Child Psychiatry & Human Development最新文献

Individuals with neurodevelopmental disorders (NDDs) are more susceptible to developing severe or resistant mood disorders. However, they often face challenges in accessing specific treatments. To understand the barriers to treatment in this group, we conducted a secondary analysis of a multicenter observational study on 305 adolescents referred to specialized care (mean age 14.38 ± 0.13 years, 57% girls, 9% bipolar disorder, 91% depressive disorders). NDDs were categorized based on the number of co-occurring NDDs for each subject (none: 67%, one: 18%, two: 7%, three: 5%, four and more: 2%). We explored the predictive value of the number of NDDs on various clinical and therapeutic factors. The analysis revealed significant associations between the number of NDDs and the duration of mood symptoms, persistent irritability, associated disruptive behavioral disorders, lower scores on the Children's Global Assessment Scale (CGAS) at baseline, and polypharmacy. The number of NDDs did not correlate with the use of antidepressants, the Clinical Global Impression-Improvement scale (CGI-I) at discharge, or changes in the CGAS score during the stay. The challenges in distinguishing mood disorders from chronic emotional and behavioral difficulties may contribute to the difficulties in accessing specific care for mood disorders. These results suggest that treatments for mood disorders demonstrate comparable effectiveness when provided regardless of the associations with NDDs.

The PSWQ-C is a widely used international scale to measure worry traits in children and adolescents. It has been translated into several versions for use in different countries. The purpose of this study was to examine the psychometric characteristics of the Penn State Worry Questionnaire for Children (PSWQ-C) particularly three reverse-scored items, and to develop a shorter version of the PSWQ-C based on Item Response Theory (IRT) methods. 903 children and adolescents of different ages from China participated in the study. This study used the Graded Response Model (GRM) to fit the data and examined the IRT parameters of each item, Item Characteristic Curve, Item Information Functions, and Differential Item Functioning. Eight items with undesirable functioning were removed, while six items with good functioning were retained, resulting in a simplified version of the PSWQ-C. The abbreviated version of the PSWQ-C was subsequently validated for its reliability and validity. The results confirmed that the abbreviated scale is reliable and effective, with a Cronbach's alpha coefficient of 0.84, indicating good reliability. Regarding validity, the abbreviated version of the PSWQ-C demonstrated significant correlations with IUS-12 and MASC, both exceeding 0.60, which closely resembles the correlation of the original PSWQ-C with these two scales. Furthermore, the correlation between the two versions was 0.96, indicating that the abbreviated PSWQ-C can effectively replace the original version and has a broader range of applications.

Adverse childhood experiences (ACEs) have been linked with attachment insecurity and psychopathology. However, some individuals remain securely attached and resilient following ACEs. Researchers have examined polymorphisms in the oxytocin receptor gene (OXTR), particularly rs53576, as a source of resilience, though examination of the biological mechanism by which rs53576 buffers the relation that would otherwise exist between ACEs and attachment insecurity is absent. The aim of the current study was to examine how ACEs interact with individual genetic and immune vulnerability to shape attachment security in older adolescents and young adults (n = 201). Moderated mediational models were tested in which ACEs acted as independent variables, attachment security acted as a dependent variable, inflammation (i.e., IL-6) was tested as a mediator, and rs53576 (i.e., AA, AG, GG genotypes) was tested as a moderator. Results indicated that physical abuse was significantly associated with decreased attachment security, with moderation by rs53576. A significant main effect of rs53576 on IL-6 was also noted. A similar pattern of results was evident across other ACEs and suggests that the effects of ACEs on attachment are buffered by the GG genotype. Association between GG and lower IL-6 suggests inflammation plays some role, though more research is needed.

The co-occurrence of externalizing and internalizing problems is acknowledged, but gender differences remain unclear. The present study examines gender differences in the longitudinal relationships between conduct and emotional problems throughout childhood. The sample, drawn from the ELISA project, included 2368 children (48.1% girls; ages 3-12). Latent growth curve models were employed to analyze the trajectories of parent-reported conduct problems and emotional symptoms separately, while parallel process latent growth curve models were utilized to compare joint trajectories. The decrease in conduct problems was consistent for girls, but not for boys. High initial emotional symptoms predicted a slower increase in emotional symptoms over time for girls. Parental positivity was a protective factor for conduct problems in girls. Grandiose-deceitful traits were more related to conduct problems in girls, while callous-unemotional traits were related to emotional symptoms in boys. This study highlights the importance of considering gender in childhood conduct and emotional problems.

Depression is a serious public health problem that often emerges during adolescence. Many adolescents do not respond to standard treatments, necessitating the development of novel interventions. We conducted a preliminary study to assess the impact of a novel creative arts intervention on depression and well-being in adolescents. In this quasi-experimental study, 69 adolescents 12-17 years completed an 8-day "Creativity Camp" intervention encompassing multiple creative activities. Self-report questionnaires to measure depression, anxiety, and well-being were administered at five time points to allow examination of change across multiple temporal segments: the 2 weeks before the intervention, the 2 weeks during the intervention, the 2 weeks after the intervention, and the 6 months after the intervention. Adolescents were assigned to one of two groups to compare changes observed during the 2 week before-intervention period (Group A) to the changes observed during the intervention period (pre-post intervention) (Group B). According to both parent and child reports, pre-to-post-intervention, mean adolescent depressive symptoms significantly decreased, and these changes were sustained 2 weeks after the intervention and (according to parents) at the 6-month follow-up. There was preliminary evidence for improved well-being at post-intervention. Comparison of Group A's changes during the before-intervention period to Group B's changes pre-post intervention was significant for parent-reported depression. Preliminary evidence suggests that the Creativity Camp intervention may positively impact adolescent depression and well-being. This evidence highlights the importance of investigating and implementing treatment approaches focusing on creative arts for adolescents with depression.

