Child Psychiatry & Human Development最新文献

This study presents an overview of prescribing patterns and provides insight into the current management practice for the core symptoms and comorbidities of ASD in children. A quantitative retrospective study was conducted at a public hospital in KwaZulu-Natal, South Africa by reviewing patient files of children diagnosed with ASD and meeting the inclusion criteria for the study. A descriptive analysis of data was done to identify treatment trends and patient therapeutic outcomes. A total of 181 children met the inclusion criteria of the study. Risperidone was the most frequently prescribed drug (88%) for the management of comorbidities and/or core symptoms of ASD. Drugs prescribed to manage ASD comorbidities included methylphenidate, melatonin, sodium valproate, risperidone, oxybutynin, carbamazepine, and others. Except for risperidone, there were no additional drugs that targeted the core symptoms of ASD. Non-pharmacological therapies were often used collaboratively with medication to manage ASD symptoms. In 41% of patients, there were improvements in their symptoms.

Avoidance is considered a hallmark feature of child anxiety, but convenient measures are scarce. This study examined the psychometric properties of the Child Avoidance Measure (CAM) in a Dutch population, focusing mainly on the child-version. We included children 8 to 13 years old from a community sample (n = 63, longitudinal design) and a sample of high-anxious children (n = 92, cross-sectional design). Regarding the child-version, the internal consistencies were acceptable to good with moderate test-retest reliability. The validity analyses showed encouraging results. High-anxious children had higher avoidance scores than children from a community sample. Regarding the parent-version, both the internal consistency and test-retest validity were excellent. Overall, this study confirmed the sound psychometric properties and usefulness of the CAM. Future studies should focus on the psychometric properties of the Dutch CAM in a clinical sample, assess its ecological validity more extensively, and examine more psychometric features of the parent-version.

Based on the general aggression model, the current study examined the mediating role of moral disengagement in the association between sensation seeking and cyberbullying perpetration and the moderating role of perceived social support. A total of 2,286 Chinese adolescents aged 11-16 years completed the questionnaires regarding sensation seeking, cyberbullying perpetration, moral disengagement, and perceived social support. After gender and age were controlled, sensation seeking was significantly and positively associated with cyberbullying perpetration and this relationship was partially mediated by moral disengagement. Moderated mediation analysis further indicated that perceived social support moderated the relationship between sensation seeking and moral disengagement as well as sensation seeking and cyberbullying perpetration. These two relationships became weaker for adolescents with high perceived social support. Specifically, adolescents with higher levels of sensation seeking were more likely to develop moral disengagement and further engaged in cyberbullying perpetration, when they perceived less social support.

Suicide screening is critical in pediatric emergency departments (EDs). Behavioral measures of suicide risk may complement self-report measures. The current study examines suicide-specific behavioral measures and tests their potential short-term within-person effects among respondents, ability to discriminate future suicide attempt from suicidal ideation, and translation into interpretable categorical composite scores. The sample included 167 youth (10-17 years), presenting for suicide-related reasons to a pediatric psychiatric ED. During their ED visit, participants completed the Death/Life Implicit Association Test (IAT) and the Suicide Stroop Task. Recurrent suicidal thoughts and attempts were assessed within 6 months of the ED visit via medical records and email surveys. Youth displayed a decrease in the levels of distress and self-injurious desires (negative mood, desire to hurt themselves, and desire to die) after completing the behavioral tasks. The Death/Life IAT prospectively differentiated with 68% accuracy between youth who attempted suicide after their ED visit and those who had suicidal ideation but no attempt, p = 0.04, OR = 5.65, although this effect became marginally significant after controlling for self-report and demographic covariates. Neither the Suicide Stroop Task, nor the categorical composite scores predicted suicide attempts, ps = 0.08-0.87, ORs = 0.96-3.95. Behavioral measures of suicide risk administered in the ED do not appear to increase distress or self-injurious desires. They may be able to distinguish those who go on to attempt suicide (vs. consider suicide) within six months after discharge.

The role of parents' early life maltreatment (ELM) (e.g. physical, sexual abuse) and related experiences, in relation to offspring anxiety is not well understood. The current study investigated the association between self-reported depression and ELM and related experiences in mothers (n = 79) and fathers (n = 50), and mother-, father-, and youth-reported symptoms of youth anxiety (n = 90). Outcomes were assessed at pre,- and posttreatment and 3-, 6-, and 12-months follow-up. Parental ELM were not associated with pre-treatment differences or differences in outcome of treatment. However ELM related experiences were associated with increased mother-, father-, and youth-rated youth anxiety at pretreatment. Fathers depressive symptoms were found to mediate the relationship between father ELM related experiences and father-rated youth anxiety symptoms. Future research is warranted on parental ELM and depression as factors affecting outcomes of treatment of youth anxiety. Trial registered at: helseforskning.etikkom.no (reg. nr. 2017/1367).

