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Despite the amount of time adolescents spend online, relatively little research has focused on parental monitoring of adolescents' online behavior. The present study examined late adolescents' retrospective evaluations of parental rules and their right to know about routine versus online activities, beliefs about the costs and benefits of regulating online behavior, and digital parenting and its correlates. 244 U.S. college students (M = 20.29 years, SD = 1.27; 178 females, 107 Asians) completed an online survey in 2019 examining parents' rules, their acceptability, and parents' right to know about their routine activities versus online behavior when they lived at home. They also rated the costs and benefits of parental monitoring of online behavior, digital parenting and its acceptability, and parent-adolescent relationship dynamics. Participants reported that parents had more rules, rated them as more acceptable, and viewed parents as having more right to know about routine than online activities. Parental monitoring of online behavior was seen as more privacy-invasive than as facilitating adolescent development. Path analyses revealed that digital parenting was associated with more rules and more psychologically controlling parenting, whereas greater acceptance of digital parenting was associated with more negative parent-adolescent relationships, more parental right to know, and beliefs that monitoring enhances maturity and safety. Late adolescents acknowledged the benefits of parental monitoring of online behavior, but they also viewed it as privacy-invasive and psychologically controlling. Findings reveal the tensions among adolescents' desires for autonomy, their need for privacy, and parents' responsibility to keep adolescents safe.

Patient satisfaction is an important indicator of healthcare quality and a determinant of treatment success. To assess parents'/carers' satisfaction with their children's/adolescents' orthodontic treatment and to investigate associations among study variables using a validated instrument. A cross-sectional survey study was conducted with parents/carers of 68 children/adolescents aged 6-17 years. Satisfaction was assessed using the Questionnaire of Satisfaction with Orthodontic Treatment, comprising 25 items distributed across three subscales: treatment process, psychosocial effect of treatment and treatment outcome. Sociodemographic and clinical data were also collected. Descriptive analyses and Poisson regression models were performed, with results expressed as odds ratio (OR) and 95% confidence interval (CI). Of the 68 parents/carers, 48 (70.6%) were male. Among the children/adolescents, 34 (50%) were male (mean age 12.84 years). Parents/carers from households with four or more individuals had significantly lower satisfaction scores on the treatment process subscale than those from households with three or fewer individuals (OR = 0.93; 95% CI = 0.83-0.98; P = 0.016). Parents/carers of children/adolescents who had undergone corrective treatment had significantly higher scores on the psychosocial effect subscale (OR = 1.10; 95% CI = 1.01-1.21; P = 0.023), treatment outcome subscale (OR = 1.07; 95% CI = 1.01-1.14; P = 0.016) and total score (OR = 1.06; 95% CI = 1.01-1.13; P = 0.032) than those whose children/adolescents had received interceptive/corrective treatment. Parents/carers of children/adolescents with more severe malocclusion reported significantly higher satisfaction scores than those with less severe malocclusion (OR = 1.02; 95% CI = 1.01-1.03; P = 0.010). Family size, type of orthodontic treatment and malocclusion severity were associated with parents'/carers' satisfaction with their children's/adolescents' orthodontic treatment. How satisfied parents and carers were with their children’s orthodontic treatmentWhy was the study done?Orthodontic treatment works better when patients and families are satisfied with the care they receive. Parents and carers play an important role when children and teenagers have orthodontic treatment.What did the researchers do?The researchers interviewed parents/carers of children/adolescents aged 6–17 years who had finished orthodontic treatment. They used questionnaires to ask about social and financial factors and about views on orthodontic care. The main questionnaire was the Questionnaire of Satisfaction with Orthodontic Treatment.What did the researchers find?The study included 68 parents/carers. Most respondents were male. Parents/carers from larger families, with four or more members, were less satisfied with the treatment. Satisfaction was higher when treatment had fewer phases and when the orthodontic problem was more severe before treatment started.What do the findings mean?Parents’/carers’ satisfaction was linked to family size, the number of treatment phases, and how severe the orthodontic problem was before treatment. Orthodontists should consider these factors when planning treatment and talking with families.