Body dysmorphic disorder (BDD) typically develops during adolescence, but there has been little research evaluating assessment tools for BDD in youth. This study sought to provide a comprehensive psychometric evaluation of a brief self-report questionnaire of BDD symptoms, the Body Image Questionnaire Child and Adolescent version (BIQ-C), in both clinical and non-clinical adolescent samples. Properties of the BIQ-C were examined in 479 adolescents recruited through schools and 118 young people with BDD attending a specialist clinic. Sensitivity to change was additionally examined in a subgroup of the clinical sample who received treatment (n = 35). Exploratory factor analysis indicated that a two-factor structure provided the best fit for the data in the non-clinical sample. The two-factor solution was corroborated through confirmatory factor analysis as the best solution in the clinical sample, although it did not fulfil predefined fit thresholds The first factor encompassed preoccupation and repetitive behaviours, while the second included items assessing functional impairment. The BIQ-C showed good internal consistency across both samples, and convergent validity with other measures of BDD. Among those in the clinical sample who received treatment, BIQ-C scores decreased significantly, and BIQ-C change scores were highly correlated with change scores on the gold-standard clinician-rated measure of BDD symptom severity. These findings indicate that the BIQ-C is a suitable tool for assessing BDD symptoms in young people and measuring change during treatment.

A well-functioning parent-child relationship is crucial for the child's psychological development. We examined the Emotional Availability (EA) in the early interaction of internationally adopted children with their mothers. We also studied whether the quality of the interaction was associated with the sex of the adopted children, the age at the time of adoption, the time they had spent in the family and parental depressive symptoms. The study sample was part of the Finnish Adoption (FinAdo) study and included 79 children (mean age at adoption = 2.58 years, SD = 1.51 months, 37% girls) and their adoptive mothers in Finland. The mother-child interactions were examined with Emotional Availability Scales (EAS) during the first months after adoption (mean = 6.3 months). Our results showed that the overall EA scores were relatively high (mean 4.78-6.18), although the mean levels of parent sensitivity, parent non-intrusiveness, child responsiveness and child involvement were under the high zone of the EA (< 5.5). Children adopted at a younger age and boys received lower scores in the interaction analysis. Our results suggest that families with internationally adopted children seem to be able to create a well-functioning early relationship between the mother and the child.

Parental depression symptoms are a prevalent risk factor for internalizing and externalizing problems in youth, with parenting and parents' physiological stress reactivity representing potential contributing factors in the intergenerational transmission of psychopathology symptoms. In a sample of adolescents (N = 97) and their parents, the current study examined parental depression symptoms, an observational measure of parenting, and parents' physiological reactivity during a dyadic conflict discussion task in association with adolescents' internalizing and externalizing psychopathology. Parental depression symptoms and harsh/insensitive parenting showed positive associations with youth psychopathology symptoms. Further, parental depression symptoms were associated with greater externalizing symptoms in youth, specifically for parents with higher physiological reactivity during the conflict task. The present study highlights risks associated with parental depression and harsh/insensitive parenting, and provides evidence for parental physiological reactivity as a moderator of the association between parent and youth psychopathology. Clinical implications, limitations, and directions for future research are discussed.

Youth substance use continues to be a public health concern, with both aggressive behavior and symptoms of depression commonly identified as risk factors for adolescent substance use. However, more research is needed to understand how proactive and reactive functions of aggression are uniquely associated with the frequency of use of specific substances and how these functions of aggression interact with symptoms of depression to contribute to substance use. To this end, the current study examined these associations in a sample of detained youth (N = 229; 80.7% Male). Results suggested that reactive aggression is uniquely associated with traditional cigarette, alcohol, and marijuana use, while proactive aggression is uniquely associated with prescription drug use. Further, although symptoms of depression did not uniquely contribute to the frequency of substance use, symptoms of depression moderate links between proactive aggression and frequency of traditional cigarette, alcohol, and prescription drug use such that proactive aggression is associated with increased frequency of use only when symptoms of depression are low. Findings suggest the need to consider functions of aggression when identifying risk for frequent substance use, as there may be distinct targets of intervention depending on the function of aggression.

Screeners are used in early intervention and early childhood education and care programs to identify children's potential need for further evaluation and diagnostics. The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioral screening instrument that can be completed by both parents and educators to assess the social and emotional traits of children. However, multiple informants' reports vary. In this study, the extent to which parents' (n = 241) and educators' (n = 157) differ and agree in their assessments of children aged 3.5 years on average, was examined. T-tests were used to examine differences between informants and correlations within a multitrait-multimethod matrix (MTMM) in their agreement. Results showed moderate to high levels of rater agreement ranging from r = .35 and r = .53 on the five subscales of the SDQ. We found that hyperactivity, peer relationship problems, and prosocial behavior vary due to meaningful reasons, e.g., the home vs. pre-school setting, and the informant's relationship towards the child. Hyperactivity seems to be relatively consistent across settings. Methodological variations might explain differences in emotional symptoms and conduct problems. Considering ratings from multiple informants outlines a more comprehensive view of children's behavior and should be preferred over single-informant research designs.