Background Generalized Anxiety Disorder (GAD) is the most prevalent anxiety disorder during the perinatal period. Conducting systematic reviews and meta-analyses to evaluate interventions in medical research is often halted due to the variability of outcomes and outcome measurement instruments (OMIs) used in treatment studies. This scoping review aimed to identify whether heterogeneity exists across outcomes and OMIs in treatment studies for perinatal GAD. The outcomes identified in this review will inform the next phase of a core outcome set development for GAD interventions in the perinatal period, standardizing the key outcomes for measurement and reporting in treatment studies. Methods Studies were included if: 1) they were English from the years 2011 to 2025; 2) participants were in the perinatal period with a GAD diagnosis; and 3) the aim of the intervention was to treat GAD during the perinatal period. Three bibliographic databases were searched. Two reviewers independently screened studies for eligibility. Study characteristics and data were extracted. Results Of the 6447 records identified, 6 studies were included. The outcomes from the six studies were mapped to five core areas in Dodd et al.'s (2018) research outcome framework, yielding 13 distinct outcomes. The most reported outcome, anxiety symptoms, was measured by 4 different OMIs. Most outcomes were mapped to the physiological/clinical core area highlighting the lack of patient-centered outcomes. Limitations Limitations included a date restricted search, English-only articles and 139 studies being excluded due to not using a diagnostic assessment tool. Conclusions Heterogeneity exists across the outcomes and OMIs in studies assessing interventions for GAD during the perinatal period. To enable the synthesis, reproducibility and comparison of treatment studies, future research should standardize outcomes and OMIs which in turn will inform clinical practice guidelines and policies.

BACKGROUND:Attention-deficit/hyperactivity disorder (ADHD) is highly prevalent in adults with anxiety and related disorders (ARDs). Quantitative research on this clinical population is mixed, with some studies suggesting that anxiety is protective against some symptoms of ADHD and others in which co-occurring ARDs and ADHD are linked to poorer clinical and psychosocial outcomes. There are also several under-researched clinical challenges, including missed or misdiagnosis and confusion around best treatment practices. Importantly, yet to be investigated are client perceptions of the relationship between ARD and ADHD symptoms, as well as the unique challenges co-occurrence raises related to assessment and treatment. OBJECTIVES:The current study utilized a descriptive phenomenological approach to qualitatively investigate the lived experiences of adults with co-occurring ARDs and ADHD. DESIGN:Sixteen (N = 16) treatment-seeking adults at a specialized outpatient ARDs clinic participated in individual semi-structured qualitative interviews and completed a survey consisting of demographic, diagnostic and treatment history questions. METHODS:Qualitative data were transcribed verbatim, and Colaizzi's seven-step approach for descriptive phenomenological thematic analysis was used to extract themes. RESULTS:Six themes were found, with the most common ones being (1) it's complicated: perceived relationship between ADHD and anxiety symptoms, (2) diagnosis experiences: validation, surprise and integration and (3) system overload and polarizing experiences with symptoms and impairment. CONCLUSIONS:The current study provides insights on the shared perceptions individuals have on the interconnectedness of their symptoms of ARDs and ADHD, and implications for improving assessment and treatment practices to better suit the needs of this clinical population.

