Maternal mental health strongly influences child development and depression risk. This study investigated how positive and negative dimensions of prenatal maternal mental health differentially shape childhood depressive symptoms through cognitive mediators.

Participants were drawn from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort. Of the 1198 mother–child dyads enrolled, 523 (52.6% boys) had sufficient data for the mediation analysis. Maternal mental health at 26 weeks’ gestation was assessed using a bifactor model derived from the Beck Depression Inventory-II, State–Trait Anxiety Inventory, and Edinburgh Postnatal Depression Scale. Child language ability was measured at age 2 years with the Bayley Scales of Infant Development, executive function at age 7 years with the Behaviour Rating Inventory of Executive Function, and depressive symptoms at age 9 years with the Children’s Depression Inventory-2. Serial mediation models tested hypothesized pathways.

Distinct mediation pathways emerged. Positive maternal mental health was associated with enhanced early language ability, which in turn was associated with fewer depressive symptoms in later childhood (β = −0.017, 95% CI: −0.042, −0.003). Conversely, negative maternal mental health was associated with poorer executive functioning, which in turn was associated with more depressive symptoms (β = 0.040, 95% CI: 0.016–0.077).

Positive and negative maternal mental health are linked to childhood depressive symptoms through distinct neurocognitive pathways. By identifying language and executive function as specific developmental mediators, our findings point to targeted and developmentally sensitive intervention opportunities to disrupt intergenerational pathways of depression.

To understand current practices for screening, implementing and clearing contact precautions (CP) for multidrug-resistant organisms (MDRO).

A survey of US-based SHEA Research Network (SRN) members and Community Healthcare Epidemiologists and Stewards (CHES).

The SRN is a consortium of healthcare facilities collaborating on multicenter research projects. CHES is an SRN-affiliated group of community hospital epidemiologists.

A Research Electronic Data Capture (REDCap) survey was administered between January 7, 2025 and February 25, 2025. Frequencies and proportions were calculated in REDCap and Microsoft Excel. Fisher’s exact and χ2 tests were calculated in R.

Of 134 facilities, 60 (45%) responded; 4 answered only demographic questions and were excluded from analysis. Most facilities (70%) performed active surveillance for ≥1 MDRO, but only 16% employed preemptive CP. All respondents reported using CP for ≥1 MDRO. CP were employed more often for infection than colonization. Clearance protocols to discontinue CP were common for MRSA (97%), C. difficile (95%), and vancomycin-resistant enterococci (82%), but uncommon for Gram-negatives. Training and adherence of frontline staff (70%), unavailability of private rooms (41%), and lack of evidence-based strategies to eradicate reservoirs (34%) were the top 3 identified barriers to MDRO infection control and prevention.

Infection control practices varied by infection, colonization, specific MDRO, and time to clearance. Variation may indicate need for more data on transmission risk by disease state, organism, and time. Evidence-based strategies are needed to guide MDRO prioritization and CP duration and clearance policies. Guidance should acknowledge limitations in adherence, availability of private rooms, and persistent environmental reservoirs as major barriers to MDRO containment identified in this survey.

The world is facing an urgent environmental emergency that calls for ambitious, coordinated action by governments to improve humankind’s relationship with nature. Mitigation (reducing pollution) and adaptation (adjusting to pollution) are both necessary, and “NextGen” health technology assessment can play a key role in helping to guide health system decision-makers to achieve environmental sustainability.

In 2022, the International Network of Agencies for Health Technology Assessment (INAHTA) identified environmental impact assessment (EIA) as an important and urgent topic for a white paper. An international author group (n=10), formed of staff from INAHTA member agencies, wrote the paper. The author group met seven times over 2022 to 2024 to develop the paper, which is based on a literature review and expert opinion of INAHTA members. A second group of members formed an international advisory group (n=11), which reviewed the draft twice. The paper was approved by the INAHTA Board before release on the INAHTA website.

EIA can be useful to help achieve the “green” policy goals of health systems by identifying technologies that are comparatively harmful to the environment. However, health technology assessment (HTA) agencies are subject to the institutional structures and regulations of their local health system that can constrain their ability to independently adapt to incorporate EIA. Nevertheless, HTA agencies are starting to do this with some success, but difficult challenges remain, particularly around lack of data and methods. Looking ahead, raising awareness and working together across the HTA ecosystem will be key to achieving the shared goal of environmental sustainability.

