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Parental Reflective Functioning (PRF) refers to parents’ capacity to view their child’s and their own behavior considering inner mental states, like thoughts, desires, and intentions. This study’s objective was to examine whether PRF acted as a moderator for the relationships between maternal depression and child internalizing and externalizing problems. The sample was comprised of 685 Iranian mothers with preschoolers (3 to 5 years old) and school-aged (6–10 years old) children. To assess PRF, the PRF questionnaire was used. Child internalizing and externalizing difficulties were assessed with the Child Behavior Checklist, and maternal depression was assessed with the Beck Depression Inventory- second version. Results indicated significant relationships between maternal depression and PRF (specifically pre-mentalizing and certainty in mental states). Also, mothers of school-aged children showed significantly higher levels of pre-mentalizing than mothers of preschoolers. Furthermore, certainty about mental states moderated the relationship between maternal depression and child externalizing behaviors in school-aged children. However, no moderating effect was found for pre-mentalizing or interest and curiosity in mental states in any age group.

BackgroundHigh rates of substance misuse during emerging adulthood require developmentally appropriate clinical programs.ObjectivesThis work outlines the development of an evidence-informed emerging adult outpatient substance use program, quality improvement process and protocol, and 1-year program insights.MethodsLiterature reviews, program reviews, environmental scans, and stakeholder consultations (including lived expertise) were used to develop the program. A 12-week emerging adult (17-25) measurement-based care program was developed including: 1) individual measurement-based care and motivational enhancement therapy sessions; 2) group programming focused on cognitive behavioural therapy, mindfulness, distress tolerance, and emotional regulation; 3) consults for diagnostic clarification and/or medication review; and 4) a separate education group for loved ones. A measurement system was concurrently created to collect clinical and program evaluation data at 6 time points.ResultsIn the first year of the program, 96 young adults fully enrolled in the program (Mean age = 21 years old, 48% female gender) primarily reporting treatment targets of alcohol (70%) and cannabis (59%). Almost all patients (97%) surpassed at least one clinical threshold for co-occurring mental health disorder, with the median/mode of positive psychiatric screens being for 5 conditions.ConclusionsThis program demonstrates that developing an integrative evidence-informed measurement-based care young adult substance use program is feasible, though requires flexibility and ongoing monitoring to meet local needs. Patient characteristics reveal very high rates of concurrent psychiatric disorders in addition to substance use disorders.

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BACKGROUND Deep transcranial magnetic stimulation (dTMS) is a novel non-invasive treatment option for psychiatric and cognitive disorders, including obsessive-compulsive disorder, substance use disorder, major depressive disorder (MDD), and Alzheimer’s Disease. With the use of Hesed-coil (H-coil) devices, dTMS can stimulate deeper regions of the brain compared to traditional repetitive transcranial magnetic stimulation (rTMS), resulting in more widespread effects. OBJECTIVE This review’s primary objective is to conduct a systematic review of the empirical literature on dTMS for psychiatric and cognitive disorders and, if feasible, a meta-analysis to compare the efficacy of active dTMS vs. sham/control for psychiatric disorders. Dementia, and related cognitive disorders, will also be examined. A secondary objective will be to examine subgroup differences (by age, sex, H-coil variety, and dTMS parameters [i.e., pulses per session, % motor threshold (%MT), session duration, number of sessions, etc.]) to evaluate whether dTMS differentially influences clinical outcomes based on these factors. METHODS A comprehensive search of the APA PsycINFO, Embase, Medline, and PubMed databases will be conducted using an appropriate search strategy. Two authors (A.D and M.D) will be responsible for screening relevant articles, assessing article eligibility (according to predetermined inclusion and exclusion criteria), and data extraction. Article eligibility discrepancies, if present, will be resolved by an independent third arbitrator (J.M.). All included articles will undergo a quality and risk of bias assessment. Data from included articles will be summarized qualitatively in a systematic review. If a sufficient number of equivalent studies are available, a meta-analysis will be performed to first (1) determine the effect of active vs. sham dTMS (or controls without a sham coil) stimulation across psychiatric and cognitive disorders, and second (2) examine subgroup effects of clinical outcomes. RESULTS N/A CONCLUSIONS We will outline the evidence relating to the clinical efficacy of dTMS in various psychiatric and cognitive disorders. The results of this review will provide clinicians with valuable insight into the clinical (i.e., participant, age, sex, psychiatric or cognitive disorder, etc.) and methodological factors (i.e., H-coil design, dTMS parameters, etc.) which may contribute to dTMS efficacy, and thereby may assist clinicians in their decision to prescribe dTMS for specific psychiatric and cognitive disorders. CLINICALTRIAL PROSPERO Registration Number: CRD42022360066