Background/Objectives: Anxiety disorders (ADs) affect up to 20% of mothers in the postpartum period, characterized by psychological symptoms (e.g., emotion dysregulation; ER) and physical symptoms (e.g., disrupted bodily awareness). Although Cognitive Behavioural Therapy effectively reduces anxiety and mood symptoms, it shows limited efficacy in addressing ER difficulties and rarely targets interoceptive dysfunction-both common in postpartum ADs. This study evaluates the effectiveness of a brief mindfulness-based intervention in improving anxiety, ER, and interoception in mothers with postpartum ADs. A secondary aim is to examine changes in brain connectivity associated with these domains. Methods: This protocol describes a proof-of-concept randomized controlled trial involving 50 postpartum mothers with ADs. Participants will be randomized to receive either a 4-week mindfulness intervention plus treatment-as-usual (TAU) or TAU alone. Participants in the mindfulness + TAU group will complete a virtual 4-week group intervention adapted from Mindfulness-Based Cognitive Therapy. The TAU group will receive usual care for 4 weeks and then be offered the mindfulness intervention. Self-report measures of anxiety, ER, and interoception will be collected at baseline, post-intervention, and at a 3-month follow-up. Resting-state functional MRI will be conducted at baseline and post-intervention to assess functional connectivity changes. This trial has been registered on ClinicalTrials.gov (NCT07262801). Results: Improvements in anxiety, ER, and interoception are anticipated, along with decreased default mode network, and increased salience network connectivity post-intervention is hypothesized. Conclusions: This study will be the first to examine the combined psychological and neural effects of mindfulness in postpartum ADs, offering a potentially scalable mind-body treatment.

Abstract Transition-aged youth (TAY) are vulnerable to experiencing mental health disorders, yet research is scarce on treatment outcomes for TAY receiving cognitive behavioural therapy (CBT), particularly for anxiety and related disorders. The present study aims to investigate whether there are differences in treatment outcomes for TAY relative to adults following completion of mixed-age disorder-specific CBT groups for social anxiety disorder (SAD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). A sample of 844 participants, including 232 TAY (aged 17–25) and 612 adults were compared on symptom specific measures (i.e. SPIN, GAD-7, Y-BOCS), group cohesion, attendance, drop-out rates, and general symptoms of low mood, stress, and anxiety (i.e. DASS-21) pre- and post-disorder specific CBT group treatment using linear mixed effects models. Although there were significant reductions in disorder-specific clinical symptoms and general symptoms of depression, stress, and anxiety in both TAY and adults from pre- to post-treatment, there were no significant differences between age groups in terms of treatment response, suggesting TAY responded as effectively as adults in mixed age treatment groups. There were no significant differences in terms of drop-out or group cohesion across age groups. TAY individuals had marginally lower attendance compared with adults, although this finding was not significant. These findings suggest that treatment as usual is effective in yielding significant improvement in anxiety and related symptoms across age groups. While these findings are encouraging for TAY who seek treatment, further research evaluating whether age-specific group CBT could enhance treatment outcomes for TAY is critical. Key learning aims (1) To increase clinician awareness of treatment considerations for transition-aged youth with anxiety and related disorders. (2) To learn about potential differences in treatment outcomes (i.e. symptom severity, attendance, and completion rates) of transition-aged youth receiving mixed-aged, disorder specific group cognitive behavioural therapy for anxiety and related disorders.

BACKGROUND:Generalized anxiety disorder during the perinatal period (pGAD) is highly prevalent and associated with adverse outcomes for both mother/birthing person (BP) and child. Yet, most treatment studies rely on researcher-selected outcomes that may not reflect patient priorities. OBJECTIVES:This study aimed to identify patient-oriented treatment outcomes for pGAD to inform the development of a core outcome set (COS). DESIGN:A qualitative study using focus groups was conducted in line with COMET and COREQ guidelines to capture patient perspectives on treatment outcomes. METHODS:Six semi-structured focus groups were conducted with participants who had a primary diagnosis of and participated in a cognitive behavioural therapy group for pGAD at the Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton. Discussions explored participants' experiences with perinatal anxiety, specifically which treatment outcomes were most important to them when seeking treatment for pGAD. Focus groups were audio-recorded, transcribed verbatim and analysed using thematic analysis with independent coding and consensus validation. RESULTS:A total of 21 participants (10 pregnant, 11 postpartum) were recruited. Three overarching themes were identified: (1) emotional well-being, (2) interpersonal and relational well-being and (3) daily functioning. Within these themes, the treatment outcomes most important to people with lived experience with pGAD were reported: increased self-awareness, management of distressing thoughts, partner relationship satisfaction, validation through support, improved sleep quality and overall quality of life. CONCLUSIONS:Patient-identified outcomes extend beyond symptom reduction and highlight the importance of psychological resilience, partner relationship satisfaction and functional recovery. Incorporating these outcomes into future treatment will enhance the relevance, comparability and clinical utility of interventions for pGAD, supporting the development of a patient-informed COS.

