The Brown University Child and Adolescent Behavior Letter最新文献

When the term “adversity” is used in a clinical context, it refers to a range of negative experiences such as abuse, neglect, poverty, bullying, or parental psychopathology. It is well-studied how adversity experienced early in childhood is associated with negative outcomes in adulthood; researchers have demonstrated connections between childhood adversity and poorer immune health, dysfunction in neural systems, worsened global physical health, and even accelerated aging (e.g., Baumeister et al., 2016; Dahmen et al., 2017). However, when researchers examine adversity, they often combine this broad range of experiences into a single construct and assess if the child has experienced adversity or not. This approach of measuring abuse with neglect, for example, fails to capture the unique differences in risk that are associated with each of those experiences. In fact, this approach has been criticized by adversity researchers due to the lack of specificity those studies can provide. Therefore, this problem is also directly applicable to clinicians; a child who experienced early life abuse and a child who experienced early life neglect could be at risk for entirely different sets of symptoms and may need different approaches to assessment and intervention accordingly.

Obsessive compulsive disorder (OCD) affects up to 4% of children and adolescents (Nazeer et al., 2020). Childhood OCD impairs overall quality of life, particularly in familial, social and academic settings. For individuals with OCD, obsessions — unwanted, intrusive thoughts, images, or impulses that cause distress are subsequently reduced by compulsions — behaviors that are designed to assuage the distress of the obsessions, according to set rules or senses of completion (American Psychiatric Association, 2013). Common obsessions surround core fears of harm avoidance, disgust and/or a sense of incompleteness, leading to common compulsions of repeating, checking, avoidance, and/or other rituals.

Many providers — and parents — are relieved when their patients and children who have drug or alcohol problems have “recovery housing.” This kind of residence is alcohol- and drug-free and can help young people stay sober. However, scams are out there. So regulators try to step in and make sure that recovery housing operators are bona fide.

In a weekly staff meeting, we recently discussed the concept of attention-seeking in children. Our child psychiatrist had noted that this term was coming up a lot in staff descriptions of behavior in the therapeutic milieu.

In a recent JAMA Health Forum article, nurses wrote about the stress facing teens due to climate change. “Growing up in an era of storms and stress — promoting hope among adolescents in the face of climate change” by Allison McCord Stafford, Ph.D., RN and colleagues from Duke University noted that the landmark court case, Held v. Montana, showed the impact of extreme weather on the livelihoods and health of young people. Young people brought the lawsuit. And their testimony — about the damages to the land, farm animals, health, finances, and their worries about their future — was eloquent. It is the older generation that has brought this stress upon them.

Youth say parents don't talk about the dangers of misusing prescription drugs, parents say they do. Clearly, families need help, because young people are buying illicit and fake pills even over the internet — and overdosing and dying.

Minority students and their families have viewed attending private schools as a way to increase their social and financial mobility. The Supreme Court case of Runyon vs McCrary (1976) prohibited private schools from excluding students based on race or ethnicity which led to increased access to quality education for racial and ethnic minorities. Private schools generally have more funding, resources, and due to smaller class sizes, students typically have more access to their teachers than students who attend public schools. Longstanding neglect of many racial and ethnic minority communities has resulted in their public schools being understaffed and overpopulated amongst other systemic issues. To break the generational cycle of unequal access to education that many minorities experience in America, families send their children to private schools and in some cases, students choose this themselves. While the increase in access to resources and quality of education is often indisputable, it is crucial to carefully consider the experience of being a racial and ethnic minority in these settings and if this experience is like that of their white peers.

Numerous health agencies, including the American Academy of Pediatrics, the U.S. Surgeon General, and the World Health Organization, have declared a state of emergency for child and adolescent mental health fueled by escalating prevalence rates and a troubling shortage of available mental health providers.

Bridging law enforcement and mental health care is tricky, and in the case of possible violence in a student, this relationship can be especially strained. The chilling phrase “anyone could have stopped me” was the title of a session on this topic at the American Psychiatric Association meeting last spring.