Relations between worry, thought control, suicidal ideation and attempt history.

BACKGROUND: Thought processes such as worries are often described as difficult to control and predict suicidal thoughts and behaviors (STBs). Due to their uncontrollable nature, worries may lead to STBs as people attempt to escape their own internal thought processes. OBJECTIVE: Examine the indirect role of perceived uncontrollability of one's thoughts in the relationship between worry and STBs. DESIGN AND METHOD: We used stepwise mediation models to examine the proposed relationship in a sample of 145 undergraduates with lifetime suicidal ideation. STBs were categorized into (1) severity of lifetime suicidal ideation, (2) likelihood and (3) severity of recent suicidal ideation, and (4) lifetime suicide attempt. The likelihood and severity of recent ideation were separated due to the skewed nature of suicidal thoughts, with many people reporting zero ideation. RESULTS: Worry was related to the severity of lifetime ideation, the likelihood of reporting recent ideation, and the severity of recent ideation through lower levels of perceived ability to control one's thoughts. Worry was not related to a lifetime suicide attempt. CONCLUSION: The perception that one's thoughts are uncontrollable may be a core feature of worry for the development and worsening of suicidal thinking. Interventions targeting internal perceptions of uncontrollability may be beneficial for suicidal ideation management.

The brief mind wandering three-factor scale (BMW-3).

In recent years, researchers from different fields have become increasingly interested in measuring individual differences in mind wandering as a psychological trait. Although there are several questionnaires that allow for an assessment of people's perceptions of their mind wandering experiences, they either define mind wandering in a very broad sense or do not sufficiently separate different aspects of mind wandering. Here, we introduce the Brief Mind Wandering Three-Factor Scale (BMW-3), a 12-item questionnaire available in German and English. The BMW-3 conceptualizes mind wandering as task-unrelated thought and measures three dimensions of mind wandering: unintentional mind wandering, intentional mind wandering, and meta-awareness of mind wandering. Based on results from 1038 participants (823 German speakers, 215 English speakers), we found support for the proposed three-factorial structure of mind wandering and for scalar measurement invariance of the German and English versions. All subscales showed good internal consistencies and moderate to high test-retest correlations and thus provide an effective assessment of individual differences in mind wandering. Moreover, the BMW-3 showed good convergent validity when compared to existing retrospective measures of mind wandering and mindfulness and was related to conscientiousness, emotional stability, and openness as well as self-reported attentional control. Lastly, it predicted the propensity for mind wandering inside and outside the lab (as assessed by in-the-moment experience sampling), the frequency of experiencing depressive symptoms, and the use of functional and dysfunctional emotion regulation strategies. All in all, the BMW-3 provides a brief, reliable, and valid assessment of mind wandering for basic and clinical research.

Are the Symptom Dimensions in Obsessive Compulsive Disorder Related to Thought-Action Fusion, Magical Thinking, and Schizotypal Personality Traits?

Introduction: This study aimed to investigate the relationship between symptom dimensions within obsessive-compulsive disorder and thought-action fusion, magical thinking, and schizotypal personality traits. Methods: This research was designed as a cross-sectional case-control study. The study population involved patients with obsessive-compulsive disorder, and healthy controls who did not exhibit any psychiatric disorders following the Structured Clinical Interview for DSM-IV (SCID-I). Thought-Action Fusion Scale (TAFS), Magical Ideation Scale (MIS), Vancouver Obsessional-Compulsive Inventory (VOCI), Schizotypal Personality Questionnaire (SPQ), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) were administered to all participants. The two groups were compared in terms of sociodemographic variables and scale scores, Spearman's correlation analysis was performed to examine the relationship between TAFS total and all subscale scores, magical thinking, schizotypal personality traits and OCD symptom dimensions scores. Results: The study comprised 37 patients with OCD and 36 healthy controls. The patient group exhibited significantly higher scores in TAF total and all subscales, MIS, SCQ, BDI, and BAI, compared to the healthy control group. Positive correlations between magical ideation scores and VOCI-obsessions and VOCI-hoarding subscale scores and between schizotypal personality scores and VOCI-obsessions, VOCI-hoarding, VOCI-just right, VOCI indecisiveness scores was found. Conclusions: The relationship between symptom dimensions in obsessive-compulsive disorder such as sexual, religious, aggression, hoarding, symmetry/ordering and magical thinking and schizotypal personality traits shows that these variables are among the determining factors for OCD symptoms. .

Medical gendered racism and Black women's experiences of genito-pelvic pain/penetration disorder in the USA - A conceptual exploration.

