European Child & Adolescent Psychiatry最新文献

Although recent studies have examined the impacts of maternal work-family conflict (WFC) on child development, the cognitive domain remains underexplored. This study investigates the longitudinal relationship between maternal WFC and children's executive function (EF) difficulties in South Korea, with an emphasis on the asymmetric effects and potential heterogeneity by the child's sex. Utilizing four waves from the Panel Study on Korean Children, this study focused on employed mothers and their school-age children (N = 1,054). Asymmetric fixed effects (FE) models were used to estimate the differential impacts of increasing versus decreasing maternal WFC while controlling for unobserved individual-level confounders. Moreover, sex-stratified analyses were performed to examine the differential patterns based on the child's sex. Asymmetric FE models revealed that the estimated effects of increasing maternal WFC on EF difficulties (β = 0.050, p < 0.001) are statistically significant and larger in magnitude than those of decreasing WFC. These differential impacts were more pronounced among boys than girls. Stratified by child's sex, the effects of increasing maternal WFC on EF difficulties were statistically significant in boys (β = 0.090, p < 0.001) but not in girls. The findings of this study suggest that the detrimental influences of increasing WFC on children's EF difficulties may not be counterbalanced by the benefits of decreasing WFC. These insights should guide policymakers to consider strategies aimed at reducing work demands and providing targeted support to families, thereby alleviating the negative consequences of maternal WFC on children's cognitive development.

This study aimed to develop consensus-based recommendations for improving the transition of care for young adults with Attention-deficit/hyperactivity disorder (ADHD) from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in Italy. A modified Delphi consensus method was employed, involving 27 stakeholders, including child psychiatrists, psychiatrists, psychologists, primary care physicians, young adults with ADHD, and parents. Recommendations were drafted by combining data from prior phases of the Transition in young adults with Diabetes, Epilepsy, and ADHD (TransiDEA) project and international guidelines (e.g., NICE, Ready Steady Go). Stakeholders evaluated 33 proposed recommendations across two rounds, rating their relevance and feasibility. Consensus was defined as ≥ 75% agreement per item. Consensus was achieved on 22 recommendations organized into four categories: planning (14 items), passage (4 items), monitoring (1 item), and services (3 items). Key recommendations included starting transition planning at age 16, involving families and interdepartmental teams, implementing practical tools for information exchange, and monitoring young adults outcomes post-transition. Training for clinicians and service self-assessment were emphasized to address systemic barriers. The final shared recommendations integrate multiple perspectives and international best practices and provide a structured, adaptable framework for improving ADHD care transitions in Italy. Future efforts should evaluate their implementation and expand the methodology to other neurodevelopmental conditions.

Psychotic-like experiences (PLEs) have been identified as risk factors for mental health issues and behavioral problems including violence. While cross-sectional studies suggest an association between PLEs and violent behavior in adolescents, their longitudinal relationship remains unexamined. This study aims to examine the temporal association between PLEs and violent behavior in adolescents. PLEs and violent behavior were assessed using data from self-report surveys conducted from 2011 to 2019 in a Tokyo junior and senior high school (grades 7-12). The study included 1685 participants aged 12-18 surveyed annually for up to 6 years. Random intercept cross-lagged panel models (RI-CLPMs) were used to examine between-person and within-person associations among study variables, with analyses stratified by gender. Results showed a bidirectional relationship between PLEs and violent behavior on both the between-person (β = 0.23, p < 0.001) and within-person levels (β = 0.07-0.25, p < 0.05). This relationship was significant for PLEs and violence towards objects (between-person: β = 0.22, p < 0.001; within-person: β = 0.07-0.32, p < 0.05), but not for PLEs and interpersonal violence. When analyzed by gender, these associations were significant in girls but not in boys. The findings suggested that PLEs may have a bidirectional relationship with violent behavior (especially violence towards objects), particularly in girls, indicating potential gender-specific pathways in this association. Further research should explore the underlying mechanisms of this bidirectional relationship, with a focus on gender-specific factors.

Background: Gestational diabetes mellitus (GDM) is associated with an increased risk of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in offspring. Our aim was to investigate whether GDM exposure is linked to wider spectrum of mental and behavioural disorders in offspring during the first 10 years of life.

Methods: This study included a population-based cohort of all women who delivered a singleton child in Finland in 2009, including 6,560 children exposed to maternal GDM and 51,770 control children. The main outcomes were the prevalence of mental and behavioural (including neurodevelopmental) disorders, and their subcategories, in study groups. Mother- and child-related covariates were adjusted for in the analyses.

