Eric A. Storch

Introduction: Osteogenesis Imperfecta (OI) is a rare genetic condition caused by an impairment in type I collagen production, resulting in several symptoms, including bone fragility and frequent fractures, bone deformities, and growth abnormalities. While physical characteristics of those with OI are well described, sexual experiences and challenges encountered by individuals with OI remain largely understudied. This study analyzed whether sexual esteem, sexual pain, desire, and emotional distress stratify between different self-reported OI types and health severity perception (HSP) groups. Sexual esteem was further evaluated to determine its relationship with the sex-related and psychosocial constructs. Methods: A cross-sectional study was conducted with 300 adults with self-reported OI diagnoses. Participants completed self-report measures of sexual esteem, sexual desire, sexual pain, anxiety, depression, and HSP. Results: This study identifies that sexual esteem is significantly different between OI types and individuals with mild vs moderate HSP. Significant associations are observed between sexual esteem with sexual pain and emotional distress. A hierarchical regression model identifies that HSP adds a significant and unique predictive value to sexual esteem. Interestingly, sexual desire was found to negatively correlate with sexual esteem. Overall, this study finds that both OI type and HSP should be considered to understand sexual well-being and highlights an important need for further research on how OI affects sexual well-being. Discussion: Individuals with OI can have positive sexual experiences which may be moderated by self-reported OI type, HSP, and emotional distress; these findings provide understanding of what degree different facets of OI affect the sexual well-being of adults with OI.

Polygenic risk scores (PRS) are rapidly developing, enabling estimates of genetic risk for developing psychiatric disorders. Psychiatric PRS are also increasingly entering consumer and clinical settings. Yet, little is known about how adults with psychiatric disorders perceive their potential use. Here, we conducted semi-structured interviews with 29 adults with psychiatric disorders to examine their perspectives on hypothetically receiving psychiatric PRS for themselves and their current or future children. Key themes emerged around perceived utility, motivations and deterrents to genetic testing, interpretation of PRS, and anticipated responses to results. In particular, participants expressed hope that PRS could support self-understanding, inform better psychiatric care, and enable earlier recognition of difficulties for their children. Participants however raised multiple concerns, including those of privacy, stigma, discrimination, eugenics, and the risk of self-fulling prophecies. Together, these findings offer critical empirical evidence to inform guidance on the responsible use of psychiatric PRS in clinical and consumer settings.

Background: Suicidal ideation among youth is a public health crisis, creating a need to identify features that can prognosticate suicide-related outcomes. This study characterized trajectories of suicidal thoughts in youth with depression/suicidality and evaluated features predicting trajectories. Methods: Participants in the Texas Youth Depression and Suicide Research Network with self-reported suicidal ideation data available for baseline and ≥2 other time points were included ( n = 1,449). Group mixture models were used to identify trajectories of suicidal thoughts at four follow-up assessments during the succeeding 6 months. Random Forest analyses evaluated baseline clinical and sociodemographic variables that predicted trajectory group membership after splitting into training (two-thirds) and validation (one-third) samples. Results: Mean (standard deviation) age was 15.6 (2.7) years, and 72.8% were female. Three trajectories were identified: persistently no (43.3%), persistently low (44.2%), and persistently high (12.4%) suicidal thoughts. In Random Forest analyses, self-reported severity of suicide propensity (including pessimism, helplessness, perceived lack of social support, and despair) plus a clinical interview of suicidal ideation predicted these trajectories. The area under the curve in training and validation samples for predicting persistently no suicidal thoughts was 0.83 and 0.80, respectively, and for persistently high suicidal thoughts was 0.87 and 0.87, respectively. Conclusions: Three distinct trajectories of suicidal thoughts were identified. A combination of baseline self-reported measures of depression, pessimism, helplessness, perceived lack of social support, and despair, along with a clinical interview of suicidal ideation, predicted no or high suicidal thoughts over 6 months with high accuracy, providing a clinically useful predictive model of suicide risk.

