Young judo athletes show highly heterogeneous pre-competition psychological states, yet prior variable-centered research has assumed a uniform linear "support-anxiety" relationship that masks individual differences. Using latent profile analysis, this study aimed to identify subgroups jointly defined by perceived social support and competitive state anxiety, examine unadjusted between-profile differences in depression and mental toughness, and investigate covariate-adjusted correlates of profile membership.

A cross-sectional design was employed. A total of 222 young Chinese judo athletes were assessed using the Multidimensional Scale of Perceived Social Support (MSPSS), the Competitive State Anxiety Inventory-2 (CSAI-2), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Sports Mental Toughness Questionnaire (SMTQ). Standardized perceived social support and competitive state anxiety served as the indicator variables for latent profile analysis (LPA); the retained profile solution was selected by jointly considering the AIC, BIC, SABIC, entropy, and class proportions. Binary logistic regression was used to examine the covariate-adjusted associations of mental toughness and habitual stress with profile membership while controlling for age, sex, and history of acute sports injury. Independent-samples t-tests were used to examine unadjusted between-profile differences in depression and mental toughness.

A two-profile solution was retained after jointly considering information criteria, profile size, classification accuracy, parsimony, and substantive interpretability (entropy = 0.679). The Resource-Deprived profile comprised 36.5% of the sample, whereas the Supported-Vigilant profile comprised 63.5%. The Supported-Vigilant profile reported lower depression (p < 0.001) and higher mental toughness (p = 0.035). Mental toughness was associated with higher adjusted odds of Supported-Vigilant profile membership (OR = 1.34, 95% CI [1.01, 1.80], p = 0.047).

The retained profiles were distinguished primarily by jointly lower versus jointly higher levels of perceived social support and composite competitive state anxiety. In the Supported-Vigilant profile, higher composite competitive state anxiety coexisted with lower depression and higher mental toughness; however, the present findings do not establish that anxiety was facilitative or that social support buffered its effects. These findings suggest that pre-competition psychological work should assess anxiety intensity together with perceived support and broader psychological adjustment, rather than uniformly pursuing anxiety reduction, while giving particular attention to resource-deprived athletes.

This study investigated whether a compliance-contingent, shortened time-out (TO) improves behavioral and emotional responses compared to a standard punishment-escalation TO among youth with conduct problems (CP) and varying callous-unemotional (CU) traits. Forty-six 7-12-year-olds in an 8-week summer treatment program completed a counterbalanced within-subject crossover: Standard TO (10-minute start; misbehavior doubled duration; fixed release criteria) vs. Modified TO (10-minute start; compliance enabled reduction to 5 minutes; additional supportive questions). Independent observers coded behavior and affect during TO episodes; staff logged TO characteristics. Analyses used zero-inflated negative binomial and mixed-effects models with covariates. Higher CU predicted fewer TO assignments but less compliance in the Standard TO condition. Contrary to predictions, the Modified TO condition showed higher aggression, lower compliance, and less calm behavior relative to Standard TO. Post-TO, higher CU was related to greater perceived aversiveness in Standard but not Modified TO. Making TO duration behaviorally negotiable did not enhance compliance and may signal rule flexibility for youth with CP and elevated CU traits. Findings of this study support emphasizing structured, consistent, non-negotiable consequences when treating youth with CP and CU.

To determine the frequency of monogenic variants and pathogenic copy number variants (CNVs) in adults with surgically treated temporal lobe epilepsy (TLE).

We performed exome sequencing (ES), including CNV analysis, in 45 adults with TLE who had previously undergone epilepsy surgery. A diagnostic exome-wide analysis was conducted to identify (likely) pathogenic variants related to epilepsy. In an exploratory approach, we screened a curated list of 45 common epilepsy genes for rare deleterious variants based on AlphaMissense and REVEL in silico predictions.

No highly penetrant monogenic variants were identified in this cohort. Pathogenic CNVs were detected in two individuals, corresponding to 4.4% of the cohort: a 16p13.11 deletion in a surgery responder and a 22q11.2 duplication in a surgery nonresponder. Both CNVs are characterized by reduced penetrance and broad phenotypic variability. Moreover, we identified two predicted deleterious missense variants in the epilepsy-associated genes KCNT1 and SLC2A1, both of which were detected in surgery nonresponders. In silico analyses, including structural evidence, suggested a potential impact on protein function; however, their clinical significance remains uncertain.

Monogenic causes are exceedingly rare in adults with surgically treated TLE, whereas CNVs may contribute to disease susceptibility in a small subset of patients. Our findings are consistent with previous reports indicating a low diagnostic yield of presurgical genetic testing and further support a predominantly polygenic architecture of TLE.

