Child Psychiatry & Human Development最新文献

Broad deficits in emotion regulation skills have been observed in children with anxiety-related disorders. These deficits typically improve during cognitive-behavioral therapy (CBT), but few studies have examined changes in expressive suppression and cognitive reappraisal in youth with anxiety disorders and/or obsessive-compulsive disorder (OCD) during CBT, especially in real-world settings. In a naturalistic treatment-seeking sample, 123 youth completed measures of anxiety, depression, and emotion regulation strategy use before and after 15 sessions of CBT. For anxious youth, anxiety and expressive suppression decreased over treatment, while cognitive reappraisal increased. Reductions in expressive suppression and increases in cognitive reappraisal were significantly associated with improvements in anxiety and remained significantly associated with post-treatment anxiety after accounting for baseline anxiety and depression. Changes in expressive suppression and cognitive reappraisal over the course of treatment were not found for youth with primary OCD. Thus, CBT improves emotion regulation abilities in anxious youth, and these improvements are associated with anxiety reduction; improvements in emotion regulation do not appear to drive changes in OCD symptoms. Further research is needed to determine whether changes in emotion regulation strategies mediate changes in anxiety among youth receiving CBT.

While the correlation between parental autonomy granting and adolescents' problematic Internet use (PIU) has been confirmed, the processes underlying this connection have not been thoroughly investigated. Drawing on the ecological systems theory, this study sought to investigate the mediating mechanism of peer attachment and the moderating mechanism of school climate that link parental autonomy granting to PIU. A two-wave longitudinal design was employed with a time interval of six months. The participants were 852 adolescents who attended three middle schools located in Guangdong Province, China. Self-report questionnaires were used to obtain data on demographics, parental autonomy granting, peer attachment, school climate, and PIU. The findings indicated that peer attachment significantly mediated the link between parental autonomy granting and adolescent PIU. A positive school climate significantly moderated the influence of parental autonomy granting on peer attachment and the influence of peer attachment on PIU. Specifically, the association between parental autonomy granting and peer attachment and the association between peer attachment and PIU were more pronounced when the school climate was perceived to be positive. This research underscores the possible significance of peer attachment in the association between parental autonomy granting and PIU and offers valuable insights for mitigating the negative outcomes of PIU.

Using data from the nationally representative Millennium Cohort Study, this study examined the association between age of starting and weekly hours in formal childcare between birth and 5 years with internalising and externalising behaviour trajectories from ages 5 to 14 years in England (N = 6194 children). Associations were analysed using multilevel general linear regression models, with adjustment for socio-economic position, maternal mental health, demographics, and child temperament. Later entry was associated with more internalising behaviours at age 14 years. Children who spent > 40 h per week in childcare between birth and 3 years displayed more externalising behaviour at 5 years than children who did not attend childcare. Controlling for socio-economic position and parental mental health attenuated findings.

This study addressed the pressing need to investigate the prevalence and nature of teachers' anxiety-accommodating behaviors across different grades. Employing a cross-sectional design, we disseminated a questionnaire to 1200 (243 responded) teachers within the Kristiansand municipality in Norway, spanning elementary to high schools. The findings revealed a pronounced trend: every teacher reported at least one anxiety-accommodating behavior, with 71% indicating frequent use. Factor analysis further elucidated two primary accommodation strategies: 'Modification' and 'Participation', which had distinct correlations to the grade levels taught. These findings fit with parental accommodation patterns for anxiety observed in the community, suggesting similar accommodation behaviors among community members and teachers. Given this widespread prevalence of anxiety accommodation, coupled with the limited availability of school-based CBT interventions, this study revealed a significant divergence from evidence-based practices that focus primarily on confronting anxiety provoking situations. The potential biases of self-reporting and the study's regional focus stand as limitations. However, the clear implication is the urgent need for tailored interventions aimed at reducing anxiety accommodating behaviors for educators, paralleling similar strategies designed for parents with the goal of improving the way school personnel manage and help to mitigate student anxiety in the school environment.

The global rise in youth mental ill-health is exacerbated by a shortage of clinicians trained in evidence-based care, making it difficult to translate research into effective practice - especially for body dysmorphic disorder (BDD), an adolescent-onset condition that often goes undetected and untreated. This study aimed to explore clinicians' experiences of participation in an online educational programme focused on the assessment and treatment of BDD in youth. We also aimed to investigate their use of newly learned skills after completing the programme. Semi-structured interviews were conducted with 12 clinicians who had completed the online education. Conventional content analysis was used, identifying three main categories. The online format - personal and flexible included reports on building personal connection within online education, flexibility allowing for individualised and integrated learning, and on-demand online supervision facilitating participation. Educational content - motivated learning and facilitated application concerned diverse perceptions of test value, challenge and impact, varying content presentation making the education effective and credible, interactive and practical content for real-world application, and personalised and supportive learning through detailed feedback. Learning outcomes - increased knowledge and changed working practices included descriptions of enhanced proficiency in assessment and treatment of BDD, transdiagnostic value and use, and spreading knowledge and improving clinical routines. Participants reported generally positive experiences of the training and changes in working practices following training. Limitations were also noted, such as insufficient applied skills training and peer support. Future improvements should focus on enhancing practical skills training and providing additional implementation support at both clinician and organisational level.

