Autism Spectrum Disorder (ASD) is associated with altered interoception, empathy, self-awareness, and alexithymia. However, limited research has been conducted to investigate the interrelationships of these constructs with psychopathological symptoms. A prior network analysis in college students examined the interrelationship of these constructs and demonstrated that cognitive empathy and alexithymia influenced interoception and autistic features. We aimed to examine the interrelationships of these constructs in people with clinical ASD using network analysis. We recruited 208 young people aged 15-25 with Autism Diagnostic Observation Schedule (ADOS-2) confirmed diagnosis of ASD and administered self-report measures for interoception, empathy, self-awareness, and alexithymia. We constructed a regularized partial correlation network. The results showed the alexithymia node of "difficulty-describing-feelings-to-others" (expected influence (EI) = 0.854), interoceptive awareness (strength = 1.273; EI = -0.084), depressive symptoms (EI = 0.537), and anxiety symptoms (EI = 0.652) were important nodes. Our findings suggested that alexithymia, depressive, and anxiety symptoms influenced empathy, self-awareness, and autistic features in people with ASD and supported the important role of interoception in the network.

Cognitive impairment is a prevalent and burdensome feature of difficult-to-treat depression, yet the symptom-level interdependencies between affective and cognitive domains remain poorly understood. We examined cross-domain interactions using a symptom network approach.

We conducted an exploratory cross-sectional symptom network analysis in 120 patients with difficult-to-treat depression. Networks included seven harmonized depression symptoms (Hamilton Depression Rating Scale/Montgomery-Åsberg Depression Rating Scale) and three cognitive measures (processing speed, semantic memory, cognitive flexibility). Network structure was estimated using Mixed Graphical Models with LASSO regularization. Bridge symptoms were identified using bridge expected influence indices.

The network revealed selective cross-domain connections. Positive associations were observed between reduced appetite and processing speed and cognitive flexibility, as well as between depressed mood and semantic memory. A negative association was observed between suicidal ideation and semantic memory. Reduced appetite emerged as the most important bridge symptom linking affective and cognitive domains. Stability analyses indicated acceptable stability of bridge nodes, while bootstrapped confidence intervals suggested substantial uncertainty in individual edge estimates, underscoring the exploratory nature of the findings.

This exploratory analysis provides initial evidence for cross-domain, symptom-level relationships in difficult-to-treat depression. These findings highlight heterogeneity that may remain obscured in total-score approaches. Bridge symptoms may represent candidate adjunctive targets, as modulating such nodes could potentially influence multiple domains simultaneously. However, given the modest sample size and limited network stability, the results are hypothesis-generating and require replication in larger, independent cohorts before clinical interpretations can be drawn.

Biological mechanisms underlying heterogeneous antipsychotic response in schizophrenia remain incompletely understood. In this exploratory cross-sectional study, we applied deep data-independent acquisition LC-MS/MS plasma proteomics to 56 adults initially enrolled (14 per group), including healthy controls and patients meeting TRRIP criteria for treatment-sensitive (TSS), treatment-resistant (TRS), and ultra-treatment-resistant schizophrenia (UTRS). Following proteomic quality control and exclusion of outliers, 52 individuals comprised the final analytical cohort. Proteomic data were analyzed using a layered strategy integrating covariate adjustment, variance partitioning, mediation analysis, monotonicity filtering, LASSO stability assessment, and redundancy reduction. More than 1400 plasma proteins were quantified; 450 differed across groups before adjustment, and 310 reviewed proteins remained significant after covariate modeling. A sensitivity-associated profile distinguishing TSS from controls (CRP, CCDC62, FBXW7, GULP1, CALD1, COPS6) was consistent with lower inflammatory tone and relative preservation of proteostatic and cytoskeletal regulation. In contrast, a resistance-associated profile separating TRS/UTRS from TSS (SHROOM1, MYH7, ABR, EZR, SERPINF2) converged on cytoskeletal organization, actin-membrane dynamics, and extracellular regulatory processes. Directionally concordant but quantitatively amplified changes were observed in UTRS relative to TRS, although multivariate separation between resistant subgroups was limited after full covariate adjustment. Several proteins enriched in resistant groups corresponded to intracellular or nuclear factors rarely detected in plasma and require cautious interpretation. Overall, these findings are compatible with a progression-like molecular pattern in which treatment sensitivity and resistance may reflect shifts in cellular adaptability and structural regulation. Replication in larger and longitudinal cohorts is required.

Firearm injury is now the leading cause of death among children and adolescents in the United States, yet far more children survive gunshot wounds and encounter substantial long-term consequences. This article argues that pediatric firearm survivors constitute a population of children with medical complexity, a group defined by severe chronic health conditions, significant functional limitations, substantial service needs, and high health care utilization. Survivors often experience multisystem trauma, neurological impairment, chronic pain, organ dysfunction, and enduring functional deficits requiring long-term rehabilitation, medical technology, and educational and psychosocial support. Families frequently manage intensive caregiving responsibilities and navigate fragmented systems of care. Survivors also demonstrate elevated mental health needs and high rates of readmissions, subspecialty care, and emergency visits, reflecting chronic and resource-intensive trajectories. By applying established frameworks for children with medical complexity, this article reframes firearm survivorship as a chronic condition rather than a discrete traumatic event.Recognizing pediatric firearm survivors as medically complex has important implications for hospice and palliative care nursing practice. Such recognition supports trauma-informed, longitudinal models of palliative care and highlights the need for targeted interventions that address the persistent medical, functional, and psychosocial burdens of this growing population.

