Child Psychiatry & Human Development最新文献

The experience of academic stress is common during high school and can have significant negative consequences for students' educational achievement and wellbeing. High school students frequently report heightened levels of school-related distress, particularly as they approach high-stakes assessments. Programs designed to reduce or prevent academic stress are needed, and their delivery in school settings is ideal to improve treatment access. The current review aimed to examine the effectiveness of high school-based programs in reducing or preventing academic stress. A systematic search returned 31 eligible studies across 13 countries. Programs were categorised according to intervention type, format, and facilitator. Results showed that the methodological quality of most studies was poor, and many used an inactive control group. As predicted by theories of academic stress, the strongest evidence was for programs grounded in cognitive-behavioural therapy (CBT). There was evidence that both universal and targeted approaches can be beneficial. The unique implementation issues for these two formats are discussed. Most programs were delivered by psychologists and were generally effective, but almost all of these were CBT programs. A smaller proportion of programs delivered by teachers were effective. Therefore, future studies should evaluate the implementation success of programs to improve the rate of effective delivery by school staff. Overall, the field will benefit from more randomised controlled trials with comparisons to active control groups, larger sample sizes and longer-term follow-ups.

Anxiety disorders are the most prevalent mental disorders experienced by adolescents. As students spend a significant amount of time within a school environment, it is not surprising that factors in the school environment have been linked to student mental health. Positive teacher-student relationships (TSRs) in children have been found to improve student mental health outcomes, with supportive TSRs associated with reduced student anxiety, and in turn, student anxiety has also been associated with reduced poorer TSR quality. The findings in adolescents are less clear. This review aimed to systematically evaluate the impact of TSRs on anxiety in secondary school students, and vice-versa using PRISMA guidelines. Searches were conducted in five databases and studies screened against inclusion and exclusion criteria, and rated for study quality by two independent researchers. Twenty-six studies across 12 countries were included. Most studies reported higher quality TSRs (e.g., those that are perceived as more supportive, caring, and warm) was associated with decreased anxiety. Conversely, TSRs that were characterised by dependence, motivational support, conflict, or harassment, were associated with increased anxiety. Most studies used a cross-sectional design and as such conclusions regarding causality as well as the direction of the effects cannot be made. However, early evidence from a limited number of longitudinal studies indicated that positive TSRs reduced anxiety over time. Future research is warranted to investigate whether anxiety affects TSRs, as well as exploring specific strategies and approaches teachers can use to establish positive relationships with their students.

This study investigated how youth attachment anxiety and avoidance are associated with informant discrepancies of intrafamilial aggression within families where youth have clinically significant mental health challenges (N = 510 youth-parent dyads). Using polynomial regressions, we tested whether youth attachment avoidance and anxiety moderated the absolute magnitude of the association between youth- and parent-reports of aggression toward each other. Furthermore, difference scores were computed to test whether youth attachment was associated with the direction of youths' reports of the frequency of aggression relative to parents (i.e., did youth under- or over-report). Dyads' reports of youth-to-parent aggression were more strongly related at high than low levels of attachment anxiety. Results also revealed that youth attachment anxiety was associated with youth over-reporting of youth-to-parent and parent-to-youth aggression (relative to parents), whereas attachment avoidance was associated with youth over-reporting parent-to-youth aggression (relative to parents). These findings highlight the importance of understanding the source of informant discrepancies in social-emotional development and family functioning.

Empathy is crucial to the development of socio-emotional skills in youth and empathy development is central to understanding and subtyping youth with externalizing problems. This study explored for the first time the psychometric properties of the Measure of Empathy in Early Childhood (MEEC) in a sample of 652 Italian children aged 6 to 8 years. The gender invariance of MEEC scores and their associations with other measures of empathy and prosocial behavior, and children's externalizing problems and callous-unemotional (CU) traits were also evaluated. Results indicated that with some modifications, a 5-factor structure of the Italian version of MEEC scores fitted the data and was invariant across gender. Results further supported the reliability and validity of MEEC total and subscale scores. Practical implications of these results are discussed.

