{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:17:55Z","timestamp":1791566275074,"version":"4.3.4"},"reference-count":64,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Ment Health"],"accepted":{"date-parts":[[2025,12,2]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epistemic trust describes the capacity to appropriately identify others as reliable and relevant sources of information, an ability closely linked to attachment and social learning. Epistemic disruption can manifest as heightened suspicion (mistrust) or excessive reliance (credulity) vis-\u00e0-vis others, affecting mentalizing abilities and increasing vulnerability to psychopathology and maladaptive traits. These interdependent and multidirectional dynamics are pivotal to therapeutic learning, and thus to therapeutic change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined associations between epistemic trust and disruption, markers of psychopathology, therapeutic relationship quality and treatment-seeking behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A naturalistic sample of 912 participants, recruited via a mental health app, completed the Epistemic Trust, Mistrust and Credulity Questionnaire, along with self-reports capturing internalising symptoms, personality functioning, maladaptive traits and the perceived therapeutic relationship within the previous 6\u2009months. Treatment-seeking behaviour and the number of sessions utilized in the past year were further explored\u2014both in psychotherapeutic and psychiatric contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Epistemic mistrust and credulity showed consistent relationships with markers of psychopathology. Higher epistemic (mis)trust correlated with more positive (negative) ratings of various aspects of the therapeutic relationship, including genuineness, realism, expectations, congruence and responsivity\u2014over the past 6\u2009months. Epistemic trust positively predicted the amount of psychotherapy sessions, while epistemic mistrust negatively predicted treatment-seeking, both controlled for personality dysfunction. Epistemic credulity predicted mental health app use\u2014all assessed retrospectively (past year).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results encourage further in-depth exploration of trust-related aspects of the therapeutic alliance and investigation of mechanisms of change in therapeutic processes that may facilitate the transition from mistrust and credulity to trust.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical implications<\/jats:title>\n                    <jats:p>Even though the magnitude and direction of effects remain to be clarified, patients with epistemic mistrust may enter a self-reinforcing cycle of reduced openness and ineffective mentalizing, potentially impacting therapeutic effectiveness. Interventions targeting epistemic disruption and impaired personality functioning seem to be crucial for improving therapeutic outcomes, including psychopharmacological treatment effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjment-2025-301751","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T16:25:16Z","timestamp":1768839916000},"page":"e301751","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["How epistemic trust, mistrust and credulity relate to mental health, personality pathology, treatment engagement and relationship in psychotherapeutic and psychiatric settings"],"prefix":"10.1136","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9933-2213","authenticated-orcid":false,"given":"Anna-Lena","family":"Br\u00f6cker","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Neurosciences, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"German Center for Mental Health (DZPG), partner site Berlin\/Potsdam, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Nolte","sequence":"additional","affiliation":[{"name":"Research Department of Clinical, Educational and Health Psychology, University College London, London, UK"},{"name":"Anna Freud, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"B\u00f6ttche","sequence":"additional","affiliation":[{"name":"German Center for Mental Health (DZPG), partner site Berlin\/Potsdam, Berlin, Germany"},{"name":"Division of Clinical-Psychological Intervention, Department of Education and Psychology, Freie Universit\u00e4t Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Knaevelsrud","sequence":"additional","affiliation":[{"name":"German