BackgroundNon-suicidal self-injury (NSSI) is prevalent among nursing students and closely linked to alexithymia and emotional dysregulation. However, conventional total-score analyses treat alexithymia and cognitive emotion regulation strategies (CERS) as unitary constructs, obscuring dimensional associations across multiple strategies. Network analysis overcomes this limitation by modeling dimensions as interconnected nodes, identifying central and bridge dimensions, and enabling comparisons of network structure across groups. This study therefore applied network analysis to the alexithymia-CERS associations in nursing students with NSSI, focusing on gender differences.MethodsThis study surveyed 1,072 nursing students with NSSI using four instruments: a Sociodemographic Questionnaire, Diagnostic and Statistical Manual of Mental Disorders (5th edition), Toronto Alexithymia Scale, and Cognitive Emotion Regulation Questionnaire.ResultsIn the overall network, “difficulty identifying feelings” emerged as the most central node, exhibiting the highest strength centrality and serving as the primary bridge linking alexithymia to CERS. The network comparison test revealed significant gender differences in network structure. Strength centrality was highest for “refocusing on planning” in males but for “difficulty identifying feelings” in females, whereas bridge centrality was highest for “difficulty identifying feelings” in males but for “externally oriented thinking” in females.ConclusionsThis study delineates the associative network between alexithymia and CERS in nursing students with NSSI. The identified network patterns exhibit significant gender differences, suggesting distinct psychological mechanisms between males and females. Given the cross-sectional design, causal inferences cannot be drawn, and longitudinal studies are warranted to verify these pathways. Nonetheless, gender-specific profiles may inform future interventions targeting emotion regulation deficits in this population.
BackgroundAutism Spectrum Disorder (ASD) remains poorly understood in molecular pathogenesis, and lacks reliable peripheral biomarkers and targeted interventions.ObjectiveThis study aimed to identify cross-omics molecular signatures and core regulatory pathways in ASD by integrating serum transcriptomic and proteomic data from children with ASD and typically developing (TD) children.MethodsSerum transcriptomics and label-free data-independent acquisition (label-free DIA) quantitative proteomics were analyzed in 13 children with ASD and 13 age- and sex-matched TD controls. Differential expression analysis, functional enrichment, and two-way orthogonal partial least squares (O2PLS) multi-omics integration were performed. A valproic acid (VPA)-induced SH-SY5Y neuronal differentiation model was used to preliminarily validate the expression patterns of the Hippo signaling pathway and its downstream molecular events.ResultsWe identified 6,563 differentially expressed genes (DEGs, 94.2% upregulated) and 157 differentially expressed proteins (DEPs, 75.2% downregulated), which demonstrated widespread post-transcriptional dysregulation in ASD serum. Functional enrichment analyses highlighted aberrations in energy metabolism, ciliary function, and chemical perception. O2PLS integration nominated Fibronectin-1 (FN1) as a pivotal cross-omics target, with elevated transcription but reduced protein abundance. The Hippo signaling pathway emerged as a central regulatory hub, with core its components significantly downregulated at the mRNA level. In vitro experiments revealed that VPA-triggered neuronal dysregulation was accompanied by Hippo pathway gene suppression, FN1 transcriptional upregulation, and selective induction of interleukin-6 (IL-6), suggesting a putative Hippo-FN1-IL-6 regulatory axis.ConclusionPost-transcriptional dysregulation represents a prominent molecular feature of ASD serum. The proposed Hippo-FN1-IL-6 cascade may provide a mechanistic link between developmental signaling defects and neuroinflammation in ASD pathogenesis. FN1 holds potential as a candidate diagnostic biomarker and therapeutic target, yet its clinical utility and the underlying detailed regulatory mechanisms require further validation in independent large-scale cohorts.
AimThis study aimed to clarify the associations of multidisciplinary team (MDT) meetings during hospitalization with voluntary and involuntary psychiatric readmission, as well as the associations of patient and community staff participation in these meetings with readmission.MethodsWe conducted a multicenter cohort study across 21 psychiatric hospitals. Participants were patients admitted to psychiatric emergency or acute care wards and discharged within one year. Data were collected at admission, discharge, and 6 and 12 months after discharge. Exposures were MDT meetings during hospitalization and patient and community staff participation. Outcomes included three aspects of voluntary and involuntary readmission: readmission within 12 months, time to readmission (days), and total days of readmission. Mixed-effects logistic regression, Cox proportional hazards models, and mixed-effects linear regression models were used.ResultsOf 491 participants, 298 (60.69%) had MDT meetings during hospitalization. Compared with no MDT meetings, MDT meetings were associated with lower odds of voluntary readmission within 12 months (OR: 0.54, 95% CI: 0.32–0.92, p = 0.024) and a lower hazard of voluntary readmission (HR: 0.61, 95% CI: 0.40–0.94, p = 0.027) but not with involuntary readmissions. No significant associations were observed with total days of readmission. Patient or community staff participation showed no associations with readmission outcome.ConclusionMDT meetings during hospitalization may reduce the voluntary readmission rate and prolong the time to voluntary readmission within one year after discharge. Further research is required to evaluate the quality of meetings and the impact of patient and community staff participation in MDT meetings.
As technological advances have occurred in medicine, including improvements in rates of resuscitation, descriptions of near-death experiences (NDEs) have increased significantly. However, NDEs have been present within religious, literary, and biographical texts for centuries. The phenomenology of NDEs encompasses an inward journey wherein review of one’s life, seeing the dead, and an encounter with a spiritually powerful “being of light” may be reported. The subjective transformations that take place in survivors, as well as the insights generated from NDEs, can be linked with dimensions of the depressive position and Bion’s concept of O. The neurophenomenology of NDEs will be discussed, focusing primarily on neurotransmitter systems. Parallels and contrasts from psychedelic literature will also be explored. Drawing from these various dimensions, the concept of the infinity object will be outlined.
BackgroundDepersonalisation-derealisation (DPDR) is associated with trauma, but the relationship between conflict-related adverse experiences and DPDR remains unclear. The present study examined armed conflict-related trauma exposures, adverse childhood experiences, trauma-related comorbid psychopathology, and trauma appraisals as predictors of DPDR.MethodsAnalyses were conducted on data from 562 Colombian adults exposed to armed conflict across three waves, over 18 months. Three generalised linear mixed modelling frameworks were used: a two-step hurdle, including (i) a logistic model after recoding DPDR as binary, and (ii) a positive-part Gamma mixed model on non-zero DPDR scores; (iii) a Tweedie model. Predictors were entered sequentially as: Trauma exposure, adverse childhood experiences, DPDR-specific covariates, and trauma appraisals.ResultsAcross all models, armed conflict-related trauma exposure variables and adverse childhood experiences were not independently associated with DPDR, while non-DPDR dissociative experiences showed significant and positive associations with DPDR. Trauma appraisals did not predict DPDR presence or severity.ConclusionsThis was the first study to investigate DPDR in adults exposed to continuous and cumulative trauma related to armed conflict. Findings suggest that, in this population, DPDR was associated with broader dissociative experiences but not with cumulative trauma exposure or trauma appraisals, with important implications for theory and practice.
