2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T672,Gender and sexual minority (GSM) people are at increased risk of mental health difficulties compared to their cisgender-heterosexual peers. This is likely because of exposure to minority stressors. Emotion regulation difficulties have been proposed as an important mechanism for mental health disparities in GSM populations. This systematic review and meta-analysis examined whether GSM groups differ from cisgender and heterosexual groups in global and specific aspects of emotion regulation (e.g., emotion awareness, strategies, impulse control, cognitive appraisal, and emotion suppression), and whether emotion dysregulation mediated the relationship between GSM identity and mental health outcomes. We identified 40 eligible studies, of which 28 provided sufficient data for inclusion in the meta-analysis. Results indicated that GSM groups reported higher global emotion regulation difficulties and higher difficulties across most specific domains, compared to cisgender and heterosexual groups. Plurisexual groups (e.g., bisexual+) had higher emotion regulation difficulties compared to monosexual minority groups (e.g., gay/lesbian). A small number of studies also suggested that emotion regulation mediated the relationship between GSM identity and self-harm, suicidality, and eating disorder symptoms. These findings suggest that emotion regulation is a relevant psychological mechanism contributing to mental health disparities in GSM populations. Emotion dysregulation may therefore represent a useful intervention target for reducing health inequalities, alongside broader efforts to address structural and interpersonal minority stress.31:T6b7,Abstract Gender and sexual minority (GSM) people are at increased risk of mental health difficulties compared to their cisgender-heterosexual peers. This is likely because of exposure to minority stressors. Emotion regulation difficulties have been proposed as an important mechanism for mental health disparities in GSM populations. This systematic review and meta-analysis examined whether GSM groups differ from cisgender and heterosexual groups in global and specific aspects of emotion regulation (e.g., emotion awareness, strategies, impulse control, cognitive appraisal, and emotion suppression), and whether emotion dysregulation mediated the relationship between GSM identity and mental health outcomes. We identified 40 eligible studies, of which 28 provided sufficient data for inclusion in the meta-analysis. Results indicated that GSM groups reported higher global emotion regulation difficulties and higher difficulties across most specific domains, compared to cisgender and heterosexual groups. Plurisexual groups (e.g., bisexual+) had higher emotion regulation difficulties compared to monosexual minority groups (e.g., gay/lesbian). A small number of studies also suggested that emotion regulation mediated the relationship between GSM identity and self-harm, suicidality, and eating disorder symptoms. These findings suggest that emotion regulation is a relevant psychological mechanism contributing to mental health disparities in GSM populations. Emotion dysregulation may therefore represent a useful intervention target for reducing health inequalities, alongside broader efforts to address structural and interpersonal minority stress.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Self-Harm: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Self-Harm (condition). Clinician-written summaries and actionable practice insights. 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Female sex and higher school level predicted membership in the Severe Symptoms group. Physical abuse, sexual abuse, and re-abuse history were more common in the Severe Symptoms group compared with the Stable and Elevated Symptoms with Mild Self-Harm groups.","limitations":"- Data are confidential and cross-sectional, preventing causal inference or replication by outside researchers.\n- The sample is limited to *officially reported* maltreatment cases in South Korea, likely underrepresenting milder or unreported cases and limiting generalizability.\n- Profile-level psychological instruments were developed and standardized specifically for this South Korean maltreated-child context, so cross-cultural applicability is uncertain.","practice_takeaway":"Maltreated children are not a uniform group—screening should aim to detect which of several distinct symptom clusters a child falls into, particularly flagging girls and older students for more severe symptom profiles. Tailored, trauma-informed interventions—rather than one-size-fits-all approaches—appear warranted given the clear heterogeneity in risk."