Subclinical symptoms of obsessive-compulsive disorder (i.e., obsessive compulsive symptoms, or "OCS") cause functional impairment, including for youth without full-syndrome OCD. Further, despite high rates of OCS in youth with anxiety disorders, knowledge of OCS in the context of specific anxiety disorders is limited. The present study seeks to: (1) compare OCS in pediatric patients with anxiety disorders and healthy youth, (2) determine which categorical anxiety disorder(s) associate most with OCS, and (3) determine relationships between OCS with anxiety severity and impairment. Data on OCS, anxiety, and functional impairment were collected from 153 youth with anxiety disorders and 45 healthy controls, ages 7-17 years (M = 11.84, SD = 3.17). Findings indicated that patients had significantly more OCS than healthy controls. Among patients, GAD was a significant predictor of OCS as well as OCD risk. These results suggest that OCS should be a primary diagnostic and treatment consideration for youth who present in clinical settings with GAD.

Individuals with Tourette syndrome (TS) have poorer quality of life (QoL) than their peers, yet factors contributing to poor QoL in this population remain unclear. Research to date has predominantly focused on the impact of tics and psychiatric symptoms on QoL in TS samples. The aim of this cross-sectional, multi-informant study was to identify psychosocial variables that may impact adolescent QoL in TS. Thirty-eight adolescents aged 13 to 17 with TS and 28 age-matched controls participated with a caregiver. No group differences were found on QoL, although the TS group reported reduced QoL compared to population normative data. In the TS group, reduced QoL was associated with lower self-esteem, poorer family functioning, higher stress, and greater depression and anxiety; QoL was unrelated to tic severity. In regression analyses, after adjusting for covariates, family functioning was the strongest predictor of QoL. These results emphasize the need to further explore the influence of psychosocial factors, particularly family functioning, on QoL in adolescents with TS.

The COVID-19 pandemic has significantly impacted the mental health of children and families. This study sought to further explore the relationship between the pandemic (accounting for age and sex) and children's mental health outcomes, parenting quality, and service complexity. Data consisted of interRAI Child and Youth Mental Health Assessments from 5,067 children and youth between the age of 4-18-years-old. Surprisingly, our findings revealed the pandemic was not a significant predictor of parenting quality and children's mental health. Significantly lower levels of service complexity during the first few months of the pandemic were observed. Compared to younger males, older female children were more likely to experience internalizing symptoms and less likely to display externalizing symptoms. Older children (vs. younger children) were more likely to receive low parenting quality and experience service complexity. Clinical implications, limitations, and future directions are discussed.

This study aimed to develop and validate a new questionnaire, the Parental Burnout in ADHD (PBA) scale, to address this gap in the literature. Drawing on existing research on parental burnout, ADHD, and related constructs such as parenting stress and self-efficacy, the PBA scale was developed through a rigorous process involving item generation, expert review, and pilot testing. The final version of the PBA scale comprised 36 items, covering five dimensions: Parental stress, Parental self-efficacy, Parental guilt, Social support for parents, Parental burnout and Parental coping strategies. The psychometric properties of the PBA scale were examined in a sample of 118 parents of children with ADHD. Confirmatory factor analysis supported the five-factor structure of the scale, with good model fit indices. In conclusion, the Parental Burnout in ADHD (PBA) scale is a reliable and valid instrument for assessing parental burnout in parents of children with ADHD.

A cross-sectional survey with 399 parents of 1-5-year-old children aimed to investigate the extent to which parents make sex-based attributions for children's behaviours, and the association of parents' own gender and social role attitudes with those attributions. Overall, parents were more likely to attribute child behaviour to children's individual characteristics, age, and lack of socialisation than to sex. However, parents were more likely to make sex-based attributions for scenarios featuring boys compared to girls. In this sample, sex-based attributions were associated with attitudes towards social roles, but not with demographics, self-ascribed masculinity-femininity, and attitudes towards marital roles and child-rearing.

Non-suicidal self-injury (NSSI) and suicidality in adolescents represent urgent public health concerns. Although distinct, these behaviors share several underlying mechanisms. To clarify their relationship and inform prevention strategies, it is crucial to identify the factors most strongly associated with NSSI and suicidality in early adolescence, as well as those that exert common influences on both. In this study, a survey of 625 Chinese early adolescents (M_age = 10.36 years, SD = 0.93 years) was conducted, and network analysis was used to examine the interconnections among NSSI, suicidal ideation, suicide attempts, and multiple influencing factors. Results showed that harsh parenting, interparental conflict, and perceived burdensomeness were central factors for the concurrent prevention and intervention of NSSI, suicidal ideation, and suicide attempts. Furthermore, meaning in life and deviant peer affiliation emerged as important factors influencing both NSSI and suicidal ideation. These findings provide a robust theoretical foundation and practical direction for the early identification and mitigation of adolescent NSSI and suicidality.