Zhi Xu

Childhood maltreatment is associated with adult stress response, but the roles of basic psychological need satisfaction and frustration remain unclear. This study examined indirect associations between childhood maltreatment and adult stress response through psychological need dimensions, considering overall maltreatment and its subtypes. Participants were 345 adults, including 74 with and 271 without a reported psychiatric diagnosis. Self-report measures assessed childhood maltreatment, need satisfaction and frustration, and stress response. Hierarchical regression, mediation, and sensitivity analyses were conducted, adjusting for age, sex, subjective socioeconomic status, and diagnosis status. In the final regression model, competence frustration and autonomy frustration were positively associated with stress response, whereas competence satisfaction was negatively associated. In parallel mediation, only competence frustration retained a significant indirect association after false discovery rate (FDR) correction (B = .144, β = .083, adjusted p = .002). In subtype-specific models, emotional abuse showed corrected indirect associations through all need frustration dimensions, emotional neglect through all need satisfaction dimensions, and physical neglect through relatedness frustration. No corrected indirect associations were observed for sexual or physical abuse. Sensitivity analyses found no robust moderation by diagnosis status. Findings highlight competence frustration and differing need-related patterns, although the cross-sectional design precludes causal interpretation.

Major depressive disorder (MDD) is a prevalent mental disorder with a significant burden on individuals and society, and timely identification and intervention are essential for effective management. Voice data have been used as behavioral indicators of MDD, offering valuable insights into an individual's mental state. In this study, we collected voice data from 221 patients diagnosed with MDD at the inpatient ward of the Department of Psychiatry and Psychosomatics, Zhongda Hospital, Southeast University, alongside 113 healthy controls, to construct the Chinese depressive voice dataset. We proposed the cross-feature residual attention fusion network (CFRAFN), which leverages extended Geneva minimalistic acoustic parameter set features along with high-dimensional embeddings extracted from the pretrained VGGish model to effectively capture MDD-associated phonetic patterns. Specifically, CFRAFN utilizes differentiated residual blocks to maintain training stability in deep hierarchical structure. Furthermore, the self-attention fusion strategy dynamically weighted the significance of each feature modality, ensuring effective feature integration and consequently improving MDD prediction accuracy. Experimental results demonstrated that CFRAFN achieved an excellent predictive performance with an area under the receiver operating characteristic curve of 0.924 in an independent test set, and significantly outperformed 11 baseline models across 5-fold cross-validation.

Balancing psychotherapy (BPT), based on Eastern philosophical systems and the theory of balance, is a localized psychotherapeutic approach tailored to the unique psychological characteristics of Chinese individuals. This paper provides a concise overview of the theory of balance. BPT focuses on two core concepts: “mastery of degree” and “coordination of relationship.” Their philosophical foundations, including Confucianism and Yin-Yang theory, and their clinical applications are illustrated. According to BPT, when the intensity of one emotion becomes excessive, it will suppress other emotions and lead to relational imbalances, potentially resulting in psychosomatic disorders. BPT has also been applied to a range of psychological disorders, including depressive disorders, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, and others. Both individual BPT and group BPT have been implemented in clinical settings and demonstrated effectiveness. The therapeutic steps of BPT are also briefly outlined. In the discussion section, this paper compares BPT with cognitive behavioral therapy and highlights the neurophysiological mechanisms that may underlie BPT. Future studies should further explore the modern neurophysiological basis of BPT to strengthen its scientific validity.

Antidepressant efficacy is influenced by a multitude of factors, yet predicting treatment outcomes remains challenging. This difficulty is partly due to the commonly employed dichotomous classifications of treatment response that rely on a single primary endpoint. The study enrolled 972 patients diagnosed with depression, including both first-episode and recurrent cases. All patients received treatment with a single class of antidepressant medication over an eight-week period. Treatment response trajectories were identified through cluster analysis using normalized score change ratios from the 17-item Hamilton Rating Scale for Depression (HAMD-17) at baseline and weeks 2, 4, 6, and 8. The impact of psychosocial factors-including childhood trauma experience, social support, and family environment-on these response patterns was evaluated using ANOVA and Tukey's HSD tests. Additionally, targeted exome sequencing was conducted to perform rare-variant burden and enrichment analyses to investigate genetic influences on antidepressant response. Three patterns of antidepressant treatment response were identified: gradual response (C1 cluster), early response (C2 cluster), and fluctuating response (C3 cluster). Notably, patients in the C3 cluster exhibited higher levels of suicidal ideation, alexithymia, and anhedonia after the treatment period, along with the highest baseline levels of family control (a subscale of the family environment). Our rare-variant analysis revealed genes associated with response efficiency between C1 and C2 clusters to be significantly enriched in the neurotrophin signaling pathway (odds ratio = 23.94; p-adjusted = 6.96e-05). In addition, genes linked to response volatility between C1 and C3 clusters were enriched in the regulation of inflammatory mediators of transient receptor potential (TRP) channels (odds ratio = 31.5; p-adjusted = 1.83e-07). Our findings suggest that patients exhibiting a fluctuating response to antidepressant treatment may endure more severe clinical symptoms throughout the treatment course. The involvement of the neurotrophin signaling pathway and TRP channels in these response patterns highlights their potential as novel targets for therapeutic intervention in depression. This underscores the importance of personalized treatment strategies that consider the underlying genetic and psychological factors influencing antidepressant efficacy.

Psychotherapy is effective in treating various types of mental disorders. However, the biological processes underlying its therapeutic efficacy in the relief of depression and anxiety remain unclear. An approach to investigating these therapeutic mechanisms derives from an understanding of disease pathogenesis, in which the dysfunction of brain-derived neurotrophic factor (BDNF) is strongly implicated. This study provides a review of various studies investigating the link between the efficacy of talking therapies in anxiety and depression and the measures of BDNF variability, the latter determined by plasma and serum BDNF concentrations, BDNF gene polymorphisms, and DNA methylation. Despite the few intriguing findings supporting the underlying hypothesis that reduced BDNF function results in poor response, many studies are limited by inadequate methodology and poor control of confounding factors. Thus, opportunities remain for further well-designed investigations, particularly utilizing the little-studied epigenetic factor of BDNF gene methylation.