Medical gendered racism in the USA has been and continues to be a significant issue for Black women across various healthcare domains, including sexual and pelvic healthcare. The experiences of Black women with Genito-Pelvic Pain/Penetration Disorder, characterised by pain with sexual intercourse, are particularly understudied in relation to medical gendered racism. This paper advances existing research on Genito-Pelvic Pain/Penetration Disorder by employing Black feminist thought and intersectionality as theoretical frameworks. We seek to conceptualise how medical gendered racism impacts Black women's experiences with genito-pelvic pain and the quality of their healthcare. We offer a nuanced, culturally sensitive approach to doing so and to clinical practice, and provide actionable recommendations for healthcare professionals. This work aims to equip researchers and healthcare practitioners with the knowledge and tools to acknowledge, understand, and support effective treatment of genito-pelvic pain experienced by Black women in the USA.

Characterizing human spontaneous thoughts and its application in major depressive disorder.

BACKGROUND: Spontaneous thought is a universal, complex, and heterogeneous cognitive activity that significantly impacts mental activity and strongly correlates with mental disorders. METHODS: Utilizing the think-aloud method, we captured spontaneous thoughts during rest from 38 diagnosed with depression, alongside 36 healthy controls and 137 healthy individuals. Through a comprehensive assessment of various dimensions of thought content, we compared thought content between individuals with depression and healthy controls, and between healthy women and men. Finally, we employed natural language processing (NLP) to develop regression models for multidimensional content assessment and a classification model to differentiate between individuals with and without depression. RESULTS: Compared to healthy controls, individuals with depression had more internally oriented and less externally oriented spontaneous thoughts. They focused more on themselves and negative things, and less on positive things, experiencing higher levels of negative emotions and lower levels of positive emotions. Besides, we found that compared to healthy men, healthy women's spontaneous thoughts focus more on interoception, the self, past events, and negative events, and they experience higher levels of negative emotions. Meanwhile, we identified the potential application of the think-aloud method to collect spontaneous thoughts and integrate NLP in the field of depression. CONCLUSIONS: This study offers direct insights into the stream of thought during individuals' resting state, revealing differences between individuals with depression and healthy controls, as well as sex differences in the content of spontaneous thoughts. It enhances our understanding of spontaneous thought and offers a new perspective for preventing, diagnosing, and treating depression.

Distilling mathematical reasoning capabilities into Small Language Models.

This work addresses the challenge of democratizing advanced Large Language Models (LLMs) by compressing their mathematical reasoning capabilities into sub-billion parameter Small Language Models (SLMs) without compromising performance. We introduce Equation-of-Thought Distillation (EoTD), a novel technique that encapsulates the reasoning process into equation-based representations to construct an EoTD dataset for fine-tuning SLMs. Additionally, we propose the Ensemble Thoughts Distillation (ETD) framework to enhance the reasoning performance of SLMs. This involves creating a reasoning dataset with multiple thought processes, including Chain-of-Thought (CoT), Program-of-Thought (PoT), and Equation-of-Thought (EoT), and using it for fine-tuning. Our experimental performance demonstrates that EoTD significantly boosts the reasoning abilities of SLMs, while ETD enables these models to achieve state-of-the-art reasoning performance.

Dynamics of spontaneous thoughts: Exploration, attentional profile and the segmentation of the stream of thoughts.

For a long time, clinical knowledge and first-person reports have pointed to individual differences in the dynamics of spontaneous thoughts, in particular in the extreme case of psychiatric conditions (e.g. racing thoughts in Attention Deficit / Hyperactivity Disorder, ADHD; rumination in depression). We used a novel procedure to investigate this individual variability by combining verbal fluency tasks and introspective reports of thought content. Our goal was twofold. First, we tested the hypothesis that a greater segmentation of the stream of thoughts would be associated with trait inattention, in line with subjective reports of ADHD patients. Second, we tested whether the segmentation of the stream of thoughts increased with an increased tendency for exploratory behavior, following recent theoretical claims on the mechanisms underpinning the generation of spontaneous thoughts. Our results support both hypotheses, shedding light on the factors contributing to the individual variability in the dynamics of the stream of thought.

The innate story code.

