Phyllis Solomon

Maternal and infant risk characteristics, including postpartum depression, infrequent neonatal intensive care unit (NICU) visitation, low gestational age, low birthweight, and prolonged NICU hospitalization, were examined as potential predictors of lower levels of maternal-infant bond or affective connection among mothers of NICU infants, while controlling for civil status and number of siblings. A correlational longitudinal design was used with a convenience sample of 101 mother-infant dyads in a university hospital NICU. Measures included the Maternal Attachment Inventory (MAI), the Edinburgh Postnatal Depression Scale, and medical record data. Multiple regression analyses, chi-square tests, and analyses of variance (ANOVA) were employed. Although the primary hypothesis was not supported, post hoc analyses showed that postpartum depression was associated with decreased maternal bond or affective connection. Mothers who developed clinical postpartum depression between Times 1 and 2 demonstrated the greatest decline in bond or connection compared to those with persistent or absent depression. Several MAI items were more normally distributed than total scores, highlighting specific attachment challenges in the NICU context. These findings suggest the need for targeted clinical interventions to address processes that may disrupt maternal-infant bond in high-risk NICU populations. The implications for disenfranchised populations, including non-White and lower socioeconomic status (SES) groups, are also discussed.

Artificial intelligence (AI) is increasingly used for psychological support, yet the conditions that shape who turns to AI for counseling remain poorly understood. Internalized shame is a well-documented barrier to formal, human-delivered mental health care, but its role may differ in AI counseling, which lacks a human interlocutor whose judgment can be anticipated. This study examined whether internalized shame mediates the association between perceived social support and AI counseling use among Korean college students. A sample of 512 Korean college students completed measures of perceived social support, internalized shame, and frequency of AI counseling use. A second-order structural equation model was estimated using weighted least squares with mean and variance adjustment to accommodate the ordinal outcome, with gender, age, academic year, and subjective socioeconomic status included as covariates. The direct association between perceived social support and AI counseling use was not significant (β = −.026). Instead, the association operated entirely through an indirect path. Lower perceived social support was associated with higher internalized shame, which in turn was associated with more frequent AI counseling use (indirect β = −.115, p < .001). This pattern indicates that internalized shame, rather than functioning solely as a deterrent to help-seeking as documented for human-delivered care, was associated with greater engagement with AI counseling. The findings suggest that the deterrent function of shame is channel-conditional, giving way to engagement when the help-seeking channel removes a human evaluator. AI counseling use may serve as an observable signal of psychological vulnerability that formal services often miss.

Background: Depression in late life is often compounded by social isolation and barriers to care. There is limited study of technology-enhanced peer support for depression among older adults. Objective: This study aimed to assess the feasibility and acceptability of a technology-enhanced peer support intervention to decrease depression among older adults. Methods: We used a mixed methods pilot study among adults aged 50 years and older with depression who received a peer support intervention called Peers+. The intervention consisted of 8 weekly video chats and unidirectional texts focused on increasing depression self-care and coping. Data obtained from screening, baseline, postintervention, and 3-month follow-up were used in the analysis to assess preliminary outcomes of the intervention. Mixed effects longitudinal models were used to assess change in depression, and qualitative data were collected and analyzed to identify key themes related to participant experiences. Results: A total of 34 older adults with a mean age of 67 (SD 9.57) years participated in the study, and 82.4% (28/34) of participants finished all 8 intervention meetings. Depressive symptoms declined over the course of the study of 35 weeks (F1, 88.8=26.0; β=–.14, 95% CI –0.20 to 0.09; P<.001). Emotional well-being (β=.48, 95% CI 0.26-0.70; P<.001), social functioning (β=.71, 95% CI 0.33-1.09; P<.001), self-efficacy (β=2.29, 95% CI 0.83-3.75; P<.001), and coping (β=2.90, 95% CI 0.24-5.55; P<.001) improved throughout the study period. Participants perceived supportive texts as reinforcing trust between peer coaches, using coping strategies, increasing social connection, and providing accountability for improving self-care. Peer coaches and older adults needed technology support for participation in the study. Conclusions: This study demonstrated the feasibility and acceptability of a peer support intervention enhanced by video chats and texts, delivered by older adult peer coaches to an ethnically diverse group of older adults with depression. Study findings indicate that ongoing and accessible technology support contributed to older adult participation and engagement.

