More than 20% of individuals with schizophrenia show minimal or no response to antipsychotic medications and little is known about genetic contributions to more severe forms of illness. This study sought to explore if cases with continuously-hospitalized, treatment-resistant schizophrenia (CH-TRS) carry a higher burden of common genetic variants compared to less severe forms. CH-TRS cases were recruited from Pennsylvania state psychiatric hospitals in the USA, with ≥ 5 years of continuous hospitalization, active treatment, and non-response to ≥ 3 antipsychotic medications. Three comparator groups were obtained from cohorts in the USA, Sweden, and the UK including TRS, general schizophrenia and non-psychiatric controls. Polygenic scores (PGS) of schizophrenia and cognitive ability were generated in individuals of European and African ancestry. Logistic regression assessed the association of PGS and CH-TRS cases (vs. comparators), with sex differences and sensitivity analyses excluding individuals with other diagnoses conducted to assess robustness. We included 18,571 individuals of European ancestry (346 CH-TRS, 10,757 TRS, 1148 general schizophrenia, 6320 non-psychiatric controls) and exploratory analyses of 476 individuals of African ancestry (78 CH-TRS, 398 non-psychiatric controls). For each standard deviation increase in the schizophrenia PGS, the odds of CH-TRS among individuals of European ancestry increased by 40-80% compared to general schizophrenia and TRS. Results in African ancestry participants mirrored those of European ancestry albeit with reduced levels of significance. Sex interactions and sensitivity analyses did not materially alter the estimates. This study demonstrates a greater burden of common genetic variants is associated with more severe forms of illness in schizophrenia.

Accumulating evidence has demonstrated that dysfunction in the brain reward circuit plays a pivotal role in the pathogenesis of both major depressive disorder (MDD) and addictive disorders (substance use and behavioral addictions). However, it remains unclear whether the neural dysfunctions during reward processing are shared or distinct between these disorders. To address this, we employed the Seed-based d Mapping (SDM) toolbox to explore shared and distinct task-based fMRI findings in MDD and addictive disorders during the processing of reward (anticipation and outcome) and loss (outcome). The electronic databases PubMed, EMBASE, Scopus, Web of Science, and PsycINFO were searched from their inception until September 20, 2025. Studies were included if they used fMRI to compare brain responses during reward/loss tasks between patients (with MDD or addictive disorders) and healthy controls, and reported whole-brain coordinates (in Talairach or MNI space). The analysis included 76 articles, including 45 articles with 1212 addiction patients, 31 articles with 1211 MDD patients, and 2126 healthy controls aggregated from the 76 articles. Conjunction analysis revealed no significant common hypo- or hyper-activated brain regions between patients with addictive disorders and those with MDD (addiction & MDD) relative to healthy controls across all experimental conditions. Differential analysis showed addiction patients had greater left striatum activation (vs. MDD) during reward anticipation, and greater right putamen and left striatum activation (vs. MDD) during reward outcome. No significant differences were found under the loss outcome. Our findings indicate that during reward processing, the striatum is a common functionally abnormal brain region in both MDD and addictive disorders, but the activation directions of the two disorders in this region show opposite trends. The striatum can serve as a transdiagnostic common abnormal marker for MDD and addictive disorders. Our results provide potential targets for future research on neuromodulatory, pharmacological, and clinical interventions in patients with MDD alone, addictive disorders alone, and comorbid patients of the two disorders.

Neurodiverse diagnoses (NDs) have been largely conceptualised as distinct categories with clear-cut diagnostic boundaries. However, converging research evidence is showing that this conventional approach may inadequately capture the individual variation and overlaps that are commonly observed in population studies. This study extended emerging quantitative research frameworks for understanding diagnostic complexity, adopting a transdiagnostic dimensional approach toward characterising the cognitive and mental health dimensions associated with NDs. A cohort of 175 adults with suspected or previously diagnosed neurodiverse conditions was recruited using convenience sampling. Cognitive domains of executive function, language, attention, processing speed, and memory were assessed using the National Institute of Health (NIH) Cognition Toolbox©. A battery consisting of the Extended Strengths and Weaknesses Assessment of Normal Behavior (E-SWAN), Strengths and Difficulties Questionnaire (SDQ), and Emotion Regulation Skills Questionnaire (ERSQ) was administered to provide additional proxy measures of mental health. Cluster analyses revealed that the sample of neurodivergent adults was best represented by three data-driven clusters, none of which mapped coherently onto traditional diagnostic labels. In contrast, these transdiagnostic groups were best characterised by a combination of strengths and weaknesses along two multivariate dimensions: 1) cognitive flexibility and processing speed, and 2) language, memory, emotional wellbeing, and behavioral regulation. This study provides novel, data-driven evidence to support the emerging dimensional structure of NDs, and highlights several component processes which may contribute to the complexity associated with neurodiversity in adults. These findings may be used to inform future assessment and/or support strategies for neurodivergent adults, beyond those framed by strictly categorical approaches.

