Early detection of first-episode psychosis (FEP) is critical for improving long-term outcomes. Training healthcare professionals to identify and intervene at the earliest stages is a key strategy for reducing the duration of untreated psychosis (DUP).

To describe a capacity-building programme, based on a 'Training of Trainers' (ToT) model designed to empower healthcare professionals to become multipliers of knowledge on early FEP detection within their communities.

A 72-h blended learning course using problem-based learning (PBL) was delivered to 47 healthcare professionals to build competencies in FEP identification and referral.

The 47 participants reported an increase in self-perceived confidence in identifying FEP symptoms. Participant satisfaction was high, with an average score of 9.0 out of 10.

The ToT model is a feasible and well-received strategy for training professionals in early FEP detection. Empowering professionals as educators is a critical step to strengthen community mental health and improve access to treatment.

ObjectiveMany older adults stop seeing a doctor despite having insurance and significant health needs. This study asks whether psychological distress predicts disengagement from care, beyond structural barriers.MethodUsing three waves of the Health and Retirement Study (N = 5,184 adults 65+), we model whether distress in one wave predicts no medical contact in the next, testing whether wealth weakens this link.ResultsOlder adults with more psychological distress were significantly more likely to disengage from care, even accounting for demographics, resources, and health needs. This link was stronger among those with less wealth, suggesting money helps buffer the effects of psychological strain. The pattern held even when looking at change within the same person over time.ConclusionPsychological distress independently predicts disengagement from care, and this effect is stronger among financially disadvantaged older adults. Mental health screening in primary care could help reduce disengagement in this group.

Modern healthcare systems are experiencing a rapid state of change, and it is evidence-based practice (EBP) that is playing a key role in ensuring safe and quality patient care. While EBP has been correlated with favorable patient outcomes, its predictive association with the quality of nursing work life (QNWL) has not been explored, especially in the Middle East region like Jordan.

This study evaluated EBP knowledge, attitudes, practices, and barriers among Jordanian nurses and factors that predict QNWL.

Descriptive, correlational, and cross-sectional research designs have been used. A convenience sample of 198 nurses in five Jordanian hospitals was completed in EBPQ, EBP Barriers Scale, and Brooks' QNWL Scale.

Participants (mean age 29.99; 58.1% female) reported a moderate level of EBP (M = 111.30) or QNWL (M = 153.45). Organizational issues were the greatest challenge to EBP implementation. Higher levels of QNWL had significant relationships with being female, having a bachelor's degree, and working in private hospitals. Of interest, EBP knowledge was one of the predictors of QNWL, followed by educational level.

Findings indicate that strengthening the knowledge of nurses on EBP can improve QNWL. Structured skill-based EBP training and skills development through mentorship should be given priority. Managers should encourage conducive environments with time and resource protection. Policymakers should make EBP competencies part of continuing professional development as well as licensure standards. Future studies should use longitudinal and intervention designs to investigate mechanisms of causal influence and test EBP-oriented workforce strategies.

Community violence exposure (CVE) is a pervasive risk to youth mental health, yet developmental research examining protective factors in Latin America remains scarce. This cross-sectional investigation examined CVE and psychological symptoms among early adolescents (N = 346) and young adults (N = 499) living in a chronically violent region of Michoacán, Mexico. Participants completed validated measures of witnessing violence, personal victimization, school belonging, depressive symptoms, and posttraumatic stress symptoms (PTSS). Results indicated that CVE was widespread in both age groups and consistently associated with elevated depressive symptoms and PTSS. Notably, developmentally distinct moderation patterns emerged. Among early adolescents, higher school belonging intensified the associations between CVE and depressive symptoms, consistent with a vulnerable-reactive pattern. In contrast, school belonging buffered the association between CVE and PTSS among young adults. These findings suggest that the function of school belonging may differ by developmental stage, operating as a source of potential ecological sensitivity in early adolescence and as a resilience resource in young adulthood. Results underscore the importance of developmentally tailored supports for youth navigating chronic violence in the Global South.

Adverse childhood experiences (ACEs) shape children's socioemotional development, yet longitudinal evidence from low- and middle-income countries remains limited. This study examined how ACEs relate to internalizing, externalizing and prosocial behaviours from childhood to adolescence in a rural Pakistani cohort.

Data were drawn from the Bachpan Cohort, a longitudinal study including 1,791 observations across three waves: ages 4-5, 8-9 and 12-15 years. ACEs were assessed using an adapted ACE-International Questionnaire. Outcomes were measured using the Strengths and Difficulties Questionnaire. Network analysis, dose-response modelling and moderation analyses were employed.

Emotional neglect was the most prevalent ACE (83.7%). Parental psychiatric issues, parental trauma exposure and emotional neglect were the most central ACE stressors. A dose-response relationship emerged: compared to children with no ACEs, those with four or more ACEs showed higher internalizing (incidence ratio [IR] = 4.24) and externalizing problems (IR = 3.42) and lower prosocial behaviour (IR = 0.90). Girls showed greater internalizing vulnerability; boys showed more externalizing problems. ACE effects on internalizing problems strengthened with age.

ACEs are strongly associated with internalizing, externalizing and prosocial outcomes from childhood to adolescence. Findings highlight the need for tiered, gender-sensitive and developmentally appropriate interventions in low-resource settings.

