Cognitive intraindividual variability (IIV), or the dispersion across neuropsychological task performance, is a sensitive marker of neurocognitive aging, but its tract-specific white matter correlates are not well characterized. This study used correlational tractography to identify pathways whose microstructural integrity relates to IIV in older adults.

Participants were a diverse sample of 510 community-dwelling older adults (M_age = 66.6 years, SD_age = 8.4) from the Health and Aging Brain Study-Health Disparities cohort. IIV was computed as the intraindividual standard deviation of demographically normed performance T scores across a multidomain battery. Diffusion MRI connectometry in DSI Studio tested partial Spearman associations between IIV and quantitative anisotropy, adjusting for sex and intracranial volume, with permutation testing and false discovery rate adjustment (0.01).

Higher IIV was associated with lower quantitative anisotropy primarily in commissural corpus callosum, fronto-subcortical, and interhemispheric long-range connection fibers. Tracts of the forceps minor were the most robust to sensitivity analyses. Effects were small in magnitude, with the primary connectometry threshold corresponding to an effect size of 0.09, but spatially specific, accounting for 7.57% of total whole-brain tract volume.

Overall, we found that IIV maps onto distributed, tract-specific differences in white matter microstructure. Findings support IIV as a marker linked to structural network-level white matter integrity and should motivate longitudinal work to further clarify its neuroanatomical substrates. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Mass graves workers play a crucial role in postconflict societies by identifying victims and providing closure to affected communities. However, little is known about the mental health consequences they face. This study examined rates of posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), and moral injury among mass graves workers in Libya. First, quantitative data were collected from 101 mass graves workers using validated measures of PTSD and CPTSD (International Trauma Questionnaire) and moral injury (Moral Injury Outcome Scale). Then, qualitative focus group discussions (n = 88) were conducted to provide deeper insights into workers' lived experiences. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed thematically. The findings showed that 27.7% of participants met the criteria for PTSD, with reexperiencing, hyperarousal, and emotional numbing among the most endorsed symptom clusters. Of the participants, 35.6% endorsed self-blame, and 31.7% reported loss of trust in others, indicating significant moral distress in this sample. Regression analyses indicated that demographic characteristics and work-related characteristics were not independent predictors of PTSD, CPTSD, or moral injury responses. The qualitative findings revealed that these psychological challenges were normalized within the occupational culture, with distress perceived as an expected consequence of the work rather than a clinical condition. Moral injury in this sample was characterized by guilt, betrayal, and procedural conflict, diverging from the shame-dominant profiles described in military populations. These findings underscore the significant psychosocial burden of mass graves work, even among workers who maintain a strong sense of occupational purpose and humanitarian identity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Multiple sclerosis (MS) is an autoinflammatory disease of the central nervous system (CNS). Epstein-Barr virus (EBV) encodes for EBNA-1_381-452, which induces autoreactive immune responses against distinct CNS derived proteins (GlialCAM_370-389, CRYAB_2-21, MBP_205-224, ANO2_135-154). Although EBV infection is considered essential for MS development, CNS-specific autoimmune responses may also be present in putatively EBV EBNA-1-seronegative patients, warranting further investigation. We studied 548 EBV EBNA-1 seropositive and 30 EBV EBNA-1 seronegative pediatric-onset MS (POMS) patients, along with 578 matched controls. CNS specific antibodies were significantly more prevalent in EBV EBNA-1 seropositive POMS patients (92.2%) than in EBV EBNA-1 seropositive controls (56.3%, P < 0.0001). However, high CNS specific antibody levels were also found in 56.6% of EBV EBNA-1 seronegative POMS patients and 17.4% of EBV EBNA-1 seronegative controls. These findings suggest that while EBV infection amplifies CNS specific autoimmune responses, high-level CNS autoreactive autoimmune responses can also occur independently of EBV EBNA-1. We further evaluated why only some individuals with high-level CNS autoreactive antibody titers develop MS. Mechanistically, we demonstrate that autoreactive immune responses are effectively controlled by NKG2C⁺ and NKG2D⁺ natural killer (NK) cells. These findings indicate that CNS-specific autoimmunity and impaired NK cell regulation, rather than EBV alone, are central to MS risk.

