Adjusting to Alzheimer's disease diagnosis is a complex process. Caregivers tend to experience feelings of loneliness and isolation, which in turn may have adverse effects on their well-being. The purpose of this study was to explore and describe the perspectives of female older adult caregivers of individuals with AD concerning the social isolation and loneliness. The study uses a mixed methods design (N = 48), combining qualitative and quantitative research components to provide a more comprehensive understanding of the phenomenon. Based on the analysis, three main themes were derived: "social isolation due to caregiving responsibilities", "changes in social circle" and "balancing caregiving and social connection". There were significant negative associations between loneliness and depression. While the detrimental effects of caregiving on psychological and physical health are well-documented, further research is needed to fully understand the multifaceted nature of the caregiving experience, particularly regarding loneliness and social isolation. This study addresses this gap by exploring the often-neglected aspect of loneliness among caregivers. The findings provide valuable insights for psychologists and healthcare professionals, enhancing their understanding of the challenges and needs of this population.

PurposeModern psychotherapy increasingly incorporates technology to support patients with mental disorders. Virtual reality (VR) enables realistic, controlled simulations, offering structured, time-limited interventions focused on present problems, which are highly valuable in clinical practice. Cognitive-behavioral therapy (CBT), one of the most widely used psychotherapeutic approaches, can be effectively enhanced by VR. This review aims to summarize the potential of VR as a support tool for CBT and to evaluate its effectiveness across selected mental disorders.MethodsA narrative review of the literature published over the last 15 years was conducted. Searches were performed in five major databases: PubMed/MEDLINE, PsycINFO, Scopus, Web of Science, and the Cochrane Library. Peer-reviewed studies involving VR as an integral component of CBT were included. The review focused on anxiety disorders, depression, eating disorders, addictions, and autism spectrum disorders (ASD).ResultsImmersive VR appears to enhance the effectiveness of CBT across multiple mental disorders. In anxiety disorders, VR-based exposure closely replicates real-life situations and represents the most extensively studied application; meta-analytic evidence (eg, Wu et al, 11 studies, 626 participants) indicates that VR-assisted CBT is effective and comparable to traditional CBT. In depression, VR facilitates behavioral activation and positive experiential learning. In eating disorders, VR supports body image modification, including realistic correction in bulimia and anorexia and altered gratification processes in obesity. VR also enables controlled exposure to substance-related cues in addiction treatment and supports training in emotional regulation and social skills in individuals with ASD.ConclusionThe available literature indicates that the strongest and most consistent evidence for VR-assisted cognitive-behavioral therapy concerns anxiety disorders, which represent the primary focus of existing research. In contrast, evidence for the use of VR in other mental disorders remains more limited, heterogeneous, and often based on smaller or more individualized interventions. This imbalance in the evidence base constitutes a key limitation of the current field and should be considered when interpreting the overall effectiveness and generalizability of VR-assisted CBT. Further high-quality research and continued technological development are required to strengthen the evidence for VR applications across a broader range of mental disorders.

BackgroundMajor depressive disorder (MDD) in adolescents represents a significant global public health challenge. Moreover, metacognitive dysfunction plays a critical role in its onset, progression, and prognosis, but research on the metacognitive characteristics of Chinese adolescents with MDD remains highly limited.MethodsThe study was conducted from January 2024 to January 2025 and employed a cross-sectional design with convenience sampling. The participants included 202 adolescents who were diagnosed with MDD, with a mean age of 15 years. All the subjects completed a self-administered general information questionnaire to collect demographic information. The Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Adverse Childhood Experience Questionnaire-Revised (ACE), Rumination Response Scale Chinese Version (RRS), and Metacognitive Questionnaire-30 (MCQ) were utilized to evaluate the psychological well-being of adolescents diagnosed with MDD.ResultsMultiple linear regression analyses demonstrated the potential of the RRS total score, reflective pondering and household dysfunction as predictors of metacognitive deficits in adolescents diagnosed with MDD, with statistical significance at p < 0.05. Furthermore, the total ACE scores of adolescents diagnosed with MDD were significantly positively correlated with the MCQ (β = 0.189, p < 0.001) and RRS (β = 0.380, p < 0.001) scores. Additionally, the total RRS score was positively correlated with the MCQ score (β = 0.675, p < 0.001). Mediation analyses demonstrated that rumination mediated the association between adverse childhood experiences and metacognitive deficits, with a mediating effect value of 1.136 and a 95% confidence interval of [0.639, 1.635], explaining 57.32% of the total effect.ConclusionRumination mediates the relationship between adverse childhood experiences and metacognitive deficits in adolescents with MDD. Rumination, reflective pondering and household dysfunction in adolescents with MDD can predict metacognitive dysfunction to varying degrees. Our study highlights that interventions targeting rumination may be particularly effective in mitigating the negative impact of ACEs on metacognitive functioning in adolescents with MDD.

