Background: Research has demonstrated the effectiveness of a mobile app-delivered Acceptance and Commitment Therapy (IACT) programme for individuals with posttraumatic stress disorder (PTSD) in their PTSD symptoms. However, there are still few studies on its mediating mechanism.Objective: This secondary analysis aimed to examine whether six components of psychological flexibility - acceptance, present-moment awareness, self-as-context, cognitive defusion, valued living, and committed action - mediate the effects of an IACT programme for individuals with PTSD.Method: Data were obtained from a randomized controlled trial in which participants were assigned to an IACT condition (n = 78) or a waitlist control (WL; n = 67). Using a latent growth curve modelling approach with bias-corrected bootstrapped confidence intervals, changes in PTSD symptoms and psychological flexibility components were assessed at baseline (T1) and following each of six intervention modules (T2-T7).Results: Relative to WL, the IACT group showed significantly greater improvements in both PTSD symptoms and all six flexibility components. Mediation analyses revealed that four processes - acceptance, self-as-context, cognitive defusion, and committed action - fully mediated the intervention's effects on PTSD outcomes, whereas valued living and present-moment awareness served as partial mediators.Conclusions: These findings suggest that enhancing these components of psychological flexibility may be crucial for effective IACT treatment of PTSD.

Sleep is essential for adolescents’ physical and psychological development. Sleep problems are common among adolescents with psychiatric disorders, but research on the prevalence of specific sleep disorders herein is lacking.

To examine the prevalence of sleep disorders in adolescents with psychiatric disorders and to explore its relationship with sleep-hygiene-behaviors.

In a cross-sectional pilot-study, 50 adolescents (16-24 years) receiving care at a specialized mental health institution completed the Holland Sleep Disorders Questionnaire and the Adolescent Sleep Hygiene Scale. The prevalence of sleep disorders and differences in sleep-hygiene-behaviors between adolescents with and without sleep disorder(s) were analyzed using cross-tabulations, <span class="CharOverride-4">&chi;</span>&sup2;-, and t-tests.

68% of adolescents scored above cut-off for at least one sleep disorder, and 54% for two or more. Insomnia disorder (60%) and circadian rhythm sleep-wake disorders (44%) were most prevalent. Comorbidity of multiple sleep disorders was high. Adolescents with sleep disorders reported significantly poorer sleep-hygiene, particularly pertaining substance use and pre-sleep emotional arousal.

Sleep disorders are highly prevalent among adolescents with psychiatric disorders and are associated with poorer sleep-hygiene. Early detection and sleep disorder treatment, along with improving sleep-hygiene-behaviors, might be essential for healthy sleep quality and better/faster psychiatric recovery in adolescents.

In forensic mental health care, clients who terminate treatment prematurely are at increased risk of recidivism. Most drop out during the initial treatment phase. Understanding factors associated with the timing of dropout may help clinicians adjust interventions in time and maximize treatment benefit.

To examine the extent to which the central eight criminogenic risk factors predict the timing of dropout (early, middle, or late) among adults receiving outpatient forensic treatment.

A retrospective file study was conducted among 1,110 adult clients who discontinued treatment prematurely. The central eight risk factors were assessed with the RAF-GGZ. Dropout subgroups were categorized based on treatment duration as early (0-4&nbsp;months), middle (4-6&nbsp;months), and late (&gt; 6&nbsp;months) dropout.

More severe family or relationship problems at the start of treatment were the only risk factor significantly associated with an increased likelihood of late dropout. No significant effects were found for the other central eight risk factors.

The central eight risk factors appear to have limited value for predicting the timing of dropout among forensic outpatients. Future research should focus on responsivity factors and treatment process variables to better understand and prevent premature termination.

Although telehealth outcomes have been widely studied, less is known about how providing telehealth influences therapists' subsequent in-person clinical practice. This qualitative study examined how marriage and family therapists (MFTs) described changes in their in-person work following telehealth experience. Forty-two MFTs completed an online survey including demographic items, a Likert-scale item assessing perceived impact on in-person services, and an open-ended prompt about changes noticed during in-person therapy. A subset completed follow-up virtual interviews. Data were analyzed using reflexive thematic analysis. Findings indicated that telehealth functioned as a formative professional experience, shaping in-person practice through heightened embodied attunement, increased observational precision, more intentional communication, expanded intervention flexibility, and refined clinical decision-making. Participants also reported enduring logistical changes related to scheduling, boundaries, and modality selection. Developmental stage influenced how these changes were integrated. Results suggest telehealth experience represents an important dimension of therapist development, with implications for training, supervision, and hybrid care.