Accidents and injuries are the leading causes of preventable death among adolescents and are often related to substance use. About 60% of US high school students have tried alcohol and 22% report current alcohol use. Preventing and reducing adolescent alcohol use would contribute to substantial health benefits and prevent major health morbidity and mortality. Advances in interactive narrative learning technologies hold promise for designing games for health that effectively deliver age-appropriate and personalized behavior change interventions. The Interactive Narrative System for Patient-Individualized Reflective Exploration (INSPIRE) is designed to serve as an extension to clinical preventive care, engaging adolescents in a theoretically grounded alcohol prevention intervention by leveraging the dual mechanisms of interactive narrative and 3D game technologies. This pre-post study aims to examine the impact of INSPIRE on adolescents' self-efficacy to avoid risky alcohol-related behavior and knowledge about alcohol risk. A total of 44 adolescents in high school (aged 14-16 years; mean 15.16, SD 0.95; n=22, 50% female) were recruited using convenience sampling from an after-school program in the San Francisco Bay Area. The largest proportion of participants identified as Hispanic or Latine (n=15, 34%), followed by White, Asian, and multiple racial or ethnic backgrounds. Participants completed two 20-minute web-based interactive narrative episodes. We compared pretest and posttest data to examine changes in adolescents' self-efficacy and knowledge using a combination of questionnaire and computer interaction trace log data. Self-efficacy was measured using a 24-item scale (&#x3b1;=.95; 0-10 rating). Knowledge was assessed using 10 multiple-choice items derived from in-game content. Pre-post changes were analyzed using Wilcoxon signed-rank tests (&#x3b1;=.05), with rank-biserial correlation effect sizes and 95% CIs. Approximately 25% (n=11, 95% CI 14.6%-39.4%) of study participants reported having consumed alcohol at least once, and 23% (n=10, 95% CI 12.8%-37.0%) reported alcohol use within the past year. Self-efficacy scores significantly increased from 7.97 (SD 2.24) at pretest to 8.72 (SD 1.58) at posttest, with a mean difference of 0.75 (95% CI 0.59-0.91; P<.001; r=0.89). Knowledge scores also significantly increased from 5.09 correct (median 5.0, IQR 4.0-6.0) at pre-test to 6.11 correct (median 7.0, IQR 5.0-8.0) at posttest, with a mean increase of 1.02 (95% CI 0.31-1.74; Wilcoxon signed-rank test, P<.001; r=0.57). Reflection tool clustering revealed 4 behavioral strategy endorsement profiles. As a first of its kind interactive narrative intervention, INSPIRE offers an innovative theoretically grounded model for supporting adolescent health behavior change. This study enhances our understanding of how to use innovative learning technologies to reduce risky alcohol use. Extending prior research in the field through using personalized narrative adaptations, this study indicates that through reinforcing goals and decisions to avoid risky behavior, adolescents can enhance their self-efficacy beliefs to avoid risky alcohol use and increase their knowledge about alcohol risk. Implications of these outcomes include the potential to facilitate the generalization of preventive behaviors to real-life situations.

Mixed evidence for the influence of structural and social factors on adolescent substance use behaviors exists across the rural-urban continuum. Therefore, this study explores how adolescent perceptions of structural and social community risk factors are associated with lifetime and past 30-day use of alcohol, marijuana, cigarettes, and illicit drugs among adolescents in different geographic locations. Data from 9819 adolescents from the 2019 Florida Youth Substance Abuse Survey were used to estimate associations between adolescent perceptions of community risk factors and lifetime and past 30-day alcohol, marijuana, cigarette, and illicit drugs using logistic regression models stratified by geographic location. Adolescent perceptions of community disorganization were significantly associated with lifetime and past 30-day alcohol use among town and rural adolescents and illicit drug use among adolescents from all geographic locations. Findings point to shared and unique risk and protective processes in geographic locations with implications for future research and community prevention efforts.

