Child Psychiatry & Human Development最新文献

The Tourette OCD Alberta Network (TOAN) supports mental health therapists to improve the delivery of care to patients with Tourette syndrome (TS) and OCD in Alberta. We evaluated the professional development needs of health care workers to develop a continuing professional development (CPD) webinar series. Health care workers demonstrated an urgent need to access a CPD program grounded in evidenced based knowledge about TS and OCD. While 80% of health care workers treated children with TS and OCD, 50% had no formal training. A curriculum consisting of a series of twelve live, online webinars was developed and delivered between September 2020 and June 2021, covering a range of clinical topics. The webinars were attended on average by 63 attendees, with the outcome of a positive knowledge gain. In future, the educational program will need to reflect the ongoing developing clinical understanding of TS and OCD.

Rumination is a vulnerability for depression and potentially linked to inhibitory control weaknesses. We aimed to replicate the association observed in adults between inhibitory control and rumination in adolescents, and to examine putative moderating roles of childhood maltreatment and perceived family cohesion in an adolescent sample at risk for depression due to familial/personal history. Ninety adolescents aged 11-17 (M = 14.6, SD = 1.8) completed self-report scales of rumination, maltreatment, and family cohesion, and performed a task assessing inhibitory control. Hierarchical regression models showed no significant relation between inhibitory control and moderator variables on rumination. However, adolescents who reported higher levels of maltreatment and who perceived lower family cohesion tended to indicate higher levels of rumination (B_{Chilhood Maltreatment} = 27.52, 95% CIs [5.63, 49.41], B_{Family Cohesion} = -0.40, 95% CIs [-0.65, -0.15]). These findings demonstrate an alternative understanding of factors that increase depression onset risk and recurrence in adolescents.

Sleep problems are common in individuals with autism spectrum disorder (ASD). How sleep problems reflect specific ASD phenotypes is unclear. We studied whether sleep problems indexed functional impairment in a heterogeneous community sample of individuals with ASD. We analyzed 977 probands (233 females; age = 11.27 ± 4.13 years) from the Rhode Island Consortium for Autism Research and Treatment dataset, a unique public-private-academic collaboration involving all major points of service for families in Rhode Island. We found that individuals with a confirmed diagnosis of ASD were more likely to have sleep problems. However, across the whole sample and above and beyond a formal diagnosis, sleep problems were dimensionally associated with worse social impairment and poorer adaptive functioning. By using a large dataset reflective of the diversity of presentations in the community, this study underscores the importance of considering sleep problems in clinical practice to improve adaptive functioning in individuals with ASD.

Engaging children and adolescents in ADHD care is critical for future independent disease management. However, there is a lack of evidence guiding health professionals and parents on how best to engage their children and adolescents in ADHD care. We recruited 41 diverse parents of children and adolescents with ADHD and 11 adolescents with ADHD from an urban, safety-net hospital to participate in in-depth, semi-structured qualitative interviews and then analyzed this data using thematic analysis. Children's level of illness insight about ADHD and self-esteem emerged as two major contributors to engagement of children and adolescents in ADHD care, and their intersection created four styles of engagement: proactive (high insight, high self-esteem), anxious (high insight, low self-esteem), apathetic (low insight, high self-esteem), and resistant (low insight, low self-esteem). This framework can help health professionals engage children and adolescents in care for ADHD and guide development of interventions to improve engagement in care.

The current study utilized mediation analyses to examine how parental symptoms of depression and anxiety impact child emotion regulation (ER) and emotion stability (ES) through parent emotion functioning, parenting, and the coparent relationship. 564 parents of children between 3 and 17 years (M_age = 9.47; 54.4% male) were recruited via Amazon's Mechanical Turk across three time points: baseline (Wave 1), 4 months (Wave 2), 8 months (Wave 3). Mediation results demonstrated that symptoms of parent depression at Wave 1 predicted worse coparent relationships and decreases in parents' ability to identify their own emotions at Wave 2. Symptoms of parental anxiety at Wave 1 predicted decreases in positive parenting and an increased tendency to have negative secondary emotional responses, impulse-control difficulties, and difficulty accessing emotion-regulation strategies at Wave 2. Additionally, symptoms of parental anxiety at Wave 1 directly predicted lower child ER and ES at Wave 3. However, no significant indirect pathways were identified between parent symptoms and child ER and ES. Sensitivity analyses examined the effects of three youth developmental stages (i.e., early and middle childhood and adolescence), as well as parent gender (i.e., mother and father), and found no significant differences across groups. Thus, even at non-clinical levels, parental symptoms of anxiety and depression may negatively impact parenting, parent regulation, and the coparent relationship, while parental anxiety symptoms may contribute to lower child ER and ES.

This research examines parental practices of Israeli highly sensitive mothers toward their adolescent children and the role of attachment avoidance as a moderator between the associations of high sensitivity and parenting practices. One hundred and one mother-adolescent dyads completed self-report questionnaires assessing mothers' degree of high sensitivity, mothers' adult attachment, and mothers' parenting practices. Results showed that highly sensitive mothers were described by their adolescent children as inconsistent and intrusive parents. Further, attachment avoidance was found to moderate the association between mothers' high sensitivity and inconsistent and psychological intrusiveness. Findings suggest that attachment avoidant highly sensitive mothers experience this period of raising adolescents as especially stressful and challenging, which contributes to the practice of negative parenting. Thus, interventions focused on regulating those mothers' emotions to better cope with parental challenges could buffer negative parenting practices.