The successful inclusion of EIA in priority setting, assessment, and appraisal, as well as knowledge sharing and dissemination activities of HTA, is a challenge since the operating principles, methods, and data in this area are not yet mature. The successful inclusion of environmental impacts in HTA will require some reconsideration of existing value frameworks and methods.

Complex post-traumatic stress disorder (C-PTSD) is closely associated with dissociative symptoms. Both of which are common responses to trauma and stress. Yet, not all individuals with C-PTSD experience high levels of dissociation. Currently, little is known about the bidirectional relationship between C-PTSD and dissociative symptoms.

This study aimed to examine whether C-PTSD and dissociative symptoms would predict each other over time.

A total of 340 participants (Mage=21.04 years; SD=2.00; 83.8% female) from Hong Kong and Taiwan completed the Multiscale Dissociation Inventory (MDI) and the International Trauma Questionnaire (ITQ) at two separate time points (M days apart = 129.4 days; SD = 7.91). Hierarchical multiple regression analyses were conducted to examine the relationship between C-PTSD and dissociative symptoms.

The analyses controlled for age, gender, education level, trauma exposure, and baseline severity of the dependent variables. Results indicated that when the MDI subscales were added into the model, baseline emotional constriction significantly predicted subsequent C-PTSD symptoms (i.e., total ITQ scores) (β=.126, p=.008), and significantly improved the model’s explanatory power (R²=.67, ΔR²=.029, ΔF = 4.772, p < .001). Nevertheless, when the same analysis was conducted, none of the six C-PTSD symptom clusters at baseline predicted the total MDI scores at follow-up (ΔF = 1.000, p = .425).

The study findings suggested that dissociative symptoms in general, and emotional constriction in particular, predicted subsequent levels of C-PTSD symptoms, while C-PTSD symptoms did not predict subsequent levels of dissociation. These results highlighted that proactive management of dissociative symptoms might be an important part of the treatment of C-PTSD. This study provided a foundation for future research to investigate the underlying mechanisms by which emotional constriction influences C-PTSD severity. Future research should also evaluate dissociation-focused interventions for people with C-PTSD.

None Declared

The Recovery Assessment Scale-Domains and Stages (RAS-DS) is a recently developed measure that builds on the original Recovery Assessment Scale (RAS). Within the RAS-DS, which measures one’s recovery from mental illness, a specific domain is called “Clinical Recovery” (RAS-DS-CR). It extends the “Not Dominated by Symptoms” subscale of the original RAS, which only has three items. The RAS-DS-CR provides a more comprehensive assessment of the sense of control over symptoms and is a promising, easily-administered outcome measure for evaluating early interventions such as psychoeducation and skills training programs.

This study examined the psychometric properties of the 7-item RAS-DS-CR in a Chinese sample of treatment seekers.

We analyzed data from 91 participants from a two-month psychoeducation program (Mage = 28.87; SD = 7.84, 89.0% female). At baseline, they exhibited high levels of post-traumatic (mean PCL-5 = 57.18; SD = 14.68) and dissociative (mean DES-T = 47.90; SD = 23.13) symptoms. All participants completed the baseline assessment, 83 completed the 2nd pretest, 58 completed the posttest, and 44 completed the two-month follow-up test. They completed the RAS-DS-CR and other validated self-report measures at each time point.

The RAS-DS-CR revealed good internal consistency (α = .805 to .871) at each time point. Intraclass correlations of two tests taken pre-intervention (ICC = .524, p <.001) and post-intervention (ICC = .613, p <.001) indicated moderate test-retest reliability. At each time point, the RAS-DS-CR was significantly correlated with self-esteem (r = .338 to .574), depressive symptoms (r = -.402 to -.486), and PTSD symptoms (r = -.245 to -.462), indicating its construct validity. The paired sample t-test also suggested that participants scored significantly higher on the RAS-DS-CR post-intervention compared to pre-intervention (t = -4.330, p < .001; Cohen’s d = 0.56), providing evidence for its sensitivity to change.