This study aims to evaluate parental knowledge, acceptability, and involvement in the use of Applied Behavior Analysis (ABA) for the treatment of children with autism spectrum disorder (ASD) in Jordan. A descriptive cross-sectional study was conducted with a sample of 157 parents of children with ASD who had been exposed to ABA. Data were collected using self-administered paper-based and online questionnaires, which included demographic characteristics and instruments measuring parental knowledge, involvement, and treatment acceptability. The majority of participants were mothers (73.5%). A significant proportion of participants' children exhibited problematic behaviors, with aggression being the most common issue (34.3%). Parental acceptability of ABA was generally high, with 96.4% reporting moderate to high acceptance. The study also found a positive correlation between ABA knowledge, acceptability, and parental involvement in ABA programs. Enhancing parents' knowledge of autism and ABA is crucial for effective treatment. To increase parental acceptance and involvement in their child's ABA, practitioners should implement educational programs that provide parents with a deeper understanding of ABA principles and their practical benefits.

[This retracts the article DOI: 10.2147/PRBM.S510544.].

ObjectiveMajor depressive disorder (MDD) significantly impairs college students’ functioning. Inter-parental conflict (IPC) is a recognized risk factor for mental health issues, yet gender-specific mechanisms linking IPC to MDD in college students remain unclear. This study aimed to examine the association between IPC and new-onset MDD among Chinese university students, and to test whether this association differs by gender.MethodsA retrospective controlled study was conducted between April 2018 and October 2019 among 8079 first-year students from two medical universities in Shandong Province, China, using cluster sampling.The Adolescent Self-rating Life Events Check List (ASLEC) assessed stressful life events, the lifetime severe traumatic events questionnaire evaluated traumatic experiences, the Egna Minnen Beträffande Uppfostran (EMBU) measured parenting styles, and the Composite International Diagnostic Interview (CIDI-3.0) diagnosed MDD based on DSM-IV criteria. With descriptive statistics computed by gender and logistic regression models employed to assess IPC’s impact on MDD risk.ResultsThe overall incidence of new-onset MDD was 2.4% (2.1% in males, 2.6% in females). Multivariate analysis revealed that occasional physical violence (OR=2.114, 95% CI:1.059–4.222) and chronic emotional neglect (OR=2.252, 95% CI:1.074–4.724) during IPC significantly increased MDD risk in male students. Among female students, seeking help from relatives during parental conflicts was independently associated with increased MDD risk (OR=2.14, 95% CI:1.09–4.20).ConclusionIPC is significantly associated with new-onset MDD among Chinese college students, and this relationship is moderated by gender. While male students show vulnerability to physical conflict and emotional neglect, female students face increased risk when involving relatives in conflict resolution. The findings support the development of gender-specific intervention strategies to mitigate familial risk and promote student mental health.

Adolescence is a critical developmental stage with increased risk for mental health problems, where family dynamics and parental involvement play key protective roles. Family-based prevention emerges as a key approach to addressing adolescent needs by preventing the onset and escalation of mental health difficulties, particularly in at-risk but often non-clinical populations. This scoping review systematically synthesizes evidence to examine the roles, characteristics, and reported outcomes of family-based prevention interventions for adolescent mental health across different prevention levels. A comprehensive search was undertaken in multiple scholarly databases, including PubMed, ScienceDirect, Scopus, EBSCOhost, SAGE Journals, Wiley Online Library, and Taylor & Francis Online, and 16 studies were included in the review. The included studies spanned universal, selective, and indicated prevention, as well as programmes framed as primary, secondary, and tertiary prevention. The review identified four primary themes characterizing the interventions of family-based prevention, including parenting skill training programs, family therapy and communication enhancement interventions, risk-specific targeted interventions, and socioeconomic and self-directed family interventions. These thematic strategies highlight different pathways to impact, from strengthening parenting practices and family communication to addressing risk-specific vulnerabilities and socioeconomic stressors. Most studies reported improvements in at least one adolescent mental health or behavioural outcome, although effect sizes and study quality varied and were not formally appraised. The findings reinforce that families remain a powerful context for preventive interventions. Family-based strategies show promise in enhancing adolescent mental health outcomes in various worldwide contexts. Future research should integrate approaches, such as combining parenting skills with economic support or family therapy with digital resources, and address carer well-being to conceptualise the family as a unit of care. In practice, these findings may inform stakeholders seeking to prioritise and refine family-based prevention strategis for adolescent mental health.