Results: Children exposed to GDM had a higher prevalence of mental and behavioural disorders (n = 1,010, 15.4%) compared with controls (n = 6,066, 11.7%; adjusted odds ratio (aOR): 1.18, 95% confidence interval [CI]: 1.09-1.28). In adjusted analyses, higher odds were observed only in boys (aOR: 1.25, 95% CI: 1.13-1.38). Specifically, GDM-exposed children had higher odds of behavioural disorders (aOR: 1.13, 95% CI: 1.02-1.25), developmental disorders (aOR: 1.14, 95% CI: 1.03-1.27) and behavioural disorders with physiological disturbances (aOR: 1.59, 95% CI: 1.16-2.18).

Conclusions: Children exposed to maternal GDM have a higher prevalence of mental and behavioural disorders compared with non-exposed children. Notably, GDM exposure was shown to be an independent risk factor for these disorders in boys only.

Attention-deficit hyperactivity disorder (ADHD) affects 8% of children worldwide, making it one of the most prevalent neurodevelopmental disorders. Traditional treatments, such as pharmacological and behavioral therapies, often have limitations. This study examined the effects of game-based digital interventions on specific cognitive and behavioral functions in children with ADHD, guided by experiential learning theory (ELT). We utilized ELT to synthesize results from various studies on game-based digital interventions across three dimensions: behavioral, cognitive, and affective responses. ELT also provided a framework for categorizing the gaming elements and strategies embedded in each intervention, facilitating the transformation of experience into learning. The systematic review included randomized controlled trials (RCTs) that assessed game-based digital health interventions targeting ADHD symptoms in children and adolescents. Studies focusing on non-digital or non-game-based interventions were excluded. A search was conducted across Embase, CINAHL, Cochrane Library, ProQuest, PsycINFO, and PubMed, with the final search date of October 20, 2024. The risk of bias in the included studies was assessed following PRISMA guidelines using the RoB 2 tool. Studies were analyzed using fixed-effects or random-effects models based on heterogeneity. The final analysis included eight RCTs, most of which focused on the cognitive effects of game-based interventions for ADHD. The meta-analysis revealed that game-based interventions significantly improved cognitive functions: (a) visuospatial short-term memory, as measured using the Corsi Block Tapping Task Forward (mean difference = 0.67; 95% confidence interval = [0.25, 1.10]), and (b) visuospatial working memory, as measured using the Corsi Block Tapping Task Backward (mean difference = 0.47; 95% confidence interval = [0.05, 0.89]). However, effects on behavioral aspects such as inhibition and monitoring, assessed using the BRIEF, were not statistically significant, suggesting limited behavioral improvement following the interventions. This study integrates the strategies and effects of game-based digital interventions for children and adolescents with ADHD within the ELT framework, highlighting the need to develop interventions that address not only cognitive deficits but also emotional and social challenges.

Recent societal crises have negatively impacted the mental health of adolescents, emphasizing the need for effective preventative mental health interventions. Schools as key environments for young people offer opportunities to deliver those interventions at low threshold. However, many interventions are not sustained beyond initial funding periods due to persistent implementation barriers, contributing to a significant gap between intervention development and long-term practice. This systematic review synthesizes qualitative research on barriers and facilitators affecting the implementation of school-based interventions in secondary schools in high-income countries. Seven databases were searched for qualitative and mixed-methods studies on the implementation of preventative school-based mental health interventions in regular secondary schools. Implementation determinants were synthesized using the updated version of the Consolidated Framework for Implementation Research. Study quality was assessed using modified checklists of the Critical Appraisal Skills Programme. Twenty-six studies, involving 5 to 8,630 pupils, met the inclusion criteria. A total of 336 implementation factors were identified, with barriers (N = 207; 61.6%) outweighing facilitators (N = 129; 38.4%). Barriers included scheduling conflicts, low prioritization of mental health, and logistical challenges. Key facilitators were leadership support, age-appropriate intervention design, and staff engagement. Sustained success of preventative mental health interventions requires integrating programs into school structures, aligning with academic priorities, and addressing resource limitations. Future research should focus on adapting interventions to fit school contexts and strengthening leadership and community support. Understanding multidimensional, interacting implementation factors is essential for creating sustainable interventions that positively impact adolescent mental health.

This study examined associations between adolescent non-suicidal self-injury (NSSI) and adult mental health within a cohort of school students who answered questionnaires in 2007 (T1: N = 992, M_age = 13.7, 50.1% girls) and 2008 (T2: N = 987, M_age = 14.9, 50.9% girls), with follow-ups in 2017 (T3: N = 557, M_age = 25.3, 58.7% women) and 2023 (T4: N = 386, M_age = 29.9, 63.0% women). Attrition was accounted for with sample weighting and mixed modelling, and robust estimates balance for residual non-normality. Significant declines in any