Child Psychiatry & Human Development最新文献

Although binge eating symptoms (BE) can contribute to worsened mental and physical health, little is known about factors associated with binge eating across the lifespan, hindering prevention and treatment. To investigate if there is an association between adverse childhood experiences (ACEs), adolescent and adult mental health conditions, and BE symptoms among young adults. One hundred and thirty-one junior high-school students participated in a series of assessments and 10 years later, 100 of these individuals participated in a follow-up assessment. Linear regression models were performed to estimate the association between ACEs, adolescent and emerging adult self-esteem, depression, and anxiety symptoms, and emerging adult BE symptoms. Among the sample, 26% had 1 ACEs, 18% had 2 ACEs, and 41% had ≥ 3ACEs. After adjusting for age, sex, and current mental health, there was a positive association between ACEs and increased levels of BE symptoms (β = 0.37, SE = 0.19, CI=(0.03; 0.7), p =.0485). Higher levels of emerging adult depression and anxiety symptoms (β = 0.02, SE = 0.01, CI=(0.01; 0.04), p =.0020) but not self-esteem (β = 0.04, SE = 0.05, CI=(-0.06; 0.14,) p =.4253), were associated with BE symptoms. Parental mental health, a parent experiencing a mental illness during the participant's childhood, was the only individual ACE associated with BE symptoms (β = 0.84, SE = 0.40, CI = 0.04, 1.64, p =.0409). Cumulative ACEs and emerging adult anxiety and depression symptoms were associated with BE symptoms. Findings indicate that ACEs, anxiety, and depression symptoms contribute to BE symptoms, highlighting the importance of screening for ACEs and mental health conditions. Persons struggling with BE symptoms may have co-occurring conditions, of which a traditional treatment for BE may not suffice.

Greater screen time is associated with increased symptoms of autism spectrum disorder (autism), attention-deficit/hyperactivity disorder (ADHD), and lower scores on measures of development in preschool-aged community samples. In the current longitudinal study, we examined screen time differences at 18 months of age based on clinically-defined outcomes (i.e., Autism, ADHD Concerns, Comparison) determined at age 3-5 years in a genetically-enriched sample based on family history, along with prospective associations between toddler screen time and preschool autism/ADHD symptoms and developmental achievement. Participants (n = 82) included children at high and low familial likelihood for autism and ADHD. Children with Autism and ADHD Concerns outcomes experienced significantly more screen exposure at 18 months than children without autism or elevated symptoms of ADHD. Greater screen time at 18 months was also associated with preschool symptoms of autism and ADHD and lower developmental achievement across the sample. Preschoolers with neurodevelopmental challenges experienced more screen exposure earlier in development than same-age peers, increasing potential for negative developmental impacts.

Although the Child and Adolescent Behavior Inventory (CABI) cognitive disengagement syndrome (CDS) scale has demonstrated validity relative to the CABI attention-deficit/hyperactivity disorder-inattention (ADHD-IN) scale with parent ratings of youth from North America, Europe, East Asia, and Central Asia, no study has evaluated the validity of the 15 symptom CDS scale with children from South America. Our purpose was to examine for the first time the validity of the CABI CDS scale with Brazilian children. Latent variable modeling procedures were used to examine the validity of CDS scores. Mothers and fathers completed measures of CDS, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), anxiety, depression, and academic impairment on 366 Brazilian children (M_age = 8.64, SD_age = 1.39, 53.3% females). First, the CDS symptoms showed strong internal validity with the ADHD-IN symptoms. Second, within and across sources, ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-HI, whereas CDS, especially across sources, showed stronger first-order and unique associations than ADHD-IN with anxiety and depression. CDS and ADHD-IN were similarly associated with academic impairment. This study is the first to support the validity of CABI CDS scores with Brazilian children, thus replicating the findings in North America, Europe, East Asia, and the Central Asia in South America.

The present study examined the effect of ADHD-related traits, academic-achievement level, and giftedness label on elementary school teachers' and counselors' referral recommendations for assessment. 532 teachers and counselors were presented with one of 12 vignettes describing a hypothetical pupil. Participants were asked to report the likelihood they would refer the pupil for ADHD diagnosis and address them during a high-level interdisciplinary school-team meeting (HISTM). High ADHD-related traits (effect size 0.359) and low academic-achievement (effect size 0.070) and their interaction were significantly related to a higher likelihood of referral. Further analysis revealed that lower academic achievement was related to a higher likelihood of referral only when ADHD-related traits were not indicated (p < .005). The status of giftedness label was not found to be significant (p > .05). These findings indicate that mainly ADHD-related traits and, to a lesser degree, low academic-achievement influence teachers' decisions to refer pupils for ADHD diagnosis and address them in HISTM.

The Parenting Anxious Kids Rating Scale-Parent Report (PAKRS-PR) measures five types of anxiogenic parenting. The present study aimed to extend the previous psychometric evaluation of the PAKRS-PR to a treatment-seeking sample and examine sensitivity to change over 15 sessions of cognitive behavioral therapy. The sample included 383 parent-child dyads presenting to treatment at a specialty outpatient clinic. Cronbach's α was acceptable for the PAKRS-PR Total scale and several subscales, although the Accommodation/Beliefs and Warmth/Support subscales were in the unacceptable/questionable range. Convergent validity was found to be mixed with the closest relationship between anxiety severity and the Accommodation/Beliefs, Warmth/Support, and Conflict PAKRS-PR subscales. Additionally, the PAKRS-PR Total score and subscales changed significantly throughout treatment, but were not associated with treatment response or child- or clinician-rated treatment outcome measures. Overall, the current findings demonstrate some support for the psychometric properties of the PAKRS-PR; however, further refinement of the PAKRS-PR at the item-level is recommended to further strengthen the measure.