People with physical disabilities in low- and middle-income countries experience elevated rates of psychological distress. This study explored the impact of a peer support intervention ('friendship group') for people with disabilities attending prosthetic and orthotic clinics in Cambodia. A total of 462 individuals were screened using the Kessler Psychological Distress Scale (K10), 47 met inclusion criteria (scores 20-29). Of these, 27 enrolled in the intervention, while 20 did not participate. Psychological distress was assessed across four domains of the K10 (nervousness, agitation, fatigue and negative affect). Intervention participants were measured at three time points (2 baseline measures and 1 follow-up), non-participants contributed baseline data only. Quantitative data were analysed using linear mixed-effects models, qualitative data from post-intervention focus groups (n = 21) were analysed thematically. Reductions in K10 scores were observed across all domains following the intervention (p < 0.001). Qualitative findings highlighted perceived benefits including restored family and community roles, emotional relief and improved self-regulation. Given the pre-post design without a full comparator group, findings should be interpreted cautiously. This exploratory study suggests that peer support may offer a feasible and culturally acceptable route to support people with disabilities in low-resource settings.

Anxiety is one of the most prevalent global mental health disorders, with its incidence having risen substantially since the COVID-19 pandemic and remaining elevated in the post-pandemic era. According to the process model of emotion regulation, mindfulness may serve as an early-stage cognitive change strategy that enhances emotional stability and ultimately reduces anxiety. While previous research has demonstrated robust interconnections among anxiety, emotional stability, and mindfulness, the majority of studies have relied on cross-sectional designs and aggregate scores, neglecting their longitudinal, item-level dynamic relationships.

This study collected data from 547 college students (M _age ± SD = 20.11 ± 1.20) across three time points and utilized a cross-lagged panel network (CLPN) approach to analyze item-level temporal dynamics. The goal was to build network models of anxiety, emotional stability, and mindfulness, and to investigate how these constructs were temporally interrelated at the item level in an exploratory manner.

Mindfulness items had higher out-Expected influence (OEI), whereas anxiety symptoms had stronger in-Expected Influence (IEI), with anxiety and emotional stability having the strongest bridge effects. Specifically, mindfulness components "Thought Acceptance" (M7) and "Nonjudgmental Awareness" (M8) exerted significant effect on anxiety and emotional stability. Anxiety symptoms were highly responsive to other symptoms, which undermined emotional stability. The network analysis revealed complex temporal and predictive associations among anxiety, emotional stability, and mindfulness.

This study is the first investigation to reveal the longitudinal dynamic connections between anxiety, emotional stability, and mindfulness at the item level, consequently provided longitudinal support consistent with the emotion regulation process model.

This study examined associations between psychological need frustration and subjective well-being among vocational college students in physical education contexts, with a focus on cognitive reappraisal and sport-related attentional disruption.

Drawing on Self-Determination Theory, emotion regulation theory, and attentional control perspectives, we tested a moderated mediation model in which cognitive reappraisal statistically accounted for part of the association between psychological need frustration and subjective well-being, and sport focus disruption moderated the association between psychological need frustration and cognitive reappraisal. Data were collected from 2,344 vocational college students in China (M = 19.2 years, SD = 1.3; 52% female) using standardized questionnaires. PROCESS Model 7 with 5,000 bootstrap samples was used to examine conditional associations, controlling for age, gender, and weekly exercise time.

Psychological need frustration was negatively associated with subjective well-being, whereas cognitive reappraisal was positively associated with subjective well-being. Sport focus disruption moderated the association between psychological need frustration and cognitive reappraisal: this association was not significant at low levels of sport focus disruption but was positive and stronger at average and high levels. The conditional indirect association between psychological need frustration and subjective well-being through cognitive reappraisal was significant only at average and high levels of sport focus disruption.

These findings suggest a conditional pattern in which cognitive reappraisal may reflect a compensatory regulatory process under higher attentional disruption. Given the cross-sectional design, all findings should be interpreted as associations rather than evidence of causal or temporal mediation.

