Artificial intelligence is entering psychedelic-assisted therapy (PaT) through at least two channels, pre-licensure facilitator training simulators and in-session administrative tools. This arrival is occurring in a context where relational factors, those interpersonal considerations between patients and providers, are not incidental but highly impactful. A 2025 international Delphi consensus study formally recognized therapeutic alliance, participant trust, and study personnel qualifications as reportable determinants of psychedelic trial outcomes. This paper uses PaT as a limit case for AI-mediated relational competence, a six-part construct originally developed for the standard clinical encounter, to test whether it holds, strains, or requires revision under conditions of altered consciousness and heightened vulnerability. Two live examples anchor the analysis: an AI simulation platform for facilitator training and ambient-AI documentation tools now used in ketamine-assisted psychotherapy. The construct's empathic-presence and relational-judgment components largely hold, and are arguably intensified, in this setting. Trustworthiness, transparency, accountable-decision-making, and equity-aware components strain against PaT's altered-consciousness context, as does its fragmented accountability infrastructure and its own documented history of racial and cultural inequity. The paper closes with a policy question. Absent an accreditation infrastructure comparable to accredited medical education, should a privately developed AI platform become the de facto standard for facilitator competency certification?

We introduce a new instrument called the Golden Mean Inventory (GMI). Founded on the proposition that the evaluation of underuse or overuse of character strengths represents an important extension of the understanding and applied use of character strength concepts, the GMI was developed as a 72-item instrument addressing underuse/optimal use/overuse in each of the 24 VIA character strengths in three contexts: work/school, relationships, and goal pursuit. Four a priori hypotheses were largely supported. Relationships with demographic variables were generally negligible. We envision a number of benefits from the GMI, including a model that effectively integrates concepts of positive and negative functioning, idiographic assessment appropriate for applied settings, and context-specific patterns of strengths use. The evidence provided here raises important questions about whether high scores on measures of positive functioning combine individuals who are operating in a highly effective manner with others who are demonstrating “too much of a good thing.”

In the United States, approximately two-thirds of children will be exposed to a traumatic event by the age of 16. Experiencing trauma can impact domains of positive development that may affect functioning at school. These challenges can alter learning and lead students to require a comprehensive psychoeducational assessment to determine if additional services are necessary in the school setting. Common assessment practices are often deficit-based and do not provide insights into areas of strength. Though strengths-based assessments exist, they lack a key component of strengths, character strengths. Character strengths provide insight into pathways that can foster well-being, positive relationships, and academic success. This study aimed to develop a trauma-informed assessment of student character strength usage, a teacher report, for use with primary through secondary students to examine a student’s character strength usage at school. A mixed methods design was used, including a comprehensive literature review, focus group with educators, expert feedback, cognitive interviews with teachers, and a pilot study. The final Character Strengths Usage Profile for Students (CSUP-S) version consisted of 33 items measuring 11 character strengths identified best to assess student character strength usage from a trauma-informed lens. The preliminary validation sample consisted of 47 K-12 general education teachers who completed several surveys for a subset of students (n = 221) who represented 14 school districts in the United States. A CFA was tested on a first- and second-order model, with the first-order model exhibiting an acceptable fit. Findings suggest the CSUP-S demonstrates an adequate first step toward demonstrating evidence of content validity and construct validity. Several considerations for the next steps in instrument development are provided.

ABSTRACT Why do members of Congress collaborate on legislation in an era of intense partisan polarization? This paper argues that shared exposure to pressing, district‐level policy problems can motivate cross‐party collaboration, particularly in a policy area that cuts across traditional ideological divides. Focusing on the case of the opioid crisis, I develop the importance of shared problem status in driving cosponsorship of opioid‐related legislation. That is, when legislators represent similarly affected constituencies, they are more likely to cosponsor opioid‐related legislation, even when they differ in party or ideology. While existing research often treats cosponsorship as a function of social networks or institutional proximity, there are clear incentives for members to respond to issue areas that reflect local problem severity. Using dyadic data on bill cosponsorship in the House and Senate from portions of the 112th through the 116th congresses (2012–2019), I find that member pairs with each legislator representing districts with high opioid death rates are significantly more likely to collaborate on opioid legislation. These findings suggest that geographically distributed policy crises can open space for bipartisan cooperation, even in an otherwise gridlocked Congress.

