Child Psychiatry & Human Development最新文献

Mental disorders tend to cluster within families, yet the majority of research focuses on one child per family. There is a paucity of research examining the impact of a child's mental disorder on siblings. This scoping review addresses the following questions: (i) How do mental disorders in children impact the mental health of their sibling(s)? (ii) Which resources exist that address the needs of siblings of children with mental disorders? We searched eight databases for empirical studies and screened for those published since 2011. n = 27 studies were included; n = 21 studies addressed research question one and n = 6 addressed research question two. Pertaining to research question one, quantitative studies found that siblings of children with mental disorders are at risk for developing mental health problems or psychopathology themselves and experience a wide range of symptoms across many diagnostic categories. Qualitative studies reported siblings' negative emotions and experiences (e.g., confusion about child's disorder, fearful of violence from the child). Pertaining to research question two, we found a paucity of research (n = 6 studies) that assessed resources or interventions for siblings, indicating that there is likely a lack of interventions available for siblings. Future research should look to use more robust quantitative study designs (e.g., longitudinal, mixed-methods) in diverse samples and qualitative methodologies that can investigate particularly concerning instances. While we did identify that sibling interventions exist, those created with sibling and family voices may be better positioned to address sibling's needs.

Despite theory and research linking parent anxiety to youth attention bias to threat, knowledge gaps remain regarding potential moderators. We examined youth attention focusing (i.e., ability to inhibit distractors and sustain attention) and attention shifting (i.e., ability to flexibility shift attention) as moderators of the association between parent anxiety and youth attention bias to threat among peripubertal youth with social anxiety disorder. We expected that parent anxiety would be associated with youth attention bias to threat at low levels of attention focusing and shifting. Participants were 165 clinically referred peripubertal youth (ages 9-14 years, M = 12.21 years; SD = 1.55; 73.9% White, 57.0% Hispanic or Latino; 63.0% females) with social anxiety disorder. We used a free-viewing task with eye tracking to measure youth attention bias to threat, self-ratings to measure youth attention focusing and shifting, and self-ratings to measure parent anxiety. Attention focusing, but not shifting, moderated the association between parent anxiety and youth attention bias to threat. At low levels of attention focusing, high parent anxiety was associated with high youth attention bias to threat. Findings suggest that parent anxiety serves as a signal that enhances socially anxious youths' attention to threat, particularly among those who struggle to sustain focused attention. We extend our findings to implications for theory and treatment of social anxiety in youth.

Childhood behavioral difficulties are recognized as early indicators of future psychiatric disorders, yet their long-term predictive validity in non-Western settings remains underexplored. This study investigated the predictive value of childhood behavioral assessments in determining adult psychiatric outcomes among 300 individuals in Ghana followed longitudinally from childhood to early adulthood. Using the Child Behavior Checklist (CBCL), both externalizing behaviors (e.g., aggression, hyperactivity) and internalizing behaviors (e.g., anxiety, withdrawal) were assessed between 2005 and 2015, while adult mental health outcomes including mood, anxiety, substance use, and psychotic disorders were measured with standardized diagnostic instruments such as the MINI, PHQ-9, and GAD-7. Logistic regression analyses revealed that both internalizing (B = 0.87, OR = 2.39, p < .001) and externalizing (B = 1.23, OR = 3.42, p < .001) behaviors significantly predicted adult psychiatric outcomes, even after controlling for sociodemographic factors. Exposure to trauma (OR = 4.67, p < .001) and low parental education (OR = 1.80, p < .01) increased risk, while early intervention (OR = 0.54, p < .01) served as a protective factor. The overall model demonstrated good fit and strong discriminative power (Nagelkerke R² = 0.29; AUC = 0.83). Cross-cultural validity analyses showed that childhood behavioral scores predicted adult psychiatric disorders effectively, with the strongest accuracy for mood disorders (AUC = 0.82) and overall psychiatric risk (AUC = 0.85). Moderate predictive power was found for psychotic (AUC = 0.73) and neurodevelopmental disorders (AUC = 0.75), and weaker for substance use (AUC = 0.68). Moderation analyses indicated that gender, socioeconomic status, family structure, exposure to trauma, parental involvement, and residence significantly influenced these relationships, with trauma being the strongest risk enhancer. The study highlights the predictive utility of culturally adapted behavioral assessments and underscores the need for early screening and family-centered interventions within Ghana's education and health systems to mitigate long-term mental health risks.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with substantial academic and social impairments, yet evidence from Middle Eastern populations remains limited. This study examined demographic, clinical, academic, and social functioning profiles of Qatari youth with ADHD, with a particular focus on sex-based differences. A cross-sectional study was conducted at a tertiary service in Qatar between 2022 and 2025, involving 131 Qatari youth aged 7-17 years with a confirmed diagnosis of ADHD. Parents completed the Vanderbilt ADHD Diagnostic Parent Rating Scale, and clinical data on comorbidities, treatment, academic performance, and social functioning were extracted from medical records. Males comprised 71% of the sample. Although most clinical features were comparable between male and female ADHD patients, females demonstrated significantly greater peer relationship difficulties compared with males, suggesting a need for targeted social intervention in females. Academic impairments were also prevalent across both sexes. Findings underscored the functional impact of ADHD and the importance of culturally and gender-sensitive care.