The associations between relational victimization, self-blame attributions, and internalizing problems in early childhood has not previously been examined. Using a sample of 116 preschool children, average age 44.05 months (SD = 4.23), multiple informants, multiple methods, and a longitudinal design, path analyses were conducted to explore the associations between relational victimization, self-blame attributions (Characterological Self-Blame[CSB] and Behavioral Self-Blame[BSB]), and maladjustment in early childhood. Concurrent significant associations were found between relational victimization and internalizing problems. The initial longitudinal models revealed some significant effects that were consistent with predictions. Importantly, follow-up tests decomposing internalizing problems, indicated that anxiety at Time 1 was positively and significantly associated with CSB at Time 2. Depression at Time 1 was negatively and significantly associated with CSB at Time 2. Implications of this work are discussed.

This article continues evaluation of the construct validity of the Australian Early Development Census (AEDC) through comparison with linked data from a sample of 2216 4-5 year old children collected as part of the Longitudinal Study of Australian Children (LSAC). This builds on the construct validity assessment of Brinkman et al. (Early Educ Dev 18(3):427-451, 2007) based on a smaller sample of linked Australian Early Development Instrument (AvEDI) and LSAC children, in which moderate to large correlations were apparent between teacher-rated AvEDI domains and subconstructs and LSAC measures, with lower levels apparent for parent reported LSAC measures. In the current study, the data showed moderate to low correlations between the domains and subdomains from the AEDC and teacher reported LSAC data. Differences in testing times, data sources (e.g. teachers versus carers) and levels of exposure to formal schooling at the time of testing are all discussed to account for the observed outcomes.

Emotion recognition difficulties are linked to callous-unemotional (CU) traits, which predict risk for severe antisocial behavior. However, few studies have investigated how stimulus characteristics influence emotion recognition performance, which could give insight into the mechanisms underpinning CU traits. To address this knowledge gap, children aged 7-10 years old (N = 45; 53% female, 47% male; 46.3% Black/African-American, 25.9% White, 16.7% Mixed race or Other, 9.3% Asian) completed an emotion recognition task featuring static facial stimuli from child and adult models and facial and full-body dynamic stimuli from adult models. Parents reported on CU traits of children in the sample. Children showed better emotion recognition for dynamic than static faces. Higher CU traits were associated with worse emotion recognition, particularly for sad and neutral expressions. Stimulus characteristics did not impact associations between CU traits and emotion recognition.

The purpose of this study was to study psychopathological and temperamental correlates of selective mutism (SM) (symptoms) in a mixed sample of non-clinical (n = 127) and clinically referred (n = 42, of whom 25 displayed the selective non-speaking behavior that is prototypical for SM) 6- to 12-year-old children. Parents completed questionnaires to measure their child's symptom levels of selective mutism, social anxiety, autism spectrum disorder, and the temperament trait of behavioral inhibition. The results first and foremost showed that SM symptoms were clearly linked to social anxiety and an anxiety-prone temperament (behavioral inhibition), but findings also suggested that autism spectrum problems are involved in the selective non-speaking behavior of children. While the latter result should be interpreted with caution given the methodological shortcomings of this study, findings align well with the notion that SM is a heterogeneous psychiatric condition and that clinical assessment and treatment need to take this diversity into account.

The Japanese term Hikikomori is used to describe a clinical condition in which young people present a prolonged social withdrawal and isolation. Hikikomori syndrome represents an emergent worldwide phenomenon but is still poorly reported and often misdiagnosed. This study investigates and describes an Italian hikikomori adolescent group. Socio-demographic and psychopathological profiles and the relationship between hikikomori and psychopathological conditions were analyzed. No gender difference, a medium-high intellectual level, and no correlation with socioeconomic status were highlighted among the clinical group. The relationship between social withdrawal and social anxiety was significant while no correlation was found with depressive symptoms. The presence of Hikikomori syndrome was also significant in Italian adolescents, suggesting that hikikomori is not a culture-bound syndrome related to the Japanese cultural context, but rather a syndrome occurring in the upper-medium class.