Search Results (171)

Background: Posttraumatic stress disorder (PTSD) in ages 3–18 is associated with disturbances in attention, working memory, processing speed, and executive control, as well as persistent difficulties in affect regulation. These neuropsychological vulnerabilities might interfere with learning, peer relationships, and the consolidation of age-appropriate developmental skills. Methods: We conducted a narrative review informed by a structured literature search in PubMed, Scopus, PsycINFO, Embase, EBSCOhost, Web of Science, and Google Scholar. English-language publications from 1990 to 2025 were considered if they examined (1) neuropsychological outcomes of trauma exposure or PTSD in youth and/or (2) interventions with potential to modify neurocognitive or affective functioning, including trauma-focused cognitive behavioral therapy (TF-CBT), mindfulness-based interventions, cognitive rehabilitation strategies, and biofeedback/neurofeedback. Results: Across study designs, trauma exposure and PTSD in youth are consistently linked to impairments in attentional control and executive functioning, with downstream effects on everyday memory and academic performance. Neurobiological studies commonly implicate altered reactivity within amygdala-centered threat circuits and reduced top-down modulation by prefrontal networks, although findings vary with trauma type, developmental stage, and comorbidity. TF-CBT remains the best-supported intervention for pediatric PTSD symptoms; however, neurocognitive outcomes are measured less frequently. Mindfulness-based programs show promise for strengthening attention and emotion regulation when carefully adapted for trauma-exposed youth. Neurofeedback and targeted cognitive rehabilitation represent emerging approaches with preliminary evidence, but the literature remains heterogeneous. Conclusions: An intervention strategy that combines symptom-focused trauma therapy with explicit targeting of executive control, memory processes, and affect regulation may represent a developmentally informed clinical framework for trauma-exposed youth. Future trials need to incorporate standardized neuropsychological endpoints and examine moderators that inform treatment matching. Full article

Background/Objectives: Mindfulness has been identified as a protective factor in promoting adaptive psychological outcomes among cancer patients, yet the mechanisms linking mindfulness to fundamental existential beliefs, such as basic hope, remain underexplored. In addition, mediational processes underlying these relationships remain understudied. Building on the theoretical framework of Acceptance and Commitment Therapy, we tested a serial multiple mediation model in which illness acceptance and fear of recurrence sequentially mediated the association between mindfulness and basic hope. Methods: Adult patients diagnosed with pelvic cancer (N = 273) who were undergoing oncological treatment completed questionnaires measuring mindfulness, illness acceptance, fear of recurrence, and basic hope. Mediation analysis was used to examine multiple mediation effects. Results: Illness acceptance also functioned as a single mediator between mindfulness and basic hope. In contrast, fear of recurrence was not a mediator between mindfulness and basic hope. The main finding was the serial mediation pathway through illness acceptance and fear of recurrence. The indirect effects showed that mindfulness was positively associated with illness acceptance dimensions—life satisfaction during illness, reconciliation with the disease, and self-distancing from the disease—which, in turn, were negatively associated with fear of recurrence, ultimately relating to higher levels of basic hope. Conclusions: The findings highlight the critical role of acceptance- and fear-related processes in sustaining basic hope among cancer patients and suggest that mindfulness-based interventions may foster adaptive adjustment to illness. Implications for clinical practice include integrating mindfulness and acceptance-focused strategies to enhance hope and support emotional well-being in patients coping with cancer. Full article

Existential, spiritual, and religious themes often evoke strong emotions in therapy, yet little is known about how clients’ emotion regulation relates to these aspects. Spiritual psychotherapy for inpatient residential and intensive treatment (SPIRIT) integrates meaning in life within a cognitive-behavioral treatment (CBT) framework in acute and intensive mental health care and provides an appropriate context for examining this. This qualitative study explores: (1) clients’ beliefs about expressing, managing, or suppressing emotions related to meaning in life, spirituality, or religion (MSR); (2) how emotion regulation strategies (e.g., reappraisal, acceptance, and distress tolerance) are influenced by addressing MSR in therapy; and (3) whether engaging with MSR activates emotion regulation mechanisms for clients’ experienced distress. We analyzed 118 client evaluation forms and 19 semi-structured client interviews using a thematic approach informed by emotion regulation theory. SPIRIT-CBT made implicit beliefs about (MSR-related) emotion regulation explicit, and group interactions sometimes led to changes. Clients showed various regulation strategies, for example: MSR-based reappraisal, connectedness, reflection, and positive refocusing. However, emotional tension and suppression were also reported. Particularly from the interviews, it emerged that the therapy facilitated regulation mechanisms, including narrative processing, perspective shifting, sense-making, and social belonging. Focusing on MSR and existential themes addresses an important gap in mental health care and may contribute to supporting clients’ emotional recovery and overall well-being. Full article