Family factors, such as parental symptomatology and parenting behaviors, are related to adolescent internalizing symptoms. Yet fewer studies have evaluated how family factors relate to the emergence of internalizing symptoms during the pubertal transition with large-scale longitudinal data. The present study addressed this issue using data from the Adolescent Brain Cognitive Development Study in adolescents who were prepubertal at baseline and had manifested puberty at 4-year follow-up (N = 2,276). Participants completed the Child Behavior Checklist (CBCL), Adult Self Report (ASR), Child Report of Parenting Behavior Inventory (CRPBI), Parental Monitoring Survey (PMQ), and Family Environment Scale (FES). Structural equation modeling revealed that higher levels of parent internalizing symptoms and parent-reported family conflict at baseline were associated with higher levels of adolescent internalizing symptoms at the 4-year follow-up. Higher baseline parental monitoring was associated with lower adolescent internalizing symptoms at the 4-year follow-up. Baseline parental acceptance and youth-reported family conflict were not related to adolescent internalizing symptoms. Adolescent sex did not moderate any associations in our models. Our results offer insights into how research, prevention, and intervention strategies can be developed to address the development of adolescent internalizing psychopathology.

Scant research exists for interventions that are accessible and effective for rural Latine youth with mental health needs. The current study examines the feasibility and preliminary effectiveness of a community health worker-facilitated, attention bias modification (ABM) intervention for rural Latine youth with anxiety. Sixty-nine Latine youth (M_age = 11.74; 67% males; 44.5% low-income) with clinical levels of anxiety were randomized to either ABM (n = 34) or to an attention control condition (ACC) (n = 35). ABM included the dot-probe attention training task, where probes appeared in the location of neutral faces on 100% of trials. For ACC, probes appeared in the location of neutral faces on 50% of trials. Participants completed questionnaires, measures of attention bias and attention control, and clinician administered interviews at baseline, post-treatment, and 3-month follow-up. Findings revealed low attrition, excellent training adherence, and favorable treatment satisfaction. There were no statistically significant differences between groups, but both groups showed significant decreases in anxiety symptoms at post-treatment. Clinician ratings of global improvement were 51% and 53% for the ABM and ACC groups respectively. Exploratory analyses examining attention bias and attention control as mechanisms of change on treatment outcomes were not significant. This is the first feasibility study of ABM in a rural Latine community, using a novel mode of delivery. Findings are promising, given excellent rates of engagement and significant decreases in anxiety over time. However, additional research is necessary to optimize anxiety improvement and identify the mechanisms of change in ABM interventions.