Preliminary clinical research supports the potential effectiveness of mindfulness-based interventions for obsessive-compulsive disorder (OCD). The current naturalistic community treatment study aimed to assess the comparative effectiveness of mindfulness-based cognitive therapy (MBCT) and cognitive behavioural therapy (CBT) and to explore whether the hypothesized treatment mechanisms in CBT and MBCT relating to improved clinical outcomes are distinct or overlap. Clinical participants (N = 245) in a university-affiliated specialty OCD assessment and treatment centre, with primary DSM-5 diagnosed OCD experiencing clinically significant obsessive-compulsive symptoms completed structured group interventions for CBT or MBCT and reported symptom, cognitive, and mindfulness ratings across treatment. The results indicated that both CBT (d = 1.64) and MBCT (d = 1.34) treatments produced clinically and statistically large and equivalent effects on the primary measure of obsessive-compulsive symptom severity. In the examination of putative treatment mechanisms, model fit was acceptable, and results supported the hypothesized cross-lagged associations between change in obsessive beliefs and symptom reduction in CBT, and cross-lagged associations between change in self-compassion and symptom reduction in MBCT. These results provide preliminary evidence for the effectiveness of mindfulness-based interventions in OCD and point to the possibility of specific treatment mechanisms distinct from CBT, although this will require further examination in randomized controlled trials.

BACKGROUND:Cognitive behavioural therapy (CBT) is the first-line treatment for anxiety and related disorders. Limited research has explored long-term outcomes following CBT for anxiety-related disorders in naturalistic settings, particularly for generalized anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). AIMS:This study examined long-term outcomes and attrition after group CBT for GAD, SAD, and PTSD in a naturalistic sample. Across disorders, it was hypothesized that gains would be maintained long-term, with a gradual return of clinically relevant symptoms observed at later follow-up points. METHOD:Data were collected from individuals completing CBT at a tertiary anxiety treatment clinic. Symptom changes pre- to post-treatment and over a 2-year follow-up were examined, as well as the influence of baseline depressive symptoms on change over time. Worry, social anxiety, and post-traumatic stress symptoms were assessed at pre- and post-treatment and 3, 6, 9, 12, and 24 months. RESULTS:On average, symptom improvements were maintained over the 2-year follow-up for all disorders. Higher pre-treatment depression was associated with greater symptom severity throughout the study but generally did not affect the magnitude of symptom change. The exception was PTSD, where baseline depression was also associated with changes in symptom severity across the whole study period. This effect was not observed for those with SAD and GAD. Attrition was high across the follow-up period. CONCLUSION:This study provides preliminary evidence for the long-term efficacy of CBT in a naturalistic setting. It also highlights challenges with retaining clients in long-term follow-up in naturalistic settings.