}},{"doi":"10.1111/1742-6723.70309","pmid":"42442415","title":"Caregiver and Care Recipient Perspectives on Paediatric\n ED\n Mental Health Presentations: A Qualitative Study","journal_title":"Emergency Medicine Australasia","journal_issn":"1742-6731","published_at":"2026-07-13T00:00:00.000Z","url":"https://doi.org/10.1111/1742-6723.70309","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:36:00.665Z","updated_at":"2026-07-20T13:36:00.665Z","tags":[{"paper_doi":"10.1111/1742-6723.70309","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"condition","value":"Attention Deficit Hyperactivity Disorder","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"condition","value":"Autism Spectrum Disorder","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"condition","value":"Paediatric Mental Health","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"sample_size","value":"n=184","value_numeric":184},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"study_design","value":"Qualitative Study (Secondary Analysis)","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"warning","value":"Care recipients (patients/caregivers) are substantially under-represented compared to care providers (36 vs. 148), which may skew findings toward provider perspectives.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"warning","value":"Findings are specific to the Australian healthcare context (2022, post-COVID); generalisability to other health systems or time periods is uncertain.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"warning","value":"Study design tag reflects the qualitative secondary analysis nature; the original data source was a Delphi survey, which may cause ambiguity in design classification.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70309","tag_type":"warning","value":"This is a secondary analysis of a Delphi study not originally designed to capture all aspects of ED mental health experience; free-text themes reflect participant-selected concerns rather than systematic data collection.","value_numeric":null}],"summaries":{"what_studied":"Secondary qualitative analysis of free-text responses from a 2022 Australian Delphi study (PREDICT network), exploring perspectives of 36 care recipients (patients/caregivers) and 148 care providers (clinicians, paramedics, police) on paediatric mental health ED presentations across 12 EDs in 3 Australian states.","key_result":"Three main challenge categories emerged: (1) care continuity and communication gaps — patients felt uninformed and abandoned post-discharge; (2) ED environment issues — long waits, lack of privacy, sensory overload, and escalating behavioural crises; (3) need for improved training — clinicians felt underprepared for mental health crises, neurodevelopmental presentations, and culturally safe care.","limitations":"Care providers were heavily over-represented (148 vs. 36 care recipients); culturally and linguistically diverse families were under-represented; voluntary QR-code/email recruitment likely attracted motivated participants, limiting generalisability beyond the Australian context.","practice_takeaway":"EDs caring for paediatric mental health patients should prioritise low-sensory spaces, structured discharge planning with clear follow-up pathways, and targeted clinician training in trauma-informed and neurodevelopment-aware care. Stronger links to community mental health services (e.g., headspace) may reduce repeat ED presentations."}},{"doi":"10.3389/fpsyt.2026.1835204","pmid":null,"title":"The effect of weather on unscheduled healthcare utilisation for mental health conditions in England, 2014–2022","journal_title":"Frontiers in Psychiatry","journal_issn":"1664-0640","published_at":"2026-06-30T00:00:00.000Z","url":"https://doi.org/10.3389/fpsyt.2026.1835204","source_score":58,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-01T13:27:27.774Z","updated_at":"2026-07-01T13:27:27.774Z","tags":[{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"condition","value":"Alcohol Use Disorder","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"condition","value":"Anxiety","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"condition","value":"Mental Health Conditions","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"condition","value":"Overdose","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"sample_size","value":"9 regions, 2014–2022 (population-level surveillance)","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"study_design","value":"Retrospective Observational Study","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"warning","value":"Full text figures were not fully extractable; specific RR point estimates for individual conditions are inferred from figure descriptions only.","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"warning","value":"Sample size tag reflects population-level surveillance data across 9 regions over 9 years; no individual-level N is reported in the abstract or available full text.","value_numeric":null},{"paper_doi":"10.3389/fpsyt.2026.1835204","tag_type":"warning","value":"Study design is observational with ecological (regional) data — causal interpretation should be made cautiously.","value_numeric":null}],"summaries":{"what_studied":"This retrospective observational study examined associations between daily weather conditions (temperature, sunshine hours, rainfall) and unscheduled mental health–related healthcare contacts across nine English regions from January 2014 to December 2022, covering emergency departments (EDs), GP out-of-hours (GP OOH) services, and NHS 111.","key_result":"Rising temperatures up to ~18°C and fewer sunshine hours were consistently associated with increased mental health–related healthcare demand across all three services, with daily demand varying within ±10–20% of baseline. Rainfall showed no consistent association. Adults over 64 showed a U-shaped temperature–ED attendance relationship (higher use in both cold and warm conditions). Alcohol-related contacts increased with higher sunshine and temperature.","limitations":"- Observational design precludes causal inference; residual confounding (e.g., air quality, social factors) cannot be excluded.