Digital Navigator Training to Increase Access to Mental Health Care in Community-Based Organizations.

Providing human support for users of behavioral health technology can help facilitate the necessary engagement and clinical integration of digital tools in mental health care. A team conducted digital navigator training that taught participants how to promote patrons' digital literacy, evaluate and recommend health apps, and interpret smartphone data. The authors trained 80 participants from 21 organizations, demonstrating this training's feasibility, acceptability, and need.

Ethics in placebo-controlled, acute treatment trials in schizophrenia: Two rival ethical frameworks.

Placebo-controlled, acute treatment trials in schizophrenia enroll acutely symptomatic persons, randomize them to receive placebo or antipsychotic medication for several weeks, and evaluate whether symptoms improve. These trials can have scientific benefits, especially when they test drugs with novel mechanisms of action. However, the use of placebo is ethically problematic inasmuch as standard treatment is withheld and participants are subjected to prolonged psychotic symptoms and associated risks.

Racial and ethnic disparities in time to first antidepressant medication or psychotherapy.

Time from first DSM4 major depressive episode (MDE) until treatment in the community was compared across racial/ethnic groups. This secondary analysis used structured baseline data from a depression research clinic (N = 260). Chi-square and survival analyses compared rates and delays to antidepressant medication and psychotherapy.

Association of maternal exposure to Superstorm Sandy and maternal cannabis use with development of psychopathology among offspring: the Stress in Pregnancy Study.

Background: Early-life adverse experiences can elevate the magnitude of the risk of developmental psychopathology, but the potential synergistic effects of multiple factors have not been well studied.

Aims: To determine whether prenatal exposures to maternal stress (Superstorm Sandy) and maternal cannabis use synergistically alter the risk of developmental psychopathology.

Method: The study included 163 children (53.

Attention allocation to negatively-valenced stimuli in PTSD is associated with reward-related neural pathways.

Background: In a recent eye-tracking study we found a differential dwell time pattern for negatively-valenced and neutral faces among patients with posttraumatic stress disorder (PTSD), trauma-exposed healthy control (TEHCs), and healthy control (HC) participants. Here, we explored whether these group differences relate to resting-state functional connectivity (rsFC) patterns of brain areas previously linked to both attention processes and PTSD. These encompass the amygdala, dorsal anterior cingulate cortex (dACC), dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC), and nucleus accumbens (NAcc).

If You Don't Ask, They Don't Tell: The Cultural Formulation Interview and Patient Perceptions of the Clinical Relationship.

More than half of participating patients expressed mistrust or ambivalence toward clinicians related to differences in cultural background using the Cultural Formulation Interview, which can help enhance communication and trust and help clinicians to anticipate treatment barriers.

A global field study of the international classification of diseases (ICD-11) mood disorders clinical descriptions and diagnostic guidelines.

Background: We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility.

Methods: 1357 clinician members of the World Health Organization's Global Clinical Practice Network completed the study in English, Spanish, Japanese or Russian.

Relationships Between Telomere Length, Plasma Glucagon-like Peptide 1, and Insulin in Early-Life Stress-Exposed Nonhuman Primates.

Background: Early-life stress is associated with alterations in telomere length, a marker of accumulated stress and aging, and a risk factor for psychiatric disorders. Nonhuman primate maternal variable foraging demand (VFD) is a validated early-life stress model, resulting in anxiety- and depressive-like symptoms in offspring. Previous studies reported increased plasma glucagon-like peptide 1 (pGLP-1) along with insulin resistance in this model.

Low Dose Lithium Treatment of Behavioral Complications in Alzheimer's Disease: Lit-AD Randomized Clinical Trial.

Background: A case series suggested efficacy for lithium to treat agitation in dementia, but no placebo-controlled trials have been conducted.

Objectives: To evaluate low-dose lithium treatment of agitation in Alzheimer's disease (AD).

