{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T21:34:32Z","timestamp":1764884072287,"version":"3.46.0"},"reference-count":71,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"State of Ohio Mental Health and Addiction Services."}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,12]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Deaths related to drug overdose and suicide in the USA have increased 500% and 35%, respectively, over the last two decades. The human and economic costs to society associated with these \u2018deaths of despair\u2019 are immense. Great efforts and substantial investments have been made in treatment and prevention, yet these efforts have not abated these increasing trajectories of deaths over time. The COVID-19 pandemic has exacerbated and highlighted these problems. Notably, some geographical areas (eg, Appalachia, farmland) and some communities (eg, low-income persons, \u2018essential workers\u2019, minoritised populations) have been disproportionately affected. Risk factors have been identified for substance use and suicide deaths: forms of adversity, neglect, opportunity indexes and trauma. Yet, the biological, psychological and social mechanisms driving risk are not uniform. Notably, most people exposed to risk factors do not become symptomatic and could broadly be considered resilient. Achieving a better understanding of biological, psychological and social mechanisms underlying both pathology and resilience will be crucial for improving approaches for prevention and treatment and creating precision medicine approaches for more efficient and effective treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The State of Ohio Adversity and Resilience (SOAR) study is a prospective, longitudinal, multimodal, integrated familial study designed to identify biological, psychological and social risk and resilience factors and processes leading to mental health disorders, substance use disorders, substance overdose, suicide and associated psychological\/medical comorbidities which reduce life expectancy and quality of life. It includes two nested longitudinal samples: (1) WD Survey: an address-based random population epidemiological sample of 15 000 individuals (unique households) representative of the state of Ohio assessed for psychosocial, psychiatric, behavioural health and substance use factors and (2) Brain Health Study: a family-based, multimodal, deep-phenotyping study conducted in 1200 families (up to 3600 persons aged 12\u201372 years) including MRI, electroencephalography, blood biomarkers and psychiatric diagnostic interviews, as well as neuropsychological, psychosocial functioning and family\/community history, dynamics and support assessments. SOAR is designed to discover, develop and deploy advanced predictive analytics and interventions to transform mental health prevention, diagnosis, treatment and recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>All participants will provide written informed consent (or parental permission and assent for minors). The study was approved by The Ohio State University Institutional Review Board (study numbers 2023H0316 (Brain Health) and 2023H0350 (Wellness Survey). The Brain Health study was also approved by institutional review boards at each partnering institution involved in conducting participant assessments. Findings will be disseminated to academic peers, clinicians and healthcare consumers, policymakers and the general public, using local and international academic channels (academic journals, evidence briefs and conferences) and outreach (workshops and seminars).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099525","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T08:51:15Z","timestamp":1763628675000},"page":"e099525","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["State of Ohio Adversity and Resilience (SOAR) study protocol: a comprehensive, multimodal, family-based, longitudinal observational investigation of risk and resilience in mental health and substance use disorders"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0764-9625","authenticated-orcid":false,"given":"Anthony P","family":"King","sequence":"first","affiliation":[{"name":"Psychiatry and Behavioral Health, Psychology, Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Langenecker","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie M","family":"Gorka","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Turner","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Wastler","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marybel","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M","family":"Christian","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, Psychology, Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Canada","family":"Keck","sequence":"additional","affiliation":[{"name":"CHRR, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randall","family":"Olsen","sequence":"additional","affiliation":[{"name":"CHRR, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyoshin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Klamer","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, Columbus, Ohio, USA"},{"name":"Center for Biostatistics, The Ohio State University School of Biomedical Science, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soledad","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb","family":"Adler","sequence":"additional","affiliation":[{"name":"Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elissar","family":"Andari","sequence":"additional","affiliation":[{"name":"Psychiatry, University of Toledo Community & Technical College, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey L","family":"Barrenger","sequence":"additional","affiliation":[{"name":"Psychiatry, Northeast Ohio Medical University College of Medicine, Rootstown, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Bonfine","sequence":"additional","affiliation":[{"name":"Psychiatry, Northeast Ohio Medical University, Rootstown, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Bozzay","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan L","family":"Brown","sequence":"additional","affiliation":[{"name":"Bowling Green State University, Bowling Green, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Browning","sequence":"additional","affiliation":[{"name":"Sociology, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Burkhouse","sequence":"additional","affiliation":[{"name":"Psychology, Penn State University, University Park, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Carter","sequence":"additional","affiliation":[{"name":"Central State University, Wilberforce, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8233-5485","authenticated-orcid":false,"given":"Kim","family":"Cecil","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2372-0081","authenticated-orcid":false,"given":"Karin G","family":"Coifman","sequence":"additional","affiliation":[{"name":"Psychological Sciences, Kent State University, Kent, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emil","family":"Coccaro","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8005-4495","authenticated-orcid":false,"given":"Timothy N","family":"Crawford","sequence":"additional","affiliation":[{"name":"Departments of Family Medicine and Population and Public Health Sciences, Wright State University, Kettering, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cory","family":"Cronin","sequence":"additional","affiliation":[{"name":"Ohio University, Athens, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Delbello","sequence":"additional","affiliation":[{"name":"Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Marie","family":"Duchemin","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven W","family":"Evans","sequence":"additional","affiliation":[{"name":"Ohio University, Athens, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Flask","sequence":"additional","affiliation":[{"name":"Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K Jean","family":"Forney","sequence":"additional","affiliation":[{"name":"Psychology, Ohio University, Athens, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larrilyn","family":"Grant","sequence":"additional","affiliation":[{"name":"Psychiatry, Wright State University, Dayton, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gunstad","sequence":"additional","affiliation":[{"name":"Department of Psychology, Kent State University, Kent, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J","family":"Hershberger","sequence":"additional","affiliation":[{"name":"Psychology, Wright State University, Dayton, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen R","family":"Hoskinson","sequence":"additional","affiliation":[{"name":"Psychiatry, Nationwide Children\u2019s Hospital, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Klein","sequence":"additional","affiliation":[{"name":"Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Koenig","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"McVoy","sequence":"additional","affiliation":[{"name":"Psychiatry, University Hospitals of Cleveland, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula K","family":"Miller","sequence":"additional","affiliation":[{"name":"Psychology, Ohio University, Athens, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Moreno","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric E","family":"Nelson","sequence":"additional","affiliation":[{"name":"Psychiatry, Nationwide