research paper best website

28 Best Academic Search Engines That make your research easier

This post may contain affiliate links that allow us to earn a commission at no expense to you. Learn more

If you’re a researcher or scholar, you know that conducting effective online research is a critical part of your job. And if you’re like most people, you’re always on the lookout for new and better ways to do it. 

I’m sure you are familiar with some research databases. But, top researchers keep an open mind and are always looking for inspiration in unexpected places. 

This article aims to give you an edge over researchers that rely mainly on Google for their entire research process.

Our list of 28 academic search engines will start with the more familiar to less.

Table of Contents

#1. Google Scholar

Google Scholar is an academic search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

Great for academic research, you can use Google Scholar to find articles from academic journals, conference proceedings, theses, and dissertations. The results returned by Google Scholar are typically more relevant and reliable than those from regular search engines like Google.

Tip: You can restrict your results to peer-reviewed articles only by clicking on the “Scholarly”

• Scholarly results are typically more relevant and reliable than those from regular search engines like Google.
• You can restrict your results to peer-reviewed articles only by clicking on the “Scholarly” tab.
• Google Scholar database Coverage is extensive, with approx. 200 million articles indexed.
• Abstracts are available for most articles.
• Related articles are shown, as well as the number of times an article has been cited.
• Links to full text are available for many articles.
• Abstracts are only a snippet of the full article, so you might need to do additional searching to get the full information you need.
• Not all articles are available in full text.

Google Scholar is completely free.

#2. ERIC (Education Resources Information Center) 

ERIC (short for educational resources information center) is a great academic search engine that focuses on education-related literature. It is sponsored by the U.S. Department of Education and produced by the Institute of Education Sciences. 

ERIC indexes over a million articles, reports, conference papers, and other resources on all aspects of education from early childhood to higher education. So, search results are more relevant to Education on ERIC. 

• Extensive coverage: ERIC indexes over a million articles, reports, and other resources on all aspects of education from early childhood to higher education.
• You can limit your results to peer-reviewed journals by clicking on the “Peer-Reviewed” tab.
• Great search engine for educators, as abstracts are available for most articles.

ERIC is a free online database of education-related literature. 

You might also like:

• SCI Journal: Science Journal Impact Factor
• 15 Best Websites to Download Research Papers for Free
• 11 Best Academic Writing Tools For Researchers 2024
• 10 Best Reference Management Software for Research 2024
• Academic Tools

#3. Wolfram Alpha

Wolfram Alpha is a “computational knowledge engine” that can answer factual questions posed in natural language. It can be a useful search tool. 

Type in a question like “What is the square root of 64?” or “What is the boiling point of water?” and Wolfram Alpha will give you an answer.

Wolfram Alpha can also be used to find academic articles. Just type in your keywords and Wolfram Alpha will generate a list of academic articles that match your query.

Tip: You can restrict your results to peer-reviewed journals by clicking on the “Scholarly” tab.

• Can answer factual questions posed in natural language.
• Can be used to find academic articles.
• Results are ranked by relevance.
• Results can be overwhelming, so it’s important to narrow down your search criteria as much as possible.
• The experience feels a bit more structured but it could also be a bit restrictive

Wolfram Alpha offers a few pricing options, including a “Pro” subscription that gives you access to additional features, such as the ability to create custom reports. You can also purchase individual articles or download them for offline use.

Pro costs $5.49 and Pro Premium costs $9.99

#4. iSEEK Education 

• 15 Best Websites To Download Research Papers For Free
• 30+ Essential Software For Researchers
• 15 Best Academic Research Trend Prediction Platforms
• 15 Best Academic Networking And Collaboration Platforms

iSEEK is a search engine targeting students, teachers, administrators, and caregiver. It’s designed to be safe with editor-reviewed content.

iSEEK Education also includes a “Cited by” feature which shows you how often an article has been cited by other researchers.

• Editor-reviewed content.
• “Cited by” feature shows how often an article has been cited by other researchers.
• Limited to academic content.
• Doesn’t have the breadth of coverage that some of the other academic search engines have.

iSEEK Education is free to use.

#5. BASE (Bielefeld Academic Search Engine)

BASE is hosted at Bielefeld University in Germany and that’s where it name stems from (Bielefeld Academic Search Engine). 

Known as “one of the most comprehensive academic web search engines,” it contains over 100 million documents from 4,000 different sources. 

Users can narrow their search using the advanced search option, so regardless of whether you need a book, a review, a lecture, a video or a thesis, BASE has what you need.

BASE indexes academic articles from a variety of disciplines, including the arts, humanities, social sciences, and natural sciences.

• One of the world’s most voluminous search engines, 
• Indexes academic articles from a variety of disciplines, especially for academic web resources
• Includes an “Advanced Search” feature that lets you restrict your results to peer-reviewed journals.
• Doesn’t include abstracts for most articles.
• Doesn’t have related articles, references, cited by

BASE is free to use.

• 10 Best Reference Management Software for Research 2023
• 15 Best Academic Networking and Collaboration Platforms
• 30+ Essential Software for Researchers
• 15 Best Academic Blogging and Content Management 
• 11 Best Academic Writing Tools For Researchers

CORE is an academic search engine that focuses on open access research papers. A link to the full text PDF or complete text web page is supplied for each search result. It’s academic search engine dedicated to open access research papers.

• Focused on open access research papers.
• Links to full text PDF or complete text web page are supplied for each search result.
• Export formats include BibTeX, Endnote, RefWorks, Zotero.
• Coverage is limited to open access research papers.
• No abstracts are available for most articles.
• No related articles, references, or cited by features.

CORE is free to use.

• Best Plagiarism Checkers for Research Papers in 2024

#7. Science.gov

Science.gov is a search engine developed and managed by the United States government. It includes results from a variety of scientific databases, including NASA, EPA, USGS, and NIST. 

US students are more likely to have early exposure to this tool for scholarly research. 

• Coverage from a variety of scientific databases (200 million articles and reports).
• Links to full text are available for some articles.

Science.gov is free to use.

• 15 Best Academic Journal Discovery Platforms
• Sci Hub Review 

#8. Semantic Scholar

Semantic Scholar is a recent entrant to the field. Its goal is to provide more relevant and effective search results via artificial intelligence-powered methods that detect hidden relationships and connections between research topics.

• Powered by artificial intelligence, which enhances search results.
• Covers a large number of academic articles (approx. 40 million).
• Related articles, references, and cited by features are all included.
• Links to full text are available for most articles.

Semantic Scholar is free to use.

• 11 Best Academic Writing Tools For Researchers 
• 10 Best Reference Management Software for Research 
• 15 Best Academic Journal Discovery Platforms 

#9. RefSeek

RefSeek searches more than five billion documents, including web pages, books, encyclopedias, journals, and newspapers.

This is one of the free search engines that feels like Yahoo with a massive directory. It could be good when you are just looking for research ideas from unexpected angles. It could lead you to some other database that you might not know such as the CIA The World Factbook, which is a great reference tool.

• Searches more than five billion documents.
• The Documents tab is very focused on research papers and easy to use.
• Results can be filtered by date, type of document, and language.
• Good source for free academic articles, open access journals, and technical reports.
• The navigation and user experience is very dated even to millenials…
• It requires more than 3 clicks to dig up interesting references (which is how it could lead to you something beyond the 1st page of Google)
• The top part of the results are ALL ads (well… it’s free to use)

RefSeek is free to use.

#10. ResearchGate 

A mixture of social networking site + forum + content databases where researchers can build their profile, share research papers, and interact with one another.

Although it is not an academic search engine that goes outside of its site, ResearchGate ‘s library of works offers an excellent choice for any curious scholar.

There are more than 100 million publications available on the site from over 11 million researchers. It is possible to search by publication, data, and author, as well as to ask the researchers questions. 

• A great place to find research papers and researchers.
• Can follow other researchers and get updates when they share new papers or make changes to their profile.
• The network effect can be helpful in finding people who have expertise in a particular topic.
• Interface is not as user friendly
• Can be overwhelming when trying to find relevant papers.
• Some papers are behind a paywall.

ResearchGate is free to use.

• 15 Best Academic Research Trend Prediction Platforms 
• 25 Best Tools for Tracking Research Impact and Citations

#11. DataONE Search (formerly CiteULike) 

A social networking site for academics who want to share and discover academic articles and papers.

• A great place to find academic papers that have been shared by other academics.
• Some papers are behind a paywall

CiteULike is free to use.

#12. DataElixir 

DataElixir is deigned to help you find, understand and use data. It includes a curated list of the best open datasets, tools and resources for data science.

• Dedicated resource for finding open data sets, tools, and resources for data science.
• The website is easy to navigate.
• The content is updated regularly
• The resources are grouped by category.
• Not all of the resources are applicable to academic research.
• Some of the content is outdated.

DataElixir is free to use.

#13. LazyScholar – browser extension

LazyScholar is a free browser plugin that helps you discover free academic full texts, metrics, and instant citation and sharing links. Lazy Scholar is created Colby Vorland, a postdoctoral fellow at Indiana University.

• It can integrate with your library to find full texts even when you’re off-campus.
• Saves your history and provides an interface to find it.
• A pre-formed citation is availlable in over 900 citation styles.
• Can recommend you topics and scans new PubMed listings to suggest new papers
• Results can be a bit hit or miss

LazyScholar is free to use.

#14. CiteseerX – digital library from PenState

CiteseerX is a digital library stores and indexes research articles in Computer Science and related fields. The site has a robust search engine that allows you to filter results by date, author.

• Searches a large number of academic papers.
• Results can be filtered by date, author, and topic.
• The website is easy to use.
• You can create an account and save your searches for future reference.

CiteseerX is free to use.

• Surfer Review: Is It Worth It?
• 25 Best Tools For Tracking Research Impact And Citations

#15. The Lens – patents search 

The Lens or the Patent Lens is an online patent and scholarly literature search facility, provided by Cambia, an Australia-based non-profit organization.

• Searches for a large number of academic papers.

The price range can be free for non-profit use to $5,000 for commercial enterprise.

#16. Fatcat – wiki for bibliographic catalog 

Fatcat is an open bibliographic catalog of written works. The scope of works is somewhat flexible, with a focus on published research outputs like journal articles, pre-prints, and conference proceedings. Records are collaboratively editable, versioned, available in bulk form, and include URL-agnostic file-level metadata.

• Open source and collaborative
• You can be part of the community that is very focused on its mission
• The archival file-level metadata (verified digests and long-term copies) is a great feature.
• Could prove to be another rabbit hole
• People either love or hate the text-only interface

#17. Lexis Web – Legal database

Are you researching legal topics? You can turn to Lexis Web for any law-related questions you may have. The results are drawn from legal sites and can be filtered based on criteria such as news, blogs, government, and commercial. Additionally, users can filter results by jurisdiction, practice area, source and file format.

• Results are drawn from legal sites.
• Filters are available based on criteria such as news, blogs, government, and commercial.
• Users can filter results by jurisdiction, practice area, source and file format.
• Not all law-related questions will be answered by this search engine.
• Coverage is limited to legal sites only.

Lexis Web is free for up to three searches per day. After that, a subscription is required.

#18. Infotopia – part of the VLRC family

Infotopia touts itself as an “alternative to Google safe search.” Scholarly book results are curated by librarians, teachers, and other educational workers. Users can select from a range of topics such as art, health, and science and technology, and then see a list of resources pertaining to the topic. 

Consequently, if you aren’t able to find what you are looking for within Infotopia’s pages, you will probably find it on one of its many suggested websites.

#19. Virtual Learning Resources Center

Virtual Learning Resources Center (VLRC) is an academic search engine that features thousands of academic sites chosen by educators and librarians worldwide. Using an index generated from a research portal, university, and library internet subject guides, students and instructors can find current, authoritative information for school.

• Thousands of academic information websites indexed by it. You will also be able to get more refined results with custom Google search, which will speed up your research. 
• Many people consider VLRC as one of the best free search engines to start looking for research material. 
• TeachThought rated the Virtual LRC #3 in it’s list of 100 Search Engines For Academic Research
• More relevant to education 
• More relevant to students

Powered by Google Custom Search Engine (CSE), Jurn is a free online search engine for accessing and downloading free full-text scholarly papers. It was created by David Haden in a public open beta version in February 2009, initially for locating open access electronic journal articles in the arts and humanities.

After the indexing process was completed, a website containing additional public directories of web links to indexed publications was introduced in mid-2009. The Jurn search service and directory has been regularly modified and cleaned since then.

• A great resource for finding academic papers that are behind paywalls.
• The content is updated regularly.uren

Jurn is free to use.

#21. WorldWideScience

The Office of Scientific and Technical Information—a branch of the Office of Science within the U.S. Department of Energy—hosts the portal WorldWideScience , which has dubbed itself “The Global Science Gateway.”

Over 70 countries’ databases are used on the website. When a user enters a query, it contacts databases from all across the world and shows results in both English and translated journals and academic resources.

• Results can be filtered by language and type of resource
• Interface is easy to use
• Contains both academic journal articles and translated academic resources 
• The website can be difficult to navigate.

WorldWideScience is free to use.

#22. Google Books

A user can browse thousands of books on Google Books, from popular titles to old titles, to find pages that include their search terms. You can look through pages, read online reviews, and find out where to buy a hard copy once you find the book you are interested in.

#23. DOAJ (Directory of Open Access Journals)

DOAJ is a free search engine for scientific and scholarly materials. It is a searchable database with over 8,000 peer-reviewed research papers organized by subject. It’s one of the most comprehensive libraries of scientific and scholarly resources, with over 8,000 journals available on a variety of themes.

#24. Baidu Scholar

Baidu Xueshu (Academic) is the Chinese version for Google Scholar. IDU Scholar indexes academic papers from a variety of disciplines in both Chinese and English.

• Articles are available in full text PDF.
• Covers a variety of academic disciplines.
• No abstracts are available for most articles, but summaries are provided for some.
• A great portal that takes you to different specialized research platform
• You need to be able to read Chinese to use the site
• Since 2021 there is a rise of focus on China and the Chinese Communist Party

Baidu Scholar is free to use.

#25. PubMed Central

PubMed is a free search engine that provides references and abstracts for medical, life sciences, and biomedical topics.

If you’re studying anything related to healthcare or science, this site is perfect. PublicMed Central is operated by the National Center for Biotechnology Information, a division of the U.S. National Library of Medicine. It contains more than 3 million full-text journal articles. 

It’s similar to PubMed Health, which focuses on health-related research and includes abstracts and citations to over 26 million articles.

#26. MEDLINE®

MEDLINE® is a paid subscription database for life sciences and biomedicine that includes more than 28 million citations to journal articles. For finding reliable, carefully chosen health information, Medline Plus provides a powerful search tool and even a dictionary.

• A great database for life sciences and biomedicine.
• Contains more than 28 million references to journal articles.
• References can be filtered by date, type of document, and language.
• The database is expensive to access.
• Some people find it difficult to navigate and find what they are looking for.

MEDLINE is not free to use ( pricing information ).

Defunct Academic Search Engines 

#27. microsoft academic  .

Microsoft Academic

Microsoft Academic Search seemed to be a failure from the beginning. It ended in 2012, then re-launched in 2016 as Microsoft Academic. It provides the researcher with the opportunity to search academic publications,

Microsoft Academic used to be the second-largest academic search engine after Google Scholar. Microsoft Academic provides a wealth of data for free, but Microsoft has announced that it will shut Microsoft Academic down in by 2022. 

#28. Scizzle

Designed to help researchers stay on top of the literature by setting up email alerts, based on key terms, for newspapers.

Unfortunately, academic search engines come and go. These are two that are no longer available.

Final Thoughts

There are many academic search engines that can help researchers and scholars find the information they need. This list provides a variety of options, starting with more familiar engines and moving on to less well-known ones. 

Keeping an open mind and exploring different sources is essential for conducting effective online research. With so much information at our fingertips, it’s important to make sure we’re using the best tools available to us.

Tell us in the comment below which academic search engine have you not heard of? Which database do you think we should add? What database do your professional societies use? What are the most useful academic websites for research in your opinion?

