ABSTRACTObjectiveThis study is designed to explore the effectiveness of pleasure perception training group (PPTG) therapy on adolescents with depression and the factors that influence the presence of non‐suicidal self‐injurious behavior (NSSI).MethodsA hundred and twenty adolescent depression patients were randomly assigned to either a control group (n = 60, routine treatment) or an observation group (n = 60, PPTG plus routine treatment) for two months. Outcome included depression (CDI), emotional intelligence (EIS), and self‐injury (OSI) scores. Patients were stratified into NSSI and Non‐NSSI groups based on NSSI history. Univariate and multifactorial logistic regression analyses were conducted to explore potential risk factors for NSSI.ResultsPost‐treatment, CDI scores decreased and EIS scores significantly increased in both groups, with greater changes in the observation group (p < 0.05). OSI scores decreased in patients with NSSI, with lower scores in the observation group (p < 0.05). Regression analysis identified family history of psychiatric disorders, left‐behind experience, childhood family dysfunction, childhood abuse, and exposure to school bullying as independent risk factors for NSSI (OR > 1, p < 0.05).ConclusionPPTG therapy effectively reduces depressive symptoms, enhances emotional regulation, and lowers NSSI in adolescents with depression. Several psychosocial factors independently increase NSSI risk.

ABSTRACTIntroductionInternet‐based cognitive behavioral therapy (iCBT) could help bridge the gap in treatment provision for mental disorders. iCBT is efficacious for the treatment of anxiety and depression in RCTs. However, more research is needed to translate findings from controlled trials to natural clinical settings. Additionally, more research is needed on predictors for treatment outcome in iCBT to guide allocation of treatment resources.MethodData originated from a routine care guided iCBT clinic and covered 1475 adults treated for either mild‐moderate depression (n = 719), panic disorder (n = 376), social phobia (n = 276), or specific phobia (n = 104). Joint models were used to examine treatment effects and predictors. Effect estimates were supported by effect sizes (Cohen's d) and calculations of the reliable change index (RCI).ResultsAll four treatments showed significant reductions on their primary outcome measure at each assessment point, according to the joint models (depression, PHQ‐9: −1.35, 95% CI: −1.44; −1.27; panic disorder, PDSS‐SR: −0.96, 95% CI: −1.04; −0.88; social phobia, SIAS: −0.96, 95% CI: −1.25; −0.67; specific phobia, FQ Main Phobia: −0.25, 95% CI: −0.33; −0.16), and effect sizes were moderate to large from baseline to the last observation (depression, d = 0.87; panic disorder, d = 0.62; social phobia, d = 0.80; specific phobia, d = 0.47). In total, 26.7% of patients improved according to RCI, and 27.0% recovered at last observation. Higher baseline symptom severity was significantly associated with the extent of improvement for all programs. Similarly, baseline comorbid severity was associated with faster improvements on primary symptoms for depression and panic disorder. Lower age, being in a relationship, and studying increased the rate of improvement for panic disorder.ConclusioniCBT treatments for depression, panic disorder and social phobia were effective. For specific phobia, effects were smaller but still significant. Future studies should investigate process variables, theoretically relevant predictors or full prediction models to enable impactful predictions.

ABSTRACTObjectivesThis study examines the continuity and comparability of internalizing and externalizing symptom spectra from adolescence to young adulthood, addressing measurement challenges across developmental stages. Leveraging the Hierarchical Taxonomy of Psychopathology (HiTOP) framework, it explores whether symptom spectra in adolescence predict corresponding symptoms in young adulthood.MethodsData were drawn from JEPSY, a follow‐up of the national KiGGS cohort (N = 2172, age 18–26). Adolescent internalizing and externalizing symptoms were assessed via the Strengths and Difficulties Questionnaire (SDQ) and substance use items. Adult outcomes included the Patient Health Questionnaire (PHQ‐4), DSM‐5 Cross‐Cutting Symptom Measure (DSM‐5 CC), and Personality Inventory for DSM‐5 (PID‐5). Factor analyses assessed structural consistency, and robust regression examined associations between adolescent and adult symptom spectra over 7–10 years.ResultsA four‐factor model best captured the SDQ structure. In young adulthood, three spectra emerged: internalizing symptoms, externalizing traits, and substance use. Adolescent emotional and peer problems predicted internalizing symptoms in adulthood. Conduct problems and hyperactivity predicted externalizing traits. Substance use was associated with hyperactivity, smoking, and risky drinking—but negatively with peer problems.ConclusionThe findings support the continuity of broad psychopathological spectra and demonstrate that harmonized approaches can bridge measurement gaps and enhance longitudinal comparability.