Children\u2019s Hospital, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randolph","family":"Nesse","sequence":"additional","affiliation":[{"name":"Arizona State University, Tempe, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Nomaguchi","sequence":"additional","affiliation":[{"name":"Department of Sociology, Bowling Green State University, Bowling Green, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alissa","family":"Paolella","sequence":"additional","affiliation":[{"name":"Central State University, Wilberforce, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edison","family":"Perdomo","sequence":"additional","affiliation":[{"name":"Central State University, Wilberforce, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Odden","sequence":"additional","affiliation":[{"name":"Research Information Technology, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Sajatovic","sequence":"additional","affiliation":[{"name":"Psychiatry, Case Western Reserve University Hospital, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"McCullumsmith","sequence":"additional","affiliation":[{"name":"Psychiatry, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Trauth","sequence":"additional","affiliation":[{"name":"Central State University, Wilberforce, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivy","family":"Tso","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Psychiatry, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer T","family":"Weinandy","sequence":"additional","affiliation":[{"name":"Psychology, Ohio University, Athens, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krista K","family":"Westrick-Payne","sequence":"additional","affiliation":[{"name":"Department of Sociology, Bowling Green State University, Bowling Green, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greta","family":"Winbush","sequence":"additional","affiliation":[{"name":"Central State University, Wilberforce, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian T","family":"Wymbs","sequence":"additional","affiliation":[{"name":"Psychology, Ohio University, Athens, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Xie","sequence":"additional","affiliation":[{"name":"Psychiatry, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Gavazzi","sequence":"additional","affiliation":[{"name":"CHRR, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy R","family":"Huerta","sequence":"additional","affiliation":[{"name":"Research Information Technology, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Maynard-Wentzel","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Kraguljac","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K Luan","family":"Phan","sequence":"additional","affiliation":[{"name":"Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"2025120413275499000_15.11.e099525.1","unstructured":"National Center for Health Statistics . National vital statistics system (nvss) and health, United States, 2020-2021. n.d. Available: https:\/\/www.cdc.gov\/nchs\/data\/hus\/2020-2021\/ODMort.pdf"},{"key":"2025120413275499000_15.11.e099525.2","doi-asserted-by":"publisher","DOI":"10.1111\/add.16318"},{"key":"2025120413275499000_15.11.e099525.3","doi-asserted-by":"crossref","unstructured":"Fujita-Imazu S , Xie J , Dhungel B , et al . Evolving trends in drug overdose mortality in the USA from 2000 to 2020: an age-period-cohort analysis. EClinicalMedicine 2023;61. doi:10.1016\/j.eclinm.2023.102079","DOI":"10.1016\/j.eclinm.2023.102079"},{"key":"2025120413275499000_15.11.e099525.4","unstructured":"Health Policy Institute of Ohio . HPIO data snapshot details suicide trends in ohio. health policy institute of Ohio. Available: https:\/\/www.healthpolicyohio.org\/health-policynews\/2024\/02\/09\/hpio-data-snapshot-details-suicide-trends-in-ohio\\ [Accessed 9 Feb 2024]."},{"key":"2025120413275499000_15.11.e099525.5","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7015a1"},{"key":"2025120413275499000_15.11.e099525.6","unstructured":"Health Policy Institute of Ohio . HPIO data snapshot details suicide trends in Ohio. Health Policy Institute of Ohio \u2014 Health Policy News; 2023. Available: https:\/\/www.healthpolicyohio.org\/health-policynews\/2024\/02\/09\/hpio-data-snapshot-details-suicide-trends-in-ohio"},{"key":"2025120413275499000_15.11.e099525.7","doi-asserted-by":"crossref","unstructured":"Rockett IRH , Ali B , Caine ED , et al . Escalating costs of self-injury mortality in the 21st century United States: an interstate observational study. BMC Public Health 2023;23. doi:10.1186\/s12889-023-15188-8","DOI":"10.1186\/s12889-023-15188-8"},{"key":"2025120413275499000_15.11.e099525.8","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12225"},{"key":"2025120413275499000_15.11.e099525.9","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1017\/cts.2020.42","article-title":"A