Germany increasingly relies on an internationally recruited migrant workforce, like Vietnamese migrants, to address shortages in the mental healthcare sector. This cross-sectional study examined differences in the Professional Quality of Life (ProQOL), measured through the subscales burnout (BO), secondary traumatic stress (STS) and compassion satisfaction (CS), among Vietnamese migrant and non-migrant mental health professionals (N = 312) in Germany. Participants completed an online survey in German or Vietnamese including the ProQOL - 5 Scale, as well as sociodemographic and work-related variables. Multiple linear regression models identified salary across all subscales and psychiatric pre-conditions for BO and STS as significant predictors for ProQOL outcomes. Analyses of covariance compared adjusted group means across migration and gender. Vietnamese migrant professionals report significantly lower CS and higher STS compared to non-migrant professionals, while no significant migration-related differences were observed for BO. Considering gender, women exhibit significantly higher CS than men, whereas no significant gender differences emerged for BO or STS. No significant migration × gender interaction effects were found. Findings indicate migration background is associated with relevant differences in ProQOL among mental health staff in Germany, underscoring the need for targeted support, like an inclusive workplace culture and work-related social network. Further research should incorporate direct measures of migration-related stressors to better understand underlying mechanisms and longitudinal designs.

Substance use and suicidality are prevalent among individuals at ultra-high-risk (UHR) of psychosis, yet their relationship remains unclear. This systematic review synthesises evidence on the relationship between substance use and suicidality-comprising suicidal ideation, self-harm, suicide attempts, and suicide deaths-in the UHR population.

A pre-registered systematic review (PROSPERO: CRD42024614852) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Systematic searches of Embase, Medline, PsycINFO, and Web of Science identified studies examining substance use and suicidality in individuals at UHR. Two reviewers independently extracted data and assessed quality using the Mixed Methods Appraisal Tool. Findings were narratively synthesised.

Twelve studies (13 papers; n = 2198) met inclusion criteria. Of 40 analyses, only 13 reported significant associations between substance use and suicidality, most of which were derived from a single study. Tobacco use showed the most consistent preliminary associations with suicidal ideation and self-harm. Alcohol and cannabis were linked to ideation and self-harm in some analyses, and cocaine to ideation only, particularly when continuous measures were used. In contrast, composite substance use variables were largely unrelated to suicide outcomes. Methodological quality varied, with major limitations including reliance on cross-sectional data and the use of dichotomous substance use outcomes.

At present, there is insufficient high-quality evidence to establish a reliable association between substance use and suicidality in individuals at UHR for psychosis. Rigorous longitudinal studies using validated, substance-specific measures are needed to better understand these relationships and inform risk assessment and early intervention.

Aerobic exercise, defined as rhythmic and continuous physical activity performed at moderate intensity to improve cardiorespiratory fitness, is widely recognised as an effective non-pharmacological intervention for improving the mental health of adolescents with subthreshold depression. However, whether the environment in which exercise is performed-such as indoor versus outdoor settings-modulates its psychological benefits remains insufficiently understood, as empirical evidence is still scarce. This study aims to compare the psychological effects of aerobic exercise conducted in different environmental contexts among adolescents with subthreshold depression and to identify which exercise setting may provide greater therapeutic advantages.

This assessor-blinded, two-arm, parallel-group randomised controlled trial will recruit adolescents who meet standardised subthreshold depression screening criteria. Participants will be randomly assigned to the indoor aerobic exercise group or outdoor aerobic exercise group using sex-stratified block randomisation to ensure balanced allocation between male and female participants. Both groups will participate in an 8-week moderate-intensity aerobic exercise programme (2-3 sessions per week, 40 min per session), with heart rate monitoring employed to ensure consistency of exercise intensity across conditions. Depressive symptoms, anxiety and sleep quality will be assessed at baseline (week 0), mid-intervention (week 4) and post-intervention (week 8). Data analysis will be conducted according to the intention-to-treat principle.

Ethical approval has been obtained from the Ethics Committee of Capital University of Physical Education and Sports (Approval No. 2025A139). The findings of this study will be disseminated through peer-reviewed publications and academic conferences.

ChiCTR2500112215.

Despite the growing focus on cyberbullying victimization across scientific, clinical, and community spheres, an agreement on the most effective evaluation methodologies for evaluating its effects remains unclear. This research sought to examine the reliability, construct validity and measurement invariance of the Cyberbullying Test (CT) across age, sex, and self-reported behavioral and emotional problems, measured with the Strengths and Difficulties Questionnaire (SDQ). To accomplish this objective, we recruited 767 Romanian adolescents (aged: 11-18; M = 13.4 years). All analyses were performed using R with packages such as "lavaan" version 0.6.19. Confirmatory factor analysis (CFA) confirmed the three-factor structure of the measure (RMSEA = .001, SRMR = .025, and CFI = 1.00), while multigroup CFA supported measurement invariance across age, sex, and self-reported behavioral and emotional problems. This supports the comparison of means across sex, age, and the presence of self-reported behavioral and emotional problems. The main differences between the latent means were: (1) Females tend to engage less as cyberaggressors compared to boys; (2) Adolescents exhibit a higher frequency of involvement in cyberbullying as cybervictims or as cyberwitnesses compared to preadolescents and less as cyberaggressors, and (3) Those included in the group with high level of self-reported behavioral and emotional problems (compared to those with low levels of problems) are frequently involved in cyberbullying in all the three roles, with associated large effect sizes. Regarding reliability, Cronbach's alpha was .95 or higher for the three subscales. The present study establishes the CT as reliable and valid, advocating for its value in measuring cyberbullying implications among young people. Theoretical implications, evaluation considerations, and prospective directions are examined.

Broad memory challenges arise for people with clinically diagnosed mental health disorders, in part due to changes in hippocampal structure and/or function. However, individuals with mental health symptoms often show memory impairments, even when symptoms do not reach the level of a formal clinical diagnosis. Building on this, the present study examined how mental health symptoms influence performance on two relational memory tasks known to be critically dependent on hippocampal function. Participants from across the adult lifespan completed a transverse patterning task for which they learned directional relations among abstract objects. In a separate experiment, participants completed a transitivity task in which they learned relations between pairs of objects and subsequently made inferences across those pairs. All participants completed the Depression, Anxiety and Stress Scale (DASS-42). Results showed that individuals with greater symptoms of anxiety performed less accurately on both relational tasks, although this association was only marginal in the transitivity task. Greater symptoms of depression were associated with accuracy declines on both tasks, but only when greater stress levels accompanied depressive symptoms. In the transitivity task, additional interactions emerged between anxiety and both stress and depression, indicating that performance declines were exacerbated by co-occurring symptoms. Generally, older participants performed less accurately; however, in transitivity, these effects emerged primarily in those with accompanying stress and depression. These findings demonstrate that even subclinical levels of depression, anxiety, and stress are associated with memory impairments, suggesting that mental health may play a role in cognitive and brain health across the lifespan.

Faced with personal and study-related stressors, students in higher education experience elevated levels of depressive and anxiety symptoms while often showing low help-seeking behavior. Although interventions have shown promise in enhancing student well-being, their potential to address stigma, which is closely linked to help-seeking, remains largely unexplored. The present study evaluates The Inquiring Mind (TIM), a Canadian anti-stigma program for post-secondary education, adapted for the German university context, assessing its potential to reduce stigma, increase mental health literacy and encourage continuum beliefs, the understanding of mental health and illness as existing on a spectrum rather than as fixed categories.

A sequential explanatory mixed-methods design was applied, using a quasi-experimental online survey (pre-, post- and follow-up assessment), and a subsequent focus group with program participants. A total of 58 students participated. The mixed-methods approach was selected to gain a better understanding of the program's impact and the effectiveness of specific components.

Findings revealed significant reductions in stigma in the intervention group at post-test and a significant increase in continuum beliefs at follow-up. While quantitative results showed no improvements in mental health literacy, qualitative analyses revealed greater awareness of mental health issues and self-stigmatizing processes, as well as improvements in the normality aspect of continuum beliefs.

Findings support the applicability of TIM in a new cultural context, contributing to research on the emerging concept of continuum beliefs and to the understanding of how interventions can influence post-secondary students' stigma. This systematic evaluation of an early, campus-based prevention program offers relevant insights for developing prevention strategies addressing students' post-pandemic mental health needs across diverse cultural and geographic settings.