Generative artificial intelligence (AI)-based music generation has the potential to create new opportunities for music therapy; however, integrated examinations of generative AI and music therapy remain limited. This paper provides a focused survey of recent studies that apply generative AI within music therapy-related contexts, examining how such approaches have been explored in relation to therapeutic considerations, including emotional and physiological regulation. Rather than offering an exhaustive historical review, we analyze generative AI-augmented music therapy systems from a system-level perspective, focusing on their overall design and implementation. Based on this survey, we discuss open research challenges at the intersection of generative music, adaptive systems, and digital health, and outline future research directions toward scalable and personalized generative AI-based music therapy. Full article

Introduction: Major depressive disorder (MDD) is a leading cause of disability worldwide and contributes significantly to the global burden of disease. Recent data show an increasing prevalence of treatment-resistant depression (TRD). Patients with autism spectrum disorder (ASD) often exhibit MDD as a comorbidity and it is often resistant to conventional treatments. ASD determines emotional dysregulation and a reduced ability to understand mental states (mentalization). These features can lead to suicidal ideation and/or behavior. Intranasal esketamine may offer a novel therapeutic option for this population. Methods: This case series focuses on the clinical response to intranasal esketamine in patients with autism and TRD; esketamine is approved in Italy as an add-on therapy in TRD, so our case study is based on an in-label treatment. Three young patients (n = 3, F/M 2:1, age range 20–25 y) with light to moderate autism (Level 1 or 2) were treated. Esketamine was administered in augmentation with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) in accordance with EMA/AIFA guidelines. A structured follow-up protocol was set to monitor depressive symptoms, social cognition, and mentalization. Follow-up during treatment was maintained for six months, and psychometric evaluations were performed at six time points: baseline (T0), 1 week (T1), 1 month (T2), 2 months (T3), 3 months (T4), and 6 months (T5). Also, subjective quality of life was investigated before and after the observation period. Results: Despite differences in clinical profile, all patients showed good efficacy of esketamine in reducing depressive symptoms: two patients experienced clinical remission at T5 (MADRS < 10), one patient showed partial response (dMADRS = 43.24%). No major side effects were reported. Significant improvements were observed after the first week of treatment (P1: MADRS_T0 = 37, MADRS_T1 = 12; P2: MADRS_T0 = 32, MADRS_T1 = 21; P3: MADRS_T0 = 25, MADRS_T1 = 12). Depressive relapses occurred (e.g., P1, T3–T4), but they were not associated with hospitalizations and/or suicidal attempts. Suicidal ideation, when present, decreased by the end of the follow-up period. Lack of mentalization and in social cognition was noted, with just mild improvements during therapy. Subjective quality of life improved significantly for all patients (P1: 28% at T0, 73% at T5. P2: 25% at T0, 71% at T5. P3: 35% at T0, 80% at T5). Conclusions: Intranasal esketamine showed a favorable efficacy and safety in these three cases of TRD in comorbidity with ASD (at six months: total remission = 66.66%, partial remission = 33.33%, inefficacy = 0%, drop-out = 0, severe adverse events = 0). Besides improvements in depressive symptoms, esketamine was associated with a constant decrease in suicidal thoughts. A case series is unfit to form statistical conclusions; preliminary data warrant further investigation in randomized controlled studies to validate the therapeutic potential of esketamine in this population. Full article

Parents of children with special educational needs (SEN) experience elevated stress, anxiety, and depression, a challenge compounded by insufficient emotional support services. This study developed and evaluated a culturally adapted online counselling programme for Hong Kong Chinese parents of adolescents with SEN, integrating Solution-Focused Brief Therapy (SFBT) and Mindfulness Training. The 8-week programme aimed to reduce parental distress and improve family dynamics by emphasising strengths, fostering self-compassion, and enhancing empathetic interactions. A mixed-methods approach was used, combining standardised self-report measures such as the Parental Stress Scale (PSS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Child Behaviour Checklist (CBCL), with qualitative interviews and behavioural observations. Quantitative analysis of pre–post data via paired samples t-tests indicated significant within-group reductions in anxiety across all groups and in depression for the active control group. However, between-group comparisons of post-test scores did not show clear superiority of the experimental intervention. Qualitative findings highlighted perceived benefits, including increased emotional regulation, a shift towards a strengths-based perspective, and enhanced self-compassion, with the programme’s cultural adaptation deemed crucial for engagement. The study addresses a significant service gap and provides preliminary evidence for the acceptability and potential mechanisms of an integrative online model, while highlighting the need for further research with larger samples. Full article