\n- Relies on coded healthcare contact data, which may undercount or misclassify mental health presentations.\n- Regional-level analysis may mask within-region variation in weather exposure and healthcare access.","practice_takeaway":"Mental health services should anticipate modestly higher demand on low-sunshine and moderately warm days, and plan additional capacity for older adults during both cold and hot spells. These findings can support NHS seasonal and climate preparedness planning."}},{"doi":"10.5694/mja2.70220","pmid":"42274377","title":"The Effects of Social Media on Adolescent Mental Health: Findings From a Population‐Based Cohort Study in Australia","journal_title":"Medical Journal of Australia","journal_issn":"0025-729X","published_at":"2026-06-11T00:00:00.000Z","url":"https://doi.org/10.5694/mja2.70220","source_score":193,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-17T13:29:57.170Z","updated_at":"2026-06-17T13:29:57.170Z","tags":[{"paper_doi":"10.5694/mja2.70220","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"condition","value":"Anxiety Symptoms","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"condition","value":"Depressive Symptoms","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"condition","value":"Poor Well-Being","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"modality","value":"Social Media Use (Behavioral Exposure)","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"sample_size","value":"n=1195","value_numeric":1195},{"paper_doi":"10.5694/mja2.70220","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"warning","value":"Self-harm data had wide confidence intervals in sex-stratified and age-period analyses; those specific estimates should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"warning","value":"Social media platforms and usage patterns shifted considerably between 2014 and 2021 (the exposure period); findings may not fully reflect current platform ecosystems (e.g., TikTok dominance).","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"warning","value":"The cohort was recruited from Melbourne schools in 2012 and may not generalize to non-Western or lower-income country populations.","value_numeric":null},{"paper_doi":"10.5694/mja2.70220","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the study's direct policy relevance (minimum age debates, screen time guidelines), but effect sizes are small overall — clinicians should note this is not equivalent to a strong clinical intervention trial.","value_numeric":null}],"summaries":{"what_studied":"This prospective longitudinal cohort study (CATS, Melbourne, Australia) examined how daily social media use (SMU) at ages 12–18 affected four mental health outcomes — depressive symptoms, anxiety symptoms, well-being, and self-harm — one year later, stratified by sex and age period (early/middle/late adolescence), using data from waves 4–11 (2014–2022) in 1,195 adolescents.","key_result":"More than 2 h/day vs. <1 h/day of SMU was associated with increased risk of high depressive symptoms (RD 6.3 per 100 [95% CI 2.7–9.9]) and poor well-being (RD 4.9 [95% CI 1.1–8.6]) across adolescence. Effects were largest in early adolescence (ages 12–13): female participants had an RD of 10.8 (95% CI 2.7–18.9) for high depressive symptoms and an RD of 10.6 for poor well-being; male participants had an RD of 7.2 for depressive symptoms and 6.5 for anxiety symptoms. No clear association was found for self-harm overall, though male adolescents showed elevated self-harm risk in early adolescence.","limitations":"- SMU was self-reported (duration only), missing platform-specific or active-vs-passive context; adolescents tend to under-report use.\n- Residual confounding, reverse causation, and shared vulnerabilities cannot be excluded despite lagged design and sensitivity analyses.\n- Late-adolescence waves occurred during the COVID-19 pandemic, potentially confounding SMU and mental health in that period.","practice_takeaway":"Early adolescence (ages 12–13) appears to be the highest-risk window for social media's mental health impact — clinicians and school health teams should prioritize screening and parental guidance around SMU for this age group. Limiting daily use to under 2 hours may be a practical, policy-supported threshold to discuss with families, especially for girls."