Few studies have examined differential treatment response, rates of familial accommodation (FA), and executive functioning (EF) in youth with OCD vs. OCD + ADHD, particularly in a partial hospital program (PHP). The current study includes 138 youth diagnosed with OCD only and 102 youth diagnosed with OCD + ADHD in a PHP setting for a total sample of 240 youth (and their families). Families and clinicians completed several measures assessing child and parent variables of interest. Findings of ANCOVA analyses suggest poorer treatment response and EF in children with comorbid OCD + ADHD compared to their counterparts with OCD only. No significant differences emerged between groups in baseline levels of symptom severity, functional impairment, or FA. Given the high rate of comorbidity between OCD + ADHD, clinicians and researchers should be aware of the need to modify treatment approaches for children with comorbid OCD + ADHD and/or weaker EF performance.

Bedtime procrastination has been associated with poorer sleep health, but evidence for this association is not sufficient. This cross-sectional study aimed to investigate the relationship between bedtime procrastination and multidimensional sleep health among students at different educational stages (from elementary school to college) in China, and further examine the moderating role of psychological distress in the procrastination-sleep health link. A total of 3539 students (M_age = 15.6 [2.9] years) completed an online survey between December 17^th and 31st, 2023. Sociodemographics, bedtime procrastination, chronotype, psychological distress, and sleep health indicators were assessed. Binary logistic regression was used to estimate the association of bedtime procrastination with sleep health. The moderating effects of psychological distress were examined using the Process macro. The results showed that, from elementary school to college, scores of bedtime procrastination displayed a gradually increasing trend. Greater bedtime procrastination across different educational stages was related to poorer sleep health, including satisfaction, alertness, timing, efficiency, and regularity. However, there was no significant association between bedtime procrastination and sleep duration among elementary, middle, and high school students. Moreover, the moderating effect of psychological distress was observed among middle and high school students. The negative association between bedtime procrastination and total sleep health was attenuated in students with high psychological distress than in students with low psychological distress. The findings underscore the importance of early prevention and intervention strategies targeting bedtime procrastination.

Adolescent suicide is a growing public health concern in Thailand. Identifying predictors of suicidal behaviors is essential for targeted prevention strategies. Using Structural Equation Modeling, this study explores the predictors of suicidal thoughts and attempts among a sample of 5657 Thai adolescents in grades 7-12, typically representing the age group 13-17 years, with nearly equal proportions of males (47%) and females (53%) participants. Data from the Thailand Global School-based Student Health Survey (GSHS) 2021 were analyzed. Explanatory Factor Analysis (EFA) identified key constructs, followed by SEM stratified by sex to examine relationships between constructs and suicidal behaviors. Reliability and validity were assessed using Cronbach's α and SEM fit indices. EFA identified five constructs: current substance use, history of violence, experiences of bullying, parental awareness, and poor mental health. SEM revealed poor mental health as a significant predictor for both sexes. Substance use, experiences of bullying, and a history of violence predicted suicidal behaviors in females. Parental vigilance was only a protective factor for males. The findings underscore the importance of gender-specific interventions and comprehensive mental health support to address the unique vulnerabilities of Thai adolescents, reducing suicidal thoughts and attempts.

We examined the social and emotional challenges (SEC) of young children and the mental health of their caregivers in areas affected by armed conflict and displacement in Colombia. Anxiety, depression, and PTSD symptoms were assessed in 1,133 caregivers. Caregivers also reported on the SEC of their children aged 21-53 months. A subsample of 487 caregivers (43%) completed a resilience self-report measure. Caregivers reported substantial levels of psychopathology ranging from 12.84% of caregivers with elevated anxiety levels, 24.5% who scored above the cutoff on the PTSD measure, and 44.7% who screened positive for depression. Correlations (r) between child SEC and caregiver psychopathology ranged from 0.15 to 0.33. The association between caregiver depression and child SEC was more substantial for boys (B = 0.56) than girls (B = 0.22). We also found that girls whose caregivers reported elevated levels of psychopathology and low levels of caregiver resilience received the highest ratings of caregiver-reported SEC. The importance of caregiver-child resilience-focused psychosocial support is discussed.

ADHD is a neurodevelopmental disorder with multifactorial origins. Several studies have shown that parent-child attachment impacts the expression of ADHD symptoms, while others have highlighted the influence of cognitive impairments on ADHD symptoms. However, few studies have simultaneously examined the respective contributions of child attachment and cognitive functions to ADHD, which is the aim of this study. We included 45 children with ADHD from a university hospital and 44 typically developing children from regular schools. Child attachment was evaluated using a self-report questionnaire, the French Attachment Security Scale (ASS-Fr), and a narrative interview, the Cartes pour l'évaluation de l'Attachement et de la Mentalisation chez l'Enfant (CAME). Cognitive assessment involved both objective and subjective measures. Perceived attachment security to both parents and disorganized attachment were significantly associated with ADHD symptoms, but these relationships were mediated by externalizing symptoms and executive function difficulties. The relationships between attachment and ADHD symptoms are indirect and mediated by the presence of externalizing symptoms and executive function impairments.