Background: Chronic pain, opioid use, and mental health disorders frequently co-occur in older adults, forming a complex and mutually reinforcing triad. Neurobiological ageing processes—such as neuroinflammation, dopaminergic decline, and impaired top-down regulation—may increase vulnerability to maladaptive coping strategies, including opioid misuse. This review aims to integrate neurobiological, affective, and clinical evidence to propose a unified neuropsychiatric framework for understanding the intersection between chronic pain, emotional distress, and opioid vulnerability in later life, while highlighting implications for integrated treatment and opioid stewardship. Methods: This structured narrative review synthesised interdisciplinary evidence from neuroscience, geriatric psychiatry, and pain medicine. The literature was thematically organised to examine shared neurobiological and psychosocial mechanisms underlying chronic pain, affective disorders, and opioid use disorder (OUD) in older adults, with attention to treatment strategies and stewardship principles. Results: Converging evidence suggests a neuroprogressive continuum linking chronic pain, emotional distress, opioid misuse, and cognitive decline. Key mechanisms include frontolimbic dysfunction, impaired reward processing, and chronic allostatic load. Therapeutic approaches that integrate analgesia with emotional regulation—such as buprenorphine, serotonin–noradrenaline reuptake inhibitors (SNRIs), and multimodal tapering strategies—may offer neuroprotective benefits. Effective opioid stewardship appears to require integrated functional, cognitive, and affective monitoring. Conclusions: Pain management in older adults may benefit from moving beyond symptom-focused approaches toward a neuropsychiatric model of care aimed at preserving homeostatic balance across sensory, emotional, and motivational domains. Within this framework, opioid therapy can be conceptualised as a potential means of functional and neuroaffective restoration, rather than solely as a strategy for risk reduction. Full article

Traumatic experiences can disrupt one’s sense of safety, self-efficacy, and relationships. Prolonged stress may lead to anxiety, depression, and diminished agency. The embodied, subjective manifestations of trauma call for personalized therapeutic approaches that address symptoms and foster resilience. Group Creative Arts Therapies (CATs) offer relational aesthetic interventions that promote resilience and trauma recovery. Incorporating body-based methods, movement, materials and visual expression, CATs support interoceptive awareness, multisensory integration, embodiment, and emotional–cognitive processing. This article presents a review and conceptual framework of group CAT interventions during wartime, focusing on challenges related to body awareness, self-efficacy, and autobiographical memory. It examines how creative aesthetic approaches help process trauma and strengthen resilience. Drawing on predictive processing accounts of brain function, the article explores the neuropsychological impact of trauma and how creative group work may modulate related brain mechanisms. Creative techniques can foster bodily anchored self-awareness, self-efficacy and processes of traumatic memory reconsolidation. Aesthetic experiences are associated with changes in brain activation and connectivity through processes of embodiment, externalization, and meaning making. On an intrapersonal level, converging evidence highlights the role of sensory and sensorimotor processing, along with the dynamic interplay between Default Mode, Executive Control, and Salience networks, as conceptualized in the Triple Network Model. On an interpersonal level, the literature points to the dynamics of brain and body synchronization, as emerging phenomena during shared creative engagement. These neurodynamics provide a coherent framework for understanding how creative arts-based psychotherapeutic group work can support trauma processing and the cultivation of resilience. Full article

The rise in ICU survival rates has introduced new challenges related to the long-term effects of intensive care, known as Post-Intensive Care Syndrome (PICS). Nurses play a key role in these clinics; however, the nature and outcomes of their interventions remain insufficiently understood. Objectives: This review aims to identify nursing interventions for PICS in follow-up clinics. Methods: Using the JBI scoping review methodology, we searched PubMed, Web of Science and CINAHL (via EBSCOhost) in March 2025, and examined grey literature in RCAAP and Open Dissertations (through B-ON). Inclusion criteria, based on JBI’s PCC (Population, Concept, Context), focused on nursing interventions for PICS for patients and families in follow-up. Studies involving children, adolescents, pregnant women, and those receiving end-of-life care were excluded. Results: Encompassing studies from 2005 to 2022 across multiple countries, this review highlights nursing interventions for post-ICU recovery. A total of 394 articles that met our search criteria were found, resulting from searches in the mentioned databases. These were initially exported to Rayyan, and 115 duplicates were removed. The 21 articles that met our inclusion criteria were fully analyzed, and those that effectively answered our questions and met our inclusion criteria were selected. In the end, 9 articles were selected, to which, after an individual analysis of their bibliographic references, 3 more were added, totaling 12 articles submitted to the final analysis. Conclusions: For patients, interventions ranged from debriefing, PICS symptom evaluation, ICU re-visits, health education, cognitive–behavioral therapy and support groups, complemented by home-based physical rehabilitation and virtual reality. Family-focused interventions centered on appointment involvement, educational sessions, patient diary review, and emotional support. These assessments and interventions address the consequences of ICU admission, with the goal of facilitating physical, mental, and emotional rehabilitation of ICU survivors. This review emphasizes the critical role of follow-up consultations in the recovery of both patients and families. A comprehensive assessment using PICS scales and the integration of families into care plans are crucial for optimizing intervention outcomes. Implications for Clinical Practice: The development of evidence-based guidelines for implementation of follow-up clinics for SPICI appointments is necessary. Full article