Objective: Postpartum anxiety is common, often underrecognized, and associated with numerous negative outcomes for both the perinatal individual and their infant. Despite its high prevalence and burden, research focused on preventative strategies for postpartum anxiety remains very limited. This study investigated whether a 6-week cognitive behavioral therapy protocol targeting intolerance of uncertainty (CBT-IU) during pregnancy could reduce risk for postpartum anxiety disorders among individuals with heightened intolerance of uncertainty (IU). Methods: In this investigator-initiated, single-site, proof-of-concept, randomized controlled trial (RCT), eligible participants (n=37), between 14 and 32 weeks' gestation, with heightened IU (baseline score of ≥64 on the 27-item Intolerance of Uncertainty Scale) were randomized to a 6-session individual CBT-IU or care as usual (CAU), of whom 35 completed measures and were included in analyses. The primary objective of this study was to evaluate whether CBT-IU for pregnant individuals with elevated IU could reduce the risk of postpartum anxiety disorder compared to CAU. Secondary outcomes included changes in worry, depression, and emotion regulation. Results: CBT-IU significantly reduced the risk of postpartum anxiety disorder onset compared to CAU (P<.001), with none of the participants in the CBT-IU group meeting diagnostic (or provisional) criteria for an anxiety or related disorder, compared to 31.6% of participants in the CAU group. CBT-IU participants showed clinically significantly reductions in IU (P=.003), worry symptoms (P<.001), emotion dysregulation (P=.018), and interviewer-rated anxiety symptoms (P<.001) compared to CAU. Treatment satisfaction among CBT-IU participants was high. Conclusion: These findings suggest that targeting IU during pregnancy may be an effective preventive strategy for reducing the risk of postpartum anxiety disorder onset. This proof-of-concept RCT supports a large-scale RCT to ultimately test CBT-IU as an effective intervention for prevention of postpartum anxiety disorders. Trial Registration: ClinicalTrials.gov identifier: NCT05691140.

IntroductionHealthcare workers (HCWs) have reported COVID-19 pandemic-related adverse mental health impacts. We examined the demographic profile of HCWs who self-referred for mental health treatment, how referrals changed over time in relation to waves of COVID-19, what the main problem was for which HCWs sought treatment, and how this changed during the pandemic. MethodsFive major healthcare institutions provided mental health supports to HCWs across Ontario during the pandemic. Data from May 2020 to March 2022 were collected from 2725 HCW self-referrals regarding referral frequency, main presenting mental health problem and demographic information including ethnicity, gender, age, healthcare setting, profession and whether the HCW had a prior mental health diagnosis or had received prior mental health treatment. ResultsTreatment-seeking HCWs who self-referred predominantly self-identified as female and White. Almost half were nurses, and almost half had received previous mental health treatment; a slightly higher percentage reported a prior mental health diagnosis. Over 60% of the overall sample of HCWs worked in hospitals. The timing of increases and decreases in monthly new referrals roughly aligned with the onset and ending, respectively, of COVID-19 waves. The top five most common presenting problems for treatment-seeking were generalized anxiety/worry symptoms, depression, situational crisis/acute stress response, difficulty with stress/occupational or financial, and posttraumatic stress symptoms. ConclusionOntario HCWs self-referred to access mental health supports during the COVID-19 pandemic. The majority sought treatment for generalized anxiety/worry or depression symptoms. Results of this study may inform system planning for future pandemics, as well as for HCW wellness programs for continued workplace stress in the postpandemic period.

Generalized anxiety disorder (GAD) is common during the perinatal period. Since its inception, substantial efforts have been put forth to improve the specificity and interrater reliability of GAD. More recently, increased attention has been given to the behavioral features of GAD, with evidence to suggest that hypervigilance, checking, and avoidance may be particularly relevant. It is unknown however if these behaviors lead to improved classification and understanding of GAD. The present study examines: (1) the proportion of perinatal individuals with and without GAD who endorse hypervigilance, checking and avoidance; (2) interrater reliability of GAD during the perinatal period; (3) whether inclusion of hypervigilance, checking, and avoidance in GAD diagnostic criteria leads to improved interrater reliability; and (4) if hypervigilance, checking and avoidance significantly predict GAD diagnostic status beyond current features of the disorder. Thirty-eight perinatal women, who were predominantly white and highly educated were randomized to one of two assessors to complete a semi-structured diagnostic assessment. Interviewers queried about the presence of current mental health disorders and engagement in behaviors of interest. Each assessment was independently rated by three assessors. More participants with GAD reported engaging in hypervigilance, checking, and avoidance than those without GAD. Interrater agreement of GAD diagnoses was excellent (κ = 0.91). Inter-rater agreement of GAD diagnoses was comparable (κ = 0.92) when checking was included in the diagnostic criteria of GAD. Checking also significantly predicted GAD diagnostic status beyond existing features of the disorder. These results support continued evaluation of the role of checking in GAD.