This article examines how federalism shapes US public health crisis responses, emphasizing that policy divergence across states creates negative spillovers that undermine effectiveness. It develops a framework arguing that policy congruence among neighboring states is key to health outcomes. Applying this to opioid mortality (2009–2016), the study finds that states aligning regulations—such as Prescription Drug Monitoring Programs—experience fewer cross-border opioid flows and lower mortality. By focusing on horizontal policy diffusion rather than federal mandates, this research shows how federalism can enhance coordination under certain conditions. These findings refine our understanding of state sovereignty, policy diffusion, and health outcomes, suggesting that shared policies help mitigate the pitfalls of fragmented governance.

OBJECTIVE:This study estimates and compares variation in the probability of child unmet need for mental health care and difficulties accessing care for each state in the United States. Estimates are also generated and compared for three socioeconomic and demographic subgroups nationwide: racial and ethnic group, household income, and insurance type. METHODS:Using a retrospective, cross-sectional design, this study pooled 2016-2019 National Survey of Children's Health data. National, state, and subgroup adjusted probabilities of caregiver-reported child unmet need for mental health care and ease of access to mental health care were generated from logistic regression models with marginal post-estimation. RESULTS:Adjusted national probabilities of caregiver-reported child unmet mental health need and difficulty in accessing care were 0.21 and 0.46, respectively. State probabilities of unmet need ranged from 0.08 to 0.32. One state was significantly above the national estimate; nine states were below it. State probabilities of difficulty accessing mental health care ranged from 0.28 to 0.57; nine states' probabilities were significantly below the national estimate and two states were significantly above it. Estimates of unmet mental health need and difficulty accessing care varied more widely across states than across racial or ethnic groups, income groups, insurance groups. CONCLUSIONS:Geographic inequities in children's mental health care access persist; in some cases, they are larger than sociodemographic inequities.

Assessment of eating disorders (ED) in youth relies heavily on self-report, yet persistent lack of recognition of the presence and/or seriousness of symptoms can be intrinsic to ED. This study examines the psychometric properties of a semi-structured interview, the parent version of the Eating Disorder Examination (PEDE), developed to systematically assess caregiver report of symptoms. A multi-site, clinical sample of youth (N = 522; age range: 12 to 18 years) seeking treatment for anorexia nervosa (AN) and subsyndromal AN were assessed using the Eating Disorder Examination (EDE) for youth and the PEDE for collateral caregiver report. Internal consistencies of the four PEDE subscales were on par with established ranges for the EDE. Significant medium-sized correlations and poor to moderate levels of agreement were found between the corresponding subscales on each measure. For the PEDE, confirmatory factor analysis of the EDE four-factor model provided a poor fit; an exploratory factor analysis indicated that a 3-factor model better fits the PEDE. Findings suggest that the PEDE has psychometric properties on par with the original EDE. The addition of the caregiver perspective may provide incremental information that can aid in the assessment of AN in youth. Future research is warranted to establish psychometric properties of the PEDE in broader transdiagnostic ED samples. Assessments for eating disorders rely primarily on self-report; yet, the denial of symptoms or symptom severity among adolescents with anorexia nervosa can complicate assessment and delay treatment in this population. The Parent Eating Disorder Examination (PEDE) is the first semi-structured interview formally developed to improve childhood eating disorder assessment by including caregiver perspectives. In this study, a large sample of adolescents with anorexia nervosa completed a self-report interview (the Eating Disorder Examination or EDE) and their parents completed the PEDE. The PEDE appeared to measure parents’ report of their child’s eating disorder symptoms consistently. Results from both interviews were related to one another but did not completely agree. This suggests that in an eating disorder assessment, the PEDE can provide additional information from caregivers that might reduce diagnostic confusion and lead to earlier intervention for youth with anorexia nervosa.

