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BackgroundThere is a growing body of evidence regarding eHealth interventions that target substance use disorders. Development and funding decisions in this area have been challenging, due to a lack of understanding of what parts of an intervention work in which context. ObjectiveWe conducted a realist review of the literature on electronic cognitive behavioral therapy (eCBT) programs for substance use with the goal of answering the following realist question: “How do different eCBT interventions for substance use interact with different contexts to produce certain outcomes?” MethodsA literature search of published and gray literature on eHealth programs targeting substance use was conducted. After data extraction, in order to conduct a feasible realist review in a timely manner, the scope had to be refined further and, ultimately, only included literature focusing on eCBT programs targeting substance use. We synthesized the available evidence from the literature into Context-Mechanism-Outcome configurations (CMOcs) in order to better understand when and how programs work. ResultsA total of 54 papers reporting on 24 programs were reviewed. Our final results identified eight CMOcs from five unique programs that met criteria for relevance and rigor. ConclusionsFive strategies that may be applied to future eCBT programs for substance use are discussed; these strategies may contribute to a better understanding of mechanisms and, ultimately, may help design more effective solutions in the future. Future research on eCBT programs should try to understand the mechanisms of program strategies and how they lead to outcomes in different contexts.

Aim: Approximately half of the population in Egypt is under the age of 25. Globally, mental illness represents the highest burden of disease in this age group. Yet in Egypt, there is still no youth‐specific mental health system in place and the vast majority of young people do not have access to any professional mental health support. The objective of this study was to describe the mental health needs of Egyptian youth and the resources they use when seeking help. Methods: An online cross‐sectional survey was distributed among medical students at Tanta University in Egypt. Of the 707 individuals who completed the survey (90.9% response rate), 60.5% were female, 62.0% lived in urban and suburban areas, and the mean age of the sample was 20.5 (±1.8) years old. Results: More than half (54%) of the students reported that they had been affected by mental health problems at some point in their lives. Anxiety and depression were the most common problems. Regarding help‐seeking behaviours, participants mainly searched the web or spoke to peers and relatives; few reported approaching medical professionals. The majority of participants (59.7%) reported being disappointed with the current mental health care system in Egypt. Conclusions: There is a high prevalence of mental challenges among Egyptian youth and the health care system is not adequately prepared to respond to their needs. E‐Mental Health and online interventions seem to be a promising solution that could increase access to mental health services for Egyptian youth. [ABSTRACT FROM AUTHOR]

It in unknown whether various types of obsessive-compulsive (OC) symptoms have a common genetic or environmental etiology. For example, it is unknown whether hoarding is etiologically associated with prototypic OC symptoms, such as washing, checking, and obsessing. Also unknown is whether particular OC-related symptoms are etiologically linked to the general tendency to experience emotional distress (negative emotionality). To investigate these and other issues, a community sample of 307 pairs of monozygotic and dizygotic adult twins provided scores on 60C-related symptoms (obsessing. neutralizing, checking, washing, ordering, and hoarding) and 2 markers of negative emotionality (trait anxiety and affective lability). Genetic factors accounted for 40%-56% of variance in the 8 phenotypic scores (M = 49% of variance for OC-related symptoms). Remaining variance was due to nonshared (person-specific) environment. More derailed analyses revealed a complex etiologic architecture, where OC-related symptoms arise from a mix of common and symptom-specific genetic and environmental factors. A general genetic Factor was identified, which influenced all symptoms and negative emotionality. An environmental factor was identified that influenced all symptoms but did not influence negative emotionality. Each of the 6 types of symptoms was also shaped by its own set of symptom-specific genetic and environmental factors. The importance of genetic factors did not vary as a function of age or sex. and the architecture of general and specific etiologic factors was replicated for participants having relatively more severe OC symptoms. Gene--environment interactions were identified. Implications for an etiology-based classification system are discussed. Keywords: obsessions, compulsions, hoarding, twins, diagnosis Supplemental materials: http://dx.doi.org/10.1037/a0021132.supp DOI: 10.1037/a0021132

J. M. Digman (1997) proposed that the Big Five personality traits showed a higher-order structure with 2 factors he labeled [alpha] and [beta]. These factors have been alternatively interpreted as heritable components of personality or as artifacts of evaluative bias. Using structural equation modeling, the authors reanalyzed data from a cross-national twin study and from American cross-observer studies and analyzed new multimethod data from a German twin study. In all analyses, artifact models outperformed substance models by root-mean-square error of approximation criteria, but models combining both artifact and substance were slightly better. These findings suggest that the search for the biological basis of personality traits may be more profitably focused on the 5 factors themselves and their specific facets, especially in monomethod studies. Keywords: Big Five, five-factor model, behavior genetics, cross-observer, cross-cultural

This study examined whether universality of the 5-factor model (FFM) of personality operationalized by the Revised NEO Personality Inventory is due to genetic influences that are invariant across diverse nations. Factor analyses were conducted on matrices of phenotypic, genetic, and environmental correlations estimated in a sample of 1,209 monozygotic and 701 dizygotic twin pairs from Canada, Germany, and Japan. Five genetic and environmental factors were extracted for each sample. High congruence coefficients were observed when phenotypic, genetic, and environmental factors were compared in each sample as well as when each factor was compared across samples. These results suggest that the FFM has a solid biological basis and may represent a common heritage of the human species. Keywords: five-factor model, Revised NEO Personality Inventory, universality, behavioral genetics, twin study

The 48-item Coping Inventory for Stressful Situations (CISS) was designed to assess three dimensions (task-oriented, emotional, and avoidant) of self-reported responses to stressful circumstances, but results from factor analyses suggest four factors. The present research used confirmatory factor analysis to verify the four-factor structure for the 21-item CISS short form in samples of 1,628 undergraduate students and 390 community-dwelling adults. Factors corresponding to task-oriented and emotional scales were orthogonal and were well defined by their seven constituent items. The avoidant scale was split into two three-item parcels that describe specific avoidance behaviors (contact a friend and treat oneself) rather than broad response categories. In the undergraduate sample, depression and anxiety correlated negatively with the task-oriented scale and positively with the emotional scale. In the community sample, the emotional scale was positively correlated with neuroticism and negatively correlated with extroversion and agreeableness, whereas the task-oriented scale was negatively correlated with neuroticism and positively correlated with extroversion, openness, agreeableness, and conscientiousness. It was concluded that the task-oriented and emotional scales have potential as measures of two types of responses to routine stressors. Keywords: coping styles; inventories; factor structure; psychometrics