There is more.

Check out our other articles on the Best Academic Tools Series for Research below.

• Learn how to get more done with these Academic Writing Tools  
• Learn how to proofread your work with these Proofreading Tools
• Learn how to broaden your research landscape with these Academic Search Engines
• Learn how to manage multiple research projects with these Project Management Tools
• Learn how to run effective survey research with these Survey Tools for Research
• Learn how get more insights from important conversations and interviews with Transcription Tools
• Learn how to manage the ever-growing list of references with these Reference Management Software
• Learn how to double your productivity with literature reviews with these AI-Based Summary Generators
• Learn how to build and develop your audience with these Academic Social Network Sites
• Learn how to make sure your content is original and trustworthy with these Plagiarism Checkers
• Learn how to talk about your work effectively with these Science Communication Tools

10 thoughts on “28 Best Academic Search Engines That make your research easier”

Thank you so much Joannah..I have found this information useful to me as librarian in an academic library

You are welcome! We are happy to hear that!

Thank You Team, for providing a comprehensive list of academic search engines that can help make research easier for students and scholars. The variety of search engines included offers a range of options for finding scholarly articles, journals, and other academic resources. The article also provides a brief summary of each search engine’s features, which helps in determining which one is the best fit for a specific research topic. Overall, this article is a valuable resource for anyone looking for a quick and easy way to access a wealth of academic information.

Thank you for taking the time to share your feedback with us. We are delighted to hear that you found our list of academic search engines helpful in making research easier for students and scholars. We understand the importance of having a variety of options when it comes to finding scholarly articles, journals, and other academic resources, and we strive to provide a comprehensive list of resources to meet those needs.

We are glad that you found the brief summary of each search engine’s features helpful in determining which one is the best fit for a specific research topic. Our goal is to make it easy for our readers to access valuable academic information and we’re glad that we were able to achieve that for you.

We appreciate your support and thank you for your kind words. We will continue to provide valuable resources for students and researchers in the future. Please let us know if you have any further questions or suggestions.

No more questions Thank You

I cannot thank you enough!!! thanks alot 🙂

Typography animation is a technique that combines text and motion to create visually engaging and dynamic animations. It involves animating individual letters, words, or phrases in various ways to convey a message, evoke emotions, or enhance the visual impact of a design or video. – Typography Animation Techniques Tools and Online Software {43}

Hi Joannah! Here’s another one you may want to add! Expontum ( https://www.expontum.com/ ) – Helps researchers quickly find knowledge gaps and identify what research projects have been completed before. Thanks!

Expontum – Helps researchers quickly find knowledge gaps and identify what research projects have been completed before. Expontum is free, open access, and available to all globally with no paid versions of the site. Automated processes scan research article information 24/7 so this website is constantly updating. By looking at over 35 million research publications (240 million by the end of 2023), the site has 146 million tagged research subjects and 122 million tagged research attributes. Learn more about methodology and sources on the Expontum About Page ( https://www.expontum.com/about.php )

Hey Ryan, I clicked and checked your site and thought it was very relevant to our reader. Thank you for sharing. And, we will be reviewing your site soon.

Sounds good! Thanks, Joannah!

Leave a Comment Cancel reply

Save my name, email, and website in this browser for the next time I comment.

We maintain and update science journals and scientific metrics. Scientific metrics data are aggregated from publicly available sources. Please note that we do NOT publish research papers on this platform. We do NOT accept any manuscript.

2012-2024 © scijournal.org

A free, AI-powered research tool for scientific literature

• Thomas Pichler
• Liquid Asset

New & Improved API for Developers

Introducing semantic reader in beta.

Stay Connected With Semantic Scholar Sign Up What Is Semantic Scholar? Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI.

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to  upgrade your browser .

Download 55 million PDFs for free

Explore our top research interests.

Engineering

Anthropology

• Earth Sciences

• Computer Science

• Mathematics

• Health Sciences

Join 259 million academics and researchers

Track your impact.

Share your work with other academics, grow your audience and track your impact on your field with our robust analytics

Discover new research

Get access to millions of research papers and stay informed with the important topics around the world

Publish your work

Publish your research with fast and rigorous service through Academia.edu Publishing. Get instant worldwide dissemination of your work

Unlock the most powerful tools with Academia Premium

Work faster and smarter with advanced research discovery tools

Search the full text and citations of our millions of papers. Download groups of related papers to jumpstart your research. Save time with detailed summaries and search alerts.

• Advanced Search
• PDF Packages of 37 papers
• Summaries and Search Alerts

Share your work, track your impact, and grow your audience

Get notified when other academics mention you or cite your papers. Track your impact with in-depth analytics and network with members of your field.

• Mentions and Citations Tracking
• Advanced Analytics
• Publishing Tools

Real stories from real people

Used by academics at over 15,000 universities

Get started and find the best quality research

• Academia.edu Publishing
•   We're Hiring!
•   Help Center
• Find new research papers in:
• Cognitive Science
• Academia ©2024

Reference management. Clean and simple.

The top list of academic research databases

2. Web of Science

5. ieee xplore, 6. sciencedirect, 7. directory of open access journals (doaj), get the most out of your academic research database, frequently asked questions about academic research databases, related articles.

Whether you are writing a thesis , dissertation, or research paper it is a key task to survey prior literature and research findings. More likely than not, you will be looking for trusted resources, most likely peer-reviewed research articles.

Academic research databases make it easy to locate the literature you are looking for. We have compiled the top list of trusted academic resources to help you get started with your research:

Scopus is one of the two big commercial, bibliographic databases that cover scholarly literature from almost any discipline. Besides searching for research articles, Scopus also provides academic journal rankings, author profiles, and an h-index calculator .

• Coverage: 90.6 million core records
• References: N/A
• Discipline: Multidisciplinary
• Access options: Limited free preview, full access by institutional subscription only
• Provider: Elsevier

Web of Science also known as Web of Knowledge is the second big bibliographic database. Usually, academic institutions provide either access to Web of Science or Scopus on their campus network for free.

• Coverage: approx. 100 million items
• References: 1.4 billion
• Access options: institutional subscription only
• Provider: Clarivate (formerly Thomson Reuters)

PubMed is the number one resource for anyone looking for literature in medicine or biological sciences. PubMed stores abstracts and bibliographic details of more than 30 million papers and provides full text links to the publisher sites or links to the free PDF on PubMed Central (PMC) .

• Coverage: approx. 35 million items
• Discipline: Medicine and Biological Sciences
• Access options: free
• Provider: NIH

For education sciences, ERIC is the number one destination. ERIC stands for Education Resources Information Center, and is a database that specifically hosts education-related literature.

• Coverage: approx. 1.6 million items
• Discipline: Education
• Provider: U.S. Department of Education

IEEE Xplore is the leading academic database in the field of engineering and computer science. It's not only journal articles, but also conference papers, standards and books that can be search for.

• Coverage: approx. 6 million items
• Discipline: Engineering
• Provider: IEEE (Institute of Electrical and Electronics Engineers)

ScienceDirect is the gateway to the millions of academic articles published by Elsevier, 1.4 million of which are open access. Journals and books can be searched via a single interface.

• Coverage: approx. 19.5 million items

The DOAJ is an open-access academic database that can be accessed and searched for free.

• Coverage: over 8 million records
• Provider: DOAJ

JSTOR is another great resource to find research papers. Any article published before 1924 in the United States is available for free and JSTOR also offers scholarships for independent researchers.

• Coverage: more than 12 million items
• Provider: ITHAKA

Start using a reference manager like Paperpile to save, organize, and cite your references. Paperpile integrates with PubMed and many popular databases, so you can save references and PDFs directly to your library using the Paperpile buttons:

Scopus is one of the two big commercial, bibliographic databases that cover scholarly literature from almost any discipline. Beside searching for research articles, Scopus also provides academic journal rankings, author profiles, and an h-index calculator .

PubMed is the number one resource for anyone looking for literature in medicine or biological sciences. PubMed stores abstracts and bibliographic details of more than 30 million papers and provides full text links to the publisher sites or links to the free PDF on PubMed Central (PMC)

Navigation group

Home banner.

Where scientists empower society

Creating solutions for healthy lives on a healthy planet.

most-cited publisher

largest publisher

2.5 billion

article views and downloads

Main Content

• Editors and reviewers
• Collaborators

Find a journal

We have a home for your research. Our community led journals cover more than 1,500 academic disciplines and are some of the largest and most cited in their fields.

Submit your research

Start your submission and get more impact for your research by publishing with us.

Author guidelines

Ready to publish? Check our author guidelines for everything you need to know about submitting, from choosing a journal and section to preparing your manuscript.

Peer review

Our efficient collaborative peer review means you’ll get a decision on your manuscript in an average of 61 days.

Article publishing charges (APCs) apply to articles that are accepted for publication by our external and independent editorial boards

Press office

Visit our press office for key media contact information, as well as Frontiers’ media kit, including our embargo policy, logos, key facts, leadership bios, and imagery.

Institutional partnerships

Join more than 555 institutions around the world already benefiting from an institutional membership with Frontiers, including CERN, Max Planck Society, and the University of Oxford.

Publishing partnerships

Partner with Frontiers and make your society’s transition to open access a reality with our custom-built platform and publishing expertise.

Policy Labs

Connecting experts from business, science, and policy to strengthen the dialogue between scientific research and informed policymaking.

How we publish

All Frontiers journals are community-run and fully open access, so every research article we publish is immediately and permanently free to read.

Editor guidelines

Reviewing a manuscript? See our guidelines for everything you need to know about our peer review process.

Become an editor

Apply to join an editorial board and collaborate with an international team of carefully selected independent researchers.

My assignments

It’s easy to find and track your editorial assignments with our platform, 'My Frontiers' – saving you time to spend on your own research.

Scientists call for urgent action to prevent immune-mediated illnesses caused by climate change and biodiversity loss

Climate change, pollution, and collapsing biodiversity are damaging our immune systems, but improving the environment offers effective and fast-acting protection.

Safeguarding peer review to ensure quality at scale

Making scientific research open has never been more important. But for research to be trusted, it must be of the highest quality. Facing an industry-wide rise in fraudulent science, Frontiers has increased its focus on safeguarding quality.

Chronic stress and inflammation linked to societal and environmental impacts in new study 

Scientists hypothesize that as-yet unrecognized inflammatory stress is spreading among people at unprecedented rates, affecting our cognitive ability to address climate change, war, and other critical issues.

Tiny crustaceans discovered preying on live jellyfish during harsh Arctic night

Scientists used DNA metabarcoding to show for the first time that jellyfish are an important food for amphipods during the Arctic polar night in waters off Svalbard, at a time of year when other food resources are scarce.

Why studying astronauts’ microbiomes is crucial to ensure deep space mission success

In a new Frontiers’ guest editorial, Prof Dr Lembit Sihver, director of CRREAT at the Nuclear Physics Institute of the Czech Academy of Sciences and his co-authors explore the impact the microbiome has on human health in space.

Cake and cookies may increase Alzheimer’s risk: Here are five Frontiers articles you won’t want to miss

At Frontiers, we bring some of the world’s best research to a global audience. But with tens of thousands of articles published each year, it’s impossible to cover all of them. Here are just five amazing papers you may have missed.

2024's top 10 tech-driven Research Topics

Frontiers has compiled a list of 10 Research Topics that embrace the potential of technology to advance scientific breakthroughs and change the world for the better.

Get the latest research updates, subscribe to our newsletter

“The only truly modern academic research engine”

Oa.mg is a search engine for academic papers, specialising in open access. we have over 250 million papers in our index..

Journal of Materials Science

Abstracts in Chinese - 中文摘要

The Journal of Materials Science is a key publication exploring the intricate relationship between structure, properties, and uses of various materials.

• Publishes high-quality research papers and reviews across a broad range of materials, including metals, ceramics, glasses, polymers, and more.
• Offers a platform for scientists studying the structure and properties of all engineering materials.
• Recognized for publishing significant original research and innovative techniques.
• C. Barry Carter

Latest issue

Volume 59, Issue 15

Latest articles

Editorial: the may 2024 cover paper.

In-situ study of the effect of grain boundary misorientation on plastic deformation of Inconel 718 at high temperature

• Jutian Chen

Designing an ultrahigh-strength and ductile Ni-based alloy with a partially recrystallized structure

• Xianghui Zheng
• Chongxiang Huang

Preparation and properties of corrosion-resistant polysiloxane-based ceramic coatings

• Yuezhen Bin

A comparative study on the impact of preparation technique on the minority carrier lifetime of Cu 2 O absorber

• Chithira Venugopalan Kartha
• Yi-Teng Huang

Journal updates

The william bonfield prize for best review paper.

The Journal of Materials Science is pleased to introduce the William Bonfield Prize for Best Review Paper, in honor of Professor William Bonfield’s immeasurable contributions to both the Journal of Materials Science and the field of Materials Research more broadly.

The Robert W. Cahn Prize for Best Research Paper

Congratulations to the Winners of the 2022 Cahn Prize! For more information, 2022's finalists, and previous years' prizes, click here!

Call for Papers: Synthesis and characterization of functional nanocomposite materials

The Journal of Materials Science invites authors to submit to a special issue exploring current and emerging trends in the synthesis and characterization of advanced functional nanocomposite materials.

Read Journal of Materials Science Articles Written by our Editors

Journal of Materials Science invites you to read highlighted articles authored by our esteemed Editors

Journal information

• Chemical Abstracts Service (CAS)
• Current Contents/Electronics & Telecommunications Collection
• Current Contents/Engineering, Computing and Technology
• Current Contents/Physical, Chemical and Earth Sciences
• EI Compendex
• FIZ Karlsruhe
• Google Scholar
• INIS Atomindex
• Japanese Science and Technology Agency (JST)
• OCLC WorldCat Discovery Service
• Science Citation Index Expanded (SCIE)
• Semantic Scholar
• TD Net Discovery Service
• UGC-CARE List (India)

Rights and permissions

Springer policies

© Springer Science+Business Media, LLC, part of Springer Nature

• Find a journal
• Publish with us
• Track your research

This paper is in the following e-collection/theme issue:

Published on 24.4.2024 in Vol 26 (2024)

The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial

Authors of this article:

Original Paper

• Diana Lemmer 1, 2 , MSc   ; 
• Markus Moessner 1 , PD, PhD   ; 
• Nicolas Arnaud 3 , PhD   ; 
• Harald Baumeister 4 , Prof Dr   ; 
• Agnes Mutter 4 , MSc   ; 
• Sarah-Lena Klemm 5 , BSc   ; 
• Elisa König 6 , Dipl-Psych   ; 
• Paul Plener 6, 7 , Prof Dr Med   ; 
• Christine Rummel-Kluge 5 , Prof Dr Med   ; 
• Rainer Thomasius 3 , Prof Dr Med   ; 
• Michael Kaess 8, 9 , Prof Dr Med   ; 
• Stephanie Bauer 1, 2, 10 , Prof Dr  

1 Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany

2 Ruprecht-Karls University Heidelberg, Heidelberg, Germany

3 German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

4 Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany

5 Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany

6 Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany

7 Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria

8 University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland

9 Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany

10 German Center for Mental Health (DZPG), Partner site Mannheim/Heidelberg/Ulm, Heidelberg, Germany

Corresponding Author:

Stephanie Bauer, Prof Dr

Center for Psychotherapy Research

Center for Psychosocial Medicine

University Hospital Heidelberg

Bergheimer Str. 54

Heidelberg, 69115

Phone: 49 6221 56 7345

Fax:49 6221 56 7350

Email: [email protected]

Background: Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers.

Objective: This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people.

Methods: This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability.

Results: No significant group effects on potential professional help seeking were found in the total sample ( F 2,1385 =0.99; P =.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help ( F 2,1385 =3.75; P =.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems.

Conclusions: Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults.