Method: In a four-site trial, patients with AD and agitation/aggression score ≥4 on the Neuropsychiatric Inventory (NPI) were randomized, double-blind, to lithium carbonate 150-600 mg daily or placebo for 12 weeks.

Violence in Psychiatric Settings: Demographic and Clinical Characteristics of Patients Who Were Targets of Aggression.

Violence is a serious concern in the psychiatric inpatient and emergency setting. Much of the research on victims of inpatient violence has focused on identifying and supporting staff who are at risk of being victimized when working in psychiatric settings. This article presents an analysis of 72 patients who were targeted during incidents of patient-on-patient physical aggression in hospital-based psychiatric settings (both inpatient and emergency) from 2014 to 2018.

Psychotherapy Tracks in US General Psychiatry Residency Programs: A Proxy for Trends in Psychotherapy Education?

Objective: The authors studied the goals and design of psychotherapy tracks in the US general psychiatry residency programs and the perceived barriers to psychotherapy tracks in programs without them.

Methods: The authors emailed 226 US general psychiatry residency program directors, asking them to complete an anonymous, online, Qualtrics survey about psychotherapy training and tracks in their program.

Results: Seventy-nine programs (35%) participated.

Using a Daily Diary Approach to Examine Substance Use and Negative Sexual Experiences Among College Students.

This article examined substance use and sexual behavior by conducting an analysis of college students' reported behaviors using a daily diary approach. By isolating particular sexual events across a 2-month period, we examined situational predictors of engagement in sex and of negative sexual experiences (coerced sex and/or sex that lacks perceived control) for college men and women. Data come from the daily diary sub-study of the Sexual Health Initiative to Foster Transformation.

Modification of everyday activities and its association with self-awareness in cognitively diverse older adults.

Cognitive impairment (CI) in older adults is frequently accompanied by difficulty performing complex everyday activities (e.g., managing finances).

Considering abuse liability and neurocognitive effects of cannabis and cannabis-derived products when assessing analgesic efficacy: a comprehensive review of randomized-controlled studies.

: Pain is the most frequent indication for which medical cannabis treatment is sought.: The clinical potential of cannabis and cannabis-derived products (CDPs) relies on their efficacy to treat an indication and potential adverse effects that impact outcomes, including abuse liability and neurocognitive effects. To ascertain the extent to which these effects impact therapeutic utility, studies investigating cannabis and CDPs for pain were reviewed for analgesic efficacy and assessments of abuse liability and neurocognitive effects.

DSM-5 substance use disorder symptom clusters and HIV antiretroviral therapy (ART) adherence.

This study examines self-reported 30-day antiretroviral therapy (ART) adherence among 101 people living with HIV and substance use disorders (SUD) in New York City in terms of Diagnostic and Statistical Manual - 5th Edition (DSM-5) SUD symptom clusters: impaired control, social impairment, risky use and pharmacological criteria. Overall, 60.4% met DSM-5 criteria for stimulant, 55.

Prescription opiate analgesics, heroin, HIV and HCV among persons who inject drugs in New York City, 2016-2018.

Objectives: Assess relationships among non-medical use of prescription opioid analgesics (POAs), heroin use, and HIV and hepatitis C (HCV) infection among persons who inject drugs (PWID) in New York City, 2016-2018.

Methods: PWID (N = 134) were recruited from Mount Sinai Beth Israel drug treatment programs. HIV seropositive persons were oversampled.

Socioeconomic Disparities in Chronic Physiologic Stress Are Associated With Brain Structure in Children.

Background: Socioeconomic factors have been consistently linked with the structure of children's hippocampus and anterior cingulate cortex (ACC). Chronic stress-as indexed by hair cortisol concentration-may represent an important mechanism underlying these associations. Here, we examined associations between hair cortisol and children's hippocampal and ACC structure, including across hippocampal subfields, and whether hair cortisol mediated associations between socioeconomic background (family income-to-needs ratio, parental education) and the structure of these brain regions.