Child Psychiatry & Human Development最新文献

This study examines risk factors associated with bullying among U.S. adolescents including social determinants of health, parental determinants, and pre-existing health conditions to inform evidence-based strategies to prevent bullying. Data for 12-17-year-old adolescents from the 2022-2023 National Survey of Children's Health (NSCH) was analyzed. Summary statistics, chi-squared tests, and binary logistic regression analyses were performed to examine associations between bullying involvement and a variety of factors, including physical health conditions, mental and developmental health variables, caregiver influences, adverse childhood experiences, and social determinants. Bivariate analyses revealed significant associations between bullying or being bullied and caregiver mental health and social determinants. Logistic regressions highlighted that being overweight, having autoimmune disease, mental health conditions (anxiety, depression, ADHD), learning disabilities, and difficulty making friends significantly increased the odds of being bullied. These findings support the need for evidence-based, multi-level, culturally specific interventions to reduce bullying and improve adolescent well-being.

Views on autism shifted from a biomedical view to a neurodiversity-framework, with a parallel change in views on the nature of wellbeing. In this qualitative study the Capability Approach (CA), a theory of wellbeing, has been operationalized to identify (a) capabilities of young autistic adults in the Netherlands, as well as (b) important aspects in the process of converting resources on a personal, social and environmental level to realize valuable beings and doings. Fourteen young autistic adults with mental health problems and a self-chosen important other were interviewed twice using a semi-structured interview protocol driven by the central capability concepts. Thematic analysis revealed eight capability themes: autonomy, human connection, peace of mind, personal development, health, enjoyment, work and education, and meaning in life. Specific capabilities identified were to be free of sensory overload, participating in specific interests, to be understood by others, and access to autism-friendly care. Preconditions for capability realization related to the interaction between being autistic and social conditions (e.g. feeling misunderstood or bullied), but also to living conditions and resources (e.g. unsafety, poverty). The CA and identified capabilities offer a framework to discuss wellbeing, individual capabilities, and the conversion process with young autistic adults and their important others.

This study investigated the associations between perceived teacher support and academic anxiety among Chinese high school students, examining academic self-efficacy and social media use as potential mediating variables. Data were collected from 3,326 students (aged 14-19) across three regions in China using validated self-report measures. Path analysis identified three key relationships: (1) a negative association between perceived teacher support and academic anxiety; (2) academic self-efficacy and social media use as individual mediators in this relationship; and (3) these factors as sequential mediators in a chain pathway linking perceived teacher support with academic anxiety. These findings underscore the significant statistical association between teacher-student relationships and academic anxiety, and further illuminate the broader correlational dynamics among external support, psychological beliefs, digital behaviors, and emotional states. This research provides preliminary evidence with important implications for addressing academic anxiety in competitive educational environments.

Preterm birth and very low birth weight (VLBW; <1500 g) are associated with a greater risk for later child psychopathology. However, longitudinal studies on influencing factors and developmental precursors for behavioral problems in VLBW children are still scarce. This study investigates whether difficult infant temperament moderates the association between VLBW and internalizing symptoms, while controlling for family contextual factors. Data from N = 146 families (n = 75 VLBW and n = 71 term birth) were derived from the longitudinal HaFEn cohort study in Hamburg, Germany. Mothers reported on infant temperament at 12 months of age, and internalizing problems at 2.0, 4.4, and 8.0 years. Parental depressive symptoms and socioeconomic status (SES) were assessed shortly after birth. The results showed no moderating effect of infant difficultness on the association between VLBW and internalizing problems. However, difficult temperament was associated with higher levels of internalizing problems in both groups. Our findings highlight the relevance of considering infant temperamental predisposition in relation to later behavioral problems in general. Future research should further examine specific factors influencing mental health outcomes in VLBW children, such as parenting or SES.

Early identification of suicide risk in pediatric outpatient settings is crucial for preventive interventions. This multicenter study aimed to develop a machine learning model to predict self-reported suicidal ideation among children and adolescents aged 7-17 years visiting pediatric outpatient settings. Least Absolute Shrinkage and Selection Operator and logistic regression analysis were used for model development and feature selection. Of 855 patients recruited, 329 were included in the analysis (mean age 11.0 years, 61.7% males). Frequent suicidal ideation (defined as always thinking life is not worth living during the past week) was reported by 20 (6.1%) patients. Based on six items assessing child-rated psychosocial functioning and physical and psychological symptoms, the selected model achieved an Area Under the Curve (AUC) of 0.81 (95% CI: 0.70-0.92). This brief six-item model can help identify children at risk of suicide in pediatric outpatient settings, potentially facilitating timely intervention.

Obsessive-compulsive disorder (OCD) is a common mental health concern in young people, as it is often severe and can become chronic without adequate psychotherapeutic intervention. As a first-line treatment, cognitive behavioral therapy (CBT) has been extensively studied in both face-to-face and online trials. However, low remission rates may indicate that not all young patients benefit from treatment. To further improve the effectiveness of digital CBT, treatment moderators should be investigated thoroughly. We analyzed data from n = 12 children and adolescents with OCD who received 14 weeks of digital sensor-assisted CBT via videoconferences (vCBT). We assessed patients' self-ratings of OCD symptom course, affect, and arousal and examined the effects of potential moderating variables (e.g., treatment satisfaction, technical usability, self-regulation, self-control, and self-efficacy) on treatment outcomes. The results revealed a significant improvement in obsessive thoughts and compulsive behavior during online CBT. Higher treatment satisfaction and perceived usability of technical devices was associated with greater decreases in obsessive thoughts and compulsive behavior. A significant moderating effect on self-rated decreases in symptoms was also found for patients with higher levels of self-efficacy, self-regulation, and self-control. Our results highlight that digital sensor-assisted CBT led to a subjective decrease in symptoms. The moderating effects of patient satisfaction and usability on symptom improvement emphasize the need for participative design approaches in the development of digital mental health interventions. The different constructs of mastery and volition appear to be moderators of decreases in OCD symptoms and should be further investigated in future trials with larger patient samples.Clinical trial registration: [ www.ClinicalTrials.gov ], identifier [NCT05291611], first submission: 2021-12-10.