Transgender and gender diverse (TGD) individuals are at risk of increased exposure to minority stressors leading to heightened vulnerability for psychopathology. However, few studies have directly explored minority stress as a treatment target using a traumafocused approach among TGD individuals. This pilot study examined treatment acceptability, feasibility, and effectiveness outcomes of Transcending, a 12-week trauma-focused, minority stress-based cognitive behavioural therapy (CBT) group for TGD individuals. A pre-post design was employed with a naturalistic sample of TGD emerging adults (17-25 years old) (N = 22). Feasibility, acceptability, and treatment effectiveness were explored, as well as minority stress factors, psychological distress, resilience, and hopefulness. There were high rates of participation and treatment completion. Participants regarded their group experiences as highly positive, leading to increased confidence in themselves and pride in their identity. All proximal stressors significantly decreased, and all resilience factors significantly increased from pre- to post-treatment. In addition, anxiety significantly decreased, and hopefulness significantly increased over treatment. This study provides preliminary support for Transcending CBT for TGD individuals experiencing minority stress and supports next steps of examining the intervention efficacy in a large randomized controlled trial. This intervention has potential to address a major gap in the care needs of TGD individuals.

Group cognitive-behavioral therapy (CBT) has facilitated increased accessibility to treatment for anxiety disorders, and previous research shows that group cohesion is an important predictor of group-CBT for social anxiety disorder (SAD). Less is known about the differential effects of group cohesion across treatment for anxiety disorders. We examined the link between group cohesion and posttreatment symptoms across group-CBT for a range of anxiety disorders. Participants were adults with a principal diagnosis of SAD (n = 119), generalized anxiety disorder (GAD; n = 162), obsessive compulsive disorder (OCD; n = 61), panic disorder or agoraphobia (PDA; n = 56), and posttraumatic stress disorder (PTSD; n = 100), who were participating in group CBT for their respective principal diagnosis. Diagnostic status was determined using the Diagnostic Assessment Research Tool (DART), and self-report measures of social anxiety, worry, OCD, panic, and PTSD symptoms were administered at baseline and post-treatment. Group cohesion was assessed at the midpoint of treatment. Group cohesion was significantly associated with treatment outcome for SAD, above and beyond baseline symptom severity. Group cohesion was not significantly associated with outcome for participants with GAD, OCD, PDA, or PTSD. Considering that individuals with SAD are particularly sensitive to scrutiny and evaluation from others, interpersonal processes such as group cohesion may be particularly helpful in facilitating treatment outcomes for this population, relative to other disorders.

Les travailleurs de la santé ont fait état d’effets néfastes sur leur santé mentale dus à la pandémie de COVID-19. Nous avons exploré le profil sociodémographique des travailleurs de la santé ayant demandé par eux-mêmes à recevoir des soins de santé mentale, l’évolution des demandes de traitement au fil des vagues de COVID- 19, la nature des principaux problèmes ayant motivé les demandes et leurs changements lors de la pandémie. Cinq grands établissements de santé de l’Ontario ont fourni du soutien en santé mentale aux travailleurs de la santé pendant la pandémie. Des données ont été recueillies à partir de 2725 demandes de traitement présentées par des travailleurs de la santé entre mai 2020 et mars 2022, à savoir la fréquence des demandes, les principaux problèmes de santé mentale ayant motivé les demandes et divers renseignements sociodémographiques (l’origine ethnique, le sexe, l’âge, le milieu de travail, la profession et l’obtention antérieure d’un diagnostic ou d’un traitement pour un problème de santé mentale). Les travailleurs de la santé qui ont demandé à recevoir du soutien étaient en majorité des femmes et des personnes blanches. Près de la moitié d’entre eux faisaient partie du personnel infirmier. Près de la moitié avaient déjà été traités pour un problème de santé mentale et un pourcentage légèrement plus élevé avait déclaré un diagnostic antérieur de problème de santé mentale. Plus de 60 % des répondants de l’échantillon travaillaient en milieu hospitalier. Le moment des augmentations et des diminutions du nombre mensuel de nouvelles demandes coïncidait approximativement avec respectivement le début et la fin des vagues de COVID-19. Les cinq principaux problèmes à l’origine des demandes de traitement étaient les symptômes d’anxiété généralisée ou d’inquiétude, la dépression, une crise situationnelle ou une réaction aiguë à un facteur de stress, la difficulté à gérer le stress (professionnel ou financier) et des symptômes de stress post-traumatique. Des travailleurs de la santé ont demandé par eux-mêmes à recevoir du soutien en santé mentale pendant la pandémie de COVID-19 en Ontario. La majorité d’entre eux voulaient obtenir un traitement pour des symptômes d’anxiété généralisée, d’inquiétude ou de dépression. Les résultats de cette étude pourraient éclairer la planification du réseau en vue des pandémies futures, ainsi que la planification des programmes de mieuxêtre destinés à aider le personnel de santé à faire face au stress en milieu de travail en période post-pandémique.