Code biology reveals a great many codes beyond the genetic code as integral to biological functioning. Recent scholars have linked the growing field of code biology to analytical psychology, confirming that the encoded information inherited by the human organism is indeed massive and capable of great sophistication. In this discussion, I will expand on this project by showing how developments in embodied cognition reveal a code that links the world of universal emotional responses to common experiences to the world of embodied visuospatial narratives--i.e., the "archetypes" of analytical psychology. Viewed in this manner, archetypes become spontaneous symbolic narratives that symbolize universal emotional responses to typical human environments. Such symbolic narratives aim toward adaptation, and use a universal code that maps such situations to visuospatial narratives, with the adaptor being the human body itself.

Thought-shape fusion in residential eating disorder treatment: Cognitive defusion as a mediator between thought-action fusion and treatment outcome.

An understudied cognitive bias within eating disorder (ED) psychopathology is Thought-Shape Fusion (TSF), which involves irrational beliefs about the likelihood and moral implications of feared outcomes related to shape, weight, and food. This phenomenon has received less attention within the context of ED treatment, with little known about potential processes of change to address TSF and ultimately promote ED recovery. We propose cognitive defusion as a process of change, a metacognitive process that emphasizes observing thoughts objectively rather than appraising thoughts as absolute truth. We explored whether cognitive defusion, that is, reductions in body image-related cognitive fusion, mediated the relationship between trait-level TSF and treatment outcomes in a transdiagnostic ED sample of adult and adolescent females (N = 130) presenting to residential care. We found that reductions in body image-related cognitive fusion mediates the association between trait-level TSF at baseline and ED severity at discharge. However, when the sample was separated into adolescent and adult subgroups, these results only remained significant for adolescents. These findings underscore the relevance of targeting cognitive defusion as a potential mechanism to address the impact of trait levels of TSF cognitions on ED psychopathology.

Social Media Escapism in Poland: Adaptation of a Measure and its Relationship With Thought Suppression and Mental Health.

Research indicates that social media use can lead to addiction, fear of missing out, higher stress levels, anxiety, and experiencing symptoms typical of depression. The purpose of the present study was to conduct a Polish adaptation of the Social Media Escapism Scale and to assess its associations with fear of missing out, Facebook addiction, thought suppression, and the experience of stress, anxiety, and symptoms typical of depression. Two studies were conducted, the first adaptive and the second testing associations. The first study included 383 participants aged 18 to 63 (M = 23.51; SD = 5.7). To adapt the scale, the following were used: the Bergen Facebook Addiction Scale, the fear of missing out Scale, and the demographic questionnaire. The second study included 417 participants aged 18 to 60 (M = 26.33; SD = 9.7). The study tested relationships using the same three scales used in the first study, and also Depression, Anxiety, Stress Scale, and the White Bear Suppression Scale. The Polish version of the Social Media Escapism Scale revealed a univariate structure with strong internal consistency (α = .91). The adapted scale was associated with fear of missing out and Facebook addiction. In study 2, the structural equation modeling analyses revealed that fear of missing out, Facebook addiction and escapism were positively related to thought suppression and the experience of anxiety, stress, and depression symptoms. In addition, thought suppression partially mediated the relationship between harmful media use and anxiety, stress, and depression. Furthermore, the findings reveal a positive correlation between escapism and several psychological constructs, including fear of missing out, Facebook addiction, as well as aspects of depression and suppression, thereby lending support to the convergent validity of the adapted measure under investigation. The results can be used in psychological intervention and developing support and treatment programs for social network addiction.

Neural correlates of treatment response to ketamine for treatment-resistant depression: A systematic review of MRI-based studies.

Treatment-resistant depression (TRD) is defined as patients diagnosed with depression having a history of failure with different antidepressants with an adequate dosage and treatment duration. The NMDA receptor antagonist ketamine rapidly reduces depressive symptoms in TRD. We examined neural correlates of treatment response to ketamine in TRD through a systematic review of brain magnetic resonance imaging (MRI) studies. A comprehensive search in PubMed was performed using "ketamine AND depression AND magnetic resonance." The time span for the database queries was "Start date: 2018/01/01; End date: 2024/05/31." Total 41 original articles comprising 1,396 TRD and 587 healthy controls (HC) were included. Diagnosis of depression was made using the Structured Clinical Interview for DSM Disorders (SCID), the Mini-International Neuropsychiatric Interview (MINI), and/or the clinical assessment by psychiatrists. Patients with affective psychotic disorders were excluded. Most studies applied ketamine [0.5mg/kg racemic ketamine and/or 0.25mg/kg S-ketamine] diluted in 60cc of normal saline via intravenous infusion over 40 min one time, four times, or six times spaced 2-3 days apart over 2 weeks. Clinical outcome was defined as either remission, response, and/or percentage changes of depressive symptoms. Brain MRI of the T2*-weighted imaging (resting-state or task performance), arterial spin labeling, diffusion weighted imaging, and T1-weighted imaging were acquired at baseline and mainly 1-3days after the ketamine administration. Only the study results replicated by ≥ 2 studies and were included in the default-mode, salience, fronto-parietal, subcortical, and limbic networks were regarded as meaningful. Putative brain-based markers of treatment response to ketamine in TRD were found in the structural/functional features of limbic (subgenual ACC, hippocampus, cingulum bundle-hippocampal portion; anhedonia/suicidal ideation), salience (dorsal ACC, insula, cingulum bundle-cingulate gyrus portion; thought rumination/suicidal ideation), fronto-parietal (dorsolateral prefrontal cortex, superior longitudinal fasciculus; anhedonia/suicidal ideation), default-mode (posterior cingulate cortex; thought rumination), and subcortical (striatum; anhedonia/thought rumination) networks. Brain features of limbic, salience, and fronto-parietal networks could be useful in predicting the TRD with better response to ketamine in relief of anhedonia, thought rumination, and suicidal ideation.

