Connor–Davidson Resilience Scale-10, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, and the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5. Correlational and mediation analyses were conducted. There were no significant gender differences in overall levels of resilience. Perceived stress was associated with depression, anxiety, and PTSD for both genders. Resilience showed significant direct protective effects for men across all mental health outcomes, whereas for women it was significantly associated only with depression and PTSD but not anxiety. Mediation analyses revealed that resilience mediated the relationship between perceived stress and mental health outcomes for men only. These findings suggest that resilience operates through gender-specific pathways. It underscores the importance of conceptualizing resilience as a contextually shaped process rather than solely an individual capacity in first responder populations. Full article