Center for Mental Health (DZPG), partner site Berlin\/Potsdam, Berlin, Germany"},{"name":"Division of Clinical-Psychological Intervention, Department of Education and Psychology, Freie Universit\u00e4t Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8588-7784","authenticated-orcid":false,"given":"Andr\u00e9","family":"Kerber","sequence":"additional","affiliation":[{"name":"German Center for Mental Health (DZPG), partner site Berlin\/Potsdam, Berlin, Germany"},{"name":"Division of Clinical-Psychological Intervention, Department of Education and Psychology, Freie Universit\u00e4t Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"2026091806100745000_29.1.e301751.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0017.2010.01394.x"},{"key":"2026091806100745000_29.1.e301751.2","unstructured":"Fonagy P , Nolte T . Epistemic trust: from concept to application in psychotherapy and psychosocial work fields. Stuttgart: Klett Cotta; 2023."},{"key":"2026091806100745000_29.1.e301751.3","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1017\/S0954579421000092","article-title":"Culture and psychopathology: An attempt at reconsidering the role of social learning","volume":"34","author":"Fonagy","year":"2022","journal-title":"Dev Psychopathol"},{"key":"2026091806100745000_29.1.e301751.4","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1146\/annurev-clinpsy-071919-015355","article-title":"The Mentalizing Approach to Psychopathology: State of the Art and Future Directions","volume":"16","author":"Luyten","year":"2020","journal-title":"Annu Rev Clin Psychol"},{"key":"2026091806100745000_29.1.e301751.5","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000001446"},{"key":"2026091806100745000_29.1.e301751.6","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2010.0319"},{"key":"2026091806100745000_29.1.e301751.7","doi-asserted-by":"crossref","unstructured":"Fonagy P , Campbell C , Allison E . Therapeutic models. In: Bateman A , Fonagy P , eds. Handbook of mentalizing in mental health practice. Washington, DC: American Psychiatric Publishing, 2019: 169\u201380.","DOI":"10.1176\/appi.books.9781615379019.lg10"},{"key":"2026091806100745000_29.1.e301751.8","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2023.37.5.633"},{"key":"2026091806100745000_29.1.e301751.9","doi-asserted-by":"crossref","DOI":"10.1002\/pmh.70006","article-title":"Disruption of Epistemic Trust in Borderline Personality Disorder: A Possible Adaptation to Avoid Making Costly Mistakes","volume":"19","author":"Kurt","year":"2025","journal-title":"Personal Ment Health"},{"key":"2026091806100745000_29.1.e301751.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0250264","article-title":"Development and validation of a self-report measure of epistemic trust","volume":"16","author":"Campbell","year":"2021","journal-title":"PLoS ONE"},{"key":"2026091806100745000_29.1.e301751.11","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1080\/15289168.2020.1812322","article-title":"Epistemic Trust as a Psycho-marker for Outcome in Psychosocial Interventions","volume":"19","author":"Knapen","year":"2020","journal-title":"J Infant Child Adolesc Psychother"},{"key":"2026091806100745000_29.1.e301751.12","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1026\/1616-3443\/a000821","article-title":"Personality Functioning","volume":"54","author":"Kerber","year":"2025","journal-title":"Zeitschrift F\u00fcr Klinische Psychologie Und Psychotherapie"},{"key":"2026091806100745000_29.1.e301751.13","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1002\/wps.21339","article-title":"The validity, reliability and clinical utility of the Alternative DSM-5 Model for Personality Disorders (AMPD) according to DSM-5 revision criteria","volume":"24","author":"Sharp","year":"2025","journal-title":"World Psychiatry"},{"key":"2026091806100745000_29.1.e301751.14","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1038\/s41398-024-03046-z","article-title":"Examining the role of personality functioning in a hierarchical taxonomy of psychopathology using two years of ambulatory assessed data","volume":"14","author":"Kerber","year":"2024","journal-title":"Transl Psychiatry"},{"key":"2026091806100745000_29.1.e301751.15","unstructured":"Tomasello M . Joint Attention as Social Cognition. Hillsdale, NJ: Lawrence Erlbaum Associates Inc, 1995:103\u201330."