To analyze the association between painful temporomandibular disorders (TMD), sleep bruxism, and anxiety symptoms in adolescents. A cross-sectional study was conducted with 497 adolescents aged 14-19 years. Data were collected on sociodemographic characteristics, painful temporomandibular disorders, sleep bruxism, and anxiety symptoms. Associations between categorical variables were assessed using Pearson's chi-square test, and binary logistic regression was performed to evaluate factors associated with painful temporomandibular disorders, with a significance level of 5%. The prevalence of painful TMD was 29.6%, anxiety symptoms were present in 78.9% of the sample, and clinically defined sleep bruxism was identified in 4.4% of the participants. In the adjusted model, adolescents with anxiety symptoms were 2.7 times more likely to have painful TMD (95% CI 1.5-4.8), and those with sleep bruxism were 6.5 times more likely to have painful TMD (95% CI 2.5-17.2). The highest estimated probability of painful TMD (74.7%) was observed among adolescents presenting both anxiety symptoms and sleep bruxism. Painful temporomandibular disorders were significantly associated with anxiety symptoms and sleep bruxism in adolescents, whereas no significant associations were observed with the sociodemographic factors examined. These findings highlight the importance of early identification of the co-occurrence of painful temporomandibular disorders, sleep bruxism, and anxiety symptoms in adolescents, supporting preventive strategies and multidisciplinary care aimed at reducing chronic pain and its psychosocial impact.

Social anxiety disorder (SAD) is a prevalent disorder that often begins during adolescence, leading to considerable challenges in social functioning and overall mental health. Previous studies have demonstrated that mentalization deficits and emotion regulation difficulties are each independently associated with social anxiety. The present study aimed to concurrently examine the associations of emotion regulation difficulties and mentalization deficits with SAD in adolescent girls. The study sample consisted of 105 adolescent girls, conducted in T&#xfc;rkiye, including 69 treatment-na&#xef;ve adolescents diagnosed with SAD without psychiatric comorbidities and 36 healthy controls. Mentalization was assessed by the Movie for the Assessment of Social Cognition (MASC) and Reading the Mind in the Eyes Test (RMET). All participants filled in the Social Anxiety Scale for Adolescents (SAS-A) and Difficulties in Emotion Regulation Scale (DERS). Compared with healthy controls, adolescents with SAD demonstrated lower general mentalizing ability, higher levels of hypermentalizing errors, and greater difficulties in emotion regulation (p&#x2009;<&#x2009;0.001). Within the SAD group, none of the mentalization measures were directly associated with symptom severity. Lower levels of no-mentalizing were associated with greater emotion regulation difficulties (&#x3b2;&#x2009;=&#x2009;-0.24, p&#x2009;=&#x2009;0.04), and greater emotion regulation difficulties were associated with higher social anxiety symptoms (&#x3b2;&#x2009;=&#x2009;0.35, p&#x2009;<&#x2009;0.01); however, the indirect effect of no-mentalizing on social anxiety symptoms through emotion regulation difficulties was not statistically significant (&#x3b2;&#x2009;=&#x2009;-0.09, 95% CI [-0.21, 0.01]). The present findings suggest that mentalization and emotion regulation processes may contribute to a more comprehensive understanding and addressing of SAD in adolescents.

Parent-child interactions constitute a critical developmental context for the psychosocial adjustment of adolescents. This study aimed to differentiate parenting styles and examine their domain-specific effects on later adolescent outcomes, using a culturally sensitive, person-centered approach. This study employed latent profile analysis (LPA) on a national sample of 8333 Chinese parent-adolescent dyads (4564 mother-child and 3769 father-child dyads) from the China Education Panel Survey (CEPS). At baseline, adolescents were aged 12.93 years on average (SD&#x2009;=&#x2009;0.82), and 51.5% of them were boys. Analyses were conducted separately for the full sample of parents, mothers, and fathers to identify distinct parenting profiles and their subsequent influence on adolescent academic difficulty, deviant peer affiliation, and depression. A robust four-profile structure namely Authoritative, Managerial, Warm Harbor, and Disengaged was identified for the full and maternal samples. Crucially, a unique five-profile structure emerged for fathers, featuring an additional Emotionally Detached profile characterized by average discipline but extremely low warmth. Further analyses revealed that the Authoritative and Warm Harbor profiles were associated with more favorable outcomes across all domains, particularly in mother-child dyads. For father-child dyads, the Emotionally Detached profile was uniquely associated with higher academic difficulty, deviant peer affiliation, and depression. These findings underscore the necessity of using gender-differentiated, person-centered approaches to understand culturally configured parenting and its consequences. Moving beyond uniform theoretical models, these results inform more targeted research and family support practices.