}},{"doi":"10.2196/88435","pmid":"42275418","title":"Between Help and Harm: An Evaluation Study of Mental Health Crisis Handling by Large Language Models","journal_title":"JMIR Mental Health","journal_issn":"2368-7959","published_at":"2026-06-11T00:00:00.000Z","url":"https://doi.org/10.2196/88435","source_score":13,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-16T13:54:40.766Z","updated_at":"2026-06-16T13:54:40.766Z","tags":[{"paper_doi":"10.2196/88435","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"brand","value":"ChatGPT","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"condition","value":"Anxiety Crisis","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"condition","value":"Mental Health Crisis","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"condition","value":"Substance Abuse","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"condition","value":"Violent Thoughts","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"generic","value":"deepseek-v3.2","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"generic","value":"gpt-4o-mini","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"generic","value":"gpt-5-nano","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"generic","value":"grok-4-fast","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"generic","value":"llama-4-scout","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"modality","value":"Large Language Model","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"sample_size","value":"n=2046","value_numeric":2046},{"paper_doi":"10.2196/88435","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"study_design","value":"Benchmark / Audit Study","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"warning","value":"All tested inputs are English-language, adult-oriented, and sourced from public datasets — some synthetic — limiting real-world and cross-cultural applicability.","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"warning","value":"LLM-as-a-judge evaluation introduces automation bias; human expert within-1 agreement (95.3%) substantially exceeds the LLM judge's (84.2%), so harmful response rates may be underestimated or misclassified.","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"warning","value":"Model versions evaluated (e.g., gpt-5-nano, grok-4-fast, deepseek-v3.2-exp) reflect a rapidly evolving landscape; findings may not apply to current or future model versions.","value_numeric":null},{"paper_doi":"10.2196/88435","tag_type":"warning","value":"Study design is best described as a benchmark/audit rather than a standard clinical study design; level of evidence reflects observational/descriptive methodology.","value_numeric":null}],"summaries":{"what_studied":"This study audited 5 widely used LLMs (gpt-4o-mini, gpt-5-nano, llama-4-scout, deepseek-v3.2, grok-4-fast) on their ability to safely detect and respond to 2,046 user inputs spanning 6 mental health crisis categories (suicidal ideation, self-harm, anxiety crisis, violent thoughts, substance abuse/withdrawal, risk-taking behaviors), rated on a clinically informed 1–5 Likert scale using an LLM-as-a-judge validated against human experts.","key_result":"Overall mean scores were high (gpt-5-nano: 4.94, deepseek-v3.2: 4.92, grok-4-fast: 4.75, llama-4-scout: 4.72, gpt-4o-mini: 4.55), but harmful response rates (score=1) were nonzero for all models: gpt-5-nano 0.26%, gpt-4o-mini 0.47%, deepseek-v3.2 0.51%, llama-4-scout 0.80%, and grok-4-fast 2.79%. In the self-harm category, grok-4-fast produced 17.51% harmful responses and llama-4-scout 4.80%; for suicidal ideation, grok-4-fast reached 6.40% vs. gpt-5-nano's 0.35%. All models failed most on indirect or ambiguous crisis queries.","limitations":"- Dataset is English-only and drawn from adult-dominated public sources, limiting generalizability to children, adolescents, and non-English speakers.\n- Crisis category labels and response scores were assigned by an LLM judge (gpt-4o-mini), which does not fully match human expert consistency (human within-1 agreement 95.3% vs. LLM 84.2%).\n- Single-turn inputs only; longitudinal follow-up, user trust, and real-world intervention pathways were not assessed.","practice_takeaway":"No current general-purpose LLM is clinically safe for unsupervised mental health crisis support — even the best-performing models occasionally produce harmful outputs, especially for self-harm and suicidal ideation with indirect phrasing. Clinicians and health systems deploying or recommending chatbots should ensure robust crisis-specific safeguards, localized helpline integration, and human-in-the-loop oversight are in place."}},{"doi":"10.2196/91367","pmid":"42155999","title":"Automated Safety Testing and Reporting Application for Conversational Safety Monitoring of Generative AI Tools for Mental Health: Development and Validation Study","journal_title":"JMIR Mental Health","journal_issn":"2368-7959","published_at":"2026-05-19T00:00:00.000Z","url":"https://doi.org/10.2196/91367","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:35:17.321Z","updated_at":"2026-05-26T13:35:17.321Z","tags":[{"paper_doi":"10.2196/91367","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"condition","value":"Mental Health","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"modality","value":"Generative Artificial Intelligence","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"sample_size","value":"n=100","value_numeric":100},{"paper_doi":"10.2196/91367","tag_type":"study_design","value":"Diagnostic Validation Study","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"warning","value":"Level of evidence assigned as 3 (diagnostic validation study with synthetic data); may be downgraded to 4–5 given the artificial dataset.","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"warning","value":"PDF metadata references a different document ('Barriers to Care in a Changing Practice Environment: 2024 Practitioner Pulse Survey'), suggesting a possible metadata mismatch unrelated to the paper