Child Psychiatry & Human Development最新文献

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.

Non-suicidal self-injury (NSSI) is prevalent among early adolescents. However, few studies have explored the complex psychosocial mechanisms underlying NSSI among this population. This study aimed to examine the roles of Internet gaming disorder (IGD) and peer victimization by linking emotional insecurity to NSSI during early adolescence. Data were collected from 886 adolescents across four primary schools at three time points, spaced six months apart, using multi-stage random sampling. All participants were of Han ethnicity, with a mean age of 10.17 years. Girls accounted for 47.4% of the sample. The results indicated that IGD served as a mediator in the relationship between emotional insecurity and adolescent NSSI. Furthermore, this indirect effect was significantly moderated by peer victimization, such that the mediating role of IGD was only significant among adolescents experiencing high levels of peer victimization. These findings emphasized the longitudinal pathways through which emotional insecurity contributes to NSSI and have important implications for prevention and intervention strategies targeting NSSI among early adolescents.

Diagnostic labelling is a controversial issue, particularly when it comes to children. There are concerns about potential harmful effects of diagnosis, especially for Oppositional Defiant Disorder (ODD). There is a lack of research on parent perceptions of helpfulness of diagnosis, which is an important gap since parents of children with ODD are both the gatekeepers for treatment and the targets of parenting interventions. This study aimed to examine parent perceptions of the helpfulness of receiving a diagnosis of ODD for their child in families receiving an evidence-based parenting intervention, and to explore the reasons why it was considered helpful or unhelpful. Parents participating in parenting intervention for child ODD retrospectively completed questionnaires about receiving a diagnosis of ODD for their child on commencement of treatment. Of 244 parents completing questions at post-treatment, 134 parents (54.9%) reported that their psychologist diagnosed ODD for their child. Of those who reported receiving a diagnosis, 75.4% rated it extremely or somewhat helpful, 23.9% reported that it was neither helpful nor unhelpful, and just one parent (0.7%) rated it as somewhat unhelpful. The reasons for helpfulness were endorsed at high rates, with more than 90% reporting increased understanding of child behavior, understanding effective programs or strategies, and increased motivation to implement intervention strategies. No significant differences in perceptions of helpfulness emerged for parent gender, child exposure to adverse experiences, and previous ODD diagnosis. The findings appear to challenge concerns about the harmful effects of diagnostic labelling for children and point to a need for further research.

Racial/ethnic discrimination is associated with elevated internalizing symptoms. However, the psychological processes through which discrimination affects internalizing symptoms in ethno-racially minoritized youth are less understood. The current study examined the role of emotion dysregulation in the association between racial/ethnic discrimination and internalizing symptoms. Participants were 5,693 ethno-racially minoritized youth (M_{age at baseline} = 9.89; 48% female; 42.3% Hispanic) enrolled in the Adolescent Brain Cognitive Development^SM Study. Path analysis revealed that experiences of racial/ethnic discrimination were associated with greater emotion dysregulation in the following year, which was, in turn, associated with greater internalizing symptoms concurrently, covarying for sex assigned at birth and caregiver education level. Findings suggest emotion dysregulation may play a key role in the link between racial/ethnic discrimination and internalizing symptom development in minoritized youth. Targeting emotion dysregulation in clinical interventions to address internalizing symptoms related to racial/ethnic discrimination may improve well-being in this population.

This study investigated the inter-rater agreement, test-retest reliability, and convergence validity of the Japanese-translated Anxiety Disorders Interview Schedule (ADIS) for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The ADIS was administered to 71 children and adolescents (53.52% females, M_age = 10.70 years, SD = 2.05) and their parents, with a two-month test-retest interval. Participants also completed questionnaires on anxiety and depression. Test-retest reliability was good for the presence or absence of a diagnosis and clinical significance ratings for all diagnoses. Inter-rater reliability was good to excellent. Strong convergent validity was observed for the separation anxiety disorder, generalized anxiety disorder, dysthymia, and depression domains in both the child- and parent-reported measures. However, correlations with parent-reported social phobia and specific phobia were not statistically significant. These results support moderate stability across time, consistent diagnostic results among independent diagnosticians, and convergent validity of the Japanese version of the ADIS for the DSM-IV.

Given the ongoing youth mental health crisis amid limited resources, young people and their families need sustainable, low-cost school-based interventions to support their wellbeing and connect them to vital services. As a first developmental phase of a clinical trial to integrate innovative digital mental health intervention into high schools, we first sought to understand the lived experience of students and parents. This study used qualitative methods to analyze diverse high school student, young adult, and parent reports of accessing in-person school-based mental health supports and use of health-related apps. Two-thirds of young people reported using health-related apps with common use related to entertainment, fitness, and mental health. Further qualitative analysis regarding access identified themes around availability, experience with services, and normalizing mental health vs. stigma in schools. Findings suggest opportunities for digital interventions to increase mental health literacy and address stigma through psychoeducation. Digital health tools may support schools as an adjunct to in-person services in reaching under-resourced students in need.

This study investigates the association between maternal trauma history (lifetime exposure to physical and sexual violence), maternal mental health and child behavior. Pregnant women attending the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru, were recruited to join the study beginning in February 2012. Maternal trauma history and prenatal mental health were assessed at 16-weeks gestation and mothers completed the Child Behavior Checklist when children were four years old. We used causal mediation analysis to examine the association between maternal trauma history and child behavior. This study population included 631 mother-child dyads; 74% of mothers reported one or more lifetime episodes of intimate partner violence (IPV). We found that 32% of the association between maternal lifetime exposure to IPV and child internalizing behavior was mediated by prenatal anxiety. Our findings suggest that prevention and treatment of perinatal IPV and mental health disorders should be prioritized.

Trichotillomania (TTM), skin-picking disorder (SPD), and nail-biting (NB) are classified as Body-Focused Repetitive Disorders (BFRBDs), which share characteristics with both obsessive-compulsive and impulse control disorders. This study aimed to compare impulsivity, metacognitions, and clinical characteristics across BFRBDs. Ninety adolescents (aged 10-18 years) with BFRBDs and 40 healthy controls (HC) completed the Revised Children's Anxiety and Depression Scale-Child Version (RCADS-CV), the Metacognitions Questionnaire for Children and Adolescents (MCQ-CA), the Barratt Impulsiveness Scale-Brief (BIS-Brief), and the Pediatric Quality of Life Inventory (PedsQL). Symptom severity was assessed using disorder-specific measures. There were no significant age differences between the BFRBDs and HC groups. However, within the BFRBDs subgroups, adolescents with TTM and SPD were significantly older than those with NB (p = .028). Notably, despite being younger, the NB group exhibited the longest duration of BFRBDs symptoms (p < .001). The TTM group showed higher MCQ-CA total, positive beliefs about worry, and cognitive monitoring. In contrast, the SPD group had higher poor self-regulation scores (all p < .05). Symptom severity across BFRBDs was negatively associated with PedsQL total scores and positively associated with MCQ-CA total and RCADS-CV total scores (all p < .05). These findings suggest that while metacognitions are more prominent in TTM, impulsivity plays a greater role in SPD. Understanding the distinct contributions of impulsivity and metacognitions in BFRBDs may facilitate the development of targeted treatment approaches tailored to each behavior.