Persistent tic disorders (PTD), including Tourette Syndrome (TS), impact individuals' lives well beyond motor and vocal tics, affecting self-beliefs, relationships, and daily functioning. This qualitative study examined stigma and discrimination experienced by youth and adults with TS, their caregivers, and healthcare providers through in-depth interviews with 35 participants. Thematic analysis revealed four major themes: limited resources and funding, widespread misconceptions and stereotypes, negative experiences shaping self-perceptions and behaviors, and the importance of supportive environments in fostering resilience. Participants reported that widespread misunderstanding and exclusion led to significant psychosocial challenges, which were often more disruptive than the tics themselves. The findings highlight the need for clinical and behavioral interventions that address broader psychosocial issues, not just symptom management. Future research should explore resilience and protective factors that may help buffer against adverse experiences and improve psychosocial outcomes. This study was pre-registered at ClinicalTrials.gov (NCT05696769) and the Open Science Framework https://doi.org/10.17605/OSF.IO/EX52G .

Early maternal life experiences, such as childhood maltreatment (CM), particularly emotional neglect may disrupt her recall of parental bonding experiences and the development of a healthy mother-infant relationship. This pilot study of thirty-eight postpartum Latina mothers examined preliminary intergenerational associations of maternal retrospective self-reported history of CM, particularly emotional and physical neglect (Childhood Trauma Questionnaire-CTQ), perception of parental bonding (PBI) and postpartum bonding PBQ with her infant. Nonparametric correlations showed that higher emotional neglect, more consistent than physical neglect, was associated with a lower perceived maternal and paternal care, and higher paternal overprotection. Furthermore, hierarchical regression analyses demonstrated preliminary evidence that emotional neglect was the most consistent predictor of postpartum bonding difficulties, including general bonding impairment, rejection/anger, and infant-focused anxiety. Higher maternal gestational age emerged as a possible protective factor across model, associated with more favorable bonding outcomes. These preliminary findings suggest that emotional neglect may exert lasting intergenerational effects on perceived parental bonding and maternal bonding capacities in the postpartum period. These results highlight the need for trauma-informed perinatal care and early screening of adverse childhood experiences (ACEs) to prevent child maltreatment in Hispanic populations.

This study examined associations of parents' subjective perceptions of disaster-related harm from the Great East Japan Earthquake (GEJE) with their mental health and with emotional and behavioral problems in their children born post-disaster. Participants included 218 parents (207 mothers, 11 fathers) and 219 children born post-GEJE, residing in affected areas. Parents served as proxy reporters, completing measures assessing their disaster-related experiences, psychological distress, depressive symptoms, post-traumatic stress symptoms, and their children's emotional and behavioral problems. Structural equation modeling was conducted to evaluate pathways among variables. Higher disaster-impact scores were significantly associated with poorer parental mental health (β = 0.15, p = .048), which was associated with more emotional and behavioral problems in children (β = 0.43, p < .001). The relationship between disaster impact and children's outcomes was mediated through parental mental health rather than through a direct pathway. Children's psychological adjustment following large-scale disasters may be influenced by their caregivers' mental health, even without direct trauma exposure. Family-centered mental health interventions are essential components of comprehensive disaster-recovery strategies.

This study aimed to explore the relationship between bullying victimization and multiple psychological symptoms among Chinese adolescents and to evaluate the moderating role of psychological resilience in this relationship. Using large-scale regional data from a county in northeastern China (N = 22,264), we identified bullying victimization subtypes through latent class analysis (LCA), quantified comorbidity risks via multinomial logistic regression, and examined the moderating effects of resilience across subgroups. Three victimization profiles emerged: non-victimized (80.9%), moderately victimized (13.6%), and poly-victimized (5.5%) groups. Compared to the non-victimized group, the moderately victimized group demonstrated higher odds ratios (ORs) for multiple psychological symptoms (all three symptoms: OR = 6.872; any two symptoms: OR = 4.470; any one symptom: OR = 2.610). The poly-victimized group exhibited significantly higher odds across all symptom categories (all three symptoms: OR = 43.678; any two symptoms: OR = 18.246; any one symptom: OR = 5.974). Resilience demonstrated heterogeneous moderation effects: it showed no significant interaction in the moderately victimized group, whereas it was associated with significant risk amplification in the poly-victimized group (OR = 1.040, p < 0.001). Bullying victimization is significantly associated with concurrent psychological symptoms. However, resilience does not universally buffer against stress. For adolescents subjected to severe poly-victimization, high levels of resilience appear to amplify psychological risks instead of providing a buffering effect. The findings suggest that tailored intervention strategies should prioritize victimization severity rather than adopt a universal resilience-promotion approach.