To examine dose-response associations of vigorous intermittent lifestyle physical activity (VILPA; bouts ≤1 min) and its moderate- to vigorous-intensity equivalent (MV-ILPA; bouts ≤3 min) with incident type 2 diabetes.

Prospective data from UK Biobank accelerometry substudy participants who reported no leisure-time exercise and had no type 2 diabetes at baseline were analyzed. Daily duration and frequency of VILPA and MV-ILPA were derived from wrist-worn accelerometers. Incident type 2 diabetes was ascertained through linked primary care, hospital, and death records. Dose-response associations were examined using multivariable-adjusted Fine-Gray subdistribution hazard models accounting for competing risks.

Among 22,706 participants (mean age 62.3 years; 56.4% female), 665 developed type 2 diabetes over an average follow-up of 7.9 years. Daily durations of VILPA and MV-ILPA showed inverse, nonlinear L-shaped associations with incident type 2 diabetes. Median durations of 3.9 min/day of VILPA and 25.3 min/day of MV-ILPA were associated with 36% and 46% lower risks of type 2 diabetes, respectively, compared with no VILPA or 3.9 min/day of MV-ILPA. Daily VILPA frequency showed a near-linear inverse association, with 10.4 bouts/day (median) corresponding to a hazard ratio (HR) of 0.64 (95% CI 0.51-0.81) compared with 0 bouts/day. Daily MV-ILPA frequency showed a U-shaped pattern, with risk reductions plateauing at approximately 56 bouts/day (HR 0.54; 95% CI 0.39-0.76).

Among adults who do not engage in leisure-time exercise, accruing brief, intermittent bouts of moderate- to vigorous-intensity physical activity during day-to-day routines may be a promising strategy for prevention of type 2 diabetes.

Background: The primary psychoactive ingredient in cannabis interacts with the endocannabinoid system, which declines with age and may alter cannabis-related effects in older adults. Animal studies suggest age-related differences in cannabis responses, though findings are mixed. Importantly, biological sex modifies the endocannabinoid system, which complicates interpreting age-related effects.Objective: This study examined how age and sex jointly influence cannabis-related outcomes in middle-aged and older adults.Methods: Self-reported measures of cannabis use behaviors, memory, mental and physical health, cannabis use disorder (CUD) symptom severity, and sleep quality were collected from 107 adults (age range = 35-78, 54 females) who use cannabis. Partial correlations examined associations between age and outcomes controlling for years of use. Self-reported biological sex was assessed as a moderator.Results: Regression analyses revealed a significant age × sex interaction for both CUD symptoms and mental health scores. Among females, CUD symptom severity decreased with age (b = -0.20, p = .03), and mental health scores improved (b = 0.59, p = .04); these age-related effects were not observed in males. Sensitivity analyses suggested that participants reporting medical-only cannabis use may exhibit a steeper age-related decline in CUD symptom severity than those reporting recreational-only use (b = 1.31, 95% CrI: -1.99 to 4.54) or hybrid use (b = 0.62, 95% CrI: -2.76 to 3.98).Conclusions: These findings suggest that factors such as sex and reason for cannabis use may be important for understanding cannabis safety profiles in aging populations and may inform individualized clinical care.

Aim: The aim of this paper is to define and discuss a new and emerging sub-discipline of special education, namely special education for individuals with mental disorders.

Materials and Methods: This paper is based on a narrative review and theoretical analysis of selected Polish and international literature from the fields of special education, psychiatry, and social sciences. The analysis included monographs and peer-reviewed articles addressing adult education, intellectual disability, autism spectrum disorders, and mental disorders, with particular emphasis on schizophrenia and affective disorders. A critical and comparative analysis of theoretical concepts and paradigmatic changes, especially the development of community-based models of care, was conducted. Mental disorders constitute an important cause of disability in adulthood and create a new area of interest for special education. The development of community psychiatry and community mental health centers opens opportunities for special educators to work with adults with mental disorders as community therapists, social skills trainers, or recovery assistants. However, the establishment of this professional role requires legal regulations and interdisciplinary cooperation.

Conclusions: Special education pedagogy for people with mental disorders constitutes a new and essential subdiscipline of special education. The expansion of community psychiatry creates structural opportunities for the development of professional roles within this field. Whether community therapists evolve into formally recognized special educators for persons with mental disorders will depend on future legislative solutions, the engagement of universities in developing specialized training programs, and close cooperation between educators and psychiatrists.

Tobacco use is prevalent among military veterans. Veterans with serious mental illness (SMI) smoke cigarettes at higher rates than their counterparts, which causes major health disparities. Additional efforts are needed to support smoking cessation in this population. This study was informed by the theory of planned behavior and used a rapid qualitative matrix approach to explore how attitudes, perceived behavioral control, and social norms influenced smoking among veterans with SMI to inform tailored treatment. In a sample of 20 veterans, smoking initiation was often linked to military culture and early exposure to smoking. Peer pressure and social belonging either facilitated or inhibited quit attempts. Veterans wanted to quit, but continued smoking due to addiction and to cope with mental health challenges. Smoking cessation discussions for veterans with SMI should be integrated into routine mental health care and explore social norms around smoking, coping strategies, and the psychological benefits of quitting.