Orthotic treatment for adolescents diagnosed with idiopathic scoliosis is long-term and often associated with challenges related to treatment adherence. Traditional patient monitoring strategies include clinical visits combined with patient discussions, clinical examination reports, and the use of standard questionnaires. Sensor-assisted monitoring is explored to improve treatment outcomes, with technology influencing different aspects of the health care system. The scoping review aimed to map evidence based on 3 research questions (RQs), namely user experience and perception, monitoring tools, and technology-assisted approaches, including smart orthoses with sensors, during orthotic treatment for an adolescent patient (aged 10 to 17.11 y) diagnosed with idiopathic scoliosis. A systematic search was conducted in MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, and Scopus as 2 complementary search components. The primary search targeted studies on smart orthoses, also called braces, and scoliosis, while the secondary search focused on user experiences with orthotic treatment to capture all 3 RQs. PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews) guidelines and checklist supported searching, analyzing, and reporting the results systematically. Predefined inclusion and exclusion criteria were followed for screening. All articles published up to May 2024 were included. Moreover, 2 independent reviewers screened 2088 articles in 2 stages of screening. Data coding was conducted using the 3 RQs by data extraction and its synthesis. A total of 88 articles met the inclusion criteria. Evidence from user experience studies highlighted discomfort, psychosocial burden, and demand for real-time feedback. Monitoring relied primarily on patient-reported outcome measures (PROMs) such as questionnaires and logbooks. Culturally adapting to patients' diverse global needs helps capture richer and more candid user perspectives. Sensor-based systems used temperature, force, or pressure, electromyography, and motion sensors to track orthosis wear time, pressure distribution, activity, and posture. Two overarching monitoring themes emerged: subjective (patient-reported or user experience) and objective (technology-assisted or sensor-based) monitoring. Integrated approaches synthesize both. Subjective clinical tools and objective technologies help monitor orthosis wear of adolescent patients with idiopathic scoliosis. Co-design of a user-centered scoliosis management system for adolescents that integrates PROMs with measured sensor data could provide a multidimensional view of orthosis adherence along with psychosocial and clinical effectiveness. Future research will focus on user-centered care, with real-time integrated monitoring, to provide clinically meaningful feedback that motivates adolescents to achieve their treatment goals.

Adverse childhood experiences (ACEs) are associated with social isolation, a known contributor to diminishing mental health with consequences for adolescent development. We evaluated effects of the SKY Schools program, which combines social emotional learning (SEL) with training in autonomic regulation (breathwork), on social connectedness (SC) in female Latinx adolescents with high ACEs, a group particularly vulnerable to ACEs effects. In this longitudinal study, female Latinx students (N&#x2009;=&#x2009;174, 14-18&#x2009;years; M&#x2009;=&#x2009;14.97; SD&#x2009;=&#x2009;0.97) in two Southern California high schools with high (&#x2265;4) and low (<4) ACEs either completed the four-week SKY Schools program plus 8&#x2009;weeks of daily breathwork or underwent their usual physical education curriculum (control). We administered the Social Connectedness Scale before and after the program and again after 8&#x2009;weeks. Relative to baseline, the high ACEs intervention group showed increased SC (7%) after daily breathwork compared with the control groups (low ACEs: 3%, high ACEs: -3%) and the low ACEs intervention group (-3%) (p&#x2009;<&#x2009;.01). Biopsychosocial programs that combine SEL and breathwork can reduce feelings of social isolation in socially vulnerable Latinx female adolescents, facilitating healthy adolescent development.