content.","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"warning","value":"Sex of participants is not applicable here (synthetic conversation dataset); sex tag omitted.","value_numeric":null},{"paper_doi":"10.2196/91367","tag_type":"warning","value":"The full text body of the paper was not extractable from the PDF (all page content was blank in the source); summaries and tags are based solely on the abstract and results sections provided.","value_numeric":null}],"summaries":{"what_studied":"This study developed and validated ASTRA (Automated Safety Testing and Reporting Application), an external AI-based system designed to detect clinically relevant risk behaviors in AI-mediated mental health conversations. It was tested on 100 synthetic therapeutic conversations written by licensed clinicians, covering 8 predefined risk categories, using human coder consensus as the reference standard.","key_result":"ASTRA achieved accuracy >0.90 across all 8 risk behavior categories, with uniformly high specificity and sensitivity ranging from 0.55 to 1.00. Agreement with human raters was substantial to almost perfect (κ=0.65–1.00), including reliable detection of subtle self-harm disclosures.","limitations":"- Dataset consisted entirely of synthetic conversations (n=100); real-world generalizability is unconfirmed.\n- Small sample size limits statistical precision for rarer risk categories.\n- Sensitivity varied widely (0.55–1.00) across categories, indicating uneven performance.","practice_takeaway":"Independent safety monitoring tools like ASTRA show promise for flagging risk in AI-assisted mental health platforms, but should be considered complementary—not replacements—for clinical oversight. Clinicians deploying generative AI tools in mental health settings should advocate for validated external safety layers pending larger real-world studies."}},{"doi":"10.1001/jamapsychiatry.2026.0603","pmid":"42054038","title":"Adolescent Mental Health Care and Stigma","journal_title":"JAMA Psychiatry","journal_issn":"2168-622X","published_at":"2026-04-29T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13130063/","source_score":38,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:20.412Z","updated_at":"2026-05-07T22:49:20.412Z","tags":[{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"condition","value":"Mental Health Stigma","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"modality","value":"Antistigma Campaign","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"modality","value":"Digital Mental Health Intervention","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"modality","value":"Task-Sharing / Community Health Worker","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"sample_size","value":"n=3739","value_numeric":3739},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"study_design","value":"Cluster Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"warning","value":"Both antistigma and digital care interventions were delivered simultaneously, making it difficult to isolate the independent effect of each component.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"warning","value":"The coprimary remission outcome (PHQ-9 <5 at 12 months) did not reach statistical significance (P=.10), though a secondary PHQ-9 score analysis did (P=.03) — clinical relevance of this discrepancy should be interpreted carefully.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0603","tag_type":"warning","value":"The trial was registered in India (CTRI/2022/02/040307); results may not be generalizable outside urban slum settings in South Asia.","value_numeric":null}],"summaries":{"what_studied":"A parallel cluster RCT in 60 slums across New Delhi and Vijayawada (Dec 2022–Dec 2023) tested a multimedia antistigma campaign plus a primary care health worker-led digital intervention vs usual care in 3,739 adolescents aged 10–19, of whom 1,761 were at high risk of depression or self-harm (PHQ-9 ≥10).","key_result":"The antistigma campaign significantly improved anticipated behavior toward people with mental illness at 12 months (mean difference +0.78; 95% CI 0.40–1.16; P<.001; SMD 0.20). Depression remission (PHQ-9 <5) was higher in the intervention arm (68.2% vs 59.4%; OR 1.47) but did not reach statistical significance (P=.10). PHQ-9 scores were significantly lower in the intervention arm at 12 months (4.05 vs 4.92; mean difference −0.87; P=.03).","limitations":"The primary remission outcome was nonsignificant despite a clinically meaningful absolute difference (7%), raising concerns about statistical power at the cluster level. The trial was conducted only in urban slums in 2 Indian cities, limiting generalizability to rural or other LMIC settings. Usual care in the control arm was not standardized, which may have introduced variability.","practice_takeaway":"A community-based antistigma campaign combined with trained primary care workers can reduce mental health stigma and modestly lower depression scores in high-risk adolescents living in urban slums. Clinicians working in similar LMIC settings should consider task-sharing with community health workers alongside stigma-reduction efforts."