Child Psychiatry & Human Development最新文献

This study aimed to examine the independent influences of academic stress, insecure attachment, and sense of community on suicidal ideation among adolescents. In particular, the independent influence of the sense of community on adolescent suicide was verified by controlling for other variables. For this purpose, youth data (7324 persons) from the panel data of the 4th to 6th Korean Education Longitudinal Studies of the Korea Educational Development Institute were used. Statistical analyses were performed using a generalized estimation equation (GEE). The analysis revealed that gender, academic stress, insecure attachment, and sense of community significantly influenced suicidal ideation. Female students had higher suicidal ideation than male students, and the higher the academic stress and degree of insecure attachment, the higher the suicidal ideation. In particular, the independent influence of a sense of community on suicidal ideation was significant; the higher the sense of community, the lower the suicide ideation score. The implication of this study is to comprehensively consider the factors related to adolescent suicidal ideation in various systems based on Bronfenbrenner's ecological theory. This research suggests that helping schools and communities to increase their sense of community, which is a macrosystem factor, is important in preventing adolescent suicide.

Herein we introduce the Collection "Measurement Based Care in Youth Depression and Suicidality." Measurement-based care (MBC), or the systematic use of measurement tools to inform treatment decisions, has been identified as a key component of providing evidence-based psychiatric care. However, the implementation of MBC at the clinic or health system level is not trivial; barriers to successful implementation are widespread but can be overcome. This Collection presents five manuscripts that cover a range of topics related to the implementation of MBC. The first two articles provide guidance to clinicians and researchers in careful selection of validated measurement tools for depression and suicidality. Next, our authors describe an effort to assess the fidelity of MBC use across the Texas Youth Depression and Suicide Research Network registry study, a statewide longitudinal cohort of depressed and suicidal youth. The following article outlines the benefits, barriers, and implementations strategies to implementing MBC at the health system level. Our final article details the implementation of MBC into a health system and provides data on screening outcomes and related clinical associations.

Children living in poverty and facing related forms of adversity are at higher risk for experiencing concurrent and later psychopathology. Although negative psychological outcomes can be improved by enhancing sensitive and responsive caregiving early in development, interventions targeting the caregiver-child dyad are not readily accessible. The present study investigated the feasibility and effectiveness of delivering a shortened eight-session form of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) in-person or remotely as an early intervention for 3-6-year-old children (N = 62) at elevated risk for psychopathology who were growing up in low-income communities. Caregiver-child dyads were randomized to eight-sessions of PCIT-ED or online parenting education. Relative to parenting education, children receiving PCIT-ED exhibited lower externalizing symptoms and functional impairment and more positive peer relationships following the intervention. Findings support the effectiveness of this shortened form of PCIT-ED, delivered in-person or remotely, as an early intervention to improve symptoms of psychopathology and functioning in high-risk children living in poverty.Trial registration Clinicaltrials.gov; NCT04399629.

There has been a growing interest in research examining the relationship between parenting and child callous-unemotional (CU) traits, particularly in early childhood. This study reviewed evidence from studies that investigated the relationship between parenting characteristics (e.g., caregiving beliefs, attitudes, behaviour or quality, or parental mental health) and callous-unemotional traits in children aged 0 to 6 years. A systematic search conducted according to PRISMA guidelines yielded 27 peer-reviewed articles. Analysis of the included articles suggested that there was strong evidence to support links between child CU traits and parenting characteristics (particularly, parental feelings about their child, warm parenting, and harsh/ inconsistent parenting). Taken together, the results of this review demonstrate the links between both positive and negative dimensions of parenting and CU traits in early childhood; however, mixed findings highlight the need for further research.

There is a high prevalence of untreated depression in adults and youth observed at the population level in the United States, and many who would benefit from treatment do not receive it. One proposed effort to increase access to care is the use of measurement-based care (MBC; repeated use of symptom measures for screening and treatment guidance) by primary care physicians to treat non-complex cases of depression. MBC has been shown to improve patient outcomes compared to care as usual, but there are barriers that need to be addressed at the health system level for effective implementation to occur. Herein we provide an overview of MBC and detail benefits and barriers of MBC implementation. Relevant considerations and guidance for implementing MBC are presented, and a case example of a health system implementing MBC is included. Though issues of reimbursement, limited human and technological resources, and resistance to systemic change are barriers to implementing MBC, effective strategies exist to overcome these barriers. In addition to helping health systems align with changes to value-based care models, effective implementation of MBC can likely improve patient outcomes and result in net financial benefits.