This study examined how resilience-based interventions enable rural older women living with HIV in Zimbabwe to confront stigma and sustain their quality of life. Guided by the 4S framework of resilience resources planning (social support, coping strategies, sagacity, and solution-seeking), the research explored how women apply these dimensions to navigate challenging life events. A purposive sample of 17 women (those not living with a spouse or in a socially sanctioned relationship), aged 40–65, all on antiretroviral therapy and drawn from rural Matabeleland South Province, participated through in-depth interviews. Using Interpretive Phenomenological Analysis, four themes emerged: (1) Social Support and Social Networks as Foundations of Resilience, (2) Self-Efficacy and Coping Strategies in Managing Emotional Distress, (3) Spirituality and Sagacity as Sources of Strength and Meaning, and (4) Sense of Purpose and Solution-Seeking Behaviours. The findings highlight that resilience is actively mobilised through family ties, peer groups, and community initiatives, enabling women to adapt to socio-economic hardship and health-related barriers. This study concludes that empowerment strategies, especially community-based programmes focused on skills development and economic opportunities, are essential for enhancing resilience, reducing vulnerability, and improving health outcomes. Strengthening these resources not only equips women to manage HIV-related challenges but also contributes to sustainable development within their communities. Full article

The rapid expansion of mindfulness research has generated both enthusiasm and controversy regarding its actual clinical value. While meditation is often regarded as the central mechanism of mindfulness-based interventions, other components such as psychoeducation and informal practice may play an equally significant role in improving mental health outcomes. This critical review examines the relative contributions of these elements to the therapeutic impact of mindfulness and clarifies the extent to which its effects are comparable to established treatments, particularly Cognitive Behavioral Therapy (CBT). Evidence from meta-analyses and high-quality trials indicates that mindfulness programs achieve moderate efficacy in reducing symptoms of anxiety, depression, and stress, but effect sizes are frequently inflated by methodological limitations. Importantly, cognitive and emotional regulation skills, especially acceptance and non-judgment, appear to sustain long-term benefits more consistently than meditation alone. These findings highlight the need for rigorous longitudinal studies and component-focused designs to identify the mechanisms that drive clinical change. By distinguishing between evidence-based applications and overstated claims, this review contributes to a more balanced understanding of mindfulness and its appropriate integration into healthcare. Full article

Background: Music therapy is a non-pharmacological psychosocial intervention that is increasingly recognised for its role in supporting older adults in acute hospital settings. Engagement with music, whether through passive listening, preferred recorded music, live music, or creative music therapy, has been linked to improvements in behavioural, cognitive, and emotional outcomes during episodes of delirium. Although there are reviews on non-pharmacological approaches to delirium, few have focused specifically on music therapy within acute hospital environments. Methods: This scoping review examined the evidence relating to music-based interventions for older adults who are experiencing delirium or who are at risk of delirium in acute care settings. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA ScR). Four electronic databases were searched systematically, namely, CINAHL, Medline, PsycINFO and Embase. Results: Seven primary research studies published between 2004 and 2024 met the inclusion criteria. A narrative synthesis approach was used to summarise the data. Three themes were identified. The first relates to the extent to which music therapy may reduce the incidence or severity of delirium or other related behaviours in acute hospital settings. The second relates to the potential for music-based interventions to support clinical practice by improving interaction between patients and staff and reducing distress during recovery and enhancing physical recovery. The third relates to the impact of music therapy on emotional regulation, engagement, cooperation with care, and overall patient experience. Conclusion: Music therapy shows promise as a person-centred, safe, and low-cost intervention that may enhance wellbeing and support delirium care for older adults in acute hospital settings. Further high-quality studies are needed to strengthen the evidence base and guide practice. Full article