}},{"doi":"10.1016/j.brat.2026.105049","pmid":"42019098","title":"The association of short-term variability in suicidal ideation with subsequent suicidal thoughts and behaviours: Longitudinal cohort study","journal_title":"Behaviour Research and Therapy","journal_issn":"0005-7967","published_at":"2026-04-20T00:00:00.000Z","url":"https://doi.org/10.1016/j.brat.2026.105049","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:44.842Z","updated_at":"2026-05-08T13:23:44.842Z","tags":[{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"sample_size","value":"n=831","value_numeric":831},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"Level of evidence is assigned as 2 (prospective cohort), but no randomised intervention was tested; this reflects the observational prognostic design.","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"The impact flag 'practice_changing' is applied cautiously — the study challenges the clinical utility of frequent SI monitoring, but this is a single cohort study and replication in acute/clinical settings is needed before changing monitoring protocols.","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"The paper is dated April 2026 and references a 3-year prospective cohort (LifeTrack); only 12-month outcome data are reported here — longer-term predictive analyses may follow.","value_numeric":null}],"summaries":{"what_studied":"This prospective longitudinal cohort study (LifeTrack, n=831 adults with suicidal ideation, 66% women) examined whether short-term intraindividual variability in suicidal ideation — measured via daily assessments over 7 days — predicted suicide attempt, self-harm, and suicidal ideation severity over 12 months.","key_result":"Four SI trajectories were identified: low stable (55%), low increasing (7%), high stable (27%), and high decreasing (11%). Trajectories did not significantly predict suicide attempts (p=0.51); variability showed only a modest association with subsequent attempts (p=0.03) but explained minimal variance beyond baseline ideation severity, with no consistent link to self-harm or SI at 12 months.","limitations":"- Study relied on 7-day daily assessments to capture variability, which may not reflect longer-term fluctuation patterns.\n- The association between variability and suicide attempts, while statistically significant (p=0.03), explained minimal additional variance, limiting clinical interpretability.\n- The sample was drawn from a population-based cohort and may not generalise to acute clinical or inpatient settings.","practice_takeaway":"Frequent repeated measurement of suicidal ideation variability appears to add little predictive value beyond baseline ideation severity, suggesting intensive monitoring protocols may not improve risk stratification. Clinicians should instead prioritise addressing depression, distress, perceived burdensomeness, and social connection in patients with suicidal thoughts."}},{"doi":"10.1176/appi.ajp.20250691","pmid":"41703689","title":"Risk of Presentation for Sexual Abuse After a First Emergency Department Presentation for Self-Harm in Childhood or Adolescence","journal_title":"American Journal of Psychiatry","journal_issn":"0002-953X","published_at":"2026-02-18T00:00:00.000Z","url":"https://doi.org/10.1176/appi.ajp.20250691","source_score":18,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-03T13:38:57.705Z","updated_at":"2026-07-03T13:38:57.705Z","tags":[{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"condition","value":"Sexual Abuse","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"condition","value":"Sexual Assault","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"sample_size","value":"n=139233","value_numeric":139233},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"study_design","value":"Population-Based Cohort Study","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"warning","value":"Impact flag 'practice_changing' applied cautiously — the study is observational and does not test a clinical intervention, but the magnitude of risk elevation has direct screening and safeguarding implications.","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"warning","value":"The 'sexual abuse' and 'sexual assault' outcomes are health-administrative codes, which may conflate incident cases with follow-up for prior abuse; causal directionality cannot be fully established.","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250691","tag_type":"warning","value":"The study captures only presentations to health services — the true burden of sexual abuse/assault is almost certainly higher due to widespread underreporting, so hazard ratios likely underestimate absolute risk differences.","value_numeric":null}],"summaries":{"what_studied":"This population-based cohort study examined whether children and adolescents with a first ED presentation for self-harm (2013–2022, Ontario, Canada; n=139,233) face elevated subsequent risk of presentation for sexual abuse or assault, compared to age-, sex-, and socioeconomic-status-matched controls over a 10-year follow-up.","key_result":"The 10-year cumulative incidence of sexual abuse presentation was 9.06% in the self-harm group vs. 1.26% in controls (adjusted HR=5.06, 95% CI 4.53–5.65); for sexual assault, 4.14% vs. 0.48% (adjusted HR=6.44, 95% CI 5.38–7.71). Females carried greater absolute risk.","limitations":"- Outcomes rely on health administrative data, so unreported sexual abuse/assault (the majority) is missed, likely underestimating true risk.