Both childhood trauma as a stressful event and perceived stress as stress appraisal increase the risks of sleep problems, particularly among adolescents. However, how childhood trauma and perceived stress exert a combined effect on the development of sleep problems in adolescence remains unclear. The present study investigated the heterogeneous developmental trajectories of sleep problems among adolescents, and whether childhood trauma and perceived stress sequentially or interactively affected the heterogeneous trajectories of sleep problems. Altogether 197 adolescents completed the Childhood Trauma Questionnaire at T1 (Nov. 2021), the Perceived Stress Scale at T2 (May 2023), and the Pittsburgh Sleep Quality Index at T1, T2, and T3 (May 2024). Results revealed three heterogeneous trajectories of sleep problems, including the low group, the high-increasing group, and the moderate-increasing group. In addition, higher perceived stress rather than childhood trauma independently predicted a greater likelihood of being in the high-increasing group or moderate-increasing group relative to the low group. Perceived stress mediated the relationship between childhood trauma and the heterogeneous trajectories of sleep problems. However, the interaction effect of childhood trauma and perceived stress on the heterogeneous trajectories of sleep problems was non-significant. These findings suggest that childhood trauma and perceived stress sequentially rather than interactively affect the heterogeneous developmental trajectories of adolescent sleep problems.

It is important to improve understanding of how parenting stress and coping strategies may be associated. Various coping strategies have been associated with different psychosocial outcomes, including anxiety and depression. Gender differences in coping between women and men may contribute to women reporting higher levels of psychological distress, depression, and anxiety. However, there is a lack of research on gender differences in stress responses and coping behaviors among parents in response to the stress of parenting adolescents, particularly during the COVID-19 pandemic. The current study aimed to address this gap in the literature by recruiting 396 parents (200 mothers and 196 fathers) of adolescents aged 12 to 16 years during the COVID-19 pandemic (November to December, 2021). Participants completed self-report measures and engaged in a standardized audio vignette paradigm to evaluate emotional responses to stress-inducing scenarios involving their adolescent children. Secondary control coping and affective symptoms were associated with maternal emotional reactions to the standardized audio vignettes, while paternal affective symptoms and secondary control coping were associated with anxious responses to the audio vignettes. These findings provide preliminary evidence that it may be important to promote secondary control coping, and to target parental affective symptoms in order to improve parent affective responses to difficult interactions with offspring.

Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity that impairs physical function and quality of life. While supervised exercise is recommended for moderate cases, its effectiveness remains debated. This meta-analysis evaluates the impact of exercise therapy on Cobb angle, trunk rotation (ATR), and quality of life (QoL) in AIS patients. We systematically searched PubMed, Web of Science, EBSCO and China National Knowledge Infrastructure (CNKI) databases from inception to October 2025 for randomized controlled trials (RCTs) investigating exercise in AIS. Study quality was assessed using the PEDro scale. Data synthesis involved pooling effect sizes, conducting subgroup analyses, and assessing publication bias using Stata 18. A total of 26 studies (21 RCT and five controlled trials) were included in the meta-analysis. The exercise intervention demonstrated statistically significant improvements across multiple functional domains: reduced the Cobb angle (Hedge's = 1.22, 95% CI [0.90-1.53]), improved the ATR (Hedge's systematically searched 1.25, 95% CI [0.74-1.76]), and enhanced QoL (Hedge's systematically searched 0.73, 95% CI [0.38-1.09]). Subgroup analyses further indicated that Schroth-based training (Hedge's = 1.304) and combined approaches (e.g., exercise with orthotic management) yielded the most favorable outcomes. Importantly, both short-term (&#x2264;12 weeks, 1-2 sessions/week) and long-term (&#x2265;25 weeks, &#x2265;5 sessions/week) intervention durations demonstrated significant clinical efficacy. Exercise therapy demonstrates significant potential as a fundamental conservative intervention for improving spinal morphology, function, and quality of life in adolescents with idiopathic scoliosis. The current evidence supports its integration into primary clinical management protocols. Future research should focus on conducting multi-center randomized controlled trials to validate long-term efficacy and to establish optimal, individualized intervention protocols.

