Karen B. Schmaling

Dodge et al. (2024) outlined the gap between population mental health needs and the current capacity of the U.S. health care system to provide necessary services. We add international examples and a global perspective to their observations. Unlike some nations, the mental health needs in the United States occur in the context of privatized, for-profit health care. Nations that offer population-based mental health services may have achieved greater success through the use of nontraditional providers and by leveraging technology. We suggest that both proactive and preventive interventions are needed to build a mentally healthy ecosystem in the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Peer review is a decisive factor in selecting research grant proposals for funding. The usefulness of peer review depends in part on the agreement of multiple reviewers’ judgments of the same proposal, and on each reviewer’s consistency in judging proposals. Peer reviewers are also instructed to disregard characteristics that are not among the evaluation criteria. However, for example, the gender identity—of the investigator or reviewer—may be associated with differing evaluations. This experiment sought to characterize the psychometric properties of peer review among 605 experienced peer reviewers and to examine possible differences in peer review judgments based on peer reviewer and investigator gender. Participants evaluated National Institutes of Health-style primary reviewers’ overall impact statements that summarized the study’s purpose, its overall evaluation, and its strengths and weaknesses in five criterion areas: significance, approach, investigator, innovation, and environment. Evaluations were generally consistent between reviewers and within reviewers over a two-week period. However, there was less consistency in judging proposals with weaknesses. Regarding gender differences, women reviewers tended to provide more positive evaluations, and women investigators received better overall evaluations. Unsuccessful grant applicants use reviewer feedback to improve their proposals, which could be made more challenging with inconsistent reviews. Peer reviewer training and calibration could increase reviewer consistency, which is especially relevant for proposals with weaknesses according to this study’s results. Evidence of systematic differences in proposal scores based on investigator and reviewer gender may also indicate the usefulness of calibration and training. For example, peer reviewers could score practice proposals and discuss differences prior to independently scoring assigned proposals.

Peer review is integral to the evaluation of grant proposals. Reviewer perceptions and characteristics have received limited study, especially their associations with reviewers’ evaluations. This mixed methods study analyzed the unstructured comments of 270 experienced peer reviewers after they scored proposals based on mock overall evaluations written by the primary reviewer. Comments were coded for topical content and emotional valence blind to participants’ characteristics. The most frequent comments were about their experiences with peer review with negative valence. Additional themes were identified within the content codes, including concerns about favoritism and inappropriate behavior observed in other reviewers. Reviewers who made negative comments gave poorer scores than reviewers who did not. Reviewer mindsets are understudied: negative moods and cognitions may affect reviewers’ overall evaluative severity. Future studies should further investigate these associations.

Background: Differential participation and success in grant applications may contribute to women’s lesser representation in the sciences. This study’s objective was to conduct a systematic review and meta-analysis to address the question of gender differences in grant award acceptance rates and reapplication award acceptance rates (potential bias in peer review outcomes) and other grant outcomes. Methods: The review was registered on PROSPERO (CRD42021232153) and conducted in accordance with PRISMA 2020 standards. We searched Academic Search Complete, PubMed, and Web of Science for the timeframe 1 January 2005 to 31 December 2020, and forward and backward citations. Studies were included that reported data, by gender, on any of the following: grant applications or reapplications, awards, award amounts, award acceptance rates, or reapplication award acceptance rates. Studies that duplicated data reported in another study were excluded. Gender differences were investigated by meta-analyses and generalized linear mixed models. Doi plots and LFK indices were used to assess reporting bias. Results: The searches identified 199 records, of which 13 were eligible. An additional 42 sources from forward and backward searches were eligible, for a total of 55 sources with data on one or more outcomes. The data from these studies ranged from 1975 to 2020: 49 sources were published papers and six were funders’ reports (the latter were identified by forwards and backwards searches). Twenty-nine studies reported person-level data, 25 reported application-level data, and one study reported both: person-level data were used in analyses. Award acceptance rates were 1% higher for men, which was not significantly different from women (95% CI 3% more for men to 1% more for women, k = 36, n = 303,795 awards and 1,277,442 applications, I² = 84%). Reapplication award acceptance rates were significantly higher for men (9%, 95% CI 18% to 1%, k = 7, n = 7319 applications and 3324 awards, I² = 63%). Women received smaller award amounts (g = -2.28, 95% CI -4.92 to 0.36, k = 13, n = 212,935, I² = 100%). Conclusions: The proportions of women that applied for grants, re-applied, accepted awards, and accepted awards after reapplication were less than the proportion of eligible women. However, the award acceptance rate was similar for women and men, implying no gender bias in this peer reviewed grant outcome. Women received smaller awards and fewer awards after re-applying, which may negatively affect continued scientific productivity. Greater transparency is needed to monitor and verify these data globally.

Borderline personality disorder (BPD) is often accompanied by other diagnoses. Some comorbidities have received a good deal of attention, but others, including somatization, have not. As effective treatments for BPD are identified, the secondary effects of these treatments on BPD comorbidities are of clinical relevance. Secondary data were used from a randomized clinical trial of dialectical behavior therapy (DBT) and community treatment by experts among 101 women with BPD in order to characterize change in somatization with treatment for BPD, and to examine emotional avoidance as a mediator. Somatization decreased significantly over time, which did not differ by treatment condition. DBT had an indirect effect on somatization through less emotional avoidance. These results suggest that the comorbid presence of significant somatization should be evaluated among those with BPD, especially in the context of emotional avoidance; treatments could be enhanced by addressing emotion regulation skills.

Objectives Depression affects an estimated 7% of the adult population at an estimated cost of over US$200 billion/year in the USA. Complete, transparent reporting of clinical trial data facilitates valid estimates of treatment efficacy. In the USA, ClinicalTrials.gov increases transparency through mandatory prospective trial registration and outcome reporting. We examined characteristics of the transparent reporting of depression treatment studies registered in ClinicalTrials.gov. Design Cross sectional. Setting and participants US-based studies identified in a search of ClinicalTrials.gov with depression as the condition, enrolling ages 18 and older, and completed between 1 January 2008 and 1 May 2019. Interventions All interventions were included. Main outcomes and measures The main outcome was whether any results were reported prior to 1 May 2020. Data were extracted regarding inclusion and exclusion criteria, publications related to the study and specification of hypotheses. Results 725 studies involving 156 634 patients met inclusion criteria. 416 (57.4%) of the studies posted some results. However, statistical test results were not included in 230 studies (55.3%). Most studies had data that could have been analysed and reported. Compared with studies without results, studies with any results were more likely to have hypotheses, include drug treatment conditions, and to have publications related to the study. Conclusions Required study registration does not always result in transparent outcome reporting. Better compliance with mandated reporting and improved reporting standards would facilitate a more comprehensive representation of depression treatment research.