BackgroundChildren with severe conduct problems often experience disruptions in parent-child relationships, yet validated observational tools suitable for early and middle childhood remain limited. This study investigated associations between mother-child emotional availability (EA) and conduct problem severity in a clinic-referred sample.MethodParticipants were 92 mother-child dyads with children aged 3 to 9 years diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder. Mothers completed standardised questionnaires and a diagnostic interview. Dyads participated in a 30-min semi-structured interaction coded with the EA Scales (4th edition), from which maternal and child EA composite scores and EA Zone classifications were derived.ResultsLower maternal EA was associated with higher clinician-rated ODD severity, although effects were modest. Child EA demonstrated only a marginal association with ODD severity, and neither maternal nor child EA predicted mother-reported conduct problems. Most dyads were classified within the "complicated" EA Zone, reflecting insecure-ambivalent relational patterns characterised by inconsistent emotional responsiveness and engagement. This finding is notable as conduct problems are more commonly linked with insecure-avoidant or disorganised attachment.ConclusionsFindings highlight the clinical relevance of maternal emotional availability and suggest that inconsistent emotional responsiveness may be an important intervention target for children with conduct problems.

The use of large language models (LLMs) such as ChatGPT (GPT-4/GPT-5) for mental health is growing rapidly, including their use to assess and help people with mood disorders, such as depression. However, we have a limited understanding of the schema of mental disorders in these language models, that is, how they internally associate and interpret the symptoms. In this work, we used contemporary measurement theory to decode how GPT-4 and GPT-5 interrelate depressive symptoms, providing an explanation of how large language models behave in clinical applications. First, we evaluated whether these models can reliably detect depressive constructs, finding that GPT-4 (a) demonstrated strong convergent validity with standard instruments and expert judgments (r = .70-.81). We mapped the model's internal schema of depression, showing that it (b) organized symptoms into an interconnected network (symptom correlations r = .23-.78) that largely aligned with the established clinical literature. However, it (c) underemphasized the relationship between suicidality and other symptoms while overemphasizing the importance of psychomotor symptoms. Finally, the associations (d) suggested novel hypotheses for symptom mechanisms, for instance, indicating that sleep and fatigue are broadly influenced by other depressive symptoms, whereas worthlessness/guilt is selectively associated with depressed mood. GPT-5 showed slightly lower convergence with self-report, which our analysis attributed to changes in the relationships among symptoms. These insights provide a generalizable, empirical foundation for understanding language models' mental health assessments across models and disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Acceptance and commitment therapy for moral injury (ACT-MI) and present-centered therapy for moral injury (PCT-MI) were developed and piloted through the study. ACT-MI was created to improve psychosocial functioning among veterans experiencing moral injury. PCT-MI was developed as a transdiagnostic process-based moral injury intervention and an active comparison condition for a future ACT-MI efficacy trial. A randomized controlled pilot trial was conducted where 74 war zone-deployed veterans were randomized to ACT-MI or PCT-MI. Aims were to test the acceptability of ACT-MI and PCT-MI, evaluate study design feasibility, and determine candidate outcomes and sample size for a future efficacy trial. ACT-MI and PCT-MI are 15-session psychotherapies, including group (12 sessions) and individual case conceptualization (three sessions) sessions. ACT-MI was acceptable to veterans as evidenced by Client Satisfaction Questionnaire (CSQ) scores (M = 29.52, SD = 3.73, 95% CI [28.10, 30.94]). In qualitative interviews, ACT-MI was described as impacting psychosocial functioning and providing alternatives to suicidal behavior and substance use. PCT-MI was also acceptable to veterans (CSQ M = 26.41, SD = 5.07; 95% CI [24.40, 28.40]). Veterans reported PCT-MI contributed to social connection, understanding moral injury symptoms, and present moment problem solving. The study design was feasible to implement. The Outcome Questionnaire-45 was the candidate psychosocial functioning measure most sensitive to change (ACT-MI: N = 29, M = -17.45, SD = 19.33, 95% CI [-24.80, -10.10]; PCT-MI: N = 27, M = -5.89, SD = 15.29, 95% CI [-11.94, 0.16]). Next steps are described, including a full-scale efficacy trial to evaluate the impacts of the interventions on psychosocial functioning. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

To determine whether moderate cognitive load alters horizontal vestibulo-ocular reflex (VOR) gain during the video head impulse test (vHIT) and to evaluate the reliability of vHIT under dual-task conditions.

Thirty-three healthy young adults (mean age 21.3 ± 2.1 years) completed two vHIT conditions: (1) a baseline single-task condition and (2) a dual-task cognitive load condition involving serial subtraction aloud while fixating a constant target at a single distance. Horizontal VOR gains were measured bilaterally. Mental effort and dizziness were rated on 0 to 10 numerical rating scales.

Baseline VOR gains were 0.925 ± 0.063 (left) and 0.924 ± 0.074 (right). Under cognitive load, gains were 0.938 ± 0.084 and 0.938 ± 0.074, small increases of 1.4 to 1.5% that were non-significant (p > 0.40) and met equivalence criteria within ± 0.05 gain units. Reliability across conditions was excellent (ICC [3,1] = 0.90 left; 0.89 right). Cognitive engagement increased significantly (2.1 ± 1.1 to 7.3 ± 1.4; p < 0.001), while dizziness remained minimal. No meaningful correlation was observed between gain change and perceived effort or dizziness (Spearman's ρ < 0.05, p > 0.05).

Horizontal vHIT gain remained stable, statistically equivalent, and highly reliable under cognitive load, despite marked increases in perceived effort. These findings highlight the attentional resilience of the horizontal VOR, consistent with its brainstem-mediated circuitry. Consequently, horizontal vHIT appears robust for use in routine clinical settings where divided attention may be present.