This study provided new evidence for the reliability and validity of the RAS-DS-CR. The RAS-DS-CR is a short and easy-to-use outcome measure of one’s mental health recovery in terms of the confidence in symptom management.

None Declared

Although complex post-traumatic stress disorder (CPTSD) is closely associated with dissociative symptoms, and although dissociation is often conceptualized as a response to trauma, less is known about the co-occurrence of dissociation and (C)PTSD.

This study examined the co-occurrence of CPTSD and dissociation and their relationship with depressive symptoms and functional impairments.

We analyzed baseline data from a clinical trial that evaluated a web-based trauma program. This study included 220 treatment seekers from Hong Kong (Mage = 35.3; SD = 7.9; 82.3% female). Participants completed measures of CPTSD, dissociation, depression and functional impairment, which were assessed with the International Trauma Questionnaire (ITQ), the Dissociative Experiences Scale-Taxon (DES-T), the Patient Health Questionnaire-9, and the Work and Social Adjustment Scale, respectively.

In this sample, 34.1% screened positive for CPTSD only, 10.0% for dissociative symptoms only (DES-T ≥ 25), and 25.0% for both conditions. For participants with CPTSD (n = 130), 42.3% had dissociative symptoms. For participants with dissociative symptoms (n = 77), 7.8% had PTSD, and 71.4% had CPTSD. Hierarchical multiple regression analyses showed that, after controlling for age, gender, education level, and trauma exposure, PTSD (β = .127, p = .033), disturbances in self-organization (DSO) (β = .524, p < .001), and dissociative (β = .169, p = .002) symptoms were all associated with depressive symptoms. Yet, only DSO symptoms were associated with functional impairments (β = .519, p < .001).

This study provides updated data regarding the co-occurrence of CPTSD/PTSD and dissociation. About half of people with CPTSD have considerable dissociative symptoms, while most dissociative individuals may be suffering from CPTSD/PTSD. Moreover, this study found that, among different trauma-related symptoms, DSO symptoms are the strongest predictor of depressive symptoms and functional impairments, highlighting the importance of providing skills training for trauma survivors to address these difficulties in clinical settings.

None Declared

Carbohydrate-Deficient Transferrin (CDT), a biomarker for excessive alcohol consumption, has been used in driver’s license regranting programs in the UK and other European countries, but relevant data is lacking in Taiwan. This study collected %CDT data from repeat drunk driving offenders to monitor their alcohol consumption and aims to provide local data to inform policies in Taiwan.

The objective of this study is to assess whether alcohol consumption decreases over a 12-month period, as measured by %CDT values and Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) scores.

Study Design

This study was conducted from 2020 to 2023, involving 65 recidivist drunk drivers whose licenses had been revoked and who sought to reapply. Participants were referred to our hospital for a one-year, monthly evaluation and intervention program. Data were collected on gender, age, marital status, education level, employment status, years of alcohol consumption, primary type of alcohol consumed, DSM-5 severity, AUDIT, and AUDIT-C scores. Blood tests, including GGT, AST, ALT, triglycerides, cholesterol, and %CDT, along with AUDIT-C assessments, were conducted at the 1st, 4th, 7th, and 11th evaluations.

Basic demographic information is shown in Image 1. There was no significant difference in %CDT before and after the intervention (p = 0.332), with values of 1.99% and 2.28%, respectively. Among 42 participants who completed the 12-month intervention, %CDT showed no significant change (p = 0.46; 1.93% vs. 1.83%). For 23 participants who did not complete the intervention, %CDT also showed no significant difference (p = 0.219; 2.11% vs. 3.14%).

However, AUDIT-C scores significantly decreased across all groups. The total group’s scores dropped from 4.51 to 3.20 (p = 0.00091), the completion group from 4.00 to 2.60 (p = 0.011), and the non-completion group from 5.43 to 4.30 (p = 0.025). These results are shown in Image 2, and the correlations between baseline variables are displayed in Image 3.