OBJECTIVE:Minority stress refers to the chronic stressors (i.e., discrimination, victimization, internalized stigma) that marginalized individuals experience, which increase the risk of psychopathology. Minority stress experiences are rarely considered during diagnostic assessment due to challenges in clinical application, as clinicians may not know what questions to ask or may hesitate to ask about identity-based experiences. To address this need, the Minority Stress Module (MSM) was developed for the Diagnostic Assessment Research Tool to facilitate minority stress assessment. An overview of its development and implications for diagnostic assessment are presented. METHOD:The development of the MSM was led by a team with expertise in minority stress and diagnostic assessment. Item development was guided by: (a) Meyer's (2003) Minority Stress Model and associated research; (b) the team's experience providing care to equity-denied individuals; and (c) insights from consultation with members of equity-denied groups. RESULTS:The MSM is a brief semistructured interview consisting of 13 questions related to symptoms, experiences, and resilience factors associated with minority stress. The MSM aims to improve therapeutic rapport, case conceptualization, diagnostic decision making, and treatment planning when working with individuals from equity-denied groups. CONCLUSIONS:Integrating minority stress assessment into diagnostic assessment is critical for developing diagnostic impressions and tailored treatment recommendations that consider contextual information. The MSM can facilitate this process, and its inclusion in the Diagnostic Assessment Research Tool will improve clinicians' access to a standardized minority stress assessment tool for clinical practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BACKGROUND:One of the most effective treatments for social anxiety disorder (SAD) is cognitive behavioural therapy (CBT). Prior research indicates group cohesion is connected to treatment success in group CBT for SAD (CBGT). Videoconference CBGT delivery is now common following the COVID-19 pandemic; however, research investigating treatment outcomes and group cohesion in videoconference CBGT for SAD is limited. AIMS:The present study aimed to compare group cohesion in videoconference CBGT for SAD to group cohesion in both in-person CBGT for SAD and videoconference CBGT for other anxiety and related disorders. A secondary aim was to compare symptom reduction across all three groups. METHOD:Patients completed a 12-week CBGT program for SAD in-person (n=28), SAD via videoconference (n=46), or for another anxiety or related disorder via videoconference (n=100). At mid- and post-treatment patients completed the Group Cohesion Scale Revised (GCS-R), and at pre- and post-treatment patients completed the Social Phobia Inventory (SPIN, only in the SAD groups) and the Depression Anxiety Stress Scales (DASS-21). RESULTS:Over the course of treatment, all three groups showed a significant increase in cohesion and a significant decrease in symptoms (ηp2 ranged from .156 to .562, all p<.001). Furthermore, analyses revealed no significant difference in cohesion scores between groups at both mid- and post-treatment. CONCLUSIONS:These results suggest that videoconference CBGT for SAD is similarly effective in facilitating cohesion and reducing symptoms compared with in-person delivery. Limitations of the study and implications for treatment are discussed.