Gaze-Based Detection of Thoughts across Naturalistic Tasks Using a PSO-Optimized Random Forest Algorithm.

One key aspect of the human experience is our ongoing stream of thoughts. These thoughts can be broadly categorized into various dimensions, which are associated with different impacts on mood, well-being, and productivity. While the past literature has often identified eye movements associated with a specific thought dimension (task-relatedness) during experimental tasks, few studies have determined if these various thought dimensions can be classified by oculomotor activity during naturalistic tasks. Employing thought sampling, eye tracking, and machine learning, we assessed the classification of nine thought dimensions (task-relatedness, freely moving, stickiness, goal-directedness, internal-external orientation, self-orientation, others orientation, visual modality, and auditory modality) across seven multi-day recordings of seven participants during self-selected computer tasks. Our analyses were based on a total of 1715 thought probes across 63 h of recordings. Automated binary-class classification of the thought dimensions was based on statistical features extracted from eye movement measures, including fixation and saccades. These features all served as input into a random forest (RF) classifier, which was then improved with particle swarm optimization (PSO)-based selection of the best subset of features for classifier performance. The mean Matthews correlation coefficient (MCC) values from the PSO-based RF classifier across the thought dimensions ranged from 0.25 to 0.54, indicating above-chance level performance in all nine thought dimensions across participants and improved performance compared to the RF classifier without feature selection. Our findings highlight the potential of machine learning approaches combined with eye movement measures for the real-time prediction of naturalistic ongoing thoughts, particularly in ecologically valid contexts.

Mind Melds: Verbal Labels Induce Greater Representational Alignment.

What determines whether two people represent something in a similar way? We examined the role of verbal labels in promoting representational alignment. Across two experiments, three groups of participants sorted novel shapes from two visually dissimilar categories. Prior to sorting, participants in two of the groups were pre-exposed to the shapes using a simple visual matching task designed to reinforce the visual category structure. In one of these groups, participants additionally heard one of two nonsense category labels accompanying the shapes. Exposure to these redundant labels led people to represent the shapes in a more categorical way, which led to greater alignment between sorters. We found this effect of label-induced alignment despite the two categories being highly visually distinct and despite participants in both pre-exposure conditions receiving identical visual experience with the shapes. Experiment 2 replicated this basic result using more even more stringent testing conditions. The results hint at the possibly extensive role that labels may play in aligning people's mental representations.

Neural signatures of default mode network subsystems in first-episode, drug-naive patients with major depressive disorder after 6-week thought induction psychotherapy treatment.

Evidence indicates that the default mode network (DMN) plays a crucial role in the neuropathology of major depressive disorder (MDD). However, the neural signatures of DMN subsystems in MDD after low resistance Thought Induction Psychotherapy (TIP) remain incompletely understood. We collected functional magnetic resonance imaging data from 20 first-episode, drug-naive MDD and 20 healthy controls (HCs). The DMN was segmented into three subsystems and seed-based functional connectivity (FC) was computed. After 6-week treatment, the significantly reduced FCs with the medial temporal lobe memory subsystem in MDD at baseline were enhanced and were comparable to that in HCs. Changed Hamilton Depression Rating Scale scores were significantly related with changed FC between the posterior cingulate cortex (PCC) and the right precuneus (PCUN). Further, changed serotonin 5-hydroxytryptamine levels were significantly correlated with changed FCs between the PCC and the left PCUN, between the posterior inferior parietal lobule and the left inferior temporal gyrus, and between the retrosplenial cortex and the right inferior frontal gyrus, opercular part. Finally, the support vector machine obtained an accuracy of 67.5% to distinguish between MDD at baseline and HCs. These findings may deepen our understanding of the neural basis of the effects of TIP on DMN subsystems in MDD.