},{"key":"2026091806100745000_29.1.e301751.16","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2015.29.5.575"},{"key":"2026091806100745000_29.1.e301751.17","doi-asserted-by":"publisher","DOI":"10.1159\/000501526"},{"key":"2026091806100745000_29.1.e301751.18","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/papt.12097","article-title":"Alliance rupture and repair processes and therapeutic change in youth with borderline personality disorder","volume":"90","author":"Gersh","year":"2017","journal-title":"Psychol Psychother"},{"key":"2026091806100745000_29.1.e301751.19","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1037\/a0036505","article-title":"The role of mentalizing and epistemic trust in the therapeutic relationship","volume":"51","author":"Fonagy","year":"2014","journal-title":"Psychotherapy (Chic)"},{"key":"2026091806100745000_29.1.e301751.20","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3390\/jcm13010177","article-title":"Epistemic Trust Is a Critical Success Factor in Psychosomatic Rehabilitation\u2014Results from a Naturalistic Multi-Center Observational Study","volume":"13","author":"Riedl","year":"2023","journal-title":"JCM"},{"key":"2026091806100745000_29.1.e301751.21","doi-asserted-by":"crossref","first-page":"2333221","DOI":"10.1080\/20008066.2024.2333221","article-title":"Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment \u2013 results of an observational single-centre pilot study","volume":"15","author":"Lampe","year":"2024","journal-title":"Eur J Psychotraumatol"},{"key":"2026091806100745000_29.1.e301751.22","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/pmh.1566","article-title":"Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP)","volume":"17","author":"Wendt","year":"2023","journal-title":"Pers Mental Health"},{"key":"2026091806100745000_29.1.e301751.23","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1159\/000542919","article-title":"Associations between Childhood Trauma and Epistemic Trust, Attachment, Mentalizing, and Symptoms of Borderline Personality Disorder","volume":"58","author":"Knapen","year":"2025","journal-title":"Psychopathology"},{"key":"2026091806100745000_29.1.e301751.24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0280328","article-title":"Unpacking trust: The Italian validation of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ)","volume":"18","author":"Liotti","year":"2023","journal-title":"PLoS One"},{"key":"2026091806100745000_29.1.e301751.25","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0312995","article-title":"Epistemic trust and associations with psychopathology: Validation of the German version of the Epistemic Trust, Mistrust and Credulity-Questionnaire (ETMCQ)","volume":"19","author":"Weiland","year":"2024","journal-title":"PLoS One"},{"key":"2026091806100745000_29.1.e301751.26","doi-asserted-by":"crossref","unstructured":"Nolte T , Schwarzer N-H , Riedl D , et al . Epistemic trust, mistrust and credulity questionnaire (etmcq) \u2013 validation of the german version in a representative sample. Psychiatry and Clinical Psychology [Preprint] 2025. doi:10.1101\/2025.09.03.25331929","DOI":"10.1101\/2025.09.03.25331929"},{"key":"2026091806100745000_29.1.e301751.27","doi-asserted-by":"crossref","DOI":"10.1002\/cpp.2930","article-title":"The development and psychometric evaluation of the Questionnaire Epistemic Trust (QET): A self-report assessment of epistemic trust","volume":"31","author":"Knapen","year":"2023","journal-title":"Clin Psychol Psychother"},{"key":"2026091806100745000_29.1.e301751.28","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1080\/10503307.2023.2299213","article-title":"The development of the Epistemic Trust Rating System (ETRS)","volume":"35","author":"Fisher","year":"2025","journal-title":"Psychother Res"},{"key":"2026091806100745000_29.1.e301751.29","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1037\/pst0000193","article-title":"Psychotherapy relationships that work III","volume":"55","author":"Norcross","year":"2018","journal-title":"Psychotherapy (Chic)"},{"key":"2026091806100745000_29.1.e301751.30","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-5-200703060-00004"},{"key":"2026091806100745000_29.1.e301751.31","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"2026091806100745000_29.1.e301751.32","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318160d093"},{"key":"2026091806100745000_29.1.e301751.33","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1001\/jamainternmed.2013.12179","article-title":"The