Volume Articles

Treatment of Youth with Bipolar Disorder and Substance Use: The Youth ACT Care Model and Self Determination Theory

Youth Assertive Community Treatment (Youth ACT) is a rising novel community based care model for youth with pervasive psychiatric illness. This type of intensive treatment follows specific principles which include an interdisciplinary team, small caseloads, 24/7 access to the team, and treatment given in the patient’s home or community. A variety of studies have reviewed outcomes and generally report that patients have statistically significant improvements in symptoms. However, much is still not well understood about how this model works, how it is applied, or about the clinical significance of the models. There have been relatively few case studies written outlining how patients respond to the Youth ACT interventions. To better understand Youth ACT, how it works, and what patients may benefit from this level of treatment, a clinical scenario is discussed. This clinical scenario involves a 15-year-old male youth with bipolar 1 disorder, psychosis and ongoing substance use. This case is indicative of the severe psychiatric symptoms that the Youth ACT teams address in the community. After case presentation, outcomes are discussed and significant clinical improvement is reflected upon.

Cultural Affirmations to Increase Cognitive Resources Available in Latinx Individuals

Introduction: The purpose of this study was to examine the effect of cultural affirmations on the neural activity of Latinx individuals. Latinx participants viewed threatening stimuli after completing a cultural affirmation intervention. We also examined the impact of identity salience on the effectiveness of cultural affirmations.

Method: To understand relationships between these variables, 28 Latinx participants (19 female) viewed photos of angry and neutral white, non-Latinx, faces while event-related potentials (ERPs) were recorded before and after engaging in a cultural affirmation writing task.

Results: Scalp map assessment showed large effects for N2 in the frontal region. Repeated measures ANOVA indicated average N2 amplitudes were higher following the cultural affirmation, specifically in the right hemisphere. As predicted, the relationship was no longer significant when identity salience was controlled.

Discussion: After engaging in cultural affirmations, Latinx participants’ N2 amplitudes increased, indicating the affirmation increased the availability of preconscious social categorization resources to allocate to the angry and neutral white, non-Latinx, faces. However, when identify salience was controlled, there were no changes in available neural resources.

Conclusion: Theoretical and clinical implications are discussed as well as future directions for researchers on how cultural affirmations may be utilized among Latinx individuals with consideration to identity salience.

Shining a Light on a “Hidden” Population: Hispanic Adolescent Women Caregivers

Many studies explore the experience of family caregiving from various perspectives within the adult population. However, little attention has been focused on adolescent caregivers, who are sometimes known as a “hidden” population. An adolescent caregiver is typically an individual who is younger than 19 years old and provides substantial assistance with physical tasks, mental or cognitive tasks, or other supports for a family member with some type of physical or mental health disability, short- or long-term. Similar to the adult caregiving population, adolescent caregivers tend to be female. Among studies that include adolescents, very few consider race/ethnicity and the specific cultural expectations for Hispanic adolescent women, who may face greater expectations to provide caregiving compared with other groups. This opinion piece describes some of the unique mental health vulnerabilities of adolescent Hispanic women caregivers and the social-emotional tradeoffs they must make in order to balance participation in typical adolescent responsibilities and activities and providing care for a family member. We conclude by calling for more research into these experiences to develop a better understanding of the supports that could mitigate the increased mental health risks of caregiving and ultimately support all family members in thriving.

Commentary on "A Post-Pandemic Wellness Experiences Scale: Demographic Variation and Influences on Depression"

This commentary critically engages with Tawa et al.’s development and validation of the Post-Pandemic Wellness (PPW) scale, a psychometrically grounded instrument designed to measure wellness across four dimensions: positive reframing, economic stress, social stress, and existential impact. The authors’ multi-time point validation (2021 and 2024) adds rigor and temporal relevance to their findings, revealing both consistencies and evolutions in post-pandemic mental health trajectories across demographic groups. While the PPW subscales show high internal consistency and statistical integrity over time, notable differences emerge in the mediation pathways previously linking race and depression, particularly among Asian American participants. The disappearance of these effects in the 2024 data invites further inquiry into how sociopolitical shifts modulate psychological stress. This commentary explores how existential stress may not only predict distress but also correlate with resilience, drawing on existing literature on post-traumatic growth. Limitations in the study’s design—including under examined intersections of age, race, and gender, and its reliance on self-reported online data—suggest directions for future research. Expanding the scale to distinguish between negative and adaptive existential responses and incorporating mixed-methods approaches—such as in-depth interviews or focus groups stratified by racial-gender identity—would enhance its applicability. Finally, while the scale offers significant diagnostic promise, its generalizability to clinical populations or minoritized subgroups with limited digital access may be constrained.