In the post-pandemic era, psychological traumas have emerged as major mental health issues. However, the post-traumatic reactions and their connections with social-emotional competence among high school students experiencing COVID-19 lockdown have not been adequately explored. This study aimed to reveal the characteristics of their positive and negative post-traumatic reactions, and their connections with social-emotional competence. Network analysis was used on data from 1096 Chinese high school students who experienced COVID-19 lockdown. Measures included the DSECS-S, the PTGI and the PC-PTSD-5. The results revealed that "Valuing life" and "Recalling unwillingly" were identified as core factors of post-traumatic reactions, while "Having close friendships", "Getting along well with others" and "Respecting others' emotions" played a bridging role in connecting the communities of social-emotional competence and post-traumatic reactions. This study enriches research on post-traumatic reactions, emphasizing the importance of implementing social-emotional competence programs to tackle mental health crises.

The aftermath of the Covid-19 pandemic has seen an increase in persistent school absenteeism and Emotionally-Based School Avoidance (EBSA). However, suitable evidence-based psychological interventions are often unavailable. We aimed to assess the feasibility and acceptability of a new parent-focused online program, Intervention for School Anxiety and Absenteeism in Children (ISAAC), which has been co-designed with parents and practitioners. This exploratory mixed-method study recruited participants from three schools in southern England, enrolling N = 9 parents for whom a child, aged 5-11 years, was experiencing signs of EBSA. The intervention consisted of three web-based psychoeducational modules respectively addressing parental stress, accommodating parenting behaviors, and communication with school staff. Module completion was assisted by weekly calls with a non-specialist "coach." Feasibility was measured using indicators of retention, module participation, overall program completion and coaching fidelity. Acceptability was assessed using semi-structured interviews, module ratings and written qualitative feedback. We also explored baseline-post change in parent-reported measures of children's school avoidance, absences, anxiety, parental stress, accommodating parenting behaviors, and quality of parent-school communication. Overall, the intervention was feasible to deliver to parents with six (67%) participants completing the full intervention. Participants found the intervention acceptable across thematic domains of affective attitude, burden, coherence, self-efficacy and perceived effectiveness. Participants particularly appreciated the coach's support. We observed small to moderate reductions in school avoidance behaviours (d with Hedges correction = 0.36), child anxiety (d with Hedges correction = 0.33) and accommodating behaviours (d with Hedges correction = 0.44) at the post timepoint compared to baseline. In conclusion, ISAAC shows early promise with the potential to deliver scalable online support for families affected by emerging EBSA. Future research should move toward establishing effectiveness in a randomized controlled trial.

The study objective was to examine the mental health of children during a time period that included the COVID-19 Lockdown. The sample included a cross-section of children aged 2 to 17 years (2019; n = 4, 194; 2020; n = 5,172), from the National Health Interview Survey. In multivariate models, survey years 2020 and 2019 were compared for significant changes in anxiety, depression, and social behaviors in children after adjustment for sociodemographic variables. Bivariate analysis also examined sociodemographic characteristics, health care utilization by anxiety, depression, and social behaviors, and examined differences in anxiety and depression from 2019 to 2020. In multivariate models, there was an increased risk of anxiety ((AOR = 1.3(1.0, 1.6)), depression ((AOR = 1.2 (1.0, 1.4)) and difficult social behaviors (AOR = 1.2 (1.0, 1.4) in children from 2019 to 2020. Girls were at increased risk compared to boys for anxiety and depression ((anxiety; AOR = 1.4 (1.2, 1.8), depression; AOR = 1.2 (1.0, 1.3)), however, girls were at decreased risk compared to boys for uncontrolled social behaviors (AOR = 0.51 (0.43, 0.61)). White children were at increased risk for anxiety and depression compared to all other race and ethnic groups. High rates of anxiety, depression and difficult social behaviors that preexisted the Covid-19 Lock Down, continued or increased during the Lockdown. Effective public health interventions could prevent further declines in mental health, and a potential trajectory into adulthood of poor physical and mental health.

This paper outlines the development and psychometric evaluation of the Fears and Worries at Nighttime—Young Children (FAWN-YC) scale; a parent-rated measure for children aged 3–5 years. Based on previous literature, it was hypothesised that the measure would be represented by a six-factor solution, with four clusters of fear types and two behavioural manifestations of fears. Exploratory factor analysis (EFA; N = 436) and confirmatory factor analysis (CFA; N = 383), resulted in a final 17 items that loaded onto 3 factors: Nighttime Fear Focus (8 items, α = 0.92), Bedtime/Sleep Avoidance and Interference (5 items, α = 0.90), and Dark Fear (4 items, α = 0.88). Evidence of convergent validity was found through strong associations between the total score and subscales of the FAWN-YC with measures of child anxiety, fear, sleep, externalizing and conduct problems. Furthermore, there was support for divergent validity (through a very weak to no relationship with a measure of prosocial behaviours), and evidence for temporal stability was also established with 2-week test–retest reliability. Overall, the results provide strong preliminary evidence for the reliability and validity of the FAWN-YC total score and subscales. Implications for the use of the measure in research and clinical practice are discussed.