somatic symptom scale-8 (SSS-8): a brief measure of somatic symptom burden","volume":"174","author":"Gierk","year":"2014","journal-title":"JAMA Intern Med"},{"key":"2026091806100745000_29.1.e301751.34","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/pmh.1434","article-title":"The Level of Personality Functioning Scale\u2010Brief Form 2.0: Update of a brief instrument for assessing level of personality functioning","volume":"13","author":"Weekers","year":"2019","journal-title":"Pers Mental Health"},{"key":"2026091806100745000_29.1.e301751.35","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1055\/a-1343-2396","article-title":"The German Version of the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF): Latent Structure, Convergent Validity and Norm Values in the General Population","volume":"71","author":"Spitzer","year":"2021","journal-title":"Psychother Psychosom Med Psychol"},{"key":"2026091806100745000_29.1.e301751.36","unstructured":"Association AP . Diagnostic and Statistical Manual of Mental Disorders. 5th edn. Washington: American Psychiatric Publication, 2013."},{"key":"2026091806100745000_29.1.e301751.37","doi-asserted-by":"publisher","DOI":"10.1097\/yco.0000000000000658"},{"key":"2026091806100745000_29.1.e301751.38","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1159\/000507589","article-title":"International Assessment of DSM-5 and ICD-11 Personality Disorder Traits: Toward a Common Nosology in DSM-5.1","volume":"53","author":"Bach","year":"2020","journal-title":"Psychopathology"},{"key":"2026091806100745000_29.1.e301751.39","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291711002674"},{"key":"2026091806100745000_29.1.e301751.40","doi-asserted-by":"publisher","DOI":"10.1521\/pedi_2014_28_130"},{"key":"2026091806100745000_29.1.e301751.41","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1177\/1073191120971848","article-title":"Development of a Short and ICD-11 Compatible Measure for DSM-5 Maladaptive Personality Traits Using Ant Colony Optimization Algorithms","volume":"29","author":"Kerber","year":"2022","journal-title":"Assessment"},{"key":"2026091806100745000_29.1.e301751.42","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.658"},{"key":"2026091806100745000_29.1.e301751.43","doi-asserted-by":"crossref","unstructured":"Barrett-Lennard GT . The Relationship Inventory: A Complete Resource and Guide. Hoboken: John Wiley & Sons, 2015.","DOI":"10.1002\/9781118789070"},{"key":"2026091806100745000_29.1.e301751.44","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20781"},{"key":"2026091806100745000_29.1.e301751.45","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1037\/a0022082","article-title":"The real relationship inventory: development and psychometric investigation of the client form","volume":"47","author":"Kelley","year":"2010","journal-title":"Psychotherapy (Chic)"},{"key":"2026091806100745000_29.1.e301751.46","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1080\/10503307.2016.1147658","article-title":"The Patient\u2019s Experience of Attunement and Responsiveness Scale","volume":"27","author":"Snyder","year":"2017","journal-title":"Psychother Res"},{"key":"2026091806100745000_29.1.e301751.47","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1037\/pas0000222","article-title":"The Alliance Negotiation Scale: A psychometric investigation","volume":"28","author":"Doran","year":"2016","journal-title":"Psychol Assess"},{"key":"2026091806100745000_29.1.e301751.48","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1080\/10503307.2012.709326","article-title":"The alliance negotiation scale: psychometric construction and preliminary reliability and validity analysis","volume":"22","author":"Doran","year":"2012","journal-title":"Psychother Res"},{"key":"2026091806100745000_29.1.e301751.49","unstructured":"Safran JD , Muran JC . Negotiating the Therapeutic Alliance: A Relational Treatment Guide. New York, NY: Guilford Press, 2000."},{"key":"2026091806100745000_29.1.e301751.50","unstructured":"Mc Donald RP . Test Theory: A Unified Treatment. Mahwah, N.J: L. Erlbaum Associates, 1999."