Conversion Disorder

Trigger finger is a common hand condition causing pain and difficulty with certain tasks. Treatment usually starts with conservative methods, but surgery may be needed if these fail. This study evaluates whether there are differences in hand function after surgery using either a transverse or longitudinal skin incision, measured by the Dash scale. The study compares two surgical techniques for trigger finger release one using a longitudinal skin incision and the other a transverse incision. Both procedures involve opening the A1 pulley to relieve symptoms. Participants are randomly assigned to one of the two incision methods, and functional outcomes are assessed immediately after surgery. Participants will be followed up to assess functional improvement using the Dash scale right after surgery, along with secondary measures such as surgeon comfort, symptom resolution, pain, infection, nerve injury, and return to work or activities at 1, 3, and 6 months after surgery. This careful monitoring helps evaluate recovery and potential complications over time.

Suicide is the second leading cause of death among youth, and rates in the US are rising despite prevention efforts. Researchers are evaluating a digital platform called Vira to improve how care is delivered to adolescents at high risk for suicide. This platform aims to use smartphone data and secure communication tools to better understand and manage risk factors like psychological distress, anhedonia, behavioral withdrawal, and sleep problems in young people receiving intensive outpatient treatment. The study compares two groups of adolescent patients aged 13 to 18 years old who are in an intensive outpatient Dialectical Behavior Therapy DBT program. One group uses the Vira platform, which collects data passively from smartphone sensors about activity, sleep, mobility, and mood-related language. Vira also prompts daily check-ins and supports practitioners with reminders to encourage behavior changes. The other group receives the usual treatment with the addition of a passive monitoring app called EARS. Participants will use their assigned app during their intensive outpatient treatment. Researchers will assess outcomes using tools like the Columbia Suicide Severity Rating Scale and Scale for Suicidal Ideation over six months. Other measures include anxiety, risky behaviors, sleep quality, mood, and pleasure scales at three and six months. The study monitors clinical outcomes to determine if the digital platform enhances care for youth at risk of suicide.

Researchers are evaluating the ViraSafe app, an enhanced version of the BRITE suicide safety planning app, to improve engagement with coping skills and safety planning among suicidal adolescents aged 13 to 24. This pragmatic randomized trial compares the new ViraSafe app integrated into the Vira behavior change platform with the original BRITE app, aiming to address rising youth suicide rates by using digital tools for intervention. The study focuses on youth who have experienced recent suicidal thoughts or attempts and are receiving care in clinical settings. Participants are randomly assigned to use either ViraSafe or BRITE. ViraSafe integrates safety planning and coping skills into a smartphone app with automated just-in-time reminders and daily distress ratings, supported by clinicians who can send additional nudges. The BRITE app offers self-monitoring, a safety plan, distress level ratings, and suggested coping activities based on distress. Both groups onboard the assigned app with a trained clinician or research staff. The trial lasts three months with assessments at baseline, one month, and three months. Participants complete virtual assessments including interviews and self-report measures at baseline, one month, and three months. Some participants using ViraSafe will take part in qualitative exit interviews for feedback. The study collects data on app engagement, technology acceptance, and suicide risk factors using standardized tools. Safety plans remain accessible throughout, and mental health indicators are monitored through self-reports and passive smartphone data. The total participation time is about three months, with ongoing support from clinical providers.

Researchers are evaluating the feasibility of conducting a larger multi-site randomized controlled trial comparing two treatments for children and teenagers aged 11 to 18 who have functional seizures FS. This study focuses on testing how well recruitment, retention, acceptability, treatment adherence, and therapy fidelity work across three sites University of Alabama at Birmingham, Yale School of MedicineYale New Haven Childrens Hospital, and Baylor College of MedicineTexas Childrens Hospital. Participants will be randomly assigned to receive either Retraining and Control Therapy ReACT or Competent Adulthood Transition with Cognitive Behavioral, Humanistic, and Interpersonal Training CATCH-IT. Both treatments include 12 therapy sessions, with the first session held in person lasting about 2 hours and the following 11 sessions delivered via video telehealth lasting about 1 hour each. ReACT involves working with a therapist to develop a plan to manage seizures, while CATCH-IT uses online CBT modules for the parent and child, supported by 12 coaching sessions. Participants and their caregivers will complete baseline and follow-up visits via secure video calls, including questionnaires about mood, relationships, and seizure symptoms. They will keep a seizure diary throughout the study. Follow-ups occur one week and two months after therapy ends, with additional long-term follow-ups at six and twelve months. Researchers will measure recruitment success, acceptability, retention rates, treatment adherence, seizure frequency, quality of life, and other psychological and functional outcomes to guide future larger trials.