Objectives: Mindfulness-based cognitive therapy (MBCT) integrates cognitive therapy and mindfulness meditation to help individuals disengage from maladaptive thoughts and reactive behavioral patterns. By cultivating nonjudgmental present-moment awareness and decentering from thoughts and emotions, MBCT enhances the capacity to respond more skillfully, thereby reducing impulsivity and promoting self-control. This study pilot-tested the effectiveness of MBCT for internet gaming disorder (MBCT-G) among college-aged students at risk for problematic gaming, focusing on reducing symptoms of internet gaming disorder and secondarily on psychological benefits. Method: A pilot experimental study was conducted in South Korea with 46 college-aged students at high risk of internet gaming disorder. The intervention group ( n = 24) participated in eight group sessions of MBCT-G and a control group ( n = 22) received no intervention. Internet gaming disorder, impulsivity, depressive symptoms, perceived stress, anxiety, and self-control were assessed before and after the intervention and at 4 weeks postintervention. Results: Linear mixed-model analyses indicated participants in the intervention group had greater reductions in internet gaming disorder symptoms, perceived stress, and state anxiety and enhanced improvement in self-control relative to the control group; these changes persisted at 4-week follow-up except for state anxiety. Conclusions: Findings suggested MBCT-G is a promising intervention for college-aged students whose gaming is problematic and puts them at risk for gaming disorder. Further research is needed with a larger sample, a comparison group receiving an alternative intervention and a longer follow-up period. Preregistration: This study was not prospectively registered; however, it was retrospectively registered with ISRCTN Registry (# ISRCTN17598517).

BACKGROUND Depression in late life is often compounded by social isolation and barriers to care. There is limited study of technology-enhanced peer support for depression among older adults. OBJECTIVE This study aimed to assess the feasibility and acceptability of a technology-enhanced peer support intervention to decrease depression among older adults. METHODS We used a mixed methods pilot study among adults aged 50 years and older with depression who received a peer support intervention called Peers+. The intervention consisted of 8 weekly video chats and unidirectional texts focused on increasing depression self-care and coping. Data obtained from screening, baseline, postintervention, and 3-month follow-up were used in the analysis to assess preliminary outcomes of the intervention. Mixed effects longitudinal models were used to assess change in depression, and qualitative data were collected and analyzed to identify key themes related to participant experiences. RESULTS A total of 34 older adults with a mean age of 67 (SD 9.57) years participated in the study, and 82.4% (28/34) of participants finished all 8 intervention meetings. Depressive symptoms declined over the course of the study of 35 weeks (F1, 88.8=26.0; β=–.14, 95% CI –0.20 to 0.09; P<.001). Emotional well-being (β=.48, 95% CI 0.26-0.70; P<.001), social functioning (β=.71, 95% CI 0.33-1.09; P<.001), self-efficacy (β=2.29, 95% CI 0.83-3.75; P<.001), and coping (β=2.90, 95% CI 0.24-5.55; P<.001) improved throughout the study period. Participants perceived supportive texts as reinforcing trust between peer coaches, using coping strategies, increasing social connection, and providing accountability for improving self-care. Peer coaches and older adults needed technology support for participation in the study. CONCLUSIONS This study demonstrated the feasibility and acceptability of a peer support intervention enhanced by video chats and texts, delivered by older adult peer coaches to an ethnically diverse group of older adults with depression. Study findings indicate that ongoing and accessible technology support contributed to older adult participation and engagement.

Social determinants of health (SDoH), including structural racism and economic marginalization, shape mental health outcomes but are frequently conceptualized at a level too broad for direct clinical intervention. In contrast, health-related social needs (HRSNs), such as food insecurity and housing instability, represent more proximal and actionable targets within clinical and community-based settings. Despite growing recognition of their importance, the relationship between HRSNs and depression among structurally marginalized older adults remains under explored. This study seeks to evaluate the association between HRSNs and depressive symptoms among low-income White as well as racially and ethnically minoritized older adults. Cross-sectional analysis of baseline data from a randomized controlled trial (Feb 2020-May 2022). Participants included 134 adults aged ≥50 years with depressive symptoms (PHQ-9 ≥ 5), cognitively intact, and either self-identified as a person of color or had income via PHQ-9. HRSNs were measured using the CMS Accountable Health Communities screening tool. Multiple linear regression models adjusted for age, gender, race/ethnicity, and comorbidity. Participants had a mean age of 70.8 years; 84.3% were female. Fifty-two percent were Black or African American; 41% were low-income White. Food insecurity (31.1%) and transportation barriers (22.7%) were common. Total HRSNs were associated with higher PHQ-9 scores in unadjusted models (p = 0.0035), but not after adjustment. Food insecurity remained independently associated with depression (B = 2.81, p = 0.001). Food insecurity is linked to greater depressive symptoms. Implementing screening and referral systems for HRSNs may improve mental health care for marginalized older adults.

Objective: This study investigated the extent to which subjective norms, attitudes, knowledge, and behavioral control explained social workers’ intention to employ exposure and response prevention (ERP) in treating obsessive-compulsive disorder in the United States. Methods: Social workers ( N  = 168) completed measures through Qualtrics. We hypothesized clinicians who endorsed greater behavioral control, social norms, and attitudes would have higher behavioral intentions of using ERP. Regression analysis tested this hypothesis. We further hypothesized clinicians with prior behavioral intent and greater knowledge would have more influential factors and current behavioral intention. These were tested with t -tests. Results: Greater behavioral control, attitudes, and social norms significantly increased behavioral intention to use ERP. Social norms produced a large effect (β = 0.50), attitudes a medium effect (β = 0.35), and behavioral control a small effect (β = 0.25) on behavioral intention. Prior behavioral intent significantly increased these factors. Discussion: Attitudes, behavioral control, and social norms significantly impact behavioral intention to use ERP.