Despite the significant increase in adolescent mental health challenges in recent years, structural barriers continue to limit access to and engagement in mental health services. As such, opportunities to learn directly from adolescents and their families on how to best structure and deliver services are paramount. The current study assumes a multi-informant approach and reports on adolescents' and caregivers' (N = 33) experiences in an adapted telehealth/hybrid Dialectical Behavior Therapy for Adolescents (DBT-A) program. Focus groups were conducted across two cohorts of families who participated in DBT-A skills groups, to collect family-centered data on the acceptability of program modifications, engagement in the adapted telehealth/hybrid DBT-A, and recommendations for improvement. Participants were predominately Latine White and were from a broad range of socioeconomic backgrounds. Additionally, 45.5% of the adolescents identified as LGBTQ + . Focus group findings emphasized how the telehealth platform was both convenient and disengaging, and how in-person sessions offered improved group connection and content engagement. Participants underscored the importance of balancing multi-family group sessions with adolescent- and caregiver-only group sessions in the program, and adolescents emphasized a need for the DBT-A program to better center adolescents' unique experiences and voices throughout sessions. Both adolescents and caregivers suggested modifications to synthesize the content and improve generalizability of the DBT-A skills to their real lives. Overall, these findings add to a new and evolving branch of DBT-A qualitative inquiry, as well as the growing body of work that recommends incorporating the voices of people with lived experiences into the development and modification of psychological services.

Correctly assessing children's theory of mind (TOM) is essential to clinical practice. Yet, most tasks heavily rely on language, which is an obstacle for several populations. Langdon and Coltheart's (Cognition 71(1):43-71, 1999) Picture Sequencing Task (PST), developed for research purposes, avoids this limitation through a minimally-verbal procedure. We thus developed a tablet adaptation of this task for individual application, engaging children's motivation and allowing response times collection. To assess this tablet-PST, we first tested a large sample of neurotypical children (6-11 years-old, N = 248), whose results confirmed the task's structural and content validity, and permitted the construction of three standardized clinical indices. In a second experiment, we applied those to previously diagnosed autistic children (N = 23), who were expected to show atypical TOM performance. Children's outcomes were consistent with what was hypothesized and confirmed the task's external validity and moderate clinical sensitivity. The tablet-PST thus appears as a suitable tool, providing detailed profiles to inform clinical decisions.

Despite the growing support for the multiple developmental pathways to phenotypic callous-unemotional (CU) traits (i.e., primary, and secondary CU variants), there remains limited research on childhood manifestations of CU variants in non-Western, community samples. Using a latent profile analysis with data sourced from the longitudinal, nationwide Korean sample (N = 1597, 48.7% girls), we discerned heterogeneous groups of children, based on externalizing problems, CU traits, and emotional reactivity level. The optimal five-profile solution identified distinct subgroups: low-risk, primary CU (characterized by low emotional reactivity and externalizing problem), reactive (low CU/moderate emotion reactivity and externalizing problem), and two secondary CU groups (i.e., secondary-high CU and secondary-moderate CU; both high in emotional reactivity and externalizing problems). The two secondary CU variants demonstrated differences from the primary CU variants, in that both are high in preschool externalizing problems (age 6) and school-age conduct problems (age 11). However, the secondary-moderate CU group displayed greater levels of anxiety at age 11 compared to secondary-high CU, indicating divergent developmental trajectories of secondary CU variants. These findings expand our understanding of CU variants among Korean preschoolers and highlight the role of emotional reactivity in distinguishing such subtypes and identifying their developmental outcomes across time.

Few studies have reported long-term follow-up data on selective preventive interventions for adolescents. No follow-up selective preventive transdiagnostic studies for adolescents at-risk for emotional disorders, such as anxiety and depression, have been reported. To fill this gap, this study aims to provide the first follow-up assessment of a randomized controlled trial (RCT) studying selective transdiagnostic prevention in at-risk adolescents. A 12-month follow-up assessment was conducted with subjects who originally received either PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), PROCARE+, which includes the PROCARE protocol along with personalized add-on modules or an active control condition (ACC) based on emotional psychoeducation, and their respective booster session for each experimental condition. 80 subjects (47.5% girls) aged between 12 and 18 years (M = 14.62; SD 1.43) who completed these treatment conditions were available for the 12-month follow-up. The results demonstrate the superior long-term efficacy of the PROCARE+ intervention in mitigating emotional symptoms and obsessive-compulsive symptomatology compared to the PROCARE and ACC conditions, with effect sizes notably exceeding those commonly observed in preventive programs. While the three treatments demonstrated beneficial impacts, the pronounced results associated with PROCARE+ at the 12-month follow-up emphasized the importance of personalized treatment modules and the sustained benefits of booster sessions in the realm of preventive psychological interventions. The findings also highlight the potential role of add-on modules in enhancing the effects of the PROCARE+ condition.

This study analyzes suicide rates, causes, methods, and age- and gender-specific trends among children and adolescents in Turkey (2004-2023) using Turkish Statistical Institute data. Utilizing data from the Turkish Statistical Institute, suicide deaths across two age groups (< 15 years and 15-19 years) were examined. During this period, 8,954 suicides were recorded, with 52.6% involving males. Hanging (41.3%) and firearms (30.2%) were the most frequently used methods, showing significant gender differences (p < 0.01). Family discord emerged as the leading cause of suicide among females, while illness was predominant among males. The findings underscore the urgent need for culturally tailored, evidence-based suicide prevention strategies. Key measures include restricting access to means of suicide, enhancing family-based interventions, and improving mental health services with a focus on early detection. Adoption of the WHO's "LIVE LIFE Initiative for Suicide Prevention" could provide a robust framework to reduce youth suicide rates in Turkey.