Adolescent screentime and suicide rates increased during the coronavirus disease 2019 (COVID-19) pandemic. This study assesses whether specific risk and protective factors moderate the relationship between screentime and suicide outcomes in a post-COVID-19, nationally-representative sample of US adolescents. Data are from the Center for Disease Control and Prevention's 2021 Youth Risk Behavior Survey (n = 17,232). Weighted logistical ANCOVAs tested relationships between screentime (low [≤2 h/day], medium [3-4 h/day], high [≥5 h/day]) and suicide (suicidal ideation [SI], plan, attempt), interactions of screentime and risk/protective factors (feeling sad, being bullied/cyberbullied, feeling close to people at school, sleep, and exercise), and the relationship between screentime and suicide behaviors, adjusting for significant risk/protective factors. Compared to low screentime, high screentime was associated with higher odds of all suicide behaviors (aORs = 1.30-1.96; 95% CI from 1.02 to 2.35), while medium screentime's effect varied by behavior (SI: aOR = 1.19; 95% CI 1.02-1.38; Plan: aOR = 1.09; 95% CI 0.92-1.29; Attempt: aOR = 0.80; 95% CI 0.65-0.98). After adjusting for combined risk factors, high screentime remained significantly associated with SI and plan (aORs = 1.39-1.62; 95% CI from 1.12 to 1.97) but not attempt (aOR = 1.10; 95% CI 0.85-1.41). In combined models, feeling close to people at school was significantly protective against SI for all levels of screentime (aORs 0.43-0.59; 95% CI from 0.35 to 0.70), and sleep was protective for SI and plan (aORs 0.59-0.60; 95% CI from 0.45 to 0.78). Among US adolescents, high screentime is a significant risk factor for suicidal ideation and plan, above and beyond other known risk factors. Findings underscore school connectedness and adequate sleep as potential areas for intervention alongside guidance on high daily screentime.

This review examined adverse childhood experiences (ACEs) associated with the risk of major depressive disorder (MDD) and treatment-resistant depression (TRD). A search was conducted in PubMed, Scopus, PsycINFO, SciELO, and LILACS. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Twenty-four studies were included, encompassing 1,119,606 participants. Family structure adversities and sexual and physical abuse were the most frequently examined exposures, although their associations with MDD varied across studies. Emotional abuse, domestic violence, and bullying were less commonly assessed but showed more consistent associations with MDD. Evidence regarding TRD was limited, with childhood neglect as a risk factor for poorer treatment response. Greater cumulative exposure to ACEs was associated with higher risk of MDD and TRD. Overall, the findings support childhood adversity as a clinically relevant determinant of depressive risk and clinical course, although heterogeneity across study designs and high risk of bias limit causal inference.

Fear of hypoglycemia may represent an important target for improving diabetes self-management among adolescents with T1DM. However, whether fear of hypoglycemia is associated with diabetes self-management remains undetermined, and the factors contributing to this uncertain association are poorly understood. This study aims to (1) examine the association between fear of hypoglycemia and diabetes self-management in Chinese adolescents with T1DM, and (2) explore potential mediators in this relationship. This muti-site cross-sectional study was conducted between January 2021 and December 2022 across three hospitals of China. Validated questionnaires assessed fear of hypoglycemia, depressive symptoms, diabetes distress and diabetes self-management. Two path analysis models were then conducted using Mplus 8.0 to test the mediating effects of diabetes distress and depressive symptoms on the relationship between fear of hypoglycemia and diabetes self-management in adolescents with T1DM. A total of 174 valid questionnaires were retained (effective response rate: 82.08%). Adolescents reported moderate fear of hypoglycemia was moderate (mean score = 14.04). Path analysis revealed that the mediating effect of diabetes distress between fear of hypoglycemia and diabetes self-management was significant(indirect effect: β = -0.165 and - 0,161, p = 0.001), whereas the mediating effect of depressive symptoms was not significant. Diabetes distress partially mediated the association between fear of hypoglycemia and diabetes self-management in adolescents with T1DM. Chinese adolescents with T1DM exhibited moderate fear of hypoglycemia. Diabetes distress partially mediated the relationship between fear of hypoglycemia and diabetes self-management, whereas depressive symptoms demonstrated no significant mediating effect in adolescents with T1DM. These findings suggest that interventions targeting diabetes distress reduction while maintaining fear of hypoglycemia at moderate levels may enhance diabetes self-management.

Irritability is a transdiagnostic construct associated with diverse psychiatric disorders in youth. This study examined the association between food insecurity and irritability in a clinically and community-recruited sample of children aged 8-16 (N = 183). Participants and their parents completed structured interviews and measures assessing irritability, food security, and socioeconomic status (SES). Child-reported food insecurity was significantly associated with greater irritability, whereas parent-reported food insecurity was not. Regression analyses identified child-reported food insecurity as a unique predictor of irritability, independent of SES indicators. These findings underscore the clinical importance of assessing food insecurity from the childs perspective and suggest that subjective experiences of food insecurity may have a stronger emotional impact than previously recognized. Results highlight the need for multi-informant assessments and targeted interventions addressing basic needs within pediatric mental health care.