This study extends a previous one revising the VIA-Youth. Goals of the revision included reducing length and extending age range down to 8. After an initial revision, further discussion suggested the need for a more secular version of the spirituality scale. Based on evidence of changes in the understanding of spirituality during adolescence, separate sets of candidate items were generated for ages 8-12 and 13-17 with two overlapping items. The revised materials were administered to 94,487 youth online and through two school districts. Retaining the two overlapping items in both sets did not reduce fit. The result is two versions of the inventory for ages 8-12 (VIA-Y-1) and 13-17 (VIA-Y-2) that differ only on two items included in the spirituality scale. These offer a measure of spirituality in youth that is developmentally sensitive without relying on items referencing a religious framework.

Intergenerational political socialization is alive and well in the polarized American polity. But, by what mechanism do parental views transmit to children? We develop a theory ( dyadic social learning theory) which posits the importance of dyadic familial communication in facilitating attitudinal concordance between parents and children. Using original survey data of 1,048 dyadic pairs of American parents and middle school-aged children, we develop a novel measure of political perception that combines the perceptive accuracy of parents with the perceptive accuracy of their children. This measure of parent-child alignment, which we argue signals quality communication in families, is a powerful determinant of parent-child congruence on political views and emotions, particularly polarization. When a dyadic pair accurately perceives each other politically, the likelihood of congruent views and shared polarization increases. This research has implications for how we understand political transference of polarized views, and for broader theories of how children are socialized into the political world. It also suggests that solutions to polarization will have to address the role of parents in initiating polarization.

To examine the association between psychologist and nurse practitioner scope-of-practice (SoP) regulations and pediatric mental health service access. A nationally representative sample of children with mental health needs was identified using 5 years of National Survey of Children’s Health (2016–2020). Utilization was measured in two ways: (1) unmet mental health care needs and (2) receipt of mental health medication. Expanded SoP for psychologists and nurse practitioners was measured based on the child’s state of residence and the year of the survey. The associations between both SoP expansion and both outcomes were assessed using logistic regression models adjusted for multiple covariates. The probability of having unmet mental health needs was 5.4 percentage points lower (95% CI − 0.102, − 0.006) for children living in a state with psychologist SoP expansion; however, there was no significant difference in unmet mental health needs between states with and without NP SoP expansion. The probability of receiving a mental health medication was 2.0 percentage points higher (95% CI 0.007, 0.034) for children living in a state with psychologist SoP expansion. Conversely, the probability of receiving a mental health medication was 1.5 percentage points lower (95% CI − 0.023, − 0.007) for children living in a state with NP SoP expansion. Expanded SoP for psychologists is associated with improved access to pediatric mental health care in terms of both unmet need and receiving medication. Expanded SoP for NPs, however, was not associated with unmet need and lower receipt of medication.

To examine the association between scope-of-practice (SoP) regulations and racial disparities in pediatric mental health services. We used the National Survey of Children’s Health (2016–2020; n = 33,790) to examine racial disparities in unmet mental health care needs and receipt of mental health medication between states with and without SoP expansions for psychologists and nurse practitioners (NP). Our primary outcomes were (1) unmet mental health care needs and (2) receipt of mental health medication. We examined heterogeneous treatment effects of SoP expansion on the outcomes using logistic regression with interaction terms between SoP expansion and race/ethnicity. We estimated population-level racial disparities for both outcomes stratified by SoP expansion to identify differences in racial disparities. The psychologist SoP expansion-associated reduction in unmet need was 15.8 percentage-points (CI= -25.3, -6.2) larger for Other-race children than for White children. The psychologist SoP expansion-associated increase in medication was 5.1