call to action to address rural mental health disparities","volume":"4","author":"Morales","year":"2020","journal-title":"J Clin Transl Sci"},{"key":"2025120413275499000_15.11.e099525.10","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000857"},{"key":"2025120413275499000_15.11.e099525.11","doi-asserted-by":"crossref","unstructured":"White TM , Borrell LN , El-Mohandes A . A review of the public health literature examining the roles of socioeconomic status and race\/ethnicity on health outcomes in the United States. J Racial Ethn Health Disparities 2024. doi:10.1007\/s40615-024-02195-7","DOI":"10.1007\/s40615-024-02195-7"},{"key":"2025120413275499000_15.11.e099525.12","doi-asserted-by":"crossref","unstructured":"Gupta M , Ladegard K , Gupta N , et al . Antecedents and trajectories of the child and adolescent mental health crisis: assimilating empirically guided pathways for stakeholders. Prim Care Companion CNS Disord 2024;26. doi:10.4088\/PCC.24nr03747","DOI":"10.4088\/PCC.24nr03747"},{"key":"2025120413275499000_15.11.e099525.13","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579422000499"},{"key":"2025120413275499000_15.11.e099525.14","doi-asserted-by":"crossref","unstructured":"Radfar A , Ferreira MM , Sosa JP , et al . Emergent crisis of COVID-19 pandemic: mental health challenges and opportunities. Front Psychiatry 2021;12. doi:10.3389\/fpsyt.2021.631008","DOI":"10.3389\/fpsyt.2021.631008"},{"key":"2025120413275499000_15.11.e099525.15","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2023.2186124"},{"key":"2025120413275499000_15.11.e099525.16","doi-asserted-by":"publisher","DOI":"10.3138\/jmvfh-2022-0025"},{"key":"2025120413275499000_15.11.e099525.17","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21160"},{"key":"2025120413275499000_15.11.e099525.18","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.53.8.1001"},{"key":"2025120413275499000_15.11.e099525.19","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.chiabu.2017.04.024","article-title":"Adverse childhood experiences and suicide attempts among those with mental and substance use disorders","volume":"69","author":"Choi","year":"2017","journal-title":"Child Abuse Negl"},{"key":"2025120413275499000_15.11.e099525.20","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20230038"},{"key":"2025120413275499000_15.11.e099525.21","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"2025120413275499000_15.11.e099525.22","doi-asserted-by":"crossref","unstructured":"Copeland WE , Gaydosh L , Hill SN , et al . Associations of despair with suicidality and substance misuse among young adults. JAMA Netw Open 2020;3. doi:10.1001\/jamanetworkopen.2020.8627","DOI":"10.1001\/jamanetworkopen.2020.8627"},{"key":"2025120413275499000_15.11.e099525.23","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-021-02116-7"},{"key":"2025120413275499000_15.11.e099525.24","doi-asserted-by":"crossref","unstructured":"Stacy M , Schulkin J . Suicide: allostatic regulation and resilience. Psychoneuroendocrinology 2022;139. doi:10.1016\/j.psyneuen.2022.105691","DOI":"10.1016\/j.psyneuen.2022.105691"},{"key":"2025120413275499000_15.11.e099525.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.06.020"},{"key":"2025120413275499000_15.11.e099525.26","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1001\/jamapsychiatry.2021.0256","article-title":"Psychiatry and deaths of despair","volume":"78","author":"Shanahan","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"2025120413275499000_15.11.e099525.27","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.6.909"},{"key":"2025120413275499000_15.11.e099525.28","doi-asserted-by":"publisher","DOI":"10.1177\/1403494817746274"},{"key":"2025120413275499000_15.11.e099525.29","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-019-0202-5"},{"key":"2025120413275499000_15.11.e099525.30","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.49.10.1349"},{"key":"2025120413275499000_15.11.e099525.31","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1001\/jamacardio.2016.2050","article-title":"Contributions of the framingham heart study to the epidemiology of Coronary Heart Disease","volume":"1","author":"Chen","year":"2016","journal-title":"JAMA Cardiol"},{"key":"2025120413275499000_15.11.e099525.32","doi-asserted-by":"publisher","DOI":"10.1016\/J.BIOPSYCH.2021.05.029"},{"key":"2025120413275499000_15.11.e099525.33","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/s40501-017-0108-y","article-title":"The ABCD study of neurodevelopment: Identifying neurocircuit targets for prevention and treatment of adolescent substance abuse","volume":"4","author":"Bjork","year":"2017","journal-title":"Curr Treat Options Psychiatry"},{"key":"2025120413275499000_15.11.e099525.