European Child & Adolescent Psychiatry最新文献

Alterations in brain structure following adversity show inconsistencies. Jointly considering maltreatment exposure alongside externalizing psychopathology may therefore prove helpful. However, few prospective studies currently follow up maltreated youth with high or low externalizing problems using neuroimaging assessments. A structural magnetic resonance imaging study was conducted using T1-weighted scans from 98 youth (M_Age = 14.76, SD_Age = 1.96; 51% girls) comparing participants with low (n = 29) and high (n = 29) maltreatment exposure to carefully matched non-maltreated controls (n = 40). Comprehensive assessments of maltreatment history and psychopathology were ascertained across two waves, applying the Maltreatment Classification System alongside caregiver- and teacher-reported externalizing problems. Neuroimaging was conducted at the second wave. We found dose-dependent amygdala volume reductions following maltreatment and particularly abuse exposure, primarily driven by the basolateral subregion. Interaction analyses revealed lower amygdalar and hippocampal volumes in youth exposed to more vs. less extensive maltreatment, but merely among those with elevated externalizing problems. These findings highlight the value of the ecophenotype model for elucidating neural correlates of maltreatment and its sequelae.

Children with attention-deficit/hyperactivity disorder (ADHD) typically experience social interaction problems. Neurocognitive functions, such as working memory and inhibitory control have been included in several studies of social problems in ADHD, with inconsistent findings emerging. Intraindividual reaction time variability (RTV) has been understudied as a factor explaining social problems in children with ADHD, despite being one of the most consistent cognitive impairments in the disorder. In the current study, we hypothesized that greater RTV would relate to greater parent-reported social problems and may reflect the negative impact of attentional fluctuations on social interactions in ADHD. We tested the association between RTV and social problems while accounting for the effects of working memory and inhibitory control in two independent samples of children with ADHD and typically developing (TD) peers. The neurocognitive functions were assessed through performance-based laboratory measures. Sample one, derived in Norway, included 41 children with ADHD and 35 TD children. Sample two, derived in the United States, included 73 children with ADHD and 26 TD children. Linear regression analyses, controlling for other relevant variables, indicated that greater RTV was associated with greater social problems across both samples. Our results support the view that attentional variability is linked to social problems in children with ADHD.

External trigeminal nerve stimulation (eTNS) is a non-invasive technique involving external cutaneous stimulation of the trigeminal nerve. In 2019, the Monarch eTNS device was approved as a treatment for children with attention-deficit/hyperactivity disorder (ADHD). The Monarch eTNS device is designed to be applied at home, which offers a certain level of convenience but also necessitates a high degree of compliance and acceptability from the families. To assess the feasibility of - and pilot a larger randomized clinical trial investigating the Monarch eTNS device versus sham for patients aged 7 to 17 years with ADHD. We will conduct a parallel-group, sham-controlled, feasibility randomised clinical trial. We will include 60 children and adolescents (aged 7 to 17 years) diagnosed with ADHD from three clinical sites in Denmark. Patients will be randomised to 4 weeks of active versus sham eTNS. Feasibility outcomes include completion of the trial; the number of eligible participants who consent to inclusion; treatment compliance; acceptability of the intervention and completion. Adverse events will be monitored throughout the trial. Exploratory clinical outcomes include ADHD core symptoms (primary) and several secondary outcomes. Autonomic functions will be evaluated by means of heart rate variability, using a heart rate sensor. This trial will allow us to evaluate the feasibility of conducting a larger randomised clinical trial investigating the use of eTNS as a home-based, non-pharmacological intervention for children and adolescents diagnosed with ADHD.Trial registration: ClinicalTrials.gov ID: NCT06655610. Registered 23.10.2024.

Individuals with intellectual disability (ID) face a higher risk for developing mental health problems. Recent research emphasizes the relevance of social determinants of mental health (SDOMH) in relation to this risk. This review aims to synthesize evidence on the associations between SDOMH and mental health in youth with ID, focusing on risk and protective factors across demographic, economic, social, and neighborhood domains. A systematic search of multiple databases identified 51 relevant studies, including 36 cross-sectional and 15 longitudinal studies. Using a framework-led approach, the strongest evidence emerged from the social/cultural domain (n = 46), followed by economic (n = 17), demographic (n = 8), and neighborhood (n = 1). A key finding is the substantial variability and mixed results across studies, highlighting complex, context-dependent associations. Nonetheless, some patterns emerged within the social/cultural domain. Based on both cross-sectional and longitudinal evidence, the most consistent links were found between social and cultural stressors and mental health vulnerabilities. Specifically, in families where children with ID displayed more behavioral problems, 1) parents experienced high distress or internalizing problems; 2) parenting behaviors were more negative; and 3) children faced stressful life events. The review also reveals notable research gaps, including limited attention to broader environmental and neighborhood factors, few longitudinal and multivariate studies, and minimal focus on protective factors. Future research should adopt a systematic approach, prioritize underexplored environmental and protective factors, apply longitudinal and multivariate designs to examine causal pathways, incorporate qualitative methods, and standardize measures to enable consistent analysis across studies.