Background: Emotional dysregulation and impulsivity represent key risk factors for adverse trajectories in adults with ADHD and are frequently observed among patients with opioid use disorder (OUD). Levomethadone, the R-enantiomer of methadone, provides more stable dopaminergic modulation than the racemic formulation and may improve emotional control. The primary objective was to examine emotional, clinical, and substance use changes after the switch to levomethadone and to determine whether these trajectories differed according to ADHD screening status. This study evaluated emotional, clinical, and behavioral outcomes—including substance use—after transitioning from racemic methadone to levomethadone maintenance therapy, focusing on the moderating role of ADHD symptoms and dose escalation. Methods: Eighty-three OUD patients in methadone maintenance were assessed at baseline, T1 (mean = 2.13 months, SD = 0.65), and T2 (mean = 6.20 months, SD = 0.91). Emotional dysregulation (RIPOST), clinical severity (Clinical Global Impression), and days of substance use were analyzed using Linear Mixed Models (participants with ≥1 valid follow-up). ADHD symptoms (Adult ADHD Self-Report Scale DSM-5) were evaluated with Wilcoxon signed-rank tests. Dose escalation (↑levomethadone) was defined as ≥1 increase during follow-up and was only included in the mixed models. Substance use analyses were restricted to baseline active users. Results: Emotional impulsivity significantly decreased over time only in participants screening positive for ADHD symptoms (ASRS ≥ 14), independent of dose escalation. Emotional instability also declined but across the full cohort. CGI scores improved in all participants. Substance use patterns showed a modest overall improvement, with reductions most evident for sedatives and alcohol. The findings indicate a specific effect of levomethadone on affective regulation and clinical stabilization, particularly in individuals with impulsivity traits. Conclusions: Levomethadone maintenance appears to improve emotional regulation and global functioning beyond dose-related effects, supporting its potential value in complex OUD patients with clinically relevant ADHD symptomatology. Combined treatment with levomethadone and methylphenidate may further enhance executive control and craving regulation in this population. Full article

Background: Methamphetamine (Meth) addiction, with its high relapse rates, poses a significant global challenge. Conventional therapies remain inadequate, highlighting the need for effective adjunctive treatments. Objective: This review synthesises evidence to propose a novel ‘Exercise Modality–Neural Target–Rehabilitation Stage’ integration model, elucidating how aerobic, resistance, and mind–body exercises differentially target specific neural pathways to ameliorate cognitive deficits, emotional dysregulation, and craving in Meth use disorder. Methods: A narrative synthesis of 84 studies (up to March 2025) from PubMed, Web of Science, and CNKI was conducted, focusing on the neurobiological basis and clinical application of exercise interventions. Results: The analysis identifies a key overarching neurobiological pattern: different exercise modalities work complementarily to reverse Meth-induced imbalance in glutamate/gamma-aminobutyric acid (Glu/GABA) neurotransmitter homeostasis. Aerobic exercise upregulates prefrontal–striatal BDNF to enhance cognitive control, while resistance training modulates the amygdala–striatal dopamine system to improve emotional stability. Additionally, mind–body exercises help balance the autonomic nervous system, which in turn helps manage cravings. Building on this, we construct a standardised ‘screening–assessment–prescription’ framework to guide personalised interventions across the various stages of withdrawal. Conclusions: The primary contribution of this review is the integrative model that positions exercise as a precise, evidence-based rehabilitation strategy. The proposed framework provides a practical blueprint for clinical translation, with future research focusing on developing personalised intelligent rehabilitation systems by integrating multimodal exercise with advanced technologies. Full article

This study examines the efficacy of virtual reality exposure therapy (VRET) in alleviating foreign language anxiety (FLA) among university students. Although research exists on FLA, interventions have relied on self-reporting measures, leaving a gap in understanding physiological indicators and anxiety reduction. While previous research has explored either the therapeutic potential of virtual reality or the neurophysiological correlations of anxiety through electroencephalography (EEG), few have integrated these methodologies within a single experimental framework. This study combined the foreign language classroom anxiety scale (FLCAS) with (EEG) data to capture subjective and neural responses to anxiety in second language (L2) speaking. The participants (n = 20) completed language speaking tasks both before and after VR intervention, which exposed them to anxiety-inducing conditions replicating language challenges. During these tasks, brainwave signals were recorded, focusing on frontal alpha asymmetry (FAA) and alpha power (F3, F4), indicating neural activity associated with stress and emotional regulation. Results showed participants experienced a significant decrease (p = 0.017 < 0.05) in self-reported FLCAS scores after VRET. The reduction in FLA showed a negative correlation with increased alpha power at F3 (r = −0.55, p = 0.012), suggesting a link between left frontal neural regulation and anxiety reduction. These findings underscored VRET’s effectiveness in influencing emotional responses during L2-speaking tasks. Full article