Commentary: An Educational Intervention to Enhance Self-Care Practices Among 1st Year Dental Students: A Mixed-Method Study Design

Burnout, stress, and mental health challenges are increasingly common among dental students. Despite their prevalence, structured self-care remains an overlooked element in healthcare education. Research shows that poor self-care among medical professionals contributes to long-term psychological distress and can negatively affect patient care. However, institutional curricula often lack systematic and culturally relevant interventions to address this issue.

There is a growing need to embed proactive self-care education early in professional training. Doing so can promote resilience, emotional well-being, and sustainable career growth. To address this gap, a mixed-method study was conducted at Riphah International University. The study evaluated the impact of a Personal Development Plan (PDP) intervention on first-year dental students.

This commentary critically examines the study’s methodology, highlights its strengths and limitations, and explores its broader implications for medical and dental education. It also outlines future directions for research and policy reform to ensure that self-care becomes an integral part of healthcare training.

Extended Diagnostic Evaluation and Neuropsychiatric Characteristics in Acute and Transient Psychotic Disorders – A Descriptive Analysis

Background and Objectives: Acute and transient psychotic disorders (ATPDs) constitute a frequent reason for acute hospitalization. The aim of this study was 1) to describe the value of an extended diagnostic evaluation program for first episode ATPDs and 2) to describe the short-term prognosis of transitioning to schizophrenia or affective disorder in relation to the initial symptom profile.

Methods: We collected medical record data from patients with consent, aged 18-65 years, and admitted due to ATPDs (ICD-10: F23.X) to an emergency psychiatry department in Copenhagen, Denmark. The extension of the diagnostic evaluation program included magnetic resonance imaging (MRI), examination of cerebrospinal fluid by lumbar puncture (LBP), and electroencephalography (EEG) if clinically indicated.

Results: A total of 53 patients were included. Twenty-nine (55%) were men, the mean age was 25.56 years (SD = 10.71), and the mean length of hospitalization was 32.74 days (SD = 15.39). Clinical evaluations using MRI, LBP, and EEG did not reveal abnormal findings of diagnostic significance. The clinical symptom profile was diverse but could broadly be classified as polymorphic, schizophrenia-like, or unspecified. A pattern towards short-term transitioning to affective disorder was observed among patients who initially presented with fluctuating moods. The majority of patients (53%) maintained their initial diagnosis of ATPD upon discharge.

Conclusions: The extended evaluation program was not of additional diagnostic value in this sample of patients with ATPDs. We observed a diverse clinical symptom profile and described patterns that were suggestive of short-term prognosis. However, further research with larger sample sizes and extended follow-up periods is needed to confirm and expand these results.

A Latent Class Analysis of Coping Strategies Among Women in Informal Settlements in Nairobi, Kenya

Objective: Women living in informal settlements face psychosocial stressors with limited access to mental health resources. Understanding their coping strategies is crucial to informing mental health interventions that address structural inequities and promote resilience in low-resource urban settings. This study examines the coping mechanisms employed by women in Kibera and Mathare, two of Nairobi’s largest informal settlements, to manage daily stressors.

Methods: The study utilized cross-sectional data from the baseline survey of a longitudinal cohort study that examined the impact of climate change on mental health among women residing in informal settlements in Nairobi, Kenya. The sample included 800 participants (400 from each settlement) to assess eight categories of coping strategies: emotional avoidance, self-care, substance use, mental health support, social support, religiosity, participation in family activities, and media dependence. It applied Latent Class Analysis (LCA) to identify distinct subgroups of coping.

Results: A four-class model was favored based on the Bayesian Information Criterion (BIC). The largest class (51%) relied on emotional avoidance, the second largest (31%) on religiosity, the third (10%) on social support, and the fourth (8%) on health care support and family activities. Most women used emotion-focused coping strategies at 83%, while a minority of 17% adopted problem-focused coping strategies.

Implications: This study provides valuable insights into developing mental health support systems and policies that aim to assist women residing in informal settlements. The common tendency among residents to avoid expressing emotions and to rely on religious coping strategies highlights the urgent need for accessible mental health support within these communities. Community-based interventions that incorporate peer support models, culturally relevant psychoeducation, and faith-based approaches can effectively close existing care gaps. To reduce mental health disparities in under-resourced urban areas, it is important to implement scalable structural solutions that increase access to problem-focused coping resources and connect them with formal mental health services.