Trial Registration: German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110

Introduction

Mental health (MH) problems in youth are prevalent and pose severe health-related, social, and financial burdens on individuals [ 1 - 5 ] and societies [ 6 , 7 ]. Approximately half of all mental disorders first manifest before the age of 18 years [ 8 ], and MH problems in youth often persist and aggravate over the life span [ 9 - 14 ]. Therefore, the need for effective prevention and intervention programs targeting young people is an important public health goal. However, while effective MH services exist, most youth with MH problems do not seek professional help. Low uptake has been reported for various conventional [ 15 - 18 ] as well as digital MH services [ 19 - 22 ]. The burden of mental illness can only be alleviated at the population level if a substantial proportion of the population uses the available services [ 23 , 24 ]. Otherwise, the public health impact of MH services remains limited. Thus, increasing the reach of MH services (ie, fostering the uptake and use of professional help) is vital for the improvement of youth MH at the population level.

To facilitate service use, specific barriers to help seeking need to be addressed. Previous research has indicated that attitudinal factors pose larger impediments to help seeking than structural factors (eg, treatment costs and inconvenient scheduling) [ 25 , 26 ]. Specifically, self-reliance, a low perceived need for help [ 25 - 27 ], low treatment expectations [ 28 ], stigma [ 26 , 27 , 29 , 30 ], and poor MH literacy [ 27 , 31 , 32 ] have been identified as major contributors to the lack of professional help seeking.

Different approaches to facilitate help seeking and promote positive attitudes toward MH issues and help seeking in youth have been evaluated in previous research, including face-to-face and digital interventions. In a systematic mapping review, 84% (106/126) of the studies focused on school-based interventions, whereas only 10 (8%) articles covered internet-based approaches to improve MH literacy, MH-related attitudes, stigma, and help-seeking behavior in adolescents [ 33 ]. The internet-based interventions included both minimal, single-session interventions [ 34 , 35 ] and multisession approaches intended to be used over several weeks [ 36 , 37 ], with different outcome measures. A total of 4 studies focused on MH more broadly, whereas 6 studies investigated interventions for specific MH problems (depression: n=5; eating disorders: n=1). Keeping the limited number of studies in this area of research in mind, the results nevertheless point to the potential of internet-based interventions with respect to reduced stigma (2 studies), enhanced help-seeking intentions (2 studies), and improved help-seeking behaviors (1 study).

Clearly, there is a need for more research in this area, particularly with respect to digital brief and microinterventions (ie, highly focused in-the-moment interventions with a narrower scope and time frame than standard interventions [ 38 ]), which allow for a flexible, easily accessible, scalable, and efficient delivery of MH content. Initial research on such brief and microinterventions with psychoeducational and destigmatizing components has shown promising results. For instance, a brief acceptance-facilitating intervention that included a text-based personalized psychoeducation component had a small but significant effect on the intention to use MH services in German university students [ 39 ]. More recently, randomized controlled trials (RCTs) in young adults, university students, and adolescents with short video interventions demonstrated effects with regard to public stigma toward schizophrenia [ 40 , 41 ] and depression [ 42 , 43 ], as well as help-seeking intentions [ 42 ] and attitudes [ 43 ]. Furthermore, an Australian pilot study with international students found that a brief, web-based MH literacy intervention alleviated MH stigma. However, it had no significant effect on help-seeking intentions or MH literacy [ 44 ].

Another component of previous help seeking–facilitating strategies has been storytelling. A pilot study on a video-based intervention indicated that storytelling was well accepted and perceived as engaging [ 45 ]. In addition, an RCT evaluated internet-based storytelling programs with varying interactivity and stigma-related content. Significant reductions in MH stigma and microaggression toward individuals with MH problems were observed [ 46 ].

Concerning the theoretical foundation of interventions, few studies have investigated help seeking–promoting strategies that were explicitly based on the premises of health behavior models. Logsdon et al [ 47 ] evaluated an internet-based depression intervention for adolescent mothers, which was conceptualized according to the theory of planned behavior. The intervention led to significant improvements in help-seeking attitudes, intentions, and behavior. Another well-established and yet more recent health behavior model, which incorporates elements of previously developed approaches, is the Health Action Process Approach (HAPA) [ 48 ]. It encompasses a stage theoretical perspective on health behavior and includes a motivational, intention-forming phase as well as a volitional phase, where planning and behavior maintenance occur. In both the HAPA model and the updated version of the theory of planned behavior, namely, the reasoned action approach, outcome expectancies (or instrumental attitudes) play a crucial role in the formation of intentions, and intentions significantly predict actual behavior [ 49 , 50 ]. The results of previous research on a trauma recovery internet intervention support the use of the HAPA model for the prediction of e-MH engagement. Specifically, outcome expectations significantly predicted the intention to use the intervention (β=.36) [ 51 ]. Skepticism about treatment effectiveness has further been identified as a predictor for not using MH services in another study with university students [ 28 ].

Building on the findings of previous research, this study investigates the short-term effectiveness of 2 brief animated video interventions to promote potential professional help seeking in a general sample of adolescents and young adults aged 14 to 29 years using a web-based RCT approach. Both interventions aimed to improve participants’ willingness to seek professional help (ie, psychotherapists, psychiatrists, and counseling services) for 5 MH problems (generalized anxiety disorder [GAD], depression, bulimia, nonsuicidal self-injury [NSSI], and problematic alcohol use). The inclusion of various MH problems allowed for the investigation of potential differential effects. While one intervention followed a destigmatizing and psychoeducational approach, the other intervention aimed to induce positive outcome expectancies in accordance with the HAPA model through storytelling. The interventions were both compared to each other and to a nonintervention control group (CG) where participants were presented with a stand-alone video vignette without an additional intervention video. This approach was chosen due to both contextual (ie, vignette characters were described as experiencing difficulties in several life domains, and thus, additional control videos referring to the vignettes were unfeasible) and practical (ie, the creation of 10 additional videos was not necessary) considerations.

This study had the following objectives:

• To investigate the short-term effectiveness of the 2 interventions in the promotion of potential MH help seeking (professional and informal), whereby self-reported professional help seeking was defined as the primary outcome.
• To investigate the interventions’ effectiveness in the improvement of self-reported attitudes toward MH problems and MH service use (stigmatization and attitudes toward seeking MH services).
• To evaluate the interventions’ self-reported acceptability.

Within the framework of this study, the videos were evaluated as stand-alone interventions. They were not developed to replace existing interventions. However, in case of favorable outcomes, they have the potential to complement existing health care services. Results and procedures are reported in accordance with the Checklist for Reporting Results of Internet E-Surveys [ 52 ] and the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) [ 53 ]. The study was preregistered at the German Clinical Trials Register on September 23, 2020 (DRKS00023110).

Study Design

This anonymous, fully automated, web-based, parallel-group exploratory RCT compared the effects of intervention 1 (psychoeducational intervention) and intervention 2 (positive consequences of help seeking) against those of the CG (no further videos after the case vignette) with regard to potential help seeking, attitudes toward help seeking, and stigma. The design comprised 15 conditions in total (5 MH problems × 3 interventional conditions). Randomization was stratified by gender and implemented using a permuted block design (block sizes: 15 and 30). Due to anonymous participation and automated randomization, researchers were unable to assign specific conditions to individuals. However, 2 of the authors were able to view the randomization list. The video material was aligned with the participants’ gender to increase identification with the character (ie, participants who identified as woman, female, or nonbinary viewed videos with a female protagonist [Paula], and participants identifying as man or male viewed videos with a male protagonist [Paul]). The study components and conditions as well as the study procedure are shown in Figure 1 .

Recruitment and Sample

Recruitment started in October 2020 and ended in May 2022. Youth aged between 14 and 29 years with sufficient German language skills were eligible for participation. The age of 14 years is widely accepted as appropriate to provide informed consent for medical decisions and participation in studies [ 54 , 55 ]. The upper age limit of 29 years aligns with the definition of emerging adulthood, a separate life stage between adolescence and adulthood [ 56 , 57 ]. Participants were primarily recruited through the web on social media platforms and via mailing lists, web-based marketplaces, and forums for adolescents and young adults (eg, accounts and emails of youth clubs and student associations). As an incentive to complete the study, participants were offered to take part in an optional gift card lottery at the end of the study (100 gift cards of €20 [US $21.58]). We asked participants for a valid email address if they were interested in the lottery and stored email addresses separately from other study data and user IDs to ensure anonymous participation.

We recorded page change time stamps. Participants whose time stamp data indicated that the video or the videos they were assigned to had not been fully viewed (ie, duration of stay<length of the respective videos) were excluded from statistical analyses. Furthermore, only data from participants who completed all questionnaires were included in the final analysis (n=1394; completion rate: 1394/2435, 57.25%). We also excluded 5 cases with duplicate user IDs, which occurred due to a technical error and indicated repeated participation ( Figure 1 ). HTTP cookies were used to assign individual user IDs to participants. For each session, new cookies were generated and used. Therefore, duplicate participation was possible after the completion of each study session and was not registered by the system. In the 5 aforementioned cases, duplicate IDs were mistakenly generated when participants tried to use the “back” button of their web browser and restarted their participation.

This study was conducted in an open access, voluntary web-based setting. A website was established to provide study information and enable participation. The ASMO software (Center for Psychotherapy Research) [ 58 ] was used to implement the RCT. A randomization list with numbers representing the conditions was generated and embedded in our ASMO database [ 58 ] before recruitment. Data were collected at the Center for Psychotherapy Research, Heidelberg. The study’s technical functionality and usability were extensively tested before recruitment by the authors and their colleagues at their respective institutions. Before their participation, the youth received detailed information about the aims, scope, procedures, data processing, and data storage of the study on the website. Participants were informed that they would be randomly assigned to 1 of 5 MH problems and 1 of 3 video versions. They were not informed about the specific health issues or the conditions’ details before participation. As the aim of the conditions was to provide information about a specific MH problem, blinding of participants after assignment to the interventions was not possible. Only participants who provided informed consent through a web-based checkbox were eligible for participation. After study completion, participants were debriefed in writing about the objectives on the study website. The debriefing form also included contact information for formal help services. Study duration amounted to approximately 30 minutes. Participants were first asked to complete sociodemographic and screening questionnaires; were then randomly assigned to 1 of the 15 experimental conditions; and, finally, were presented with the outcome questionnaires. The whole study (including informed consent and gift card lottery pages) comprised 26 pages with 1 to 12 items on each page. Each segment or measure was presented on 1 or 2 separate pages depending on its respective length. Some items were conditional for adaptive questioning (eg, when lifetime NSSI was denied, no further questions about NSSI were presented). Changes to the item responses could only be made while they had not been confirmed through a click on the “next” button, which brought participants to the next page. There was no “back” button.

Sociodemographics and Screening

All measures were self-reported. The sociodemographic form asked participants about their age, gender, migration background, education, whether they knew someone with MH problems, and participants’ previous or current MH service use (actual help seeking). Thereafter, participants’ subjective psychological distress was assessed using several screening instruments.

Anxiety symptoms were measured using the 7-item Generalized Anxiety Disorder Scale (GAD-7) [ 59 ]. Symptom frequency within the previous 2 weeks was indicated on a 4-point response scale. Total scores (potential range 0-21) were used for further analyses. Scores of ≥5 indicate a mild anxiety symptomatology, scores of ≥10 indicate a moderate anxiety symptomatology, and scores of ≥15 indicate a severe anxiety symptomatology [ 59 ].

The 9-item Patient Health Questionnaire (PHQ-9) [ 60 ] was used for depression symptomatology assessment. Frequencies of depression symptoms within the previous 2 weeks were measured on a 4-point scale. Total scores (potential range 0-27) were calculated for further analyses. Total scores of ≥5 were interpreted as mild, scores of ≥10 were interpreted as moderate, scores of ≥15 were interpreted as moderately severe, and scores of ≥20 were interpreted as severe depression symptomatology [ 60 ].

The Weight Concerns Scale (WCS) [ 61 , 62 ] assessed weight and body shape concerns. It consists of 5 items with varying response scale types (4- to 7-point scales). The response categories of each item represent scores between 0 and 100. The mean across all items was used for further analyses. Scores of ≥57 are indicative of a high risk of eating disorders [ 61 ].

Problematic alcohol use during the previous 12 months was measured using the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) [ 63 , 64 ]. It comprises 3 items with 5-point response scales. Sum scores range between 0 and 12. A score of 0 indicates abstinence, whereas scores between 1 and 3 are interpreted as moderate alcohol consumption. Scores of ≥4 indicate hazardous alcohol consumption [ 63 , 65 ].

A total of 4 items of the Self-Injurious Thoughts and Behaviors Interview [ 66 ] served to assess NSSI. The first item identified whether participants had ever harmed themselves without suicidal intention. If participants reported lifetime NSSI, the 3 subsequent questions were presented. These items measured the frequency of NSSI within the last year, the age at the first occurrence of NSSI, and the age at the last occurrence of NSSI. Item responses were analyzed separately and descriptively.

Experimental Conditions and Materials

The interventional strategies were applied using short animated videos. The videos were created with the Pro+ version of the web-based animation tool Powtoon (Powtoon Limited) [ 67 ]. Each research group involved in this study prepared materials for 1 of the 5 MH problems based on their respective field of expertise. The materials were structured in a similar fashion across MH problems. The main characters, Paul and Paula, were introduced as students aged 16 years in each condition. In total, 30 videos were created: 5 MH problems × 2 main character genders × 3 video types. Participants in the control condition only viewed a vignette, whereas participants in both intervention groups each viewed 1 additional video (either for intervention 1 or intervention 2). A subset of the videos was pretested between July 2020 and September 2020 with a convenience sample of 9 youths (mean age 18.56, SD 3.74 years; range 14-24 years; 3/9, 33% male), who confirmed comprehensibility and overall acceptability.

All participants viewed a case vignette. Each vignette depicted the respective main character, who was affected by 1 of 5 MH problems (GAD, depression, bulimia, NSSI, or problematic alcohol use). The vignettes introduced the characters to the viewers in a third-person perspective and described their challenges in their everyday lives due to their MH conditions (eg, difficult emotions and cognitions, physical symptoms, and social and school-related issues). The accurate diagnostic labels were not presented in the vignettes [ 68 ]. Vignette duration ranged from 2 minutes, 19 seconds to 2 minutes, 47 seconds (mean 2 min, 29 s; SD 11 s). The bulimia vignettes were developed first. They were inspired by the vignettes by Mond et al [ 69 ] and adapted in accordance with International Classification of Diseases, 10th Revision and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria, as well as further literature on the symptomatology and psychological strain of bulimia [ 70 ]. The bulimia vignettes then served as a template for the vignettes of the other 4 MH problems.

Intervention 1

Intervention 1 aimed to improve MH literacy and decrease stigmatization through the presentation of psychoeducational information to encourage help seeking. These intervention videos first presented the correct diagnostic label, prevalence rates, and core symptoms of the condition shown in the vignette. Next, 5 destigmatizing and psychoeducational facts about the respective condition were presented (eg, “Bulimia is a serious illness and not a lifestyle”), which were inspired by the work by Bulik [ 71 ]. The videos then presented treatment options, information about potential challenges in professional help seeking, and encouraging statements about the benefits of professional MH support. Intervention 1 video durations ranged from 4 to 5 minutes (mean 4 min, 27 s; SD 21 s). The information provided in these intervention videos was based on epidemiological, etiological, diagnostic, barrier-related, and interventional findings on the respective MH problems (eg, the studies by Bulik [ 71 ], Keski-Rahkonen and Mustelin [ 72 ], and Nagl et al [ 73 ] for bulimia).