Bullying is widespread and negatively impacts youth mental health. However, differences between in-person bullying, cyberbullying, and their combination are understudied. To compare the prevalence, clinical presentations, and impairment associated with in-person bullying, cyberbullying, and their combination among depressed youth. Participants were N = 1,281 depressed and/or suicidal youth in Texas aged 8–17 years. Chi-square tests compared bullying prevalence across age, sociodemographic, and identity groups. Multivariate analysis of variance and post-hoc tests compared clinical presentations across forms of bullying experienced. Bullying prevalence differed by age group. Youth who experienced cyberbullying or combined bullying reported greater depression, anxiety, and impairment than non-bullied youth. Prevention and intervention strategies should address the combined effects of in-person and cyberbullying.

Objective: Chronic sensing-enabled deep brain stimulation (DBS) devices enable long-term neural recordings in naturalistic settings, but interpreting these data requires concurrent behavioral context. Our objective was to develop a reproducible end-to-end framework for continuous acquisition and synchronization of wearable-derived behavioral data alongside chronic DBS recordings to enable longitudinal neurobehavioral studies. Approach: We developed a publicly available software framework that includes automated wearable data ingestion, neural artifact handling, epoch-based temporal synchronization, and generation of analysis-ready neurobehavioral datasets. We tested this framework using simultaneous sensing-enabled DBS and Oura Ring recordings from three participants with obsessive-compulsive disorder. Main results: Using this framework, we synchronized 6,384 hours of intracranial neural recordings and wearable-derived data. The resulting multimodal neurobehavioral datasets spanned months of ambulatory monitoring and integrated chronic neural recordings with sleep-wake state, physical activity, autonomic physiology, and DBS parameters. Benchtop testing revealed 12 seconds of Medtronic Percept clock drift relative to network time over a one-week period. This temporal error was substantially smaller than the 10-minute sampling interval of the chronic neural recordings, supporting reliable alignment with wearable-derived data. Significance: This work provides an open-source, reproducible framework for continuous acquisition, synchronization, and analysis of wearable-derived data alongside sensing-enabled DBS recordings. By reducing the technical barriers to generating behaviorally annotated neural datasets, this framework enables scalable longitudinal neurobehavioral studies and provides practical foundation for biomarker discovery.

Clinical improvement following psychiatric neuromodulation often requires weeks to months, creating prolonged uncertainty during treatment optimization. Neural biomarkers could reduce this uncertainty by forecasting treatment outcome, providing early evidence of therapeutic engagement, and objectively tracking clinical response. We analyzed nearly 120,000 patient-hours of chronic intracranial recordings from 24 patients undergoing ventral capsule/ventral striatum deep brain stimulation for treatment-resistant obsessive-compulsive disorder. Before stimulation initiation, circadian neural features distinguished eventual responders from non-responders. Within the first two weeks of therapy, reductions in neural predictability differentiated eventual responders from non-responders and correlated with the magnitude of subsequent symptom improvement, months before stable clinical response was achieved. During chronic treatment, neural predictability tracked clinical response state. Together, these findings establish a framework for neural biomarkers spanning the course of DBS therapy: forecasting treatment response before stimulation, detecting early therapeutic engagement after activation, and longitudinally monitoring clinical response.

Objective: Approach–avoidance behaviors are key maintaining processes in pediatric anxiety and obsessive-compulsive disorder (OCD). However, limited research has examined which modifiable, transdiagnostic variables are most strongly and uniquely associated with these behaviors. Identifying modifiable variables is clinically important because they can be directly targeted in treatment, and transdiagnostic variables are relevant across multiple conditions that benefit from approach-based interventions. Method: Using baseline data from 112 parent–youth dyads enrolled in a larger intervention study, we applied an exploratory network analysis to examine the interconnections between candidate variables and both child- and parent-reported approach–avoidance behaviors. Results: Higher child-reported distress tolerance was uniquely associated with lower child-reported avoidance, whereas higher parent-reported child anxiety symptoms were uniquely associated with greater parent-reported child avoidance. Child- and parent-reported avoidance were also uniquely positively associated. Conclusions: Distress tolerance and anxiety symptom severity emerged as potentially important network correlates linked to approach–avoidance behaviors in anxious youth. These domains may warrant further investigation as potential intervention-relevant correlates of approach–avoidance behavior. Future research would benefit from examining correlates of approach–avoidance behaviors across additional clinical and non-anxiety contexts with larger samples.