Abstract thematic roles in infants' representation of social events.

Infants' thoughts are classically characterized as iconic, perceptual-like representations.1,2,3 Less clear is whether preverbal infants also possess a propositional language of thought, where mental symbols are combined according to syntactic rules, very much like words in sentences.4,5,6,7,8,9,10,11,12,13,14,15,16,17 Because it is rich, productive, and abstract, a language of thought would provide a key to explaining impressive achievements in early infancy, from logical inference to representation of false beliefs.18,19,20,21,22,23,24,25,26,27,28,29,30,31 A propositional language-including a language of thought5-implies thematic roles that, in a sentence, indicate the relation between noun and verb phrases, defining who acts on whom; i.e., who is the agent and who is the patient.32,33,34,35,36,37,38,39 Agent and patient roles are abstract in that they generally apply to different situations: whether A kicks, helps, or kisses B, A is the agent and B is the patient. Do preverbal infants represent abstract agent and patient roles? We presented 7-month-olds (n = 143) with sequences of scenes where the posture or relative positioning of two individuals indicated that, across different interactions, A acted on B. Results from habituation (experiment 1) and pupillometry paradigms (experiments 2 and 3) demonstrated that infants showed surprise when roles eventually switched (B acted on A). Thus, while encoding social interactions, infants fill in an abstract relational structure that marks the roles of agent and patient and that can be accessed via different event scenes and properties of the event participants (body postures or positioning). This mental process implies a combinatorial capacity that lays the foundations for productivity and compositionality in language and cognition.

Homogenization of word relationships in schizophrenia: Topological analysis of cortical semantic representations.

AIM: Patients with schizophrenia typically exhibit symptoms of disorganized thought and display concreteness and over-inclusion in verbal reports, depending on the level of abstraction. While concreteness and over-inclusion may appear contradictory, the underlying psychopathology that explains these symptoms remains unclear. In the current study, we used functional magnetic resonance imaging with an encoding modeling approach to examine how concepts of various words, represented as brain activity, are anomalously connected at different levels of abstraction in patients with schizophrenia. METHODS: Fourteen individuals diagnosed with schizophrenia and 17 healthy controls underwent functional magnetic resonance imaging to measure brain activity representing concepts of various words. We used a persistent homology (PH) method to analyze the topological structures of word representations in schizophrenia patients, healthy controls, and random data, across different levels of abstraction by varying dissimilarity scales in the representation space. RESULTS: The results revealed that patients with schizophrenia exhibited more homogeneous word relationships across different levels of abstraction compared with healthy controls. Additionally, topological structures exhibited a shift toward a random network structure in patients with schizophrenia compared with controls. The PH method successfully distinguished semantic representations of patients with schizophrenia from those of controls. CONCLUSIONS: The current results provide an explanation for the mechanisms underlying the deficits in abstraction ability observed in schizophrenia. The isotopic connection of individual concepts reflects both the reduction of contextual connections at a semantically fine-grained scale and the absence of clear boundaries between related concepts at a coarse scale, which lead to concreteness and over-inclusion, respectively.

Deciphering language disturbances in schizophrenia: A study using fine-tuned language models.

This research presents two stable language metrics, namely Successful Prediction Rate (SPR) and Disfluency (DF), to objectively quantify the linguistic disturbances associated with schizophrenia. These novel language metrics can capture both off-topic responses and incoherence in patients' speech by modeling speech information and fine-tuning techniques. Additionally, these metrics exhibit cultural sensitivity while providing a more comprehensive evaluation of linguistic abnormalities in schizophrenia. This research fine-tuned the ELECTRA Pretrained Language Model on a 750 MB text corpus obtained from major Chinese mental health forums. The effectiveness of the fine-tuned language model is verified on a group comprising 38 individuals diagnosed with schizophrenia and 25 meticulously matched healthy controls. The study explores the association between the fine-tuned language model and the Positive and Negative Syndrome Scale (PANSS) items. The results demonstrate that SPR is higher in healthy controls, indicating better language understanding by the pre-trained language model. Conversely, DF is higher in individuals with schizophrenia, indicating more inconsistent language structure. The relationship between linguistic features and P2 (conceptual disorganization) reveals that patients with positive P2 exhibit lower SPR and higher DF. Binary logistic regression using the combined SPR and DF features achieves 84.5 % accuracy in classifying P2, exceeding the performance of traditional features by 20.5 %. Moreover, the proposed linguistic features outperform traditional linguistic features in discriminating FTD (formal thought disorder), as demonstrated by multivariate linear regression analysis.