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2017.10.002"},{"key":"2025120413275499000_15.11.e099525.35","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-019-0581-3"},{"key":"2025120413275499000_15.11.e099525.36","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12416"},{"key":"2025120413275499000_15.11.e099525.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.03.056"},{"key":"2025120413275499000_15.11.e099525.38","doi-asserted-by":"crossref","unstructured":"Victor TA , Khalsa SS , Simmons WK , et al . Tulsa 1000: a naturalistic study protocol for multilevel assessment and outcome prediction in a large psychiatric sample. BMJ Open 2018;8. doi:10.1136\/bmjopen-2017-016620","DOI":"10.1136\/bmjopen-2017-016620"},{"key":"2025120413275499000_15.11.e099525.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2019.12.004"},{"key":"2025120413275499000_15.11.e099525.40","doi-asserted-by":"crossref","unstructured":"Karguth N . Understanding and predicting the intergenerational transmission of mental illness. Open Access Government; 2024. Available: https:\/\/www.openaccessgovernment.org\/article\/understanding-and-predicting-the-intergenerationaltransmission-of-mental-illness\/182773\/","DOI":"10.56367\/OAG-044-11713"},{"key":"2025120413275499000_15.11.e099525.41","doi-asserted-by":"crossref","first-page":"3885","DOI":"10.1007\/s00787-024-02423-9","article-title":"Running in the FAMILY: understanding and predicting the intergenerational transmission of mental illness","volume":"33","author":"van Houtum","year":"2024","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2025120413275499000_15.11.e099525.42","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/papt.12185","article-title":"Conceptualizing resilience in adult mental health literature: a systematic review and narrative synthesis","volume":"92","author":"Ayed","year":"2019","journal-title":"Psychol Psychother Theory Res Pract"},{"key":"2025120413275499000_15.11.e099525.43","doi-asserted-by":"crossref","unstructured":"Ioannidis K , Askelund AD , Kievit RA , et al . The complex neurobiology of resilient functioning after childhood maltreatment. BMC Med 2020;18. doi:10.1186\/s12916-020-1490-7","DOI":"10.1186\/s12916-020-1490-7"},{"key":"2025120413275499000_15.11.e099525.44","doi-asserted-by":"crossref","first-page":"98","DOI":"10.5964\/ejop.2251","article-title":"Integrative review of the recent literature on human resilience: From concepts, theories, and discussions towards a complex understanding","volume":"18","author":"M\u00e9tais","year":"2022","journal-title":"Eur J Psychol"},{"key":"2025120413275499000_15.11.e099525.45","doi-asserted-by":"crossref","unstructured":"Sch\u00e4fer SK , Supke M , Kausmann C , et al . A systematic review of individual, social, and societal resilience factors in response to societal challenges and crises. Commun Psychol 2024;2. doi:10.1038\/s44271-024-00138-w","DOI":"10.1038\/s44271-024-00138-w"},{"key":"2025120413275499000_15.11.e099525.46","doi-asserted-by":"publisher","DOI":"10.1017\/S0959259810000420"},{"key":"2025120413275499000_15.11.e099525.47","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1001\/jamapsychiatry.2018.0050","article-title":"An interactive developmental neuroscience perspective on adolescent resilience to familial depression","volume":"75","author":"Bessette","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"2025120413275499000_15.11.e099525.48","doi-asserted-by":"crossref","unstructured":"Bethell C , Jones J , Gombojav N , et al . Positive childhood experiences and adult mental and relational health in a statewide sample: associations across adverse childhood experiences levels. JAMA Pediatr 2019;173. doi:10.1001\/jamapediatrics.2019.3007","DOI":"10.1001\/jamapediatrics.2019.3007"},{"key":"2025120413275499000_15.11.e099525.49","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2021.2018896"},{"key":"2025120413275499000_15.11.e099525.50","doi-asserted-by":"crossref","unstructured":"Fuller AE , Garg A , Brown NM , et al . Relationships between material hardship, resilience, and health care use. Pediatrics 2020;145. doi:10.1542\/peds.2019-1975","DOI":"10.1542\/peds.2019-1975"},{"key":"2025120413275499000_15.11.e099525.51","unstructured":"U.S. Census Bureau. Ohio . Profile (or \u201cOhio: census bureau profile\u201d). data.census.gov; 2025. Available: https:\/\/data.census.gov\/profile\/Ohio?g=040XX00US39"},{"key":"2025120413275499000_15.11.e099525.52","unstructured":"Pew Research Center . People in Ohio. Pew research center \u2014 religious landscape study. 