Researchers are evaluating the use of an accelerated, intermittent theta burst stimulation a-iTBS-rTMS protocol targeting the left dorsolateral prefrontal cortex for people with Psychogenic Non-Epileptic Seizures PNES or Seizure-Type Functional Neurologic Disorder FND-seiz. This early-phase study aims to assess the feasibility, tolerability, and preliminary effects of this brain-network based treatment, which may help address the challenges and poor outcomes seen with current treatments. The study is open-label and focuses on improving seizure frequency and quality of life measures in this population. Participants will receive 6 to 10 sessions of theta burst TMS per day, each session consisting of 600 pulses, over 3 to 5 days, targeting a total of 30 sessions 18,000 pulses. Treatment is delivered using a MagVenture MagPro TMS System aimed at a specific brain region called Beam F3 to align with previous research and clinical practice. The sessions are spaced with 15-minute intervals, and the study includes a safety protocol developed with experts to monitor risks, including seizure induction. During the study, participants will be assessed through self-report measures before treatment and again four weeks after completing sessions. Researchers will track seizure frequency, stigma, quality of life, depression, PTSD, somatic symptoms, psychosocial functioning, and overall improvement. Safety is monitored daily during treatment and at follow-up. The total participation duration covers screening, treatment days, and a 4-week follow-up to evaluate the interventions effects and tolerability.

This research aims to assess whether an Ecological Momentary Intervention EMI using music listening and cognitive reappraisal can reduce the intensity and impairment caused by somatic symptoms in adults aged 18 to 65 with Somatic Symptom Disorder SSD. The study addresses the impact of negative psychological factors such as catastrophizing and negative affectivity on symptom severity. The trial uses a randomized controlled design to evaluate these interventions in daily life, providing real-time data and interventions to better understand and manage SSD symptoms. Participants will take part in a 42-day study divided into three phases a 7-day baseline phase, a 28-day intervention phase, and a 7-day post-intervention phase. During the intervention phase, participants will be randomly assigned daily to no intervention, music listening, or cognitive reappraisal. Music listening involves 10 minutes of self-selected happy music, while cognitive reappraisal involves a 5 to 10-minute reflective writing exercise. Participants will complete multiple daily assessments via a smartphone app, including fixed-time and self-initiated reports of symptom intensity and impairment. Throughout the study, participants will report symptom intensity, impairment, and negative psychological factors up to four times daily using the app. Assessments include real-time symptom evaluations after acute symptom events and fixed daily prompts. Additional questionnaires measuring symptom severity, distress, and perceived stress will be completed before and after the intervention. Study materials will be provided and collected in person, and participants will be monitored for changes in symptom intensity, impairment, and psychological factors over the six-week period.

Researchers are studying autonomic dysfunction in patients with functional dysphonia FD, a voice disorder without clear organic cause, to better understand its underlying psychophysiology and improve therapy options. The study includes both a case-control comparison with vocally healthy individuals matched by age and gender, and a randomized controlled trial to evaluate a novel autonomic nervous system ANS regulation therapy alongside conventional voice therapy CVT. The goal is to assess the frequency of symptoms related to autonomic dysfunction and compare treatment effects on voice and autonomic function. The trial involves three treatment groups for patients with FD ANS regulation therapy using heart rate variability biofeedback, conventional voice therapy CVT, and a combination of both therapies. Each participant practices daily for 20 minutes over one month, including one weekly clinic session supervised by a therapist and home sessions tracked by specialized apps and heart rate monitors. The ANS therapy focuses on personalized slow-paced breathing exercises, while the CVT includes voice education, hygiene, posture, breathing, and vocal exercises. Participants will be assessed before treatment, immediately after one month of therapy, and at three months follow-up. Evaluations include physiological measures like heart rate variability, respiration rate, skin conductance, and psychological questionnaires related to stress and anxiety. Voice assessments include the Dysphonia Severity Index, acoustic voice quality, and patient-reported voice outcomes. The study aims to monitor changes in autonomic and voice function over time to inform future treatment approaches for FD.