Drug addiction is characterized by orchestrated transcriptional changes in brain reward regions, including the nucleus accumbens (NAc). The transcription factor E2F3a has emerged as a novel regulator of cocaine's rewarding effects, yet its sex- and cell-specific mechanisms, as well as its genome-wide targets, remain undetermined. Here, we investigated the motivational and reinforcing roles of E2F3a in cocaine reward using conditioned place preference (CPP) and self-administration, combined with behavioral economics and viral-mediated gene manipulation. Selective overexpression of E2F3a in D1-type medium spiny neurons (MSNs), but not D2-MSNs, increased cocaine CPP in both male and female mice, whereas knockdown produced the opposite effects. Behavioral economics analyses further revealed that E2F3a regulates specific aspects of cocaine reinforcement. Genome-wide mapping revealed increased E2F3a binding to DNA at genes associated with cocaine exposure. Together, these results establish E2F3a as a central substrate of cocaine reward via the recruitment of D1-MSNs and coordinated expression of both proven and new molecular drivers.

Forty-one states in the United States that adopted Medicaid expansion through the Affordable Care Act reached historically low rates of uninsured that have endured through 2025. The One Big Beautiful Bill Act (OBBBA) signed into law on 4 July 2025 contains numerous provisions that place Medicaid expansion coverage at risk. Resulting changes to Medicaid expansion include work requirements, a decrease in federal match funds for expansion programs, cost-sharing fees for recipients, stricter eligibility requirements, more frequent re-enrollment periods, and limitations on family planning services provided by organizations that also provide abortion services. Because each state with Medicaid expansion has implemented this program differently, states will be impacted differently and with various timelines. The impact of OBBBA on Medicaid expansion in the state of New Hampshire is discussed in detail and examined from the perspective of a community mental health center. Nursing implications are discussed within the framework of Fawcett and Russell's conceptual model of nursing and health policy. Recommendations for advocacy and the nurse's role as an important stakeholder are discussed.

To analyze the interplay between family history of type 2 diabetes (T2D) and cardiovascular health (CVH) in relation to T2D onset age and subsequent cardiovascular disease (CVD) risk.

A total of 79 831 participants were included to investigate the association between family history and T2D onset age. Then, 7387 diagnosed T2D patients were 1:1 matched with non-T2D individuals to analyze the association of T2D onset age with subsequent CVD risk. The benefit of good CVH was further assessed. Stratified Cox regression and conditional Cox regression were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Family history was associated with younger T2D onset, with an approximately 2.4-year earlier onset of T2D, which further increased the subsequent risk of CVD. Compared with individuals without family history, those with family history had HRs (95% CIs) of 3.911 (3.041, 5.032), 3.785 (3.385, 4.233), 3.627 (3.340, 3.938), 3.465 (3.189, 3.764), and 3.169 (2.787, 3.603) for T2D onset at < 40, 40-50, 50-60, 60-70, and ≥ 70 years old, respectively (P_interaction = 0.007). Among individuals with family history, HR (95% CI) for incident CVD was 3.598 (1.372, 9.433) for those diagnosed T2D < 50 years compared with those without T2D, while the HR (95% CI) was 2.336 (1.232, 4.428) among those without family history. However, high CVH could mitigate risk of young-onset T2D, and could further decrease CVD risk after their T2D diagnosis.

Having family history of T2D increased susceptibility to young-onset T2D and subsequent CVD risks, while ideal CVH could counteract these risks, highlighting the necessity of early screening and intervention.

To analyse subjective experiences of power of adults with noncommunicable diseases in relationships with healthcare practitioners as well as underlying facilitators and barriers of these experiences.

Systematic review (4 databases) of experiences using reflexive thematic analysis underpinned by critical realist approach. The analysis was conducted with an abductive reasoning using previous theories on social power as well as retroduction.

Based on 24 studies, we formed three themes, which depict experiences of power as 1) the position, equal ability and freedom to make one's own choices and (re)negotiate within shared dialogue, 2) the ability to use knowledge to claim one's rights, 3) resistance. Facilitators were connected to acknowledgement as an equally valuable individual, positive healthcare practitioner attitudes and actions towards patient activity and views, safety in the relationship as well as to sufficient, clear and varied information. Main barriers were experiences of dehumanisation, negative healthcare practitioner attitudes and actions, perceived or assumed practitioner domination in interactions, lack of or incomprehensible knowledge and testimonial smothering.

Results suggest that adults with noncommunicable diseases may experience power primarily as a positive power: being acknowledged as having legitimate position to make decisions and being in possession of varied knowledge through which they can gain agency to protect and claim their rights, by resisting, if necessary. Healthcare practitioners are in key position to support these experiences through positive transforming actions, while knowledge asymmetries, persistent inequality and paternalistic structures continue to hinder it.