The VIA-Youth (Park & Peterson, 2006) is perhaps the most commonly administered youth measure of the Peterson and Seligman (2004) character strengths. This article is the first in a series describing revision of the VIA-Youth, with the goals of making the development process more transparent, targeting scale unidimensionality, achieving measurement invariance, and extending the age range to 8-17. A sample of 286 youth in three countries completed 198 candidate items, from which a 98-item inventory was developed. Ratings of strengths were provided for 250 of the youth by 202 parents and 164 teachers. The relative size of relationships between informants was related to youth age, and to ratings of the observability and evaluativeness of the strengths, in the expected direction. The findings suggest youth self-report of character strengths and ratings by significant others are not highly related, but are consistent with prior studies of informant convergence in youth ratings.

To describe the characteristics of patients receiving psychotropic medication from prescribing psychologists, psychiatrists, and primary care physicians. This descriptive study was conducted using private insurance claims of patients from New Mexico and Louisiana receiving psychotropic medications (anticonvulsants, antidepressants, antipsychotics, hypotensive agents, anxiolytics/sedatives/hypnotics, and stimulants) from 2004 to 2021 (N = 307,478). Patient characteristics were captured during the 6 months prior to their first psychotropic medication using administrative information, diagnosis and procedure codes, and medication data. Logistic regression models estimated the associations of patient characteristics with prescriber type. Additional logistic regression models estimated the association of prescriber type with medication classes prescribed. Patients were most likely to see specialists (psychologists or psychiatrists) if they had bipolar disorder (average marginal effect and 95% CI 0.214 [0.196, 0.231]), schizophrenia/psychotic disorders (0.118 [0.097, 0.138]), or had 1-4 visits of psychotherapy (0.267 [0.258, 0.026]). Specialist patients were most likely to see a prescribing psychologist if they had 1-4 visits of psychotherapy (0.196 [0.183, 0.210]) or had insomnia (0.309 [0.203, 0.415]). Prescribing psychologists were more likely to prescribe antidepressants (0.028 [0.011, 0.045]) and less likely to prescribe antipsychotics (-0.016 [-0.020, -0.012]) than psychiatrists. Primary care physicians were less likely to prescribe all psychotropic medications except antidepressants (0.011 [0.002, 0.019]) and anxiolytics (0.074 [0.067, 0.080]). Prescribing psychologists treat patients who are more similar to those of psychiatrists than patients of primary care physicians; they are less likely to prescribe antipsychotics and more likely to prescribe antidepressants.

This paper explores the speed of rulemaking in American state governments. Drawing on a unique data set of over 250,000 individual rules issued by states from 1993 through 2009, we introduce new measures of the speed and breadth of rulemaking in American state bureaucracies, providing a new way of evaluating the incidence of rulemaking delay within and across governments. We focus specifically on how professionalism and oversight powers of state legislative and executive branches affect rulemaking speed and find that states with more professionalized legislatures and governments with extensive legislative/executive oversight powers experience greater delays in rule adoption. These findings provide important new insights into the politics of regulatory delay and suggest disparate ways in which sub-national governments approach regulatory policymaking in a federal system.

BackgroundThe Global Resilience Oral Workshops (GROW) Free and Strong programs take a strengths-based, positive youth development (PYD) approach to promoting thriving. Through both prevention (GROW Strong) and intervention (GROW Free) exercises, these programs aim to build character and emotional resilience while also lowering unhealthy alcohol use.ObjectiveTo meaningfully assess the impact of the GROW programs on health and PYD, ecologically and psychometrically valid measures of character strengths were needed, with a focus on the strengths of hope, forgiveness, spirituality, prudence, and self-control (self-regulation) promoted by GROW.MethodWe tested a series of exploratory and confirmatory factor analyses of these five key constructs using two samples: a school-based youth sample enrolled in GROW Strong (n = 460; Mage = 15.04 years, SDage = 1.21; 53.0% female); and a community-based adult sample enrolled in GROW Free (n = 457; Mage = 20.60 years, SDage = 1.88; 49.7% female); both enrolled using a waitlist-control design.ResultsMeasures demonstrated strong invariance across specific subgroups present in the data sets, with differences emerging across ages, urban/rural locations, and baseline study conditions.ConclusionsTo meaningfully document PYD programs and character development in the majority world, measurement models must be theory-predicated, robust, and empirically validated for the specific context. The results provide evidence for such a measure that will be useful in future intervention studies promoting character strengths to address unhealthy alcohol use in Zambia.