Attachment insecurity is associated with callous-unemotionality (CU), but few studies have considered whether specific dimensions of insecurity are differentially associated with CU. The first aim of this preregistered study was to test whether attachment avoidance and anxiety were differentially associated with CU. The second aim was to examine whether specific emotion regulation strategies explain these associations. The third aim was to evaluate the moderating effect of trauma exposure. Participants included 316 justice-involved adolescents (M = 16 years, 20% female, 39% White/non-Hispanic) who self-reported attachment avoidance and anxiety, emotion regulation strategies, trauma exposure, and CU. As predicted, CU was positively associated with attachment avoidance and negatively associated with attachment anxiety. There was limited evidence that these associations were accounted for by emotion regulation strategies or moderated by trauma exposure. These findings align with the proposition that specific forms of attachment insecurity are differentially associated with CU among high-risk youth.

Children of mentally ill parents are at a higher risk of developing mental health disorders and experiencing maltreatment. Identifying predictors of maltreatment in this risk group may help provide support at an earlier stage. A random forest classifier was applied to a sample of psychiatric inpatients (n = 330, 59.70% female, M _Age = 41.15 years, SD _Age = 7.12) and their children (n = 95, 60.00% female, M _Age = 15.03 years, SD _Age = 2.14) to examine whether child maltreatment could be predicted based on reports from both parents and children. Maltreatment symptoms were assessed using a cut-off score from the Childhood Trauma Questionnaire Short-Form. Model 1, which predicted children's trauma scores as estimated by the parents, achieved 76.62% accuracy with an area under the curve (AUC) of .85. Model 2, which used only parental data to predict children's self-assessed maltreatment scores, showed a slightly lower accuracy of 68.42% and an AUC of .69. Model 3, which predicted children's maltreatment scores based solely on children's self-reports, showed an accuracy of 73.68% and an AUC of .84. These findings indicate moderate-to-good predictability of children's maltreatment scores and provide initial insights into the risk-assessment of children's maltreatment in families with a mentally ill parent.This study was preregistered as a clinical trial (28.04.2017, DRKS00011533) at the Deutsches Register Klinischer Studien (DRKS).

Adolescents with attention-deficit/hyperactivity disorder (ADHD) exhibit heightened vulnerability to school bullying, with sex-specific patterns. This study analyzed data from the 2021 Korean National Survey on Mental Health of Youth, comprising 6,689 adolescents (ages 12-18; 50.9% male). After inverse probability of treatment weighting (IPTW) adjustment, the effective sample comprised 3,1789 adolescents at risk of ADHD and 3,511 controls. Logistic regression analyses revealed pronounced sex differences. Female adolescents with ADHD symptoms showed significantly elevated odds of overall victimization, teasing/verbal provocation, and bullying perpetration, particularly verbal abuse. Conversely, male adolescents with ADHD symptoms demonstrated reduced odds of social exclusion and sexual harassment victimization, but an increased risk of verbal abuse perpetration. These findings underscore the critical role of sex in shaping the dynamics of ADHD-related bullying behaviors. They highlight the need for tailored, sex-sensitive interventions targeting emotional regulation and social skills deficits in adolescents with ADHD.

Voices and experiences of youth aged 12-15 years are rarely heard and prioritized. Understanding their perspectives is essential for tailoring effective mental health interventions and supports. As such, this qualitative study, co-designed with a youth advisory committee (n=7), interviewed 19 youth (aged 12-15 years) to explore their understanding of good mental health. Interviews were analyzed thematically following a reflexive thematic analysis approach. Three overarching themes were identified: 1) Everything is OK, describing a state of being able to manage the challenges of life, 2) Building Personal Strength and Resources, needed to maintain good mental health as an adolescent, and 3) Seeking Acceptance and Community, emphasizing the profound influence of social connections. Addressing adolescent mental health effectively requires a nuanced understanding of their perspectives to develop responsive and impactful mental health interventions and their active involvement in all facets of service design, research, and policymaking. PLAIN LANGUAGE TITLE: "My day is already planned out before I even get to choose it": Understanding what matters to youth aged 12-15 years and the implications for mental health services Youth aged 12-15 years are at a key developmental age and actively seek mental health services, yet their perspectives on these mental health services are rarely heard. Understanding what good mental health means to them is essential for creating support systems that meet their needs. This study explored how youth define good mental health. We worked with a youth advisory committee (n=7, aged 12-15 years) to co-design the research. Then, we interviewed 19 youth (aged 12-15 years, median age 14) from British Columbia, Canada, to learn about their views. Using an analysis approach that identifies patterns or themes in a way that reflects on the authors own perspectives and the process of analysis, we identified three key themes: 1. Everything is OK - Youth described good mental health as balancing their emotions to be able to handle life's challenges, including school and family pressures. 2. Building Personal Strength and Resources - Youth emphasized the importance of developing coping skills, confidence, and self-awareness to support their mental well-being. 3.Seeking Acceptance and Community - Youth highlighted the role of supportive relationships in having good mental health. These findings show that youth mental health is deeply connected to youths' environment, social connections, and ability to navigate challenges. To support them effectively, we must listen to their perspectives and include them in shaping mental health services, research, and policies. By prioritizing their voices, we can create meaningful and accessible mental health resources that align with their needs.