To validate a wrist-worn multimodal wearable system for synchronised monitoring of multispectral light exposure, activity phenotypes and five-stage sleep architecture in children and adolescents in a structured 24-h pilot validation protocol. A wrist-mounted multimodal wearable system was developed, integrating a 9-channel multispectral light sensor (350-1000&#x2009;nm), a 9-axis inertial measurement unit (IMU) and a photoplethysmography (PPG) sensor for synchronised acquisition of environmental light, body movement and cardiovascular signals. Twelve healthy children and adolescents (mean age: 10.04&#x2009;&#xb1;&#x2009;3.26 years; range: 6-15 years) underwent a 24-h pilot validation protocol. Long short-term memory (LSTM) networks were developed for activity recognition and a Stacking ensemble framework combined with cost-sensitive learning was implemented for five-stage sleep classification, i.e., wake (W), non-rapid eye movement stage 1 (N1), non-rapid eye movement stage 2 (N2), non-rapid eye movement stage 3 (N3) and rapid eye movement (REM). Under the three lighting conditions tested, the device captured distinct spectral irradiance profiles: outdoor natural light (1.8&#x2009;W&#x2009;m-2&#x2009;nm-1; broad-spectrum 350-1000&#x2009;nm), indoor natural light (0.30&#x2009;W&#x2009;m-2&#x2009;nm-1) and artificial illumination (0.07&#x2009;W&#x2009;m-2&#x2009;nm-1; peak at 545-600&#x2009;nm). The LSTM-based model achieved 86.33% overall accuracy for five-activity classification, with 92.4% for writing and 91.5% for walking. The Stacking ensemble sleep classifier attained 83.41% overall accuracy; cost-sensitive learning improved N3 and REM detection by 15.8% and 8.9%, respectively. Incorporation of PPG signals enhanced activity recognition accuracy by 3.62%. This multimodal platform enabled objective, high-resolution quantification of paediatric light exposure, behaviour and sleep architecture in a structured pilot validation setting, supporting individualised assessment of modifiable myopia-related factors.

Despite the growth of research in the United Kingdom exploring adolescent partner violence (APV), the perspectives of adults working with young people have been excluded. This exploratory study used interviews with safeguarding leads, pastoral workers and service practitioners to understand their perspectives on APV. Thematic analysis generated four themes: (a) a lack of conceptual clarity; (b) multiple oppressions and harmful relationship norms; (c) inadequate prevention and support; and (d) collaborative intervention. The findings, analysed through an intersectional lens, highlight the complexities of APV and the need for greater clarity, tailored support and collaboration between young people, their guardians and professionals. Theoretically, this advances current scholarship by situating the drivers of APV within interlocking systems of oppression, thereby embedding individual experiences within wider structural power relations. These findings extend the literature by evidencing the limitations of rigid victim-perpetrator labels and advancing a more nuanced, intersectionally informed understanding of relationship harm, particularly in the context of alternative provision.

To validate the accuracy and safety of the Arm-Type Fully Automatic Blood Pressure Monitor (model: DBP-62F4B-P) manufactured by JOYTECH Healthcare Co., Ltd. for blood pressure (BP) measurement in adolescents and adults with arm circumference 22.0-42.0&#x2005;cm, in accordance with the Association for the Advancement of Medical Instrumentation (AAMI)/European Society of Hypertension (ESH)/International Organization for Standardization (ISO) (ISO 81060-2:2018+Amd 2:2024) international standard. A total of 90 subjects were enrolled. Three valid datasets were collected from each subject, yielding 270 datasets for analysis. The mercury sphygmomanometer (reference device) data were used as the gold standard to evaluate whether the accuracy of the test device met the requirements. Based on 270 valid datasets, the mean difference between the test device and the reference device for SBP was -0.49&#x2005;mmHg (SD&#x2005;=&#x2005;7.29&#x2005;mmHg), and for DBP was 1.45&#x2005;mmHg (SD&#x2005;=&#x2005;6.14&#x2005;mmHg), meeting Criterion 1 requirements. Analysis based on individual averages of the 90 subjects showed a mean difference of -0.49&#x2005;mmHg (SD&#x2005;=&#x2005;5.57&#x2005;mmHg) for SBP and 1.45&#x2005;mmHg (SD&#x2005;=&#x2005;5.05&#x2005;mmHg) for DBP, both meeting the requirements of Criterion 2. The device maintained stable measurement performance across different arm circumferences, ages, and BP levels. The Arm-Type Fully Automatic Blood Pressure Monitor (model: DBP-62F4B-P) meets the accuracy and consistency requirements of the AAMI/ESH/ISO (ISO 81060-2:2018+Amd 2:2024) standard for SBP and DBP measurement in adolescents and adults with arm circumference 22.0-42.0&#x2005;cm. It can be safely and effectively used for BP monitoring in clinical settings and, by extension, is suitable for home use based on its design features and validation performance.