},{"key":"2026091806100745000_29.1.e301751.51","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1159\/000507377","article-title":"A Common Metric for Self-Reported Severity of Personality Disorder","volume":"53","author":"Zimmermann","year":"2020","journal-title":"Psychopathology"},{"key":"2026091806100745000_29.1.e301751.52","unstructured":"R Core Team . R: a language and environment for statistical computing. R Foundation for Statistical Computing; 2024. Available: https:\/\/www.R-project.org"},{"key":"2026091806100745000_29.1.e301751.53","unstructured":"Revelle W . Psych: procedures for psychological, psychometric, and personality research. R package version 2.4.6.26; 2024. Available: https:\/\/cran.r-project.org\/web\/packages\/psych"},{"key":"2026091806100745000_29.1.e301751.54","unstructured":"Rosseel Y , Jorgensen TD , Wilde L , et al . Lavaan: latent variable analysis. R package version 0.6-19; 2024. Available: https:\/\/cran.r-project.org\/web\/packages\/lavaan"},{"key":"2026091806100745000_29.1.e301751.55","unstructured":"Cohen J . Statistical Power Analysis for the Behavioral Sciences. 2nd edn. New York: Routledge, 1988."},{"key":"2026091806100745000_29.1.e301751.56","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/S0140-6736(17)32802-7","article-title":"Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis","volume":"391","author":"Cipriani","year":"2018","journal-title":"The Lancet"},{"key":"2026091806100745000_29.1.e301751.57","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/NMD.0000000000001825","article-title":"Associations Between Epistemic Trust and the Severity of Personality Disorder: Results From a Study Comparing Patients With Personality Disorder, Anxiety Disorder, and Controls","volume":"213","author":"Knapen","year":"2025","journal-title":"J Nerv Ment Dis"},{"key":"2026091806100745000_29.1.e301751.58","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.copsyc.2021.01.001","article-title":"Future directions in personality pathology","volume":"37","author":"Fonagy","year":"2021","journal-title":"Curr Opin Psychol"},{"key":"2026091806100745000_29.1.e301751.59","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.jad.2024.12.050","article-title":"Mentalizing, epistemic trust and interpersonal problems in emotion regulation: A sequential path analysis across common mental health disorders and community control samples","volume":"372","author":"Kumpaso\u011flu","year":"2025","journal-title":"J Affect Disord"},{"key":"2026091806100745000_29.1.e301751.60","first-page":"80","article-title":"More than Meets the \u201cI\u201d: A Panoramic View of Epistemic Trust in Psychotherapy","volume":"58","author":"Fisher","year":"2025","journal-title":"Psychopathology"},{"key":"2026091806100745000_29.1.e301751.61","doi-asserted-by":"crossref","DOI":"10.1192\/bjo.2025.10813","article-title":"Development and validation of the Revised Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ-R)","volume":"11","author":"Campbell","year":"2025","journal-title":"BJPsych Open"},{"key":"2026091806100745000_29.1.e301751.62","doi-asserted-by":"crossref","first-page":"704","DOI":"10.4081\/ripppo.2023.704","article-title":"Epistemic trust: a comprehensive review of empirical insights and implications for developmental psychopathology","volume":"26","author":"Li","year":"2023","journal-title":"Res Psychother-Psych"},{"key":"2026091806100745000_29.1.e301751.63","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1037\/cou0000625","article-title":"Mapping the journey from epistemic mistrust in depressed adolescents receiving psychotherapy","volume":"69","author":"Li","year":"2022","journal-title":"J Couns Psychol"},{"key":"2026091806100745000_29.1.e301751.64","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1002\/pmh.1578","article-title":"Adverse childhood experiences and personality functioning interact substantially in predicting depression, anxiety, and somatization","volume":"17","author":"Kerber","year":"2023","journal-title":"Pers Mental Health"}],"container-title":["BMJ Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjment-2025-301751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:10:22Z","timestamp":1789737022000},"score":1,"resource":{"primary":{"URL":"https:\/\/mentalhealth.bmj.com\/lookup\/doi\/10.1136\/bmjment-2025-301751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":64,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,19]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bmjment-2025-301751"],"URL":"https:\/\/doi.org\/10.1136\/bmjment-2025-301751","relation":{},"ISSN":["2755-9734"],"issn-type":[{"value":"2755-9734","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}