Temporal lobe epilepsy (TLE) is a common type of epilepsy in adults, and some patients undergo surgery when medications fail. It is unclear whether genetic testing can help predict surgical success. In this study, we used comprehensive genetic testing in 45 adult TLE patients who had undergone epilepsy surgery. We did not find single-gene causes of epilepsy. Two patients had structural genetic changes, which increase epilepsy risk but show variable effects. We also identified a few rare variants in epilepsy-related genes, but their clinical relevance remains uncertain. Overall, our results suggest that single-gene causes are rare in adults with TLE. Genetic testing may therefore have a low diagnostic rate in this population.

The experience of emotions is that of dynamic, time-changing processes. Yet, many functional MRI (fMRI) studies of emotion average across time to focus on maps of static activations, overlooking the temporal dimension of emotional responses. In this study, we used time-resolved fMRI, group spatial independent component analysis (ICA), dual regression, and Gaussian curve fitting to examine both the spatial and temporal properties of whole-brain networks during a behavioral task. This task included trials that spanned over 25 s of watching short, emotionally evocative movie clips, making emotion-related decisions, and an intertrial rest period. We identified four whole-brain networks with unique spatial and temporal features that mapped onto different stages of the task. A network activated early in the course of the task included perceptual and affective evaluation regions, while two later networks supported semantic interpretation and decision-making, and a final network aligned with default mode activity. Both spatial and temporal properties of all four networks were modulated by the emotional content of the movie clips. Our findings extend current models of emotion by integrating temporal dynamics with large-scale network activity, offering a richer framework for understanding how emotions unfold across distributed circuits. Such temporal-spatial markers of emotional processing may prove valuable for identifying and tracking alterations in clinical populations.

Identifying early temperamental predictors of later psychopathology is crucial for detecting at-risk individuals and implementing targeted prevention efforts. However, there is limited research using laboratory-based observations of temperament and "gold-standard" assessments of psychiatric disorders across early adolescence and young adulthood. Using a multimethod, prospective longitudinal study (N = 291), we investigated whether temperament (i.e., behavioral inhibition [BI], exuberance) observed at 24 and 36 months predicted the likelihood of psychiatric disorders across adolescence/young adulthood. Results suggested that early childhood BI was not predictive of anxiety diagnosis over time; however, exuberance predicted attention-deficit/hyperactivity disorder at ages 12, 15, and 18 years. Results add to prior work that has rarely found direct relations between early temperament and psychopathology and highlight early adolescence/young adulthood as a vulnerable time for the development of psychopathology.

The symptoms experienced by people with narcolepsy and idiopathic hypersomnia (IH) have profound effects on individuals' lives, affecting daily functioning, relationships and mental health, and can impair performance at work or school. Although numerous studies have evaluated the impact of narcolepsy and IH on work-related outcomes, the evidence base is highly fragmented and difficult to meaningfully summarize. We conducted a systematic literature review of published evidence to better understand the impact of these disorders on employment, work productivity, work satisfaction, and related outcomes. We identified 54 publications representing 51 unique studies that met the study inclusion criteria and were included in the review. Although most people with narcolepsy or IH were employed, fewer were in paid work than control populations, and absenteeism and presenteeism were high. Having narcolepsy and IH resulted in lower wages and missed work time, leading to unfavorable impacts on career progression, promotion, job satisfaction, and income. The most frequently reported work-related problems were sleepiness at work, reduced performance, work accidents, and lateness. More severe excessive daytime sleepiness was associated with greater work impairment. Narcolepsy-specific medications that improved excessive daytime sleepiness were reported to improve work productivity in clinical trials; however, many people are left with substantial residual impairment despite treatment. These findings indicate that narcolepsy and IH impose a substantial burden on work functioning and employment, and there is a need for more research to inform interventions and policies aimed at mitigating the impact of these debilitating conditions on individuals' professional lives.

Vulvar inflammatory dermatoses, including lichen sclerosus, lichen planus, lichen simplex chronicus, and psoriasis, have been shown to impact mental health and quality of life.

We aimed to synthesize and evaluate the current literature regarding the association between anxiety and vulvar inflammatory dermatoses.

A comprehensive search was conducted using the Ovid MEDLINE, Embase, Cochrane, PubMed, PsycINFO, and Web of Science databases. Search terms included vulvar conditions (eg, "lichen sclerosus," "lichen planus," "lichen simplex chronicus," and "psoriasis") combined with anxiety-related terms ("anxiety," "anxious," and "mental health").

We included appropriate studies (eg, clinical trials, case-control studies, cohort studies, cross-sectional studies, or interview studies) directly addressing vulvar inflammatory dermatoses and anxiety. Studies without quantifiable anxiety outcomes or those that were reviews, protocols, commentaries, or abstracts were excluded. Two reviewers independently screened and resolved discrepancies by consensus.

A comprehensive search was conducted using the Ovid MEDLINE, Embase, Cochrane, PubMed, PsycINFO, and Web of Science databases. We included appropriate studies (eg, clinical trials, case-control studies, cohort studies, cross-sectional studies, or interview studies) directly addressing vulvar inflammatory dermatoses and anxiety.