BackgroundRecent studies have indicated a possible connection between impaired mitochondrial bioenergetics and neurodevelopmental disorders (NDDs) such autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and Tourette’s syndrome (TS). The precise causal relationship between them is yet uncertain. This study utilized bidirectional dual-sample Mendelian randomization (MR) analysis to investigate the causal relationship between Mitochondrial DNA (mtDNA) copy quantity, an indicator of mitochondrial malfunction, and NDDs.MethodsThe study utilized data from the Psychiatric Genomics Consortium (PGC) and IEU OpenGWAS Project database to investigate the relationship between mtDNA copy number and NDDs using MR method. The accuracy and confidence of our results were evaluated using the inverse-variance weighted (IVW) method along with sensitivity analyses such as weighted median, MR-Egger, and MR-PRESSO. Additionally, we conducted the same procedure in the reverse manner with instruments for NDDs.ResultsA notable correlation was discovered between mtDNA copy number and ASD (OR=0.78, 95% CI: 0.65–0.94, P=0.0077). Furthermore, confirmatory GWAS data analysis yielded similar results, which were even more significant (OR=0.80, 95% CI: 0.68–0.93, P=0.0047). However, bidirectional two-sample MR analysis did not reveal significant correlations between mtDNA copy number and ADHD or TS.ConclusionThis study has uncovered a significant genetic causal relationship between mtDNA copy number and ASD. No associations were discovered between ADHD and TS during the investigation. Due to the inherent constraints of MR investigations, additional study is needed to definitively clarify these genetic causal links.

PurposeChildhood depression is a significant global public health concern, and family dynamics are a primary context for its development. While the link between family life, attachment, and depression is established, the field lacks a coherent framework that systematically integrates the core, measurable dimensions from major family systems theories to explain the specific pathways to depression. This review aims to develop and propose such a framework by synthesizing these foundational theories through the lens of attachment theory.Patients and MethodsA narrative review of the literature was conducted. Major English- and Chinese-language databases, including PubMed, PsycINFO, and China National Knowledge Infrastructure, were searched for seminal theoretical papers, meta-analyses, and empirical studies on family dynamics, parenting, attachment, and childhood depression published up to August 2025. A narrative synthesis methodology was employed to facilitate theory integration and development.ResultsThe proposed integrative framework maps the core dimensions from four foundational models of family systems (Olson, Beavers, McMaster, Skinner)—such as communication, cohesion, affective involvement, and role performance—onto the mechanisms of attachment security. The framework posits that these dimensions of family dynamics collectively shape the quality of the parent-child attachment relationship, which serves as the central mediating pathway to childhood depression. Parental rejection and hostility are identified as particularly potent mechanisms within this pathway. The framework’s utility is illustrated using the case of China’s “left-behind children”, where systemic family disruption predictably elevates depression risk.ConclusionDysfunctional family dynamics contribute to childhood depression primarily by undermining the security of the parent-child attachment bond. This integrative, attachment-centered model provides a robust theoretical foundation for research and clinical practice. It suggests that interventions such as Attachment-Based Family Therapy, which directly target the repair of attachment ruptures, represent a theoretically sound and evidence-informed strategy for preventing and treating childhood depression.

BackgroundThe growing aging population has led to escalating demands for gerontological nursing, further intensified by the COVID-19 pandemic. While ageism is a recognized barrier to nursing students’ career motivation toward gerontological nursing (CMGN), the underlying mechanisms through which it exerts influence remain underexplored. Moreover, empirical research on CMGN and related factors in the post-pandemic context is limited.ObjectiveThis study examined the levels and predictors of CMGN among early-stage nursing students in the post-pandemic context and explored how ageism influences CMGN directly and indirectly through a sequential-parallel mediation model.MethodsA cross-sectional online survey was conducted at a medical university in Jiangxi Province, China. A total of 1,192 completed questionnaires from nursing students (mean age = 18.44; 90.3% female; 85.6% first-year students) across two academic tracks (bachelor’s and diploma programs) were included in the analysis. T-tests, ANOVA, regression, and structural equation modeling were used to identify key predictors and mediating pathways.ResultsStudents reported a moderate overall level of CMGN (M = 64.12, SD = 12.86; range = 20–100). Key predictors of both CMGN subscales—Expectancy and Value—with β > 0.1 and p < 0.01 included empathy, intergenerational contact quality, and learning experiences in gerontological nursing. Ageism was a dimension-specific negative predictor, affecting only the Value subscale (β = −0.212, p < 0.001). Mediation analysis further showed that ageism influenced Value both directly (β = −0.200, p < 0.001) and indirectly (β = −0.124, p < 0.001) through a sequential pathway involving contact quality and Expectancy, as well as a parallel pathway mediated by gratitude.ConclusionThe multifaceted negative impact of ageism on CMGN underscores the need for a holistic curriculum strategy. Key recommendations include integrated gerontological nursing education, anti-ageism instruction, interventions to foster gratitude and empathy, and interpersonal communication training tailored to geriatric care.