Mindfulness-based interventions (MBIs) have received great attention in both healthy and clinical populations, with recent studies supplementing self-report and behavioural outcomes with neurobiological evidence. This paper reviewed the impact of MBIs on the neuroplasticity of healthy populations, and those with depression, bipolar disorder, generalized anxiety disorder, social anxiety disorder, and post-traumatic stress disorder. A literature search across Web of Science and PsycINFO was conducted, including studies published from inception to June 2024. MBIs have been associated with neuroplasticity primarily in the default mode network, salience network, and central executive network in both clinical and non-clinical populations, evidenced by distinct changes in resting-state and task-based activity and functional connectivity. These changes correspond to improvements in emotion regulation, bodily awareness, attentional control, and executive function, which are often consistent with self-report measures. These findings suggest a promising multifaceted psychotherapeutic approach to improving the wellbeing of healthy individuals as well as mitigating psychopathology. Though neural signatures of MBIs are emerging, further studies examining mindfulness are needed to validate the precise neurobiological mechanisms with improved methodological rigour. This study is not preregistered.

Parenting plays an important role in children’s emotion regulation (ER) development. Parent-mediated interventions, preventative approaches that equip caregivers with skills to enhance their children’s emotional, behavioural, or developmental outcomes, have emerged as a promising strategy to address difficulties in child ER, particularly during the early to middle childhood years (Morawska et al., 2019). This narrative review synthesized studies evaluating the effectiveness of parent-mediated preventative interventions aimed at enhancing ER in children aged 0–12 years. A search across three databases yielded 3189 articles, with 24 studies retained after applying inclusion criteria. Key interventions included Tuning in to Kids, Incredible Years, Parent-Child Interaction Therapy, Family Check-Up, and Triple P – Positive Parenting Program. While the interventions varied in design, all included a parental and child ER element (albeit using varied terminology to describe it), providing caregivers with skills to regulate their emotions, engage in effective parenting practices, and model healthy ER behaviours. Despite these promising outcomes, significant methodological limitations, such as inconsistent and imprecise measurement of ER and limited research on middle childhood, restricted a comprehensive understanding of the impact of these interventions. Future research should incorporate rigorous and comprehensive ER assessments and expand the focus of inquiry to include children in middle childhood to addressing the identified gaps in current literature and further promote adaptive ER development in children.

LAY SUMMARY Public safety personnel (PSP), like police officers, firefighters, and paramedics, often face stressful situations at work in which their moral values are violated. These experiences place PSP at risk for moral injury. Moral injury is a type of mental health experience that can greatly affect how someone feels and behaves. This study aimed to understand whether and how moral injury relates to different coping methods and supports that PSP may regularly use. The results showed that organizational support, spiritual well-being, self-compassion, and social support were each associated with less moral injury. These results will help inform prevention and intervention strategies for PSP experiencing moral injury.

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the gold-standard tool for measuring obsessive compulsive symptom severity. An updated second edition was introduced to address limitations of the original instrument, with both clinician-administered and self-report versions. No published studies have examined the psychometric properties of the self-report version, which is the purpose of the current study. Individuals with a diagnosis of obsessive-compulsive disorder (OCD, N = 67) completed the clinician-administered and self-report Y-BOCS-II, as well as a number of other self-report measures assessing obsessive-compulsive symptoms, depression, and impairment from symptoms in a counterbalanced order. Results suggest an internally consistent measure (alpha = .90) that has strong convergent validity with measures of OCD symptoms including the clinician- rated Y-BOCS-II, but only moderate correlations with the Obsessive-Compulsive Inventory-Revised. The self- report version also demonstrated fair discriminant validity. A reliable change index of 8 was found for this measure, which was associated with a large effect size following cognitive-behavioral therapy for OCD. Limitations include a predominantly White and female sample. The self-report version of the Y-BOCS-II appears to be a psychometrically reasonable measure for use with individuals with OCD though its ability to discriminate OCD from other disorders characterized by anxiety or depression requires further study.