Eighteen studies met inclusion criteria. Up to 52% of patients with vulvar inflammatory disease experience symptoms of anxiety that affect sexual functioning, activities of daily living, and plans for pregnancy. The severity of anxiety may be greater in newly diagnosed patients and younger women, while treatment serves as a protective factor. Treatment modalities, including topical corticosteroids, fat grafting, biologics, and platelet-rich plasma, were associated with reductions in anxiety symptoms concurrent with improvement in vulvar disease severity and quality-of-life measures.

There is a paucity of data reviewing vulvar dermatoses, specifically vulvar involvement of common dermatologic diseases such as lichen simplex chronicus and psoriasis.

The association between vulvar inflammatory diseases and anxiety may be multifaceted, with emerging evidence suggesting that vulvar disease may increase the risk of anxiety symptoms. Future efforts should focus on establishing targeted interventions that address both the dermatologic and psychological aspects of vulvar disease.

Learning health systems (LHS) show promise in making sense of uncertainty and emerging evidence in complex conditions. Long COVID challenges how care is delivered. The Veterans Health Administration has funded a Long COVID Practice-Based Research Network (LC-PBRN) to create an LHS-based infrastructure to promote interdisciplinary collaboration (eg, multidisciplinary clinicians, researchers, operational partners, policymakers, and intra-agency workgroups).

This article describes the LC-PBRN model, outlines associated lessons learned, and provides suggestions to assist with future PBRN implementations. Lessons learned include incorporating veterans' voices to ensure network efforts align with patient needs, developing an interdisciplinary leadership team to foster diverse viewpoints, setting clear expectations and goals with partners, and building engaging relationships to bridge gaps between internal and external partners.

The LC-PBRN experience can inform the evolving role of other PBRNs as an integral part of building and sustaining LHS infrastructure.

Problematic social media use (PSMU) is associated with impaired inhibitory control and dorsolateral prefrontal cortex (DLPFC) dysfunction. This randomized controlled study with stratified randomization investigated the acute effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on inhibitory control in college students with PSMU. Fifty-four participants were assigned to HIIT, MICT, or control groups (CONs). Prefrontal activity was measured using functional near-infrared spectroscopy (fNIRS) during a social cue-embedded Go/NoGo task. Graph theoretical and network-based statistical analyses evaluated brain network topology. HIIT reduced reaction time (RT) more than the CON (mean difference = 25.61 ms, 95% CI [0.23, 51.00]), whereas MICT showed within-group improvement without a significant advantage over control. No significant group differences were observed for omission or commission errors (CEs). HIIT increased small-world indices (aSigma and aGamma), enhanced degree centrality (aDC) and nodal efficiency (aNE) in the left orbitofrontal cortex (OFC), and strengthened functional connectivity centered on the right DLPFC. In contrast, MICT produced localized network changes without coherent prefrontal-wide connectivity reorganization. Exploratory analyses indicated that greater smartphone addiction severity (SAS) was associated with larger HIIT-induced network topological changes, although these findings are preliminary and require replication. These findings suggest that a single HIIT session may improve inhibitory control through transient reorganization of prefrontal brain networks in individuals with PSMU, with responsiveness potentially influenced by baseline addiction severity.

To describe one-year clinical and imaging outcomes in patients with temporomandibular joint osteoarthritis (TMJO) who received a standardized, phased, multimodal, non-invasive management protocol.

An exploratory retrospective, non-concurrent cohort study was conducted using the records of 78 consecutive eligible patients with TMJO. Seventy patients completed the one-year evaluation. The predefined eligibility range included adolescents aged 13-19 years and adults aged 20-65 years; the observed age range in the final sample was 13-62 years. Current TMJ-related pain intensity was self-reported by each patient using a 0-10 visual analogue scale (VAS) at baseline and at one year. CT and MRI findings, appointment attendance, and self-reported compliance with treatment recommendations were also recorded. Psycho-behavioral status was assessed at baseline using the Hospital Anxiety and Depression Scale (HADS) in patients who were not receiving psychological or psychiatric treatment.Data were analyzed descriptively and compared using Wilcoxon tests (P < .05).

Seventy of 78 patients completed follow-up. Mean patient-reported pain decreased from 4.41 ± 2.58 at baseline to 0.61 ± 1.28 at one year (P < .001). Forty-two patients completed the HADS assessment at baseline, whereas the remaining participants were already receiving mental health treatment. According to the HADS results, 50% of patients were probable cases of anxiety and 2.4% were probable cases of depression. Mean appointment attendance was 76.7%. Descriptive imaging findings suggested a reduction in the presence of synovitis.

In this exploratory retrospective cohort, patients receiving multimodal non-invasive management showed substantial reductions in patient-reported pain over one year.