Early-emerging combinatorial thought: Human infants flexibly combine kind and quantity concepts.

Combinatorial thought, or the ability to combine a finite set of concepts into a myriad of complex ideas and knowledge structures, is the key to the productivity of the human mind and underlies communication, science, technology, and art. Despite the importance of combinatorial thought for human cognition and culture, its developmental origins remain unknown. To address this, we tested whether 12-mo-old infants (N = 60), who cannot yet speak and only understand a handful of words, can combine quantity and kind concepts activated by verbal input. We proceeded in two steps: first, we taught infants two novel labels denoting quantity (e.g., "mize" for 1 item; "padu" for 2 items, Experiment 1). Then, we assessed whether they could combine quantity and kind concepts upon hearing complex expressions comprising their labels (e.g., "padu duck", Experiments 2-3). At test, infants viewed four different sets of objects (e.g., 1 duck, 2 ducks, 1 ball, 2 balls) while being presented with the target phrase (e.g., "padu duck") naming one of them (e.g., 2 ducks). They successfully retrieved and combined on-line the labeled concepts, as evidenced by increased looking to the named sets but not to distractor sets. Our results suggest that combinatorial processes for building complex representations are available by the end of the first year of life. The infant mind seems geared to integrate concepts in novel productive ways. This ability may be a precondition for deciphering the ambient language(s) and building abstract models of experience that enable fast and flexible learning.

Adverse Childhood Experience, Parental Bonding, and Fatherhood as Parenting Vulnerabilities to Social Anxiety Severity.

Background: The present study aims to elucidate the association between adverse childhood experiences, parental bonding, fatherhood, and social anxiety symptoms among emerging adults within an Iranian context. Methods: This prospective cross-sectional study utilized self-reported assessments to evaluate fatherhood, parental bonding, anxious thoughts, and childhood trauma. The study was administered to 242 university students exhibiting social anxiety symptoms. Among the participants, 181 (74.8%) were boys and 61 (25.2%) were girls between the ages of 18 and 29. In terms of educational background, 64.9% of them held a bachelor's degree, and 35.1% held a master's degree. A majority of them (84.3%) were of middle-class socio-economic status, 6.6% were of low income, and 9.1% were of high income. Results: Analysis via multiple linear regression revealed that individuals with adverse childhood experiences exhibited heightened levels of social anxiety symptoms (R2 = 0.32) compared to their counterparts without such experiences. Furthermore, fatherhood (R2 = 0.28), paternal bonding (R2 = 0.26), and maternal bonding (R2 = 0.26) were all significantly and equally associated with variance in social anxiety symptoms. The findings underscored the substantial correlation between ACEs, fatherhood, and both maternal and paternal bonding with social anxiety symptoms in adulthood. Conclusions: Accordingly, the study emphasizes the importance of thoroughly assessing the multifaceted contributors to social anxiety. Such insights are pivotal for the design and implementation of community-based preventive interventions aimed at reducing the societal burden of social anxiety disorders.

Risk of suicide and suicide-related events in subjects treated with antiseizure medications.

INTRODUCTION: In the United States, it is reported that 1.4% of the general population commits suicide. It has been postulated that antiseizure medications (ASMs) can lead to the development of suicidal ideation and suicidal behavior; however, this risk is still very low and has yet to be precisely established. AREAS COVERED: This narrative review evaluates the risk of suicide-related events (SREs) in subjects taking ASMs for various neurological disorders. Screening tools for suicidal ideation and suicidal behavior are also discussed. References for this article were found using PubMed/MEDLINE. EXPERT OPINION: Although some ASMs can be associated with SREs, this is not yet clearly established. The mechanisms involved in suicide risk in subjects taking ASMs are multifactorial. The bidirectional relationship between depression and epilepsy, as well as other associations, should be kept in mind when interpreting any impact of ASMs in PWE. Screening for SREs, close monitoring of subjects taking ASMs are the most appropriate strategies to minimize suicide risk. More efforts should be made to achieve accurate risk stratification through prognostic models that could be applied to subjects taking ASMs. Studies exploring the association between ASMs and suicide should consider ASMs individually and control for prior SREs.