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Image 2:

Image 3:

Our study found that monitoring drunk-driving recidivists with %CDT every three months did not yield a statistically significant change in %CDT, but did result in a significant reduction in AUDIT-C scores. Fleming et al. (2004) suggest that psychological pressure from long-term biomarker monitoring may have a therapeutic effect, with bimonthly CDT follow-ups potentially beneficial. Thus, using %CDT for license reinstatement is feasible, though adjustments to assessment intervals and inclusion of other biomarkers should be considered.

Fleming et al., Alcohol Clin Exp Res 2004; 28: 1347–55.

None Declared

Depression is commonly comorbid with post-traumatic stress disorder (PTSD) symptoms. There is a lack of studies evaluating trauma-informed interventions for people with depression and PTSD symptoms.

We examined whether an online, easily accessible, trauma psychoeducation program would be helpful for people with both depressive and PTSD symptoms.

Participants with depression (PHQ-9 ≥ 10) and co-occurring PTSD symptoms were recruited online and randomly assigned to the intervention group (i.e., a 10-session online program based on Be a Teammate With Yourself) or the control group. Outcome measures included the Brief-COPE, a subscale of the Endorsed and Anticipated Stigma Inventory, and the Post-traumatic Maladaptive Beliefs Scale. These outcomes were assessed at baseline, posttest, and 2-month follow-up. Qualitative feedback was also obtained from the participants.

35 participants were randomly assigned to the intervention group, and 34 to the control group. With only email reminders, 9 participants in the intervention group and 14 in the control group completed posttest and follow-up surveys. Completers-only analyses were conducted. One-way repeated measures ANOVA showed that the intervention group had significant reductions in post-traumatic maladaptive beliefs, with a large effect size (F = 4.152, p = .035, Partial Eta Squared = 0.342). The control group did not have such changes. Both groups did not have significant changes in coping and self-stigma. Of 12 participants who provided feedback, 100% agreed that the program could help them remain hopeful for recovery, and 91.6% agreed that they were satisfied with the program. The qualitative feedback also supported the usefulness and acceptability of the programme.

Participation in this program was associated with significant decreases in post-traumatic maladaptive beliefs. Completers were satisfied with the program. Given a small sample with a high dropout rate (66.6%), the results should be interpreted with caution.

None Declared

Childhood sexual abuse (CSA) is a major public health concern and is closely associated with dissociative symptoms. According to the betrayal trauma theory, dissociation can be interpreted as a response towards betrayal trauma (i.e., trauma perpetrated by a close person, such as a family member). No previous study has validated this theory with a focus on CSA in the Chinese context.

We hypothesized that people with betrayal CSA, but not non-betrayal CSA, would report significantly more dissociative symptoms than people without CSA. We also hypothesized that betrayal CSA, but not non-betrayal CSA, would be significantly associated with the severity of dissociative symptoms. We tested the hypotheses in two independent Chinese-speaking samples.

Sample 1 (N = 91) consisted of participants seeking treatment in an evaluation study; while Sample 2 (N = 376) included community health service users in a survey study. In both Chinese-speaking samples, participants completed the two CSA items on the Brief Betrayal Trauma Survey and the 16-item Dissociative Features Section of the Self-report Dissociative Disorders Interview Schedule (SR-DDIS). ANOVA and regression analyses were used to test our hypotheses.

Across both samples, participants with betrayal CSA reported significantly more dissociative symptoms than those without any CSA (Sample 1: M = 5.60, SD = 3.14 vs M = 3.67, SD = 3.06; F = 3.301, p = .041, Sample 2: M = 2.06, SD = 2.49 vs M = 0.93, SD = 1.32; F = 8.428, p < .001). As hypothesized, no significant differences in dissociative symptoms were observed between participants with and without non-betrayal CSA (Sample 1: M = 4.00, SD = 3.71 vs M = 3.67, SD = 3.06; Sample 2: M = 1.14, SD = 1.83 vs M = .93, SD = 1.32). Across both samples, betrayal CSA, but not non-betrayal CSA, was significantly associated with dissociative symptoms (Sample 1: β = .250, p = .024, Sample 2: β = .189, p < .001), after controlling for age and gender.

This study provides cross-cultural evidence for the betrayal trauma theory. We suggest that proactive family-centered child protection is needed to prevent CSA, and screening for dissociative symptoms is also necessary in CSA survivors.

None Declared