2025. Available: https:\/\/www.pewresearch.org\/religious-landscape-study\/state\/ohio"},{"key":"2025120413275499000_15.11.e099525.53","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.bpsgos.2021.12.012","article-title":"Neurite orientation dispersion and density imaging in psychiatric disorders: a systematic literature review and a technical note","volume":"3","author":"Kraguljac","year":"2023","journal-title":"Biol Psychiatry Glob Open Sci"},{"key":"2025120413275499000_15.11.e099525.54","doi-asserted-by":"publisher","DOI":"10.1037\/1076-898X.8.2.75"},{"key":"2025120413275499000_15.11.e099525.55","doi-asserted-by":"crossref","unstructured":"Aguilar-Gaxiola S , Ahmed S , Anise A , et al . Assessing meaningful community engagement: a conceptual model to advance health equity through transformed systems for health. NAM Perspectives 2022;22. doi:10.31478\/202202c","DOI":"10.31478\/202202c"},{"key":"2025120413275499000_15.11.e099525.56","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802313"},{"key":"2025120413275499000_15.11.e099525.57","unstructured":"Ohio Opportunity Index Consortium . The Ohio opportunity indices and dashboard tools. The Ohio College of Medicine Government Resource Center; 2021. Available: https:\/\/grc.osu.edu\/Projects\/OhioOpportunityIndex"},{"key":"2025120413275499000_15.11.e099525.58","first-page":"235","article-title":"Reducing fatal opioid overdose: prevention, treatment and harm reduction strategies","volume":"88","author":"Hawk","year":"2015","journal-title":"Yale J Biol Med"},{"key":"2025120413275499000_15.11.e099525.59","doi-asserted-by":"crossref","unstructured":"Samuels EA , Bailer DA , Yolken A . Overdose prevention centers: an essential strategy to address the overdose crisis. JAMA Netw Open 2022;5. doi:10.1001\/jamanetworkopen.2022.22153","DOI":"10.1001\/jamanetworkopen.2022.22153"},{"key":"2025120413275499000_15.11.e099525.60","first-page":"S54","article-title":"Cognition assessment using the NIH Toolbox","volume":"80","author":"Weintraub","year":"2013","journal-title":"Neurology (ECronicon)"},{"key":"2025120413275499000_15.11.e099525.61","unstructured":"Wechsler D . Wechsler Abbreviated Scale of Intelligence Second. 2018."},{"key":"2025120413275499000_15.11.e099525.62","doi-asserted-by":"publisher","DOI":"10.1080\/13803390601147611"},{"key":"2025120413275499000_15.11.e099525.63","doi-asserted-by":"crossref","unstructured":"Compagne C , Mayer JT , Gabriel D , et al . Adaptations of the balloon analog risk task for neuroimaging settings: a systematic review. Front Neurosci 2023;17. doi:10.3389\/fnins.2023.1237734","DOI":"10.3389\/fnins.2023.1237734"},{"key":"2025120413275499000_15.11.e099525.64","doi-asserted-by":"publisher","DOI":"10.1016\/J.DCN.2018.03.001"},{"key":"2025120413275499000_15.11.e099525.65","doi-asserted-by":"crossref","unstructured":"DeJoseph ML , Herzberg MP , Sifre RD , et al . Measurement matters: an individual differences examination of family socioeconomic factors, latent dimensions of children\u2019s experiences, and resting state functional brain connectivity in the ABCD sample. Dev Cogn Neurosci 2022;53. doi:10.1016\/j.dcn.2021.101043","DOI":"10.1016\/j.dcn.2021.101043"},{"key":"2025120413275499000_15.11.e099525.66","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3758\/s13415-016-0486-4","article-title":"Neural correlates of rumination in adolescents with remitted major depressive disorder and healthy controls","volume":"17","author":"Burkhouse","year":"2017","journal-title":"Cogn Affect Behav Neurosci"},{"key":"2025120413275499000_15.11.e099525.67","doi-asserted-by":"publisher","DOI":"10.3758\/CABN.10.4.470"},{"key":"2025120413275499000_15.11.e099525.68","doi-asserted-by":"crossref","unstructured":"Schreiner MW , Miller RH , Jacobsen AM , et al . Rumination induction task in fmri: test-retest reliability in youth and potential mechanisms of change with intervention. preprint posted online october 10. [Preprint] 2023.","DOI":"10.1101\/2023.10.09.23296759"},{"key":"2025120413275499000_15.11.e099525.69","doi-asserted-by":"publisher","DOI":"10.3758\/BF03203267"},{"key":"2025120413275499000_15.11.e099525.70","doi-asserted-by":"publisher","DOI":"10.1038\/nprot.2012.001"},{"key":"2025120413275499000_15.11.e099525.71","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2017.11.005"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-099525","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T21:30:13Z","timestamp":1764883813000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-099525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":71,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,19]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bmjopen-2025-099525"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-099525","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}