Intervention 2

The second strategy (intervention 2) was based on the premises of the HAPA [ 48 ]. Intervention 2 was designed to induce positive outcome expectancies of professional help seeking through the continuation of Paul and Paula’s stories. The videos showed the main characters 1 year after their initial situation as described in the vignettes. Intervention 2 videos first demonstrated the help-seeking process of the main characters in a retrospective fashion. Encouraged by their teachers, friends, or parents, the main characters sought and received professional support from a psychotherapist. The psychotherapist’s gender matched the gender of the main character. The videos showed how the psychotherapist informed the main character about the correct diagnostic label of their condition and shortly portrayed the therapeutic process. The process included initial difficulties of the main character, such as feelings of insecurity about disclosing their experiences to their therapist, which were resolved over time, and the main characters became invested in their psychotherapy. Then, 5 positive consequences of psychotherapy were presented, such as decreased impairment and an improved quality of life. The videos ended with the notion that the main character was still facing occasional difficulties, but substantial improvements in overall well-being and satisfaction with their decision to seek help were emphasized. Intervention 2 video durations ranged from 4 minutes, 1 second to 4 minutes, 29 seconds (mean 4 min, 15 s; SD 14 s). These interventions were designed in accordance with previous literature on the therapeutic process in MH conditions, including treatment expectations, experiences, and consequences [ 74 ].

Outcome Measures

Primary outcome measure.

Our primary outcome was the potential use of professional MH services (ie, the hypothetical likelihood of seeking formal sources of help if participants experienced Paul’s or Paula’s MH problem), measured using a 12-item version of the General Help Seeking Questionnaire (GHSQ) [ 75 ]. The GHSQ measures the willingness of seeking various formal and informal sources of help within the next 4 weeks for an indicated MH problem on a 7-point rating scale (1=“extremely unlikely”; 7=“extremely likely”). The maximum score among the 3 items, which measured potential help seeking with professional MH services (psychotherapists, psychiatrists, and counseling services), was used as our primary outcome. The GHSQ is the most frequently used instrument for help seeking [ 76 ].

Secondary Outcome Measures

GHSQ data on the potential use of informal sources (romantic partner, friend, parent, or other family member) and no intended help seeking (1 item) were used as secondary outcomes. For informal sources of support, the items’ maximum score was used for the analyses.

Attitudes toward help seeking were measured using the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS) [ 77 ] on a 5-point rating scale. It comprises 24 items. Its 3 dimensions—“psychological openness,” “help-seeking propensity,” and “indifference to stigma”—are represented with 8 items. Subscale scores range from 0 to 32. Higher scores indicate more positive attitudes.

The Universal Stigma Scale (USS) [ 78 ] was used for stigma measurement. It consists of 11 statements in 2 subscales (“blame/personal responsibility”: 5 items; “impairment/distrust”: 6 items). The extent of agreement with these statements is indicated on a 5-point Likert scale. Means were calculated for each of the 2 subscales. Lower scores indicate higher stigmatization.

Transportation (ie, the immersiveness of the stories presented in the videos) was measured using an adapted version of the Transportation Scale–Short Form [ 79 ]. Adjustments were made to suit the medium of the narratives (ie, video material in contrast to written stories). Our adapted version contained 5 items on a 7-point Likert scale.

Video acceptability was measured using a translated and adapted 4-item version of the acceptability and likability scale used by Gaudiano et al [ 45 ]. In total, 3 items measured overall likability, comprehensibility, and interestingness of the videos on a 5-point rating scale.

Statistical Analysis

Sociodemographic, screening, and outcome data were first analyzed descriptively. Intervention effects on potential professional help seeking (primary outcome) and secondary outcomes in the total sample (ie, across all MH problems and across participants with and without actual help seeking as reported in the screening) were analyzed via analyses of covariance (ANCOVAs) at an α level of P <.05. In addition to the intervention group, the models included age as a covariate, the participants’ actual help seeking (fixed effects), and the 5 MH problems (random effects) as control variables. The results of the main ANCOVA in the total sample are presented in the Results section.

Subgroup ANCOVAs were conducted for each of the 5 MH problems separately. In this case, the respective screening scores (GAD-7, PHQ-9, WCS, number of NSSI events during the last year, and AUDIT-C) were included as additional covariates. Subgroup analyses were further conducted for cases with and without actual help seeking in the total sample and within each of the 5 MH issue groups.

In case of significant ( P <.05) and trend ANCOVA effects, pairwise group comparisons were conducted using 2-tailed t tests. All tests were 2-sided with an α level of 5%. Mean differences (MDs) adjusted for covariates are reported in the Results section.

An a priori power analysis was conducted using G*Power (Heinrich-Heine-Universität Düsseldorf) [ 80 ]. Under the assumption of a medium effect size ( f =0.25), a minimum of 240 participants (80 per condition) were needed to test the expected effect within each of the 5 MH problems via ANCOVAs with a significance criterion of α=.05 and a power of 90%. Statistical analyses were performed using R (version 4.3; R Foundation for Statistical Computing) [ 81 ] and SPSS (version 28; IBM Corp) [ 82 ]. R was also used to generate the random allocation sequence. Authors involved in data analysis and interpretation were not blinded with respect to the assigned experimental conditions.

Deviations From the Protocol

In the beginning of recruitment, the upper age limit was raised from 25 years originally to 29 years due to the aforementioned findings of previous research.

Ethical Considerations

Ethics approval was obtained from Ethics Committee I of the Heidelberg Medical Faculty on July 27, 2020 (protocol S378/2020). The procedures were in accordance with the Helsinki Declaration of 1975, as revised in 2000. All participants received information about the study’s aims, scope, procedures, data processing, and data storage on the study website in written form. Furthermore, all participants received contact information if they wished to clarify questions via telephone or email. Only participants who provided their informed consent through a web-based checkbox were eligible for participation. Participants were able to opt out of the study at any time by closing the study website, which they were informed of before their participation. Participants were offered to take part in an optional gift card lottery at the end of the study (100 gift cards of €20 [US $21.58] each). If they were interested in the lottery, they could enter their email address. Email addresses were stored separately from other study data and user IDs to ensure anonymity. All other data were collected and are reported anonymously. Thus, this study does not contain any individual data of identifiable participants.

Sample Characteristics

Figure 1 shows the flow of participants. Of the 2208 participants who were randomized to 1 of the 15 conditions, 472 (21.38%) were excluded because their time spent on the video pages fell below the durations of the videos they were assigned to, indicating that they did not view the entire videos. Of the remaining 1736 participants, 342 (19.7%) were excluded due to incomplete data (ie, they did not complete all the relevant scales that the study entailed [beginning with informed consent up to and including the last acceptability item]). Our final sample consisted of 1394 youths aged 14 to 29 years (mean 20.97, SD 3.67 years). Sociodemographic and screening results are shown in Table 1 .

a MH: mental health.

b GAD-7: 7-item Generalized Anxiety Disorder Scale.

c PHQ-9: 9-item Patient Health Questionnaire.

d WCS: Weight Concerns Scale.

e SITBI-G: German version of the Self-Injurious Thoughts and Behaviors Interview.

f NSSI: nonsuicidal self-injury.

g We excluded 4 cases in “Age of last NSSI – age of first NSSI” due to invalid values (age of first NSSI>age of last NSSI).

h AUDIT-C: Alcohol Use Disorders Identification Test for Consumption.

A total of 79.56% (1109/1394) of the sample identified as woman or girl, and 44.76% (624/1394) were help seekers (ie, they used professional MH services at the time of or before data collection). On average, the youth were moderately anxious (mean GAD-7 score 8.38, SD 5.00) and depressed (mean PHQ-9 score 9.56, SD 6.07). While 22.88% (319/1394) reported abstinence in the AUDIT-C, 30.85% (430/1394) indicated hazardous alcohol consumption. A total of 19.58% (273/1394) were at high risk of developing an eating disorder according to the WCS. One-third (479/1394, 34.36%) of the sample reported a lifetime history of NSSI according to the Self-Injurious Thoughts and Behaviors Interview, with a 12-month prevalence rate of 19.01% (265/1394).

Intervention Effects

The main results are presented in Table 2 .

a Results controlled for help seeking (fixed factor), mental health issue (random factor), and age (covariate).

b CG: control group.

c GHSQ: General Help Seeking Questionnaire.

d Higher scores represent a greater level of agreement.

e Pairwise comparisons were conducted in case of significant or trend analysis of covariance effects. Empty cells indicate that pairwise comparisons were not conducted due to the analysis of covariance results.

f USS: Universal Stigma Scale.

g Higher scores represent more positive attitudes toward mental health issues and help seeking.

h IASMHS: Inventory of Attitudes Toward Seeking Mental Health Services.

i TS-SF: Transportation Scale–Short Form.

Figure 2 summarizes the results of the overall efficacy and the MH issue–specific subgroup analyses graphically. Specific results of the subgroup analyses can be found in Multimedia Appendices 1 , 2 , and 3 .

Primary Outcome: Potential Professional Help Seeking (GHSQ)

On the 7-point scale of the GHSQ, most participants (1046/1394, 75.04%) selected a score of ≥4 (CG: 409/554, 73.8%; intervention 1: 316/410, 77.1%; intervention 2: 321/430, 74.7%). In total, 19.23% (268/1394; CG: 105/554, 19%; intervention 1: 74/410, 18%; intervention 2: 89/430, 20.7%) of participants reported a score of 7 (“extremely likely”), whereas 6.74% (94/1394; CG: 47/554, 8.5%; intervention 1: 24/410, 5.9%; intervention 2: 23/430, 5.3%) responded with a score of 1 (“extremely unlikely”). Across all MH problems, no statistically significant group main effect was found on potential professional help seeking ( F 2,1385 =0.99; P =.37; Table 2 ).

Secondary Outcomes

Potential informal help seeking (ghsq).

For informal sources of support, most participants (1190/1394, 85.37%) selected a score of ≥5 on the 7-point scale (CG: 478/554, 86.3%; intervention 1: 338/410, 82.4%; intervention 2: 374/430, 87%). For 43.69% (609/1394) of the participants, informal help seeking was “extremely likely,” with a selected score of 7 (CG: 244/554, 44%; intervention 1: 161/410, 39.3%; intervention 2: 204/430, 47.4%), whereas a minority of 1% (14/1394; CG: 4/554, 0.7%; intervention 1: 7/410, 1.7%; intervention 2: 3/430, 0.7%) responded with a score of 1 (“extremely unlikely”). In the total sample, significant group differences were found regarding informal help seeking ( F 2,1385 =3.75; P =.02), with intervention 2 showing a significantly higher mean score than intervention 1 (adjusted MD=0.25; P =.007; Table 2 ). In the subsample of help seekers across MH problems, the same pattern was observed ( F 2,616 =3.21; P =.04; adjusted MD=0.37; P =.01; Multimedia Appendix 1 ). A significant group effect was also found for the total sample in the problematic alcohol use conditions ( F 2,273 =3.51; P =.03; Multimedia Appendix 2 ). Both the CG (adjusted MD=0.42; P =.02) and intervention 2 (adjusted MD=0.41; P =.03) had greater mean scores than intervention 1.

No Potential Help Seeking (GHSQ)

With regard to no intention of seeking help with any of the potential sources listed in the GHSQ (“I would not seek help from anyone” item), almost half (674/1394, 48.35%) of participants selected a score of 1 or 2 (1=“extremely unlikely”; CG: 264/554, 47.7%; intervention 1: 185/410, 45.1%; intervention 2: 225/430, 52.3%), whereas 15.42% (215/1394) responded with a score of 6 or 7 (7=“extremely likely”; CG: 89/554, 16.1%; intervention 1: 68/410, 16.6%; intervention 2: 58/430, 13.5%). There were no statistically significant group differences in the total sample ( P =.07; Table 2 ). However, there were trends for group differences in some of the MH issue subgroups ( Multimedia Appendices 2 and 3 and Figure 2 ).

Public Stigma: Blame and Personal Responsibility (USS)

With regard to the USS blame and personal responsibility subscale, statistically significant group differences were found in the total sample ( F 2,1385 =3.25; P =.04; Table 2 ) and in non–help seekers across MH problems ( F 2,762 =3.21; P =.04; Multimedia Appendix 1 ). In the total sample, both intervention 1 and intervention 2 had significantly greater means compared to the CG (intervention 1>CG: adjusted MD=0.084 and P =.03; intervention 2>CG: adjusted MD=0.085 and P =.03). In the subgroup of non–help seekers, there was a significant difference between intervention 2 and the CG (adjusted MD=0.13; P =.02). Further subgroup analyses revealed no additional differences between experimental conditions. It should be noted that blame and personal responsibility data distributions were heavily skewed to the left (total sample: skew=−1.58). As logarithmic, natural logarithm, square root, and reciprocal transformations did not normalize the distributions, we decided to perform ANCOVAs using the untransformed blame data. Therefore, results should be interpreted with caution.

Public Stigma: Impairment and Distrust (USS)

For the USS distrust subscale, ANCOVAs revealed statistically significant group differences in the total sample ( F 2,1385 =8.01; P <.001; Table 2 ) in both help seekers ( F 2,616 =4.39; P =.01) and non–help-seekers across MH problems ( F 2,762 =3.74; P =.02; Multimedia Appendix 1 ). Moreover, statistically significant group differences were found in the total problematic alcohol use subsample ( F 2,273 =4.49; P =.01; Multimedia Appendix 2 ) and its subgroup of non–help seekers ( F 2,144 =4.00; P =.02; Multimedia Appendix 3 ). In the NSSI subgroup of non–help seekers, a significant group main effect was observed ( F 2,160 =4.50; P =.01; Multimedia Appendix 3 ). Across MH problems, both in the total sample (intervention 1>CG: adjusted MD=0.13 and P =.005; intervention 2>CG: adjusted MD=0.17 and P <.001) and the subsample of help seekers (intervention 1>CG: adjusted MD=0.16 and P =.02; intervention 2>CG: adjusted MD=0.17 and P =.01), significantly larger means in both interventions as compared to the CG were observed. Among participants without previous help seeking across MH problems, post hoc comparisons only revealed a statistically significant difference between intervention 2 and the CG (adjusted MD=0.16; P =.007). In the NSSI subgroup of non–help seekers, intervention 2 differed significantly from both the CG (adjusted MD=0.36; P =.005) and intervention 1 (adjusted MD=0.31; P =.02). For problematic alcohol use, in both the total sample and the subsample of non–help seekers, significant post hoc differences between intervention 2 and the CG (MD for the total=0.32 and P =.003; MD for those without previous help seeking=0.42 and P =.006) were found.

Psychological Openness (IASMHS)

No statistically significant group main effect on the IASMHS psychological openness subscale was found in the total sample ( Table 2 ). Significant effects were found in the total depression sample ( F 2,255 =4.59; P =.01; Multimedia Appendix 2 ) and its subgroup of non–help seekers ( F 2,138 =4.20; P =.02; Multimedia Appendix 3 ). In the total depression sample, intervention 1 showed a greater mean in comparison to the CG (adjusted MD=1.38; P =.046) and intervention 2 (adjusted MD=2.24; P =.003). In the subsample of non–help seekers in the depression conditions, intervention 1 was found to have a greater mean than intervention 2 (adjusted MD=2.75; P =.004), but no significant difference was found with the CG (adjusted MD=1.55; P =.09). No significant group main effects were observed in the other subsamples.

Help Seeking Propensity (IASMHS)

In the total sample, no significant group main effect was found for the IASMHS help seeking propensity subscale ( Table 2 ). Subgroup analyses revealed significant differences in the total bulimia sample ( F 2,271 =3.27; P =.04), where both intervention 1 (adjusted MD=1.51; P =.03) and intervention 2 (adjusted MD=1.40; P =.04) showed larger means than the CG ( Multimedia Appendix 2 ). No further group differences were found in the other subsamples.