Most research on gender identity in individuals with 46,XX congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) is focused on severe forms of CAH, commonly termed "classic CAH." Much less is known about gender identity outcomes in milder, non-classic/late-onset CAH, and how gender dysphoria may impact clinical care and management decisions. This case series presents four pediatric patients with 46,XX karyotype who were diagnosed with CAH in early-to mid-childhood and represents a varying spectrum of CAH severity. In each case, patients had female-typical genitalia or their genital variation was not appreciated and further evaluated by the care team at birth; thus, all patients were assigned female at birth without targeted discussion on gender development. Each patient later experienced gender dysphoria and identified as male, transitioning socially and/or medically. This case series reflects on commonalities across cases, intentional non-adherence to CAH medication to allow for desired increased androgen levels, as well as mental health concerns. This case series highlights the importance of interdisciplinary care for youth with 46,XX CAH, and in particular, the benefits of collaboration with behavioral health providers to improve care for patients with CAH throughout childhood and young adulthood.

Mental and behavioral disorders (MBDs) represent a significant global health challenge. Nitrogen dioxide (NO₂), a prevalent urban air pollutant with potential neurotoxicity, has been studied for its acute effects on MBDs. However, existing evidence remains limited and inconsistent. A time-series study of over 10 years was conducted in Xinxiang, China, to investigate the acute effects of NO₂ on outpatient visits for MBDs from 1 January 2015 to 30 June 2025. The analysis comprised 2,409,583 valid records. A generalized additive model (GAM) with a quasi-Poisson distribution was utilized, with adjustments for long-term temporal trends, meteorological variables, weekday effects, and public holidays. For every 10 µg/m³ increase in NO₂ concentrations at lag0, outpatient visits for MBDs increased by 2.54% (95% CI: 2.04%, 3.04%). This effect was stronger during the cool season. The exposure-response (E-R) curve indicated a potential non-linear relationship, but the estimates at high concentrations are uncertain. Results from sensitivity analyses indicated no substantial changes in effect estimates. Our findings demonstrate that short-term NO₂ exposure was linked to elevated outpatient visits for MBDs, particularly in the cool season, thereby supporting the need for air pollution control and mental health protection.

Perturbation-based balance training (PBT) is a promising approach for improving reactive balance skills, but the role of the primary motor cortex (M1) remains unclear. This study investigated the role of M1 in short-term PBT combined with transcranial direct current stimulation (tDCS). Thirty-four healthy participants completed a three-session PBT involving surface translations, with anodal, sham, or no-tDCS delivered centered over M1. Electromyography of the tibialis anterior and soleus muscles, along with center of mass (COM) kinematics, were analyzed across long-latency responses (LLR1/LLR2 (reactive phase) and LLR3 (voluntary phase)). Balance improved across all groups, indicated by enhanced COM displacements in backward perturbations and increased COM velocity in LLR3 in forward perturbations. Only the anodal tDCS group showed reduced COM velocity in LLR2 in forward perturbations, heightened LLR1 activity, and decreased onset latency in the tibialis anterior muscle. The different indices of improved performance in forward and backward perturbations likely stem from direction-specific limits of stability. In forward perturbations, reduced reactive COM velocity may reflect stimulation-related improvement, while increased voluntary velocity implies training-only effects. Our findings suggest that tDCS centered over M1 may improve postural recovery by modulating neuromuscular activity, consistent with a contribution of cortical-subcortical communication to reactive balance control.

Vitiligo is a complex autoimmune skin disorder influenced by genetic susceptibility and environmental factors. Psychiatric morbidity has been proposed as a potential antecedent or correlate of vitiligo, but its prospective association with incident vitiligo remains unclear.

To investigate the prospective association between psychiatric morbidity and vitiligo and determine the extent to which this association is modified by genetic susceptibility, quantified by polygenic risk scores (PRS).

This study included 379,589 UK Biobank participants. Psychiatric morbidity and vitiligo were ascertained using ICD-10 codes. A vitiligo-specific PRS was analysed as elevated versus non-elevated genetic risk. Cox proportional hazards models were employed to evaluate associations, followed by interaction and exploratory pathway analyses.

During a median follow-up of 13.6 years, anxiety (HR 1.78, 95% CI 1.23-2.56) and depression (HR 1.46, 95% CI 1.03-2.06) were associated with incident vitiligo in the fully adjusted model. Elevated PRS was associated with higher vitiligo risk (HR 1.48, 95% CI 1.17-1.88). Stratified analyses revealed heterogeneous effects of psychiatric morbidity across genetic backgrounds. Participants with both psychiatric morbidity and elevated PRS had the highest point estimate (HR 2.28, 95% CI 1.06-4.88). Exploratory pathway analyses suggested lymphocyte percentage as a possible immune-related marker.

Hospital-recorded psychiatric morbidity and elevated genetic susceptibility were prospectively associated with incident vitiligo. These observational findings support consideration of mental health in holistic vitiligo care, while causal mechanisms require independent validation.

Understanding how emotional regulation (ER) mediates the relationship between self-esteem and subjective wellbeing (SWB) is central to promoting mental health among high school students. This paper provides a comprehensive integrative review of theoretical and empirical research exploring this interplay, while integrating perspectives from behavioral sciences and computational psychology. Traditional research primarily relies on self-report measures and cross-sectional designs, which limit the detection of dynamic emotional processes. On the other hand, emerging computational methods, such as machine learning-based mediation modeling and linguistic sentiment analysis enable new approaches to quantify and predict ER and wellbeing. This review develops an integrative framework that connects behavioral constructs and empirical evidence on adolescent ER and SWB with computational approaches for modeling these relationships. Rather than treating behavioral and computational methods as separate approaches, the framework considers how psychological measures, contextual and digital data, computational modeling, and adaptive feedback can be combined to support a more comprehensive understanding of adolescent wellbeing.

Hypertensive disorders of pregnancy (HDPs) affect approximately one in seven US deliveries and are associated with significant adverse maternal health outcomes. Standard postpartum care, typically a single 6-week visit, is insufficient for ongoing HDP management, education, and support. Combining home blood pressure monitoring with health coaching may enhance self-management, lifestyle change, and engagement with care, yet patient perspectives remain underexplored. This qualitative study examined 1-year postpartum experiences among birthing people with HDPs and explored perceptions of a postpartum health coaching intervention.

This qualitative study was embedded within the STAC-MyHEARTp randomized trial (NCT05685251), which compared home blood pressure monitoring plus health coaching to usual care. Using an explanatory sequential design, semi-structured interviews were conducted posttrial and analyzed thematically. Self-Determination Theory and Self-Regulation Theory guided coding and interpretation, with comparison across intervention and control arms.

Thirty-two participants (16 per arm) completed interviews. Four themes were identified: (1) postpartum experiences were emotionally and medically challenging, characterized by fear, anxiety, and hypervigilance; (2) participants strongly desired education and support, with coaching filling gaps unmet by standard care; (3) coaching provided behavioral, emotional, and healthcare benefits, including enhanced motivation, confidence, self-monitoring, lifestyle change, and self-advocacy; (4) persistent gaps, particularly in mental health support and continuity of care, remained across groups. Control participants recognized the potential value of structured support.

Health coaching offers meaningful, multidimensional support for individuals with HDP, promoting self-efficacy, engagement, and lifestyle change. Integrating structured coaching into comprehensive postpartum care can address persistent gaps, improve patient experience, and potentially enhance long-term cardiovascular and psychosocial outcomes, underscoring the need for sustained, person-centered postpartum care.

The metacognitive model of psychological disorders describes self-regulation within a hierarchical dynamic interplay between two distinct systems of cognition: a metacognitive control system and a cognitive system. In this model, metacognitive biases give rise to the Cognitive Attentional Syndrome (CAS), a pattern of perseverative thinking and maladaptive coping that sustains emotional distress. Among these biases, metacognitive knowledge, including individuals' declarative beliefs about their cognitive processes, plays a particularly influential role. Associations between metacognitive beliefs, CAS strategies, and emotional symptoms are well documented, but most studies have relied on cross-sectional designs or longitudinal assessments with limited temporal resolution, restricting examination of short-term dynamic processes central to the model. The present study employed an intensive longitudinal design with twice-daily assessments over 30 days in a sample of 171 adults, allowing for examination of within-person contemporaneous and short-term prospective hypothesised associations specified by the metacognitive model. Within-person analyses demonstrated contemporaneous positive associations between metacognitive beliefs, CAS, and emotional symptoms. In addition, increases in morning metacognitive beliefs prospectively predicted increases in evening CAS engagement. CAS strategies were strongly positively associated with same-day symptoms of anxiety and depression, and the association between morning metacognitive beliefs and evening symptoms was attenuated when evening CAS was controlled for. The results align with key hypotheses of the metacognitive model and are consistent with the proposed role of metacognitive beliefs as an underlying influence on self-regulatory strategies and emotional distress symptoms at the within-person level.