\n- Matched controls share age/sex/SES but residual confounding by unmeasured psychiatric or trauma history cannot be excluded.\n- Findings are from a single Canadian province and may not generalize to other health systems or populations.","practice_takeaway":"A child or adolescent presenting with self-harm carries a roughly 5–8× higher risk of future sexual abuse or assault — treat the presentation as both a potential marker of past abuse and a signal for prospective safeguarding. Clinicians should routinely screen for abuse history and consider safety planning around sexual violence risk at every self-harm encounter."}},{"doi":"10.1007/s10508-025-03276-2","pmid":"41402604","title":"Emotion Regulation Differences Between Gender and Sexuality Groups: A Systematic Review and Meta-Analysis","journal_title":"Archives of Sexual Behavior","journal_issn":"0004-0002","published_at":"2025-12-17T00:00:00.000Z","url":"https://doi.org/10.1007/s10508-025-03276-2","source_score":18,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-20","doi":"10.1007/s10508-025-03276-2","days":"30","issn":"0004-0002","rank":"9","field":"Clinical Medicine","score":"18","category":"Psychology, Clinical","categories":["Psychology, Clinical"],"_categories":["Psychology, Clinical"]},"pubmed":{"doi":"10.1007/s10508-025-03276-2","title":"Emotion Regulation Differences Between Gender and Sexuality Groups: A Systematic Review and Meta-Analysis.","journal":"Archives of sexual behavior","methods":"","results":"","abstract":"$30","keywords":["Emotion regulation","Gender diverse","LGBTQ+ ","Meta-analysis","Sexual minority"],"pubmed_id":"41402604","conclusions":"","publication_date":"2025-12-17T00:00:00"},"crossref":{"DOI":"10.1007/s10508-025-03276-2","URL":"https://doi.org/10.1007/s10508-025-03276-2","ISSN":["0004-0002","1573-2800"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1007/s10508-025-03276-2.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1007/s10508-025-03276-2","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1007/s10508-025-03276-2.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":"3957-3994","type":"journal-article","issue":"10","score":1,"title":["Emotion Regulation Differences Between Gender and Sexuality Groups: A Systematic Review and Meta-Analysis"],"author":[{"given":"Jake","family":"Camp","sequence":"first","affiliation":[]},{"given":"Emma","family":"Blundell","sequence":"additional","affiliation":[]},{"given":"Patrick","family":"Smith","sequence":"additional","affiliation":[]},{"given":"Katharine A.","family":"Rimes","sequence":"additional","affiliation":[]}],"funder":[{"id":[{"id":"10.13039/501100000272","id-type":"DOI","asserted-by":"crossref"}],"DOI":"10.13039/501100000272","name":"National Institute for Health and Care Research","award":["NIHR302655"],"award-info":[{"award-number":["NIHR302655"]}],"doi-asserted-by":"crossref"}],"issued":{"date-parts":[[2025,11]]},"member":"297","prefix":"10.1007","source":"Crossref","volume":"54","created":{"date-time":"2025-12-16T19:38:32Z","timestamp":1765913912000,"date-parts":[[2025,12,16]]},"indexed":{"date-time":"2025-12-30T14:35:48Z","timestamp":1767105348923,"date-parts":[[2025,12,30]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000,"date-parts":[[2025,11,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000,"date-parts":[[2025,12,16]]},"delay-in-days":45,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1007/s10508-025-03276-2"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"7 November 2024"},{"name":"revised","group":{"name":"ArticleHistory","label":"Article History"},"label":"Revised","order":2,"value":"4 July 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":3,"value":"9 August 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":4,"value":"16 December 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"},"order":2,"value":"The authors declare that they have no conflict of interest to be disclosed."}],"deposited":{"date-time":"2025-12-30T14:32:42Z","timestamp":1767105162000,"date-parts":[[2025,12,30]]},"issn-type":[{"type":"print","value":"0004-0002"},{"type":"electronic","value":"1573-2800"}],"published":{"date-parts":[[2025,11]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.1023/a:1019873015594","key":"3276_CR1","year":"2002","issue":null,"author":"JR Abela","volume":"30","first-page":"515","unstructured":"Abela, J. 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A small number of studies indicated that emotion dysregulation mediated associations between minority identity and self-harm, suicidality, and eating disorder symptoms.","limitations":"Only 28 of 40 studies contributed data to the meta-analysis. The abstract provides no effect sizes or absolute differences, and mediation evidence comes from a small subset of studies.","practice_takeaway":"Routinely assess and address emotion regulation difficulties in care for gender and sexual minority patients, with particular attention to plurisexual individuals. Pair this with efforts to reduce minority stressors in care planning."}}],"initialOffset":10,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Self-Harm"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Self-Harm"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Self-Harm"}}}]]

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