This article builds on two previous ones describing revisions of the VIA-Youth. The new revised version consists of 98 items. The inventory is considered appropriate for ages 8-17. A unique aspect of the revision is that the two items on the spirituality scale differ for youth ages 8-12 (VIA-Y-1) and 13-17 (VIA-Y-2). Participants in this study consisted of 94,487 youth who completed the revised VIA-Youth online or through two school districts. Unidimensionality is established for all 24 character strength scales, though doing so required freeing a small set of error covariances. Configural and metric invariance for age and gender was achieved for all scales, and scalar invariance was supported by age for all scales except for spirituality. This series of three articles presents the most thoroughly vetted measure of positive personality in youth to date.

This study aimed to compare patient outcomes between prescribing psychologists, psychiatrists, and primary care physicians (PCPs). Private insurance claims (2005-2021; n = 307,478) were used to conduct an active comparator, new user longitudinal cohort study developed using target trial emulation. Inverse propensity for treatment weighting was used to adjust for baseline differences in a range of sociodemographic, clinical, and contextual patient factors. Differences in the 1-year rate of health care visits for adverse drug events (ADEs), psychiatric emergency department (ED) utilization, medication adherence, and psychotropic polypharmacy were identified between prescribing psychologists and the other provider types using doubly robust Cox proportional hazards models. Compared to patients of psychiatrists, patients of prescribing psychologists had a 24% lower rate of ADEs (95% CI [0.60, 0.96]), a 20% lower rate of psychotropic polypharmacy (95% CI [0.74, 0.86]), and similar rates of psychiatric ED utilization and medication nonadherence. Compared to patients of PCPs, patients of prescribing psychologists had 138% higher rates of psychiatric ED utilization (95% CI [1.67, 3.39]), 175% higher rates of psychotropic polypharmacy (95% CI [2.53, 2.99]), 28% lower rates of medication nonadherence (95% CI [0.66, 0.78]), and similar rates of ADEs. Using robust pharmacoepidemiological methods, we noted that among mental health specialists, prescribing psychologists appear to be as safe and efficacious as psychiatrists in a large sample of privately insured patients. Notable differences in safety and efficacy when compared to PCPs may be attributable to differences between specialty and primary care. Future research on prescribing psychologists should move toward studies of care quality. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study simulated the impact of granting prescriptive authority to licensed psychologists on shortages of mental health providers with prescriptive authority. We used national and state-level secondary data to construct a policy simulation. Mental health prescribing need and the number of mental health prescribers were estimated at the national and state levels, and the provider shortage was calculated as the difference between these two values. The simulated policy intervention added 10% of psychologists to the prescriber group to estimate the associated reduction in prescriber shortages. Probabilistic uncertainty and sensitivity analyses were conducted using 10,000 Markov trials in which all model parameters varied randomly based on their associated uncertainty. The simulated policy value was allowed to vary between 5% and 15%. The prescriber shortage was predicted to fall by 4.34% (95% CI [0.75%, 16.58%]) nationally, though this varied widely by state, ranging from 1.10% [0.20%, 3.82%] in North Dakota to 26.44% [2.89%, 570.29%] in Washington, DC. Uncertainty and sensitivity analyses demonstrated that variability in the provider shortage reduction was primarily driven by the percentage of psychologists becoming licensed to prescribe. Our results suggest that granting prescriptive authority to licensed psychologists would reduce the shortage of mental health professionals with prescriptive authority. Further work is needed to examine the potential implications for other mental health providers.