Child Psychiatry & Human Development最新文献

The diagnosis of bipolar disorder (BD) in young children has been a topic of debate, in part owing to varied interpretation of manic-like symptoms. We examined how expert academic clinicians participating in the pediatric bipolar biobank varied in their interpretation and application of Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria and diagnoses. Study co-investigators reviewed 12 standardized narratives and for each marked a visual analog scale with their confidence in the presence of manic episodes and criteria. We analyzed raters' confidence and inter-rater agreement using interclass correlation (ICC). Symptoms with good ICC ranging from 0.60 to 0.74 included inflated self-esteem/grandiosity and decreased need for sleep. Diagnoses and episodes with poor ICCs (< 0.4) included Hypomania and Bipolar Not Elsewhere Classified/Not Otherwise Specified. Despite efforts made to refine BD criteria with DSM-5, there was substantive variation in diagnostic interpretation among investigators working with children presenting with manic-like symptoms.

Positive Childhood Experiences (PCEs) may mitigate the negative outcomes resulting from Adverse Childhood Experiences (ACEs). To date, most PCE research has used cross-sectional or retrospective designs. PubMed, EMBASE, Cochrane, PsychINFO, CINAHL, and Scopus were searched in May 2024 for longitudinal studies that examined the impact of cumulative PCEs. Eight publications from five longitudinal studies with a total of 16,451 participants were included. Three studies focused only on adolescent outcomes. PCEs were associated with reduced rates of depression, substance use, delinquent behavior, risky sexual behavior, persistent insomnia, and lower inflammatory markers. Cumulative PCEs in childhood may moderate the impact of ACEs, potentially playing an important role in reducing the risk for mental disorders and other adverse outcomes later in life.PROSPERO (ID: CRD42022384775).

This pilot study evaluated the outcomes associated with a training workshop in cognitive-behavioural therapy with exposure and response prevention (ERP) for youth with obsessive-compulsive disorder (OCD) aimed at improving clinicians' capabilities and motivations. Questionnaires and role-plays were completed by 17 Australian clinicians working across community youth (i.e., child and adolescent) mental health services. Knowledge, beliefs, and confidence in using ERP, and adherence delivering it improved at post-training. At 6-month follow-up improvements in beliefs were not maintained, while competence delivering ERP improved. At pre-training, participants utilised ERP significantly less than they intended to. At follow-up, the proportion of time clinicians intended to dedicate to and self-reported time spent implementing ERP was unchanged relative to pre-training, and the intention-behaviour gap remained. Overall, training was associated with improvements in implementation capabilities, but the association with improvements in motivations and behaviour was less clear. Future research should explore the impact of implementation opportunities and develop strategies to support training.

There are few psychometrically sound measures of overprotection designed for the caregiver and focusing largely on overt behaviours and actions. The Parental Overprotection Measure (POM) was developed for research with preschool aged children and has been used in a range of research projects and translated into several languages. However, its full psychometric properties have not previously been reported. The aim of the current paper was to evaluate the psychometric properties of the original, English-language version of the POM. Mothers (N = 288) of children aged between 36 and 71 months completed the POM along with measures assessing validity. A subsample (n = 86) also repeated the POM after approximately 5 weeks. Exploratory factor analysis of the present sample, did not show very clear factor structure and we therefore recommend use of the full scale at this stage. However, two, potentially interpretable factors related to restriction and comfort. Reliability for both factors and the total was strong (alphas and omegas .74 to .90) and the (sub)scales all showed good retest reliability (.72 to .75). Correlations with other measures of overprotection were moderate for the total and restriction scales but smaller for comfort and the two subscales correlated differently from each other with other aspects of parenting. The total and restriction subscale correlated moderately with child anxiety but the comfort subscale failed to relate significantly. Overall, the POM shows solid psychometric properties and could be used as a self-report measure of caregiver overprotection.

This study examined the prevalence and correlates of mental disorders among youth in Kumasi, Ghana, through a community-based cross-sectional survey. 672 urban participants aged 6-17 years were surveyed. Mental disorders were screened using Rutter's A2 Scale for Parent Assessment of Child Behaviour, with diagnoses confirmed by the Kiddie-Schedule for Affective Disorders and Schizophrenia. The Double Sampling method was used for weighted prevalence estimates, and correlates analysed using chi-square and logistic regression. Lifetime weighted prevalence of CAMH disorders was 30.4% (95% CI: 26.9-33.9), predominantly anxiety-related disorders, with current weighted prevalence 18.6% (95% CI: 15.7-21.5). Notably, lacking an active reading habit was associated with nearly three times the odds of mental illness. Children in the 3rd and 4th wealth quintiles had significantly higher odds of mental disorder (12- and 9-times increased odds, respectively), as did lack of caregiver homework supervision among children under 11 years. This study provides the first community-based prevalence figures for childhood mental disorders in Ghana, highlighting the link between poverty-related factors and mental health, and suggesting potential policy interventions to inform policy.