Longitudinal studies that visualise individual trajectories of depressive and/or anxiety disorders can inform prevention and treatment strategies. Participants of the Netherlands Mental Health Survey and Incidence Study (NEMESIS) were assessed at four timepoints from 2007-2009 to 2016-2018 (N=6646 at baseline). DSM-IV disorders were assessed using the Composite International Diagnostic Interview. Onset and course trajectories were visualised with Sankey diagrams and summarised in incidence, remission, recurrence, and persistency rates, considering presence of any depressive or anxiety disorder as outcome. Among those without a lifetime depressive or anxiety disorder at baseline, 13% developed a depressive and/or anxiety disorder over 9years, with higher rates in women and younger adults. Recurrence rates over 9years were 28% for depressive, 26% for anxiety, and 38% for comorbid disorders. For those with a current disorder at baseline, recurrence (including persistence) was 33%, 31%, and 51%, respectively. Course trajectories were similar across sexes but less favourable for younger adults with a disorder history. Between 31% and 51% of persons with a current depressive and/or anxiety disorder do not remit over 9years. This highlights the need for long-term treatment strategies, including ongoing monitoring, management, and relapse prevention.

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ABSTRACTObjectivesIn middle‐ and lower‐income countries, the scarcity of psychiatric expertise and IQ testing should be considered when developing and testing assessment tools. This study aims to assess the psychometric properties of a modified Arabic version of the Childhood Autism Rating Scale 2 Standard Form.MethodsA diagnostic accuracy study, including 286 children, was conducted from December 1, 2023, to August 1, 2024, at Baghdad's National Centre and Al‐Subtain Academy for Autism. Confirmatory factor analysis was utilized for structural validity, standardized alpha and the average inter‐item correlation for reliability, and ROC curve analysis for diagnostic accuracy.ResultsGood fit was demonstrated for the 1‐, 2‐, and 3‐factor solutions. In all models, ‘activity levels’ had the lowest loadings and higher scores in children with ADHD (p‐value = 0.0002). Excellent internal consistency was shown with a standardised alpha of 0.90 (> 0.7) and an average inter‐item correlation of 0.394 (> 0.15). At the optimal cut‐off (≥ 28.5), the scale had a sensitivity of 82.6%, a specificity of 93.4%, and would increase the child's odds of having ASD by 12.5.ConclusionThe modified scale has good psychometric properties and might be utilised to adjust the psychiatric evaluation of children suspected of having a neurodevelopmental disorder.

ABSTRACTObjectivesEarly identification of individuals at risk for developing mental health disorders is critical for timely intervention, reducing distress and improving outcomes. This study outlines the development and preliminary validation of ‘TRACE’, a short self‐report measure designed to detect a pluripotent at‐risk mental state (PARMS). The measure captures a range of subthreshold symptoms and traits associated with emerging manifestations of mania, psychosis and borderline personality disorder.MethodsA sample of 2037 general‐population adolescents and young adults (aged 14–36) completed TRACE questions and other psychometrics.ResultsExploratory Graph Analysis, undertaken on one‐half of the dataset, generated a three‐factor structure that was successfully replicated in the other half of the data, via confirmatory factor analysis. The final 26‐item scale has acceptable model fit (with a scaled CFI of 0.93, TLI of 0.92, with acceptable‐to‐good error, RMSEA of 0.073) and good concurrent validity with other relevant psychometrics, such as neuroticism and loneliness (r = 0.29 and 0.43, respectively).ConclusionThese findings suggest that the tool may be useful in identifying individuals with a broad, pluripotent vulnerability to develop severe mental health disorders. Future research will focus on validating the tool longitudinally and across diverse populations to assess its predictive utility and clinical value.

ABSTRACTObjectivesComprehensive scales should be used to better understand the patterns of restrictive and repetitive behaviours in children with autism spectrum disorder in middle and lower‐income countries. This study aimed to validate an Arabic translation of the revised Repetitive Behaviours Scale.MethodsParents of 258 children were interviewed in a cross‐sectional study conducted at Al‐Subtain Academy from December 1, 2023, to August 1, 2024. The R Language and Environment for Statistical Programing v4.4.2 was utilised for statistical analysis.ResultsFollowing confirmatory factor analysis, the 6‐factor solution was selected for further testing based on more favourable fitness indices and the 2‐factor solution was selected based on an acceptable RMSEA of 0.064 and evidence of cross‐cultural validity from previous validations. The 2‐factor solution demonstrated better subscales' reliability, with composite coefficients of 0.801 and 0.908, and corrected item‐total correlations that are more consistent with the theoretical framework for the scale. A modification for this model was suggested based on item performance and demonstrated a marginal improvement in the CFI and TLI indices.ConclusionThe Arabic revised repetitive behaviours scale demonstrates a valid and reliable structure, aligning with the conceptual classification of repetitive and restrictive behaviours into repetitive sensory‐motor behaviours and insistence on sameness.