Indifference to Stigma (IASMHS)

For the IASMHS indifference to stigma subscale, differential group main effects were found in the total sample ( F 2,1385 =3.18; P =.04; Table 2 ), in the subsample of non–help seekers ( F 2,762 =3.74; P =.02; Multimedia Appendix 1 ), in the total ( F 2,288 =3.22; P =.04; Multimedia Appendix 2 ) and non–help-seeking ( F 2,176 =4.48; P =.01; Multimedia Appendix 3 ) GAD samples, in the total bulimia sample ( F 2,271 =3.45; P =.03; Multimedia Appendix 2 ), and in the NSSI subsample of non–help seekers ( F 2,160 =3.23; P =.04; Multimedia Appendix 3 ). Across MH problems, the CG showed a larger mean than intervention 1 in the total sample (adjusted MD=0.97; P =.02), whereas a greater mean score in the CG compared to those of both intervention 1 (adjusted MD=1.20; P= .02) and intervention 2 (adjusted MD=1.15; P =.02) was found in the subsample without previous help seeking. A similar pattern emerged in the total GAD sample and its subsample of non–help seekers, where the CG’s means were significantly larger in comparison to those of intervention 1 (adjusted MD=2.09; P =.02) in the total sample and of both intervention 1 (adjusted MD=2.57; P =.02) and intervention 2 (adjusted MD=2.91; P =.008) among non–help seekers. In the total bulimia sample, intervention 1 had a significantly higher mean than intervention 2 (adjusted MD=2.26; P =.009), whereas both the CG (adjusted MD=2.10; P =.04) and intervention 2 had greater means than intervention 1 (adjusted MD=2.59; P= .02) in the NSSI subsample of non–help seekers.

Video Acceptability and Transportation

In the total sample, most participants (1041/1394, 74.68%) rated the videos with a score of “4” (705/1394, 50.57%) or “5” (336/1394, 24.1%) on the overall likability item. Regarding comprehensibility, 83.93% (1170/1394) rated the videos as “very comprehensible” (“5” on the 5-point scale), whereas 14.13% (197/1394) assigned them a score of “4.” With respect to the videos’ interestingness, the responses were distributed across the 5-point scale as follows: 27.4% (382/1394) of participants gave a rating of “5,” a total of 41.61% (580/1394) gave the videos a rating of “4,” a total of 22.02% (307/1394) assigned them a score of “3,” and 7.32% (102/1394) gave them a rating of “2.” A minority of participants (23/1394, 1.65%) rated the videos with a score of “1” on the interestingness scale.

In the total sample ( Table 2 ), the intervention 1 videos were rated as generally more likable ( F 2,1385 =12.20; P <.001; intervention 1>CG: adjusted MD=0.25 and P <.001; intervention 1>intervention 2: adjusted MD=0.20 and P <.001) and interesting ( F 2,1385 =6.39; P =.002; intervention 1>CG: adjusted MD=0.06 and P =.02; intervention 1>intervention 2: adjusted MD=0.07 and P <.001) in comparison to those of the CG and intervention 2. The groups did not differ significantly in video comprehensibility ( F 2,1385 =2.01; P =.13). Participants felt more “transported” into the videos’ narratives in the CG and intervention 1 as compared to participants in intervention 2 ( F 2,1385 =4.23; P =.02; CG>intervention 2: adjusted MD=0.17 and P =.03; intervention 1>intervention 2: adjusted MD=0.23 and P =.006; Table 2 ). Most subgroup analyses revealed either similar patterns with regard to general likability and interestingness (eg, total help seekers, total GAD sample, and GAD non–help seekers) or no significant differences (eg, GAD help seekers, bulimia help seekers, all depression samples, and all alcohol use samples; Multimedia Appendices 1 - 3 ). In the cases of bulimia (total and non–help-seeking subsamples; Multimedia Appendices 2 and 3 ) and NSSI ( Multimedia Appendix 2 ), different patterns emerged. In the total bulimia sample, the videos of both the CG and intervention 1 scored significantly higher on the interestingness scale than those of intervention 2 ( F 2,271 =4.49; P =.01; CG>intervention 2: adjusted MD=0.33 and P =.02; intervention 1>intervention 2: adjusted MD=0.44 and P =.005). In the total NSSI sample, the videos of both intervention 1 and intervention 2 were rated as significantly more likable than those of the CG ( F 2,277 =10.31; P <.001; intervention 1>CG: adjusted MD=0.51 and P <.001; intervention 2>CG: adjusted MD=0.29 and P =.008).

Principal Findings

This study developed and tested the short-term effectiveness of 2 brief video-based strategies targeted at adolescents and young adults (aged 14 to 29 years) aiming to foster potential professional help seeking (main outcome) and related attitudes for 5 MH problems. In the total sample, we did not find effects of either intervention 1 (psychoeducation) or intervention 2 (positive outcome expectancies) on our primary outcome. However, significant group effects were found with respect to potential informal help seeking, stigma toward others, and indifference to stigma in the total sample. While both intervention groups showed more favorable attitudes than the CG with regard to public stigma, this did not translate to participants’ own indifference to stigma. In this case, the CG showed significantly more positive attitudes in comparison to intervention 1. However, this finding was not apparent in the MH issue–specific subgroup analysis with the exception of GAD. Unintended adverse effects of MH interventions have been reported in previous research [ 83 - 85 ], which underlines the need for thorough evaluations of such interventions before their public dissemination. Accordingly, we would advise against the implementation of our GAD interventions at the current stage and would recommend the development and evaluation of other tailored strategies for this MH problem.

With regard to informal help, participants in intervention 2 showed a greater willingness to approach friends, family members, or romantic partners for help than participants in intervention 1. This might have been due to the interventions’ design as intervention 2 explicitly depicted improvements in social relationships after the main characters in the videos had sought professional support. Overall, the videos were well accepted and rated as quite interesting, with some room for improvement and with the videos of intervention 1 outperforming those of the other 2 conditions. All videos were, on average, rated as very comprehensible, and no significant group differences were observed in this regard. Interestingly, participants felt more transported into the narratives in the CG and intervention 1 as compared to those in intervention 2. As intervention 2 followed a narrative approach, continuing Paul and Paula’s vignette stories, this was surprising. However, as previously stated, intervention 1 was generally more liked and viewed as more interesting in comparison to intervention 2. The animated and fictional third-person approach of intervention 2 seemed to not have sparked as much interest in participants as the facts presented in intervention 1. While we aimed to increase identification with our main characters through the alignment of their genders with those of the participants, intervention 2 might have been insufficient with regard to the perceived “realness” of the story and the characters, which has been identified as crucial for the formation of narrative transportation and, in turn, attitudes and intentions [ 86 ]. The rather optimistic portrayal of the help-seeking process might have contributed to a lack of perceived authenticity in this sample as well. Furthermore, implicit MH statements in the videos’ scenarios could have been more fruitful. For instance, the viewer could have watched directly how Paul and Paula discussed their issues with a psychotherapist rather than having a narrator describe the situation to them. These types of videos have been associated with improved health literacy and more beneficial attitudes toward cervical cancer [ 87 ], and their application to the field of MH would be interesting.

We further observed differential outcomes with respect to the assigned MH problems and participants’ actual help-seeking status. While the CG outperformed either intervention 1 (total) or both interventions (subgroup of non–help seekers) for GAD with regard to stigma indifference and no further outcomes were found for GAD, different patterns emerged in the other MH issue groups. Results were mixed, where both intervention 1 and intervention 2 outperformed the other conditions in some of the outcomes but not in others (eg, in depression), or a clearer tendency toward the superiority of one of the interventions emerged (eg, in NSSI). In summary, our results point toward the usefulness of tailored interventions with regard to MH issue type and previous help-seeking experiences of potential target groups. Our finding that different strategies might work differently for each of the 5 MH problems included in our study is in accordance with those of previous research. For example, Ebneter and Latner [ 78 ] found varying stigmatizing attitudes among different MH problems. The participants in their study blamed a vignette character with an eating disorder more for their condition than a character with depression, whereas the latter was regarded as more impaired. Our finding that a destigmatizing and psychoeducational intervention such as intervention 1 might work better for bulimia fits their recommendation to target stigmatizing attitudes toward specific MH problems [ 78 ]. Similarly, alcohol dependency and self-endangering behaviors were perceived as particularly dangerous in a Swiss vignette study [ 88 ]. The humanizing depiction of our NSSI and problematic alcohol use characters within a framework of close supportive relationships, which improved in quality through psychotherapy, might have been a relevant factor for reduced distrust scores in the intervention 2 condition as compared to the CG and in the case of non–help seekers in the NSSI condition as compared to intervention 1 as well. This approach might be advantageous to reduce public stigma regarding MH problems that are viewed as particularly dangerous. Decisions for one or another interventional strategy may also depend on the specific goal and targeted outcome. While more research is needed, our study provides preliminary evidence for the tailored strategies suggested in Table 3 .

a Check marks (✓) represent recommended use of an intervention; crosses (X) represent advice against the use of an intervention; and question marks (?) represent inconclusive results and, therefore, no clear recommendation. Recommendations are solely based on the results of this study.

b GAD: generalized anxiety disorder.

c No recommended use.

d NSSI: nonsuicidal self-injury.

Limitations

One limitation of this study lies within the sole investigation of effects on hypothetical intentions and attitudes instead of actual help-seeking behavior. While intentions are substantially associated with behavior and provide valuable insights, they do not translate directly to behavior change [ 49 ]. Moreover, only short-term effects were investigated. Previous studies on short video-based interventions have demonstrated sustaining destigmatizing effects for 1 [ 40 ] and 5 months after their delivery [ 43 ]. While potential long-term effects of our interventions in particular remain unknown and might be investigated in the future, the current state of research points toward potentially impactful long-term effects of low-threshold microinterventions. Related to this, we did not investigate dose-response effects. Research on optimal doses (ie, durations, frequencies, and amounts of intervention components) needed for sustainable change through microinterventions and interventions in general is crucial for well-founded recommendations for or against specific interventions [ 89 ].

Just as in other microintervention studies among youth [ 39 ], group differences in our study were small. However, the potential high reach of easily accessible, low-threshold interventions such as the ones evaluated in this study is apparent in the final sample size of 1394. As it depends on both effectiveness and reach, this allows for a comparably high public health impact [ 23 , 24 ]. We also included trend effects in our overview ( Figure 2 ), which should be interpreted with caution. However, these findings might be useful to inform the planning of subsequent research in this field.

Future research should focus on improvements in the effectiveness of microinterventions. One approach could be the investigation of interventional framing. In a Japanese study on depression, loss-framed messages (ie, emphasizing negative consequences of refraining from help seeking) had a greater impact on help-seeking intentions than gain-framed (positive consequences of help seeking) or neutral (eg, prevalence rates) messages as well as unformatted, plain-text messages in middle-aged adults [ 90 ]. Thus, it might be interesting to conduct future studies on the effects of video-based microinterventions with differently framed messaging as the videos in this study emphasized potential gains of help seeking rather than potential losses of help seeking restraint.

Furthermore, our sample showed, on average, a high level of education, very little public stigma, a pronounced willingness to seek help, and a high rate of actual professional help seeking (624/1394, 44.76%), which limits the generalizability of our findings. More than 90% (1285/1394, 92.18%) of our sample knew someone with MH problems. While we were careful not to recruit MH experts, such as university students of medicine and psychology, youth with a personal interest in MH-related topics seemed to have been more inclined to participate. Related to this, we aimed for a community youth sample rather than a clinical sample. The scenarios that our items referred to were hypothetical and did not necessarily reflect participants’ own experiences due to the random assignment to 1 of the 5 MH problems. A similar approach with targeted interventions according to youth’s actual MH status and more individualized elements with regard to gender-related [ 91 ] and cultural [ 92 , 93 ] aspects could be promising in future research. Thus, upcoming studies should strive to align their research objectives more closely with the characteristics and needs of the selected target groups.

Finally, we did not include a comprehension check to assess participants’ understanding of and engagement with the content presented in the videos. While we accounted for the time participants spent on the video pages and only included participants with sufficient durations of stay in the final analyses, they may not have fully comprehended or attended to the video material. The substantial number of excluded participants who completed the study without meeting the time threshold (472/2208, 21.38%) underlines this potential issue. Thus, future studies should address this limitation by including comprehension checks to improve the robustness of the findings.

Conclusions

The low uptake of professional MH services in youth reflects the need for appropriate strategies to facilitate professional help seeking. This study investigated the effectiveness of 2 short video-based strategies targeted at youth (aged 14 to 29 years) on potential professional help seeking and related attitudes for 5 MH problems. While we did not find intervention effects on potential professional help seeking (with the exception of previous help seekers in the depression conditions), differential intervention effects depending on each MH problem and participants’ actual help-seeking status were found in our secondary outcomes, such as public stigma. Our study results can be used to inform the development of new antistigma interventions, which, based on our results, we would recommend tailoring to specific MH problems, target groups, and outcomes. While group differences were small, such low-threshold interventions can be easily disseminated and, therefore, hold potential for a high reach and, thus, a meaningful impact at the population level. More research is needed for more robust and generalizable recommendations.

Acknowledgments

This study was funded by the German Federal Ministry of Education and Research (funding identifier: 01GL1904). The Federal Ministry of Education and Research had no influence on the design of the study and was not involved in data collection, analysis, and interpretation or the writing of the manuscript. For the publication fee, the authors acknowledge financial support from Heidelberg University. The authors thank Sabrina Baldofski, Elisabeth Kohls, Felicitas Mayr, and Maria I. Austermann for their support in the creation of video materials for this study (depression and alcohol abuse videos). The authors thank Lutfi Arikan (University Hospital Heidelberg) for enabling the technical implementation of this study.

Data Availability

Individual participant data underlying the results presented in this publication (text, tables, figures, and appendices) and statistical code will be shared during the period of 3 months to 5 years following publication of the paper with researchers who provide a methodologically sound proposal to the corresponding author.

Authors' Contributions

SB, MM, and MK conceptualized the study. SB led the grant application. SB, MM, MK, and DL contributed to the study design and selection of screening and outcome measures. DL prepared the technical implementation of this study. DL, AM, EK, and SK prepared the video interventions under the supervision of MM, NA, HB, PP, CRK, RT, and SB, who also provided feedback and information with regard to their fields of expertise. MM generated the random allocation sequence. DL was responsible for study recruitment, which was supported by student assistants. DL analyzed the data, wrote the first draft of this manuscript, and created its tables and figures, with SB and MM providing further feedback, guidance, and supervision during each step. All authors provided feedback on the manuscript. All authors read and approved the final manuscript.

Conflicts of Interest

PP is an advisor for Boehringer Ingelheim and has received speaker’s honoraria from InfectoPharm, GSK, Janssen, and Oral B.

Separate analysis of covariance results and pairwise comparisons for participants with and without previous help-seeking experience.

Separate analysis of covariance results and pairwise comparisons for outcomes per mental health problem.

Separate analysis of covariance results and pairwise comparisons for participants with and without previous help-seeking experience per mental health problem.

CONSORT-eHEALTH Checklist V 1.6.1.