Researchers are investigating how the intestinal microbiota develops in healthy infants during their first two years of life and beyond. This study focuses on understanding the composition, diversity, and metabolic activity of gut bacteria in infants, as well as how factors like maternal microbiota and the environment affect this development. The goal is to learn how the maturation of the microbiota influences infant growth, immune system development, and potential health issues such as abdominal pain. The study will follow 250 pregnant women and their babies from the 20th week of pregnancy until the children reach 10 years old. Researchers will collect and analyze various biological samples, including infant stool, maternal milk, vaginal and skin swabs, to study bacterial species and their metabolic functions using advanced sequencing and mass spectrometry techniques. The study will also assess infant nutrition, hygiene, socioeconomic factors, and clinical outcomes at regular visits. Participants will be monitored through clinical evaluations, questionnaires, and biological sample collection at multiple time points from birth up to 10 years. The primary outcomes focus on changes in the complexity and activity of the infant gut microbiota at specific intervals after birth. Secondary outcomes include assessing environmental impacts, maternal bacterial transfer, and effects on child development. Any important health findings will be shared with participants and their doctors, and participants can opt out of human DNA analysis without affecting their involvement.

Researchers are evaluating the feasibility of a brief psychotherapy called Clinician-Assisted Videofeedback Exposure Approach Therapy CAVEAT for mothers experiencing interpersonal violence-related posttraumatic stress disorder PTSD and their very young children aged 1 to 3 years. This open clinical trial aims to pilot the intervention along with pre- and post-intervention measures over a 2-year period with up to 10 mother-child pairs referred to an academic medical center ambulatory care setting. The therapy is based on research showing psychobiological dysregulation in traumatized mothers and its impact on early mother-child relationships. The CAVEAT intervention is a manualized brief psychotherapy divided into four modules, including evaluation and diagnosis, differentiation between past and present relationships, and further therapeutic components. The treatment is delivered to mothers and their young children to help improve maternal perceptions, sensitivity, and reflective functioning. This study involves one experimental group receiving the CAVEAT therapy. Participants will be assessed before and after the intervention using tools such as the Parenting Stress Index-Short Form, Maternal Attributions Rating Scale, and the Brief Infant-Toddler Social Emotional Assessment within six weeks of the last session. Additional measures include intervention satisfaction questionnaires. Mothers and children will be monitored for changes in stress, maternal perceptions, and child social-emotional symptoms during the trial, which runs until July 2026.

Researchers are evaluating the effects of Heart Rate Variability Biofeedback HRV-BFB training in adults with Functional Neurological Disorders FND. FND is a common neurological condition with unclear causes, possibly involving disrupted emotional processes and autonomic nervous system dysfunction. This study aims to understand these mechanisms and assess how HRV-BFB compares to a placebo treatment using a single-blind crossover design. Participants will be randomly assigned to either the HRV-BFB group or a placebo group. Both groups will use the Inner Balance Coherence Plus software with a Bluetooth ear sensor and smartphone app. Training sessions last 8 minutes, twice daily for 30 days, with different breathing instructions depending on the group. The HRV-BFB group will work to increase their heart rate variability, while the placebo group will receive similar sessions without specific HRV effects. Throughout the study, participants will undergo comprehensive evaluations including symptoms, functional capacity, quality of life, and psychological assessments. These will be measured multiple times up to 360 days after starting. Emotional tasks and autonomic measures will also be repeated. Researchers will track heart rate variability and other physical and psychological outcomes to understand the effects of the training and identify patient subgroups based on autonomic profiles.