The intersection of pediatric psychiatry and infectious disease can present complex diagnostic challenges, particularly when symptoms of organic medical etiology mimic severe psychiatric disorders. This case study analyzes the clinical trajectory of an adolescent patient who developed delirious mania - a subtype of catatonia combining manic, delirious, and psychotic features - following the administration of clarithromycin and amoxicillin for Helicobacter pylori (H. pylori) gastritis. Initially presenting with psychosis and delirium attributed to a prior Coronavirus Disease 2019 (COVID-19) infection and recurrent cannabis use, the patient underwent six hospital admissions over four months. While the patient's initial symptoms were thought to be likely due to cannabis-induced psychosis, the emergence of treatment-resistant delirious mania during her sixth admission led to treatment shifts that resulted in symptom improvement. This case review proposes a methodological framework for mitigating "anchoring bias" and identifying iatrogenic or other triggers in treatment-refractory psychiatric presentations. Ultimately, this work emphasizes the critical need for continuous medical re-evaluation in psychiatric settings as well as demonstrates that even common antibiotic regimens, like "triple therapy" for H. pylori, can precipitate severe neuropsychiatric syndromes in vulnerable adolescents.

Health care transition (HCT) is underexplored among autistic adolescents and young adults (AYAs). We explored autistic AYAs' HCT experiences through virtual semi-structured interviews with 19 participants (mean age&#x2009;=&#x2009;21.4&#x2009;years; range&#x2009;=&#x2009;15-25). Data were analyzed using reflexive thematic analysis and interpreted through self-determination theory (SDT). Participants described HCT as marked by increased expectations for independent health care management without commensurate preparation, relational continuity, or structural support. Findings were organized around SDT domains of competence, autonomy, and relatedness, which were interconnected. Gaps in competence constrained autonomy and contributed to stress and care avoidance. Autonomy was negotiated and situational, often supported through ongoing caregiver involvement rather than full independence. Relatedness was undermined by fragmented care, limited continuity, and experiences of being dismissed by providers. Structural factors (transportation, insurance acceptance, provider availability, and rurality) shaped when and how these psychological needs could be met, amplifying transition-related challenges. Autistic AYAs want to take ownership of their care, but successful HCT depends on developmentally scaffolded skill-building, supportive interdependence, and health systems that foster competence, autonomy, and relatedness. Findings highlight the need for autism-responsive HCT models that incorporate gradual preparation, provider training, caregiver-supported autonomy, and structural accommodations, particularly in rural communities.Lay AbstractMoving from pediatric to adult health care can be challenging for autistic adolescents and young adults, especially in rural areas. We interviewed 19 autistic participants ages 15 to 25 to understand their experiences of health care transition. We analyzed interviews to identify themes and organized findings around three needs: feeling capable of managing health care (skills and confidence), having appropriate choice and control, and feeling supported and taken seriously by health care providers. Participants often described being expected to manage appointments, medications, and communication with providers more independently, without enough preparation or clear guidance. Many reported that limited skills or confidence made it harder to take charge of their care and contributed to stress and sometimes avoiding care. Independence was not "all-or-nothing": participants described sharing responsibilities with caregivers in ways that changed across situations, rather than becoming fully independent at once. Participants also described challenges with continuity and relationships such as switching providers, fragmented services, and feeling dismissed, making it harder to feel understood and supported. Practical barriers shaped these experiences, including transportation, whether providers accepted insurance, limited local providers, and rural distance. Overall, participants wanted to take more ownership of their health, but they emphasized the need for step-by-step skill-building, supportive shared responsibility with caregivers, and health care systems that help autistic young people feel capable, in control, and supported, especially in rural communities.