Over a quarter of children with Attention-deficit/hyperactivity disorder (ADHD) meet diagnostic criteria for an anxiety disorder as well. The goals of this paper are (a) to examine what is currently known about co-occurring ADHD and anxiety in children, (b) propose and outline underlying factors relevant to the development of anxiety in children with ADHD, and (c) discuss future directions and clinical implications for the prevention and identification of anxiety development in children with ADHD. It is proposed that certain associated features of ADHD (i.e., low effortful control and emotion dysregulation) as well as various interpersonal factors related to ADHD (i.e., poor parent, teacher, and peer relationships) form a negative feedback loop that increases susceptibility to anxiety in a subset of children with ADHD. The literature supports interrelations between and across the associated features and interpersonal factors. Additional research is needed to test the validity of the proposed process. Obtaining further insight into the interplay between these different factors can help identify a subset of children with ADHD who are at risk for developing anxiety, which can enhance the precision of prevention, assessment, and treatment efforts for these children.

Digital parent training programs (DPTs) aimed at treating child behavior problems have shown efficacy in a number of trials, but less is known about the active ingredients parents find helpful while using DPTs. We analyzed data from users of self-guided DPTs within a randomized controlled trial setting: a standard program (DPT-STD) and an enhanced program (DPT-TP). Thematic analysis of interviews (n = 16) reveals that users of both programs endorsed the "content", "content presentation", "accessibility", and "therapeutic context" as beneficial. However, only DPT-TP users identified the "therapeutic persuasiveness" as helpful, attributing this to features embedded exclusively in the enhanced program, including call-to-action reminders and assessment-based feedback. Findings were reinforced by the analysis of responses to open-ended questions from a larger sample of users (n = 31 DPT-STD users and n = 34 DPT-TP users). These findings underscore the importance of utilizing features that help parents make positive changes in their home.

This study examined the psychometric properties of self-rated symptoms of oppositional defiant disorder (ODD) and conduct disorder (CD). We analyzed symptom ratings from a clinical outpatient sample of 658 adolescents aged 11;0-17;11 years diagnosed with ODD/CD and/or attention-deficit hyperactivity disorder. In two steps, we examined the factor structure of ODD models and an additional CD symptom dimension using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). Our preferred three-factor CFA and ESEM models (CFI = 0.937-0.975, TLI = 0.926-0.962, RMSEA = 0.049-0.068, SRMR = 0.045-0.070) demonstrated scalar measurement invariance across age groups (≥ 14;0 years) and metric measurement invariance across informants (parents, teachers). With exceptions, the self-rated symptom scales showed acceptable internal consistencies (α = 0.68-0.84). Convergent (r =.27-.65) and divergent validity (r =.13-.41) were supported using Achenbach's Youth Self Report Form. Our results provide implications for using self-rated ODD/CD symptoms in clinical practice and research.

Social anxiety (SA) and depressive disorder usually coexist. Emotional Intelligence (EI) is a protective factor against emotional disorders. The aim of this study is to examine the moderating role of EI in the relationship between SA and depression among Spanish and Portuguese adolescents. Information on these variables was collected through a cross-sectional study with 1456 students between 12 and 19 years of age. The software PROCESS was used to perform the analysis of conditional processes (model 1). The moderation model was conducted, including the covariate country, and showed significant differences between countries in the relationship between SA and Depression. The summary model explained that 42% of the Depression. The statistical analysis was repeated separately for Portuguese and Spanish adolescents, with EI as the moderating variable. The effect of SA on depression was significant for individuals with low or moderate EI, while for adolescents with high EI there was no statistically significant effect. To prevent these outcomes, early interventions, including the enhancement of Trait EI, with adolescents with SA could reduce the risk of developing SA disorder, as well as subsequent depressive disorders in adolescence and early adulthood. This is especially important because research indicates that depression caused by SA is strongly associated with a worse course of depression.

Time-out is an empirically supported component of parenting interventions for child conduct problems; however, it is receiving increasing criticism among parents and some practitioners. This study aimed to investigate practitioners' use and acceptability of time-out for child conduct problems; examine whether perceived effectiveness and knowledge of evidence-based parameters of time-out implementation influence use and acceptability of time-out; and explore practitioners' perceptions about alternatives to time-out. One hundred and ten Australian and New Zealand practitioners who have worked with children and families completed an online survey investigating their use and acceptability of time-out for children with conduct problems. Results showed that 55.5% of the sample have used timeout, with 38.0% considered current TO users. Acceptability of the strategy varied, with some practitioners critical of time-out. Increased knowledge of evidence-based parameters of time-out implementation was associated with increased frequency of time-out use and acceptability, while perceived effectiveness was associated with increased acceptability only. Practitioners perceived a number of other parenting strategies as effective alternatives to time-out. These findings have important implications for improving practitioners' implementation of time-out with parents of children with conduct problems.