• Gibb SJ, Fergusson DM, Horwood LJ. Burden of psychiatric disorder in young adulthood and life outcomes at age 30. Br J Psychiatry. Aug 2010;197(2):122-127. [ CrossRef ] [ Medline ]
• Weitkamp K, Daniels JK, Romer G, Wiegand-Grefe S. Health-related quality of life of children and adolescents with mental disorders. Health Qual Life Outcomes. Jul 31, 2013;11(1):129. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Sawyer MG, Whaites L, Rey JM, Hazell PL, Graetz BW, Baghurst P. Health-related quality of life of children and adolescents with mental disorders. J Am Acad Child Adolesc Psychiatry. May 2002;41(5):530-537. [ CrossRef ] [ Medline ]
• Romanowska S, MacQueen G, Goldstein BI, Wang J, Kennedy SH, Bray S, et al. Social and role functioning in youth at risk of serious mental illness. Early Interv Psychiatry. Aug 10, 2020;14(4):463-469. [ CrossRef ] [ Medline ]
• Gardner A, Filia K, Killackey E, Cotton S. The social inclusion of young people with serious mental illness: a narrative review of the literature and suggested future directions. Aust N Z J Psychiatry. Jan 2019;53(1):15-26. [ CrossRef ] [ Medline ]
• Erskine HE, Moffitt TE, Copeland WE, Costello EJ, Ferrari AJ, Patton G, et al. A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth. Psychol Med. May 2015;45(7):1551-1563. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Suhrcke M, Pillas D, Selai C. Economic aspects of mental health in children and adolescents. Social Cohesion for Mental Wellbeing among adolescents. 2008. URL: https:/​/pure.​york.ac.uk/​portal/​en/​publications/​economic-aspects-of-mental-health-in-children-and-adolescents [accessed 2024-04-08]
• Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. Jan 02, 2022;27(1):281-295. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ, et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. Apr 01, 2012;69(4):372-380. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Hofstra MB, Van Der Ende J, Verhulst FC. Adolescents' self-reported problems as predictors of psychopathology in adulthood: 10-year follow-up study. Br J Psychiatry. Sep 02, 2001;179(3):203-209. [ CrossRef ] [ Medline ]
• Pardini D, White HR, Stouthamer-Loeber M. Early adolescent psychopathology as a predictor of alcohol use disorders by young adulthood. Drug Alcohol Depend. Apr 2007;88 Suppl 1(Suppl 1):S38-S49. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Heijmens Visser JH, van der Ende J, Koot HM, Verhulst FC. Predictors of psychopathology in young adults referred to mental health services in childhood or adolescence. Br J Psychiatry. Jul 02, 2000;177(1):59-65. [ CrossRef ] [ Medline ]
• Reef J, Diamantopoulou S, van Meurs I, Verhulst F, van der Ende J. Child to adult continuities of psychopathology: a 24-year follow-up. Acta Psychiatr Scand. Sep 03, 2009;120(3):230-238. [ CrossRef ] [ Medline ]
• Pearson CM, Miller J, Ackard DM, Loth KA, Wall MM, Haynos AF, et al. Stability and change in patterns of eating disorder symptoms from adolescence to young adulthood. Int J Eat Disord. Jul 15, 2017;50(7):748-757. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Hintzpeter B, Metzner F, Pawils S, Bichmann H, Kamtsiuris P, Ravens-Sieberer U, et al. Inanspruchnahme von ärztlichen und psychotherapeutischen Leistungen durch Kinder und Jugendliche mit psychischen Auffälligkeiten. Kindh Entwickl. Oct 2014;23(4):229-238. [ CrossRef ]
• Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, et al. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet. Sep 08, 2007;370(9590):841-850. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Cotter P, Kaess M, Corcoran P, Parzer P, Brunner R, Keeley H, et al. Help-seeking behaviour following school-based screening for current suicidality among European adolescents. Soc Psychiatry Psychiatr Epidemiol. Jun 6, 2015;50(6):973-982. [ CrossRef ] [ Medline ]
• Vanheusden K, Mulder CL, van der Ende J, van Lenthe FJ, Mackenbach JP, Verhulst FC. Young adults face major barriers to seeking help from mental health services. Patient Educ Couns. Oct 2008;73(1):97-104. [ CrossRef ] [ Medline ]
• Kaltenthaler E, Sutcliffe P, Parry G, Beverley C, Rees A, Ferriter M. The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review. Psychol Med. Nov 2008;38(11):1521-1530. [ CrossRef ] [ Medline ]
• Lawrence D, Johnson S, Hafekost J, Boterhoven de Haan K, Sawyer M, Ainley J, et al. The mental health of children and adolescents: report on the second Australian child and adolescent survey of mental health and wellbeing. Government of Australia. 2015. URL: https:/​/www.​health.gov.au/​sites/​default/​files/​documents/​2020/​11/​the-mental-health-of-children-and-adolescents_0.​pdf [accessed 2024-04-08]
• Lillevoll KR, Vangberg HC, Griffiths KM, Waterloo K, Eisemann MR. Uptake and adherence of a self-directed internet-based mental health intervention with tailored e-mail reminders in senior high schools in Norway. BMC Psychiatry. Jan 21, 2014;14(1):14. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Woodford J, Farrand P, Bessant M, Williams C. Recruitment into a guided internet based CBT (iCBT) intervention for depression: lesson learnt from the failure of a prevalence recruitment strategy. Contemp Clin Trials. Sep 2011;32(5):641-648. [ CrossRef ] [ Medline ]
• Glasgow RE, Estabrooks PE. Pragmatic applications of RE-AIM for health care initiatives in community and clinical settings. Prev Chronic Dis. Jan 04, 2018;15:E02. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. Sep 1999;89(9):1322-1327. [ CrossRef ] [ Medline ]
• Andrade LH, Alonso J, Mneimneh Z, Wells JE, Al-Hamzawi A, Borges G, et al. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med. Aug 09, 2013;44(6):1303-1317. [ CrossRef ]
• Mojtabai R, Olfson M, Sampson NA, Jin R, Druss B, Wang PS, et al. Barriers to mental health treatment: results from the National Comorbidity Survey replication. Psychol Med. Aug 2011;41(8):1751-1761. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry. Dec 30, 2010;10:113. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Eisenberg D, Golberstein E, Gollust SE. Help-seeking and access to mental health care in a university student population. Med Care. Jul 2007;45(7):594-601. [ CrossRef ] [ Medline ]
• Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? a systematic review of quantitative and qualitative studies. Psychol Med. Jan 2015;45(1):11-27. [ CrossRef ] [ Medline ]
• Schnyder N, Panczak R, Groth N, Schultze-Lutter F. Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. Br J Psychiatry. Apr 2017;210(4):261-268. [ CrossRef ] [ Medline ]
• Furnham A, Swami V. Mental health literacy: a review of what it is and why it matters. Int Perspect Psychol. Oct 2018;7(4):240-257. [ CrossRef ]
• Jorm AF. Mental health literacy: empowering the community to take action for better mental health. Am Psychol. Apr 2012;67(3):231-243. [ CrossRef ] [ Medline ]
• Patafio B, Miller P, Baldwin R, Taylor N, Hyder S. A systematic mapping review of interventions to improve adolescent mental health literacy, attitudes and behaviours. Early Interv Psychiatry. Dec 03, 2021;15(6):1470-1501. [ CrossRef ] [ Medline ]
• Howard KA, Griffiths KM, McKetin R, Ma J. Can a brief biologically-based psychoeducational intervention reduce stigma and increase help-seeking intentions for depression in young people? a randomised controlled trial. J Child Adolesc Ment Health. May 15, 2018;30(1):27-39. [ CrossRef ] [ Medline ]
• Jaber R, Farroukh M, Ismail M, Najda J, Sobh H, Hammad A, et al. Measuring depression and stigma towards depression and mental health treatment among adolescents in an Arab-American community. Int J Cult Ment Health. Sep 24, 2015;8(3):247-254. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Bruning Brown J, Winzelberg AJ, Abascal LB, Taylor CB. An evaluation of an internet-delivered eating disorder prevention program for adolescents and their parents. J Adolesc Health. Oct 2004;35(4):290-296. [ CrossRef ] [ Medline ]
• O'Kearney R, Kang K, Christensen H, Griffiths K. A controlled trial of a school-based internet program for reducing depressive symptoms in adolescent girls. Depress Anxiety. 2009;26(1):65-72. [ CrossRef ] [ Medline ]
• Baumel A, Fleming T, Schueller SM. Digital micro interventions for behavioral and mental health gains: core components and conceptualization of digital micro intervention care. J Med Internet Res. Oct 29, 2020;22(10):e20631. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ebert DD, Franke M, Kählke F, Küchler AM, Bruffaerts R, Mortier P, et al. WHO World Mental Health - International College Student collaborators. Increasing intentions to use mental health services among university students. Results of a pilot randomized controlled trial within the World Health Organization's World Mental Health International college student initiative. Int J Methods Psychiatr Res. Jun 2019;28(2):e1754. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Amsalem D, Markowitz JC, Jankowski SE, Yang LH, Valeri L, Lieff SA, et al. Sustained effect of a brief video in reducing public stigma toward individuals with psychosis: a randomized controlled trial of young adults. Am J Psychiatry. Jul 26, 2021;178(7):635-642. [ CrossRef ] [ Medline ]
• Amsalem D, Jankowski SE, Pagdon S, Valeri L, Smith S, Yang LH, et al. "It is hard to be a woman with schizophrenia": randomized controlled trial of a brief video intervention to reduce public stigma in young adults. J Clin Psychiatry. Dec 19, 2022;84(1):22m14534. [ CrossRef ] [ Medline ]
• Amsalem D, Martin A. Reducing depression-related stigma and increasing treatment seeking among adolescents: randomized controlled trial of a brief video intervention. J Child Psychol Psychiatry. Feb 06, 2022;63(2):210-217. [ CrossRef ] [ Medline ]
• Conceição V, Rothes I, Gusmão R. The effects of a video-based randomized controlled trial intervention on depression stigma and help-seeking attitudes in university students. Psychiatry Res. Feb 2022;308:114356. [ CrossRef ] [ Medline ]
• Clough BA, Nazareth SM, Casey LM. Making the grade: a pilot investigation of an e-intervention to increase mental health literacy and help-seeking intentions among international university students. Br J Guid Couns. Oct 03, 2019;48(3):347-359. [ CrossRef ]
• Gaudiano BA, Davis CH, Miller IW, Uebelacker L. Pilot randomized controlled trial of a video self-help intervention for depression based on acceptance and commitment therapy: feasibility and acceptability. Clin Psychol Psychother. May 28, 2020;27(3):396-407. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Fong TH, Mak WW. The effects of internet-based storytelling programs (amazing adventure against stigma) in reducing mental illness stigma with mediation by interactivity and stigma content: randomized controlled trial. J Med Internet Res. Aug 12, 2022;24(8):e37973. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Logsdon CM, Myers J, Rushton J, Gregg JL, Josephson AM, Davis DW, et al. Efficacy of an internet-based depression intervention to improve rates of treatment in adolescent mothers. Arch Womens Ment Health. Jun 2018;21(3):273-285. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Schwarzer R, Luszczynska A. How to overcome health-compromising behaviors. Eur Psychol. Jan 2008;13(2):141-151. [ CrossRef ]
• Zhang CQ, Zhang R, Schwarzer R, Hagger MS. A meta-analysis of the health action process approach. Health Psychol. Jul 2019;38(7):623-637. [ CrossRef ] [ Medline ]
• Fishbein M, Ajzen I. Predicting and Changing Behavior: The Reasoned Action Approach. New York, NY. Psychology Press; 2010.
• Yeager CM, Shoji K, Luszczynska A, Benight CC. Engagement with a trauma recovery internet intervention explained with the Health Action Process Approach (HAPA): longitudinal study. JMIR Ment Health. Apr 10, 2018;5(2):e29. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Eysenbach G. Improving the quality of web surveys: the checklist for reporting results of internet E-surveys (CHERRIES). J Med Internet Res. Sep 29, 2004;6(3):e34. [ CrossRef ] [ Medline ]
• Eysenbach G, CONSORT-EHEALTH Group. CONSORT-EHEALTH: improving and standardizing evaluation reports of web-based and mobile health interventions. J Med Internet Res. Dec 31, 2011;13(4):e126. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Santelli JS, Rosenfeld WD, DuRant RH, Dubler N, Morreale M, English A, et al. Guidelines for adolescent health research: a position paper of the society for adolescent medicine. J Adolesc Health. Nov 1995;17(5):270-276. [ CrossRef ] [ Medline ]
• Schachter D, Kleinman I, Harvey W. Informed consent and adolescents. Can J Psychiatry. Aug 01, 2005;50(9):534-540. [ CrossRef ] [ Medline ]
• Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469-480. [ CrossRef ]
• Mehta CM, Arnett JJ, Palmer CG, Nelson LJ. Established adulthood: a new conception of ages 30 to 45. Am Psychol. May 2020;75(4):431-444. [ CrossRef ] [ Medline ]
• Wilhelm M, Feldhege J, Bauer S, Moessner M. Einsatz internetbasierter verlaufsmessung in der psychotherapieforschung. Psychotherapeut. Oct 12, 2020;65(6):505-511. [ CrossRef ]
• Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. May 22, 2006;166(10):1092-1097. [ CrossRef ] [ Medline ]
• Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. Sep 2001;16(9):606-613. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Killen JD, Taylor CB, Hammer LD, Litt I, Wilson DM, Rich T, et al. An attempt to modify unhealthful eating attitudes and weight regulation practices of young adolescent girls. Int J Eat Disord. May 1993;13(4):369-384. [ CrossRef ] [ Medline ]
• Killen JD, Taylor CB, Hayward C, Wilson DM, Haydel KF, Hammer LD, et al. Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: a three-year prospective analysis. Int J Eat Disord. Nov 1994;16(3):227-238. [ CrossRef ] [ Medline ]
• Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (ACQUIP). Alcohol use disorders identification test. Arch Intern Med. Sep 14, 1998;158(16):1789-1795. [ CrossRef ] [ Medline ]
• Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption--II. Addiction. Jun 1993;88(6):791-804. [ CrossRef ] [ Medline ]
• Kuitunen-Paul S, Roerecke M. Alcohol Use isorders Identification Test (AUDIT) and mortality risk: a systematic review and meta-analysis. J Epidemiol Community Health. Sep 2018;72(9):856-863. [ CrossRef ] [ Medline ]
• Fischer G, Ameis N, Parzer P, Plener PL, Groschwitz R, Vonderlin E, et al. The German version of the self-injurious thoughts and behaviors interview (SITBI-G): a tool to assess non-suicidal self-injury and suicidal behavior disorder. BMC Psychiatry. Sep 18, 2014;14(1):265. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Home page. Powtoon. URL: https://www.powtoon.com/ [accessed 2024-04-08]
• Wright A, Jorm AF, Mackinnon AJ. Labels used by young people to describe mental disorders: which ones predict effective help-seeking choices? Soc Psychiatry Psychiatr Epidemiol. Jun 2012;47(6):917-926. [ CrossRef ] [ Medline ]
• Mond JM, Hay PJ, Paxton SJ, Rodgers B, Darby A, Nillson J, et al. Eating disorders "mental health literacy" in low risk, high risk and symptomatic women: implications for health promotion programs. Eat Disord. 2010;18(4):267-285. [ CrossRef ] [ Medline ]
• DeJong H, Hillcoat J, Perkins S, Grover M, Schmidt U. Illness perception in bulimia nervosa. J Health Psychol. Apr 2012;17(3):399-408. [ CrossRef ] [ Medline ]
• Bulik CM. Towards a science of eating disorders: replacing myths with realities: the fourth Birgit Olsson lecture. Nord J Psychiatry. Sep 10, 2016;70(3):224-230. [ CrossRef ] [ Medline ]
• Keski-Rahkonen A, Mustelin L. Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Curr Opin Psychiatry. Nov 2016;29(6):340-345. [ CrossRef ] [ Medline ]
• Nagl M, Jacobi C, Paul M, Beesdo-Baum K, Höfler M, Lieb R, et al. Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults. Eur Child Adolesc Psychiatry. Aug 2016;25(8):903-918. [ CrossRef ] [ Medline ]
• Laberg S, Törnkvist Å, Andersson G. Experiences of patients in cognitive behavioural group therapy: a qualitative study of eating disorders. Cogn Behav Ther. Jan 2001;30(4):161-178. [ CrossRef ]
• Wilson CJ, Deane FP, Ciarrochi J, Rickwood D. Measuring help-seeking intentions: properties of the general help-seeking questionnaire. Can J Couns. 2005;39(1):15-28. [ FREE Full text ]
• Divin N, Harper P, Curran E, Corry D, Leavey G. Help-seeking measures and their use in adolescents: a systematic review. Adolescent Res Rev. Jan 17, 2018;3(1):113-122. [ CrossRef ]
• Mackenzie CS, Knox VJ, Gekoski WL, Macaulay HL. An adaptation and extension of the attitudes toward seeking professional psychological help scale. J Applied Social Pyschol. Jul 31, 2006;34(11):2410-2433. [ CrossRef ]
• Ebneter DS, Latner JD. Stigmatizing attitudes differ across mental health disorders: a comparison of stigma across eating disorders, obesity, and major depressive disorder. J Nerv Ment Dis. Apr 2013;201(4):281-285. [ CrossRef ] [ Medline ]
• Appel M, Gnambs T, Richter T, Green MC. The Transportation Scale–Short Form (TS–SF). Media Psychol. Feb 03, 2015;18(2):243-266. [ CrossRef ]
• Faul F, Erdfelder E, Lang A, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. May 2007;39(2):175-191. [ CrossRef ]
• R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. URL: https://www.r-project.org/ [accessed 2024-04-08]
• IBM SPSS Statistics for Windows, version 28.0. IBM Corp. URL: https://www.ibm.com/support/pages/downloading-ibm-spss-statistics-28010 [accessed 2024-04-08]
• Lienemann BA, Siegel JT, Crano WD. Persuading people with depression to seek help: respect the boomerang. Health Commun. Oct 2013;28(7):718-728. [ CrossRef ] [ Medline ]
• Lienemann BA, Siegel JT. State psychological reactance to depression public service announcements among people with varying levels of depressive symptomatology. Health Commun. Jun 18, 2016;31(1):102-116. [ CrossRef ] [ Medline ]
• Siegel JT, Lienemann BA, Rosenberg BD. Resistance, reactance, and misinterpretation: highlighting the challenge of persuading people with depression to seek help. Soc Pers Psychol Compass. Jun 05, 2017;11(6):e12322. [ CrossRef ]
• van Laer T, de Ruyter K, Visconti LM, Wetzels M. The extended transportation-imagery model: a meta-analysis of the antecedents and consequences of consumers' narrative transportation. J Consum Res. Feb 01, 2014;40(5):797-817. [ FREE Full text ] [ CrossRef ]
• Murphy ST, Frank LB, Chatterjee JS, Baezconde-Garbanati L. Narrative versus non-narrative: the role of identification, transportation and emotion in reducing health disparities. J Commun. Feb 07, 2013;63(1):116-137. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Sowislo JF, Gonet-Wirz F, Borgwardt S, Lang UE, Huber CG. Perceived dangerousness as related to psychiatric symptoms and psychiatric service use - a vignette based representative population survey. Sci Rep. Apr 03, 2017;8(1):45716. [ FREE Full text ] [ CrossRef ] [ Medline ]
• McVay MA, Bennett GG, Steinberg D, Voils CI. Dose-response research in digital health interventions: concepts, considerations, and challenges. Health Psychol. Dec 2019;38(12):1168-1174. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Suka M, Yamauchi T, Yanagisawa H. Comparing responses to differently framed and formatted persuasive messages to encourage help-seeking for depression in Japanese adults: a cross-sectional study with 2-month follow-up. BMJ Open. Nov 12, 2018;8(11):e020823. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Kaushik A, Kostaki E, Kyriakopoulos M. The stigma of mental illness in children and adolescents: a systematic review. Psychiatry Res. Sep 30, 2016;243:469-494. [ CrossRef ] [ Medline ]
• Misra S, Jackson VW, Chong J, Choe K, Tay C, Wong J, et al. Systematic review of cultural aspects of stigma and mental illness among racial and ethnic minority groups in the United States: implications for interventions. Am J Community Psychol. Dec 2021;68(3-4):486-512. [ CrossRef ] [ Medline ]
• Papadopoulos C, Foster J, Caldwell K. 'Individualism-collectivism' as an explanatory device for mental illness stigma. Community Ment Health J. Jun 27, 2013;49(3):270-280. [ CrossRef ] [ Medline ]

Abbreviations

Edited by G Eysenbach, T de Azevedo Cardoso; submitted 13.11.23; peer-reviewed by A Morgan; comments to author 15.12.23; revised version received 22.12.23; accepted 08.03.24; published 24.04.24.

©Diana Lemmer, Markus Moessner, Nicolas Arnaud, Harald Baumeister, Agnes Mutter, Sarah-Lena Klemm, Elisa König, Paul Plener, Christine Rummel-Kluge, Rainer Thomasius, Michael Kaess, Stephanie Bauer. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 24.04.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

Help | Advanced Search

Computer Science > Information Retrieval

Title: a survey on retrieval-augmented text generation for large language models.

Abstract: Retrieval-Augmented Generation (RAG) merges retrieval methods with deep learning advancements to address the static limitations of large language models (LLMs) by enabling the dynamic integration of up-to-date external information. This methodology, focusing primarily on the text domain, provides a cost-effective solution to the generation of plausible but incorrect responses by LLMs, thereby enhancing the accuracy and reliability of their outputs through the use of real-world data. As RAG grows in complexity and incorporates multiple concepts that can influence its performance, this paper organizes the RAG paradigm into four categories: pre-retrieval, retrieval, post-retrieval, and generation, offering a detailed perspective from the retrieval viewpoint. It outlines RAG's evolution and discusses the field's progression through the analysis of significant studies. Additionally, the paper introduces evaluation methods for RAG, addressing the challenges faced and proposing future research directions. By offering an organized framework and categorization, the study aims to consolidate existing research on RAG, clarify its technological underpinnings, and highlight its potential to broaden the adaptability and applications of LLMs.

Submission history

Access paper:.

• HTML (experimental)
• Other Formats

References & Citations

• Google Scholar
• Semantic Scholar

BibTeX formatted citation

Bibliographic and Citation Tools

Code, data and media associated with this article, recommenders and search tools.

• Institution

arXivLabs: experimental projects with community collaborators

arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website.

Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them.

Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs .

AI Index Report

Welcome to the seventh edition of the AI Index report. The 2024 Index is our most comprehensive to date and arrives at an important moment when AI’s influence on society has never been more pronounced. This year, we have broadened our scope to more extensively cover essential trends such as technical advancements in AI, public perceptions of the technology, and the geopolitical dynamics surrounding its development. Featuring more original data than ever before, this edition introduces new estimates on AI training costs, detailed analyses of the responsible AI landscape, and an entirely new chapter dedicated to AI’s impact on science and medicine.

Read the 2024 AI Index Report

The AI Index report tracks, collates, distills, and visualizes data related to artificial intelligence (AI). Our mission is to provide unbiased, rigorously vetted, broadly sourced data in order for policymakers, researchers, executives, journalists, and the general public to develop a more thorough and nuanced understanding of the complex field of AI.

The AI Index is recognized globally as one of the most credible and authoritative sources for data and insights on artificial intelligence. Previous editions have been cited in major newspapers, including the The New York Times, Bloomberg, and The Guardian, have amassed hundreds of academic citations, and been referenced by high-level policymakers in the United States, the United Kingdom, and the European Union, among other places. This year’s edition surpasses all previous ones in size, scale, and scope, reflecting the growing significance that AI is coming to hold in all of our lives.

Steering Committee Co-Directors

Ray Perrault

Steering committee members.

Erik Brynjolfsson

John Etchemendy

Katrina Ligett

Terah Lyons

James Manyika

Juan Carlos Niebles

Vanessa Parli

Yoav Shoham

Russell Wald

Staff members.

Loredana Fattorini

Nestor Maslej

Letter from the co-directors.

A decade ago, the best AI systems in the world were unable to classify objects in images at a human level. AI struggled with language comprehension and could not solve math problems. Today, AI systems routinely exceed human performance on standard benchmarks.

Progress accelerated in 2023. New state-of-the-art systems like GPT-4, Gemini, and Claude 3 are impressively multimodal: They can generate fluent text in dozens of languages, process audio, and even explain memes. As AI has improved, it has increasingly forced its way into our lives. Companies are racing to build AI-based products, and AI is increasingly being used by the general public. But current AI technology still has significant problems. It cannot reliably deal with facts, perform complex reasoning, or explain its conclusions.

AI faces two interrelated futures. First, technology continues to improve and is increasingly used, having major consequences for productivity and employment. It can be put to both good and bad uses. In the second future, the adoption of AI is constrained by the limitations of the technology. Regardless of which future unfolds, governments are increasingly concerned. They are stepping in to encourage the upside, such as funding university R&D and incentivizing private investment. Governments are also aiming to manage the potential downsides, such as impacts on employment, privacy concerns, misinformation, and intellectual property rights.

As AI rapidly evolves, the AI Index aims to help the AI community, policymakers, business leaders, journalists, and the general public navigate this complex landscape. It provides ongoing, objective snapshots tracking several key areas: technical progress in AI capabilities, the community and investments driving AI development and deployment, public opinion on current and potential future impacts, and policy measures taken to stimulate AI innovation while managing its risks and challenges. By comprehensively monitoring the AI ecosystem, the Index serves as an important resource for understanding this transformative technological force.

On the technical front, this year’s AI Index reports that the number of new large language models released worldwide in 2023 doubled over the previous year. Two-thirds were open-source, but the highest-performing models came from industry players with closed systems. Gemini Ultra became the first LLM to reach human-level performance on the Massive Multitask Language Understanding (MMLU) benchmark; performance on the benchmark has improved by 15 percentage points since last year. Additionally, GPT-4 achieved an impressive 0.97 mean win rate score on the comprehensive Holistic Evaluation of Language Models (HELM) benchmark, which includes MMLU among other evaluations.

Although global private investment in AI decreased for the second consecutive year, investment in generative AI skyrocketed. More Fortune 500 earnings calls mentioned AI than ever before, and new studies show that AI tangibly boosts worker productivity. On the policymaking front, global mentions of AI in legislative proceedings have never been higher. U.S. regulators passed more AI-related regulations in 2023 than ever before. Still, many expressed concerns about AI’s ability to generate deepfakes and impact elections. The public became more aware of AI, and studies suggest that they responded with nervousness.

Ray Perrault Co-director, AI Index

Our Supporting Partners

Analytics & Research Partners

Stay up to date on the AI Index by subscribing to the  Stanford HAI newsletter.

Suggestions or feedback?

MIT News | Massachusetts Institute of Technology

• Machine learning
• Social justice
• Black holes
• Classes and programs

Departments

• Aeronautics and Astronautics
• Brain and Cognitive Sciences
• Architecture
• Political Science
• Mechanical Engineering

Centers, Labs, & Programs

• Abdul Latif Jameel Poverty Action Lab (J-PAL)
• Picower Institute for Learning and Memory
• Lincoln Laboratory
• School of Architecture + Planning
• School of Engineering
• School of Humanities, Arts, and Social Sciences
• Sloan School of Management
• School of Science
• MIT Schwarzman College of Computing

Researchers detect a new molecule in space

Press contact :.

Previous image Next image

New research from the group of MIT Professor Brett McGuire has revealed the presence of a previously unknown molecule in space. The team's open-access paper, “ Rotational Spectrum and First Interstellar Detection of 2-Methoxyethanol Using ALMA Observations of NGC 6334I ,” appears in April 12 issue of The Astrophysical Journal Letters .

Zachary T.P. Fried , a graduate student in the McGuire group and the lead author of the publication, worked to assemble a puzzle comprised of pieces collected from across the globe, extending beyond MIT to France, Florida, Virginia, and Copenhagen, to achieve this exciting discovery. 

“Our group tries to understand what molecules are present in regions of space where stars and solar systems will eventually take shape,” explains Fried. “This allows us to piece together how chemistry evolves alongside the process of star and planet formation. We do this by looking at the rotational spectra of molecules, the unique patterns of light they give off as they tumble end-over-end in space. These patterns are fingerprints (barcodes) for molecules. To detect new molecules in space, we first must have an idea of what molecule we want to look for, then we can record its spectrum in the lab here on Earth, and then finally we look for that spectrum in space using telescopes.”

Searching for molecules in space

The McGuire Group has recently begun to utilize machine learning to suggest good target molecules to search for. In 2023, one of these machine learning models suggested the researchers target a molecule known as 2-methoxyethanol. 

“There are a number of 'methoxy' molecules in space, like dimethyl ether, methoxymethanol, ethyl methyl ether, and methyl formate, but 2-methoxyethanol would be the largest and most complex ever seen,” says Fried. To detect this molecule using radiotelescope observations, the group first needed to measure and analyze its rotational spectrum on Earth. The researchers combined experiments from the University of Lille (Lille, France), the New College of Florida (Sarasota, Florida), and the McGuire lab at MIT to measure this spectrum over a broadband region of frequencies ranging from the microwave to sub-millimeter wave regimes (approximately 8 to 500 gigahertz). 

The data gleaned from these measurements permitted a search for the molecule using Atacama Large Millimeter/submillimeter Array (ALMA) observations toward two separate star-forming regions: NGC 6334I and IRAS 16293-2422B. Members of the McGuire group analyzed these telescope observations alongside researchers at the National Radio Astronomy Observatory (Charlottesville, Virginia) and the University of Copenhagen, Denmark. 

“Ultimately, we observed 25 rotational lines of 2-methoxyethanol that lined up with the molecular signal observed toward NGC 6334I (the barcode matched!), thus resulting in a secure detection of 2-methoxyethanol in this source,” says Fried. “This allowed us to then derive physical parameters of the molecule toward NGC 6334I, such as its abundance and excitation temperature. It also enabled an investigation of the possible chemical formation pathways from known interstellar precursors.”

Looking forward

Molecular discoveries like this one help the researchers to better understand the development of molecular complexity in space during the star formation process. 2-methoxyethanol, which contains 13 atoms, is quite large for interstellar standards — as of 2021, only six species larger than 13 atoms were detected outside the solar system , many by McGuire’s group, and all of them existing as ringed structures.  

“Continued observations of large molecules and subsequent derivations of their abundances allows us to advance our knowledge of how efficiently large molecules can form and by which specific reactions they may be produced,” says Fried. “Additionally, since we detected this molecule in NGC 6334I but not in IRAS 16293-2422B, we were presented with a unique opportunity to look into how the differing physical conditions of these two sources may be affecting the chemistry that can occur.”

Share this news article on:

Related links.

• McGuire Lab
• Department of Chemistry

Related Topics

• Space, astronomy and planetary science
• Astrophysics

Related Articles

Found in space: Complex carbon-based molecules

Previous item Next item

More MIT News

A closed-loop drug-delivery system could improve chemotherapy

Read full story →

MIT scientists tune the entanglement structure in an array of qubits

Geologists discover rocks with the oldest evidence yet of Earth’s magnetic field

Mapping the brain pathways of visual memorability

Professor Emeritus Bernhardt Wuensch, crystallographer and esteemed educator, dies at 90

How light can vaporize water without the need for heat

• More news on MIT News homepage →

Massachusetts Institute of Technology 77 Massachusetts Avenue, Cambridge, MA, USA

• Map (opens in new window)
• Events (opens in new window)
• People (opens in new window)
• Careers (opens in new window)
• Accessibility
• Social Media Hub
• MIT on Facebook
• MIT on YouTube
• MIT on Instagram

• Hydraulic Fracturing
• Flame Retardants and Cancer Risk
• Information for Participants
• Publications

INFORMATION FOR

• Prospective Students
• Current Students
• Academic Calendar

Yurkow Honored For Best Original Research Paper By An Early Career Scholar

Sydney Yurkow, PhD, associate research scientist in psychiatry, is first author of a research paper named winner of the Best Original Research Paper by an Early Career Scholar published in the International Journal of Eating Disorders.

The award covers the 2023 publishing period. The title of the paper is “Improvements in cardiovascular disease risk factors associated with modest weight loss following treatment in patients with binge-eating disorder and obesity.”

Co-authors of the paper are Carlos Grilo, PhD, professor of psychiatry and of psychology, and Valentina Ivezaj, PhD, assistant professor of psychiatry.

Yurkow works in the Program for Obesity, Weight and Eating Research (POWER) at Yale with Grilo and Ivezaj.

• Awards & Honors

Featured in this article

• Sydney Yurkow, PhD Associate Research Scientist in Psychiatry
• Carlos Grilo, PhD Professor of Psychiatry and of Psychology; Director, Program for Obesity, Weight and Eating Research (POWER) at Yale, Psychiatry
• Valentina Ivezaj, PhD Assistant Professor of Psychiatry; Program for Obesity Weight and Eating Research (POWER), Psychiatry

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts

Collection  12 March 2023

Journal Top 100 - 2022

This collection highlights our most downloaded* research papers published in 2022. Featuring authors from around the world, these papers highlight valuable research from an international community.

You can also check out the Top 100 across various subject areas here .

*Data obtained from SN Insights, which is based on Digital Science’s Dimensions.

mRNA vaccine-induced antibodies more effective than natural immunity in neutralizing SARS-CoV-2 and its high affinity variants

• Dominic Esposito

Cats learn the names of their friend cats in their daily lives

• Saho Takagi
• Atsuko Saito
• Hika Kuroshima

Metformin administration is associated with enhanced response to transarterial chemoembolization for hepatocellular carcinoma in type 2 diabetes patients

• Woo Jin Jung
• Sangmi Jang
• Jin-Wook Kim

The impact of digital media on children’s intelligence while controlling for genetic differences in cognition and socioeconomic background

• Bruno Sauce
• Magnus Liebherr
• Torkel Klingberg

Life tables of annual life expectancy and mortality for companion dogs in the United Kingdom

• Kendy Tzu-yun Teng
• Dave C. Brodbelt
• Dan G. O’Neill

Bioarchaeological and palaeogenomic portrait of two Pompeians that died during the eruption of Vesuvius in 79 AD

• Gabriele Scorrano
• Serena Viva
• Fabio Macciardi

Reading on a smartphone affects sigh generation, brain activity, and comprehension

• Motoyasu Honma
• Yuri Masaoka
• Masahiko Izumizaki

Principal Component Analyses (PCA)-based findings in population genetic studies are highly biased and must be reevaluated

• Eran Elhaik

The determinants of COVID-19 morbidity and mortality across countries

• Dianna Chang
• Kelvin Jui Keng Tan

Birdsongs alleviate anxiety and paranoia in healthy participants

• J. Sundermann

Identification of ADS024, a newly characterized strain of Bacillus velezensis with direct Clostridiodes difficile killing and toxin degradation bio-activities

• Michelle M. O’Donnell
• James W. Hegarty
• Laurent Chesnel

Multiple sclerosis genetic and non-genetic factors interact through the transient transcriptome

• Renato Umeton
• Gianmarco Bellucci
• Giovanni Ristori

The effect of metformin on the survival of colorectal cancer patients with type 2 diabetes mellitus

• Zeinab Tarhini
• Kamelia Manceur
• Niki Christou

Chemical characterisation of the vapour emitted by an e-cigarette using a ceramic wick-based technology

• M. Isabel Pinto

Large-magnitude (VEI ≥ 7) ‘wet’ explosive silicic eruption preserved a Lower Miocene habitat at the Ipolytarnóc Fossil Site, North Hungary

• Dávid Karátson
• Imre Szarvas

Far-UVC (222 nm) efficiently inactivates an airborne pathogen in a room-sized chamber

• Waseem Hiwar
• Kenneth Wood

Low dose aspirin associated with greater bone mineral density in older adults

• Hongzhan Liu
• Xungang Xiao

First direct evidence of adult European eels migrating to their breeding place in the Sargasso Sea

• Rosalind M. Wright
• Adam T. Piper
• David Righton

Infections with the SARS-CoV-2 Delta variant exhibit fourfold increased viral loads in the upper airways compared to Alpha or non-variants of concern

• Christian J. H. von Wintersdorff
• Jozef Dingemans
• Paul H. M. Savelkoul

Inappropriate sinus tachycardia in post-COVID-19 syndrome

• Júlia Aranyó
• Victor Bazan
• Roger Villuendas

The microstructure and the origin of the Venus from Willendorf

• Gerhard W. Weber
• Alexander Lukeneder

COVID-19 reinfections among naturally infected and vaccinated individuals

• Sezanur Rahman
• M. Mahfuzur Rahman
• Mustafizur Rahman

Lockdown measures during the COVID-19 pandemic strongly impacted the circulation of respiratory pathogens in Southern China

• Heping Wang
• Yuejie Zheng
• Wenjian Wang

Alzheimer’s disease large-scale gene expression portrait identifies exercise as the top theoretical treatment

• Mason A. Hill
• Stephen C. Gammie

COVID-19 symptoms are reduced by targeted hydration of the nose, larynx and trachea

• Carolin Elizabeth George
• Gerhard Scheuch
• David A. Edwards

SARS-CoV-2 spike protein induces cognitive deficit and anxiety-like behavior in mouse via non-cell autonomous hippocampal neuronal death

• Junyoung Oh
• Woo-Hyun Cho
• Sung Joong Lee

Abdominal pain patterns during COVID-19: an observational study

• Alexandre Balaphas
• Kyriaki Gkoufa
• Christian Toso

Detection of human pathogenic bacteria in rectal DNA samples from Zalophus californianus in the Gulf of California, Mexico

• Francesco Cicala
• David Ramírez-Delgado
• Alexei F. Licea-Navarro

Industrialised fishing nations largely contribute to floating plastic pollution in the North Pacific subtropical gyre

• Laurent Lebreton
• Sarah-Jeanne Royer
• Matthias Egger

Hypertension and diabetes including their earlier stage are associated with increased risk of sudden cardiac arrest

• Seung Young Roh
• Young-Hoon Kim

Utility of an artificial intelligence system for classification of esophageal lesions when simulating its clinical use

• Ayaka Tajiri
• Ryu Ishihara
• Tomohiro Tada

Prevalence, age of decision, and interpersonal warmth judgements of childfree adults

• Zachary P. Neal
• Jennifer Watling Neal

Acute and protracted abstinence from methamphetamine bidirectionally changes intrinsic excitability of indirect pathway spiny projection neurons in the dorsomedial striatum

• Sanghoon Choi
• Steven M. Graves

Indeterminacy of cannabis impairment and ∆ 9 -tetrahydrocannabinol (∆ 9 -THC) levels in blood and breath

• Gregory T. Wurz
• Michael W. DeGregorio

High rates of plasmid cotransformation in E. coli overturn the clonality myth and reveal colony development

• Delia Tomoiaga
• Jaclyn Bubnell
• Paul Feinstein

Metformin sensitizes leukemic cells to cytotoxic lymphocytes by increasing expression of intercellular adhesion molecule-1 (ICAM-1)

• Nerea Allende-Vega
• Joaquin Marco Brualla
• Martin Villalba

Incorporation of machine learning and deep neural network approaches into a remote sensing-integrated crop model for the simulation of rice growth

• Seungtaek Jeong
• Jong-min Yeom

Perceiving societal pressure to be happy is linked to poor well-being, especially in happy nations

• Egon Dejonckheere
• Joshua J. Rhee
• Brock Bastian

The earliest Pleistocene record of a large-bodied hominin from the Levant supports two out-of-Africa dispersal events

• Alon Barash
• Miriam Belmaker

Generation mechanism and prediction of an observed extreme rogue wave

• Johannes Gemmrich

Fitness tracking reveals task-specific associations between memory, mental health, and physical activity

• Jeremy R. Manning
• Gina M. Notaro
• Paxton C. Fitzpatrick

Domestic dogs ( Canis familiaris ) grieve over the loss of a conspecific

• Stefania Uccheddu
• Lucia Ronconi
• Federica Pirrone

Human transgenerational observations of regular smoking before puberty on fat mass in grandchildren and great-grandchildren

• Jean Golding
• Steve Gregory
• Matthew Suderman

Chlamydia pneumoniae can infect the central nervous system via the olfactory and trigeminal nerves and contributes to Alzheimer’s disease risk

• Jenny A. K. Ekberg

Oxycodone/naloxone versus tapentadol in real-world chronic non-cancer pain management: an observational and pharmacogenetic study

• Jordi Barrachina
• Cesar Margarit
• Ana M. Peiró

Cooking methods are associated with inflammatory factors, renal function, and other hormones and nutritional biomarkers in older adults

• Montserrat Rodríguez-Ayala
• José Ramón Banegas
• Pilar Guallar-Castillón

Classification of pig calls produced from birth to slaughter according to their emotional valence and context of production

• Elodie F. Briefer
• Ciara C.-R. Sypherd
• Céline Tallet

Higher emotional awareness is associated with greater domain-general reflective tendencies

• Michelle Persich
• William D. S. Killgore

A large Megaraptoridae (Theropoda: Coelurosauria) from Upper Cretaceous (Maastrichtian) of Patagonia, Argentina

• Alexis M. Aranciaga Rolando
• Matias J. Motta
• Fernando E. Novas

Long COVID occurrence in COVID-19 survivors

• Aya Sugiyama
• Junko Tanaka

Water activated disposable paper battery

• Alexandre Poulin
• Xavier Aeby
• Gustav Nyström

Intestinal preservation in a birdlike dinosaur supports conservatism in digestive canal evolution among theropods

• Yichuan Liu

Antiviral effect of cetylpyridinium chloride in mouthwash on SARS-CoV-2

• Hirofumi Sawa

Evidence of an oceanic impact and megatsunami sedimentation in Chryse Planitia, Mars

• J. Alexis P. Rodriguez
• Darrel K. Robertson
• Mario Zarroca

Curcumin and metformin synergistically modulate peripheral and central immune mechanisms of pain

• Peththa Wadu Dasuni Wasana
• Pasarapa Towiwat

The first occurrence of an avian-style respiratory infection in a non-avian dinosaur

• D. Cary Woodruff
• Ewan D. S. Wolff
• Lawrence M. Witmer

Optimal linear estimation models predict 1400–2900 years of overlap between Homo sapiens and Neandertals prior to their disappearance from France and northern Spain

• Igor Djakovic
• Alastair Key
• Marie Soressi

The influence of time on the sensitivity of SARS-CoV-2 serological testing

• Arturo Torres Ortiz
• Fernanda Fenn Torrente
• Louis Grandjean

Online misinformation is linked to early COVID-19 vaccination hesitancy and refusal

• Francesco Pierri
• Brea L. Perry
• John Bryden

A distinct symptom pattern emerges for COVID-19 long-haul: a nationwide study

• Melissa D. Pinto
• Charles A. Downs
• Natalie Lambert

SARS-CoV-2-reactive IFN-γ-producing CD4 + and CD8 + T cells in blood do not correlate with clinical severity in unvaccinated critically ill COVID-19 patients

• Beatriz Olea
• Eliseo Albert
• David Navarro

Classification of 74 facial emoji’s emotional states on the valence-arousal axes

• Gaku Kutsuzawa
• Hiroyuki Umemura
• Yoshiyuki Kobayashi

The emergence of a new sex-system (XX/XY 1 Y 2 ) suggests a species complex in the “monotypic” rodent Oecomys auyantepui (Rodentia, Sigmodontinae)

• Willam Oliveira da Silva
• Celina Coelho Rosa
• Cleusa Yoshiko Nagamachi

Detection of COVID-19 using multimodal data from a wearable device: results from the first TemPredict Study

• Ashley E. Mason
• Frederick M. Hecht
• Benjamin L. Smarr

Spinal degeneration is associated with lumbar multifidus morphology in secondary care patients with low back or leg pain

• Jeffrey R. Cooley
• Tue S. Jensen
• Jeffrey J. Hebert

Phenomenology and content of the inhaled N , N -dimethyltryptamine ( N , N -DMT) experience

• David Wyndham Lawrence
• Robin Carhart-Harris
• Christopher Timmermann

A gigantic bizarre marine turtle (Testudines: Chelonioidea) from the Middle Campanian (Late Cretaceous) of South-western Europe

• Oscar Castillo-Visa
• Àngel H. Luján
• Albert Sellés

The first experience with fully endoscopic posterior cervical foraminotomy and discectomy for radiculopathy performed in Viet Duc University Hospital

• Son Ngoc Dinh
• Hung The Dinh

Mapping the “catscape” formed by a population of pet cats with outdoor access

• Richard Bischof
• Nina Rosita Hansen
• Torbjørn Haugaasen

Investigation of humans individual differences as predictors of their animal interaction styles, focused on the domestic cat

• Lauren R. Finka
• Lucia Ripari
• Marnie L. Brennan

Genesis of fecal floatation is causally linked to gut microbial colonization in mice

• Syed Mohammed Musheer Aalam
• Daphne Norma Crasta
• Nagarajan Kannan

Young children’s screen time during the first COVID-19 lockdown in 12 countries

• Christina Bergmann
• Nevena Dimitrova
• Nivedita Mani

Cichlids and stingrays can add and subtract ‘one’ in the number space from one to five

• V. Schluessel

Elevated estradiol levels in frozen embryo transfer have different effects on pregnancy outcomes depending on the stage of transferred embryos

• Liming Ruan

Group VR experiences can produce ego attenuation and connectedness comparable to psychedelics

• David R. Glowacki
• Rhoslyn Roebuck Williams
• Mike Chatziapostolou

New therizinosaurid dinosaur from the marine Osoushinai Formation (Upper Cretaceous, Japan) provides insight for function and evolution of therizinosaur claws

• Yoshitsugu Kobayashi
• Ryuji Takasaki
• Yoshinori Hikida

Smartphone-based ecological momentary assessment reveals mental health benefits of birdlife

• Ryan Hammoud
• Stefania Tognin
• Andrea Mechelli

Long-term outcomes of cataract surgery with toric intraocular lens implantation by the type of preoperative astigmatism

• Tetsuro Oshika
• Shinichiro Nakano
• Tsutomu Kaneko

Forest fire detection system using wireless sensor networks and machine learning

• Udaya Dampage
• Lumini Bandaranayake
• Bathiya Jayasanka

Misinformation of COVID-19 vaccines and vaccine hesitancy

• Sun Kyong Lee
• Juhyung Sun
• Shane Connelly

Deep language algorithms predict semantic comprehension from brain activity

• Charlotte Caucheteux
• Alexandre Gramfort
• Jean-Rémi King

Children with autism spectrum disorder show atypical electroencephalographic response to processing contextual incongruencies

• Amparo V. Márquez-García
• Vasily A. Vakorin
• Sam M. Doesburg

A generalizable one health framework for the control of zoonotic diseases

• Ria R. Ghai
• Ryan M. Wallace
• Casey Barton Behravesh

HS3ST2 expression induces the cell autonomous aggregation of tau

• M. B. Huynh
• N. Rebergue
• D. Papy-Garcia

Exceptional warming over the Barents area

• Ketil Isaksen
• Øyvind Nordli
• Tatiana Karandasheva

A new Early Cretaceous lizard in Myanmar amber with exceptionally preserved integument

• Andrej Čerňanský
• Edward L. Stanley
• Susan E. Evans

Coffee consumption and diabetic retinopathy in adults with diabetes mellitus

• Hak Jun Lee
• Daniel Duck-Jin Hwang

Shifts in the foraging tactics of crocodiles following invasion by toxic prey

• Abhilasha Aiyer
• Richard Shine
• Georgia Ward-Fear

Production of high loading insulin nanoparticles suitable for oral delivery by spray drying and freeze drying techniques

• Alberto Baldelli
• Anubhav Pratap-Singh

Cable news and COVID-19 vaccine uptake

• Matteo Pinna
• Christoph Goessmann

Estimating the time of last drinking from blood ethyl glucuronide and ethyl sulphate concentrations

• Zhongyuan Guo

COVID-19 infections in infants

• Małgorzata Sobolewska-Pilarczyk
• Maria Pokorska-Śpiewak
• Małgorzata Pawłowska

COVID-19 increases the risk for the onset of atrial fibrillation in hospitalized patients

• Jakob Wollborn
• Sergey Karamnov
• Jochen D. Muehlschlegel

Childhood temperament and adulthood personality differentially predict life outcomes

• Amanda J. Wright
• Joshua J. Jackson

Antivirus applied to JAR malware detection based on runtime behaviors

• Ricardo P. Pinheiro
• Sidney M. L. Lima
• Wellington P. dos Santos

Therapeutic enzyme engineering using a generative neural network

• Andrew Giessel
• Athanasios Dousis
• Stuart Licht

Identification of genes associated with human-canine communication in canine evolution

• Akiko Tonoike
• Ken-ichi Otaki
• Miho Nagasawa

Breath chemical markers of sexual arousal in humans

• G. Pugliese
• J. Williams

A 5-km-thick reservoir with > 380,000 km 3 of magma within the ancient Earth's crust

• Rais Latypov
• Sofya Chistyakova
• Mauritz van der Merwe

Return of large fin whale feeding aggregations to historical whaling grounds in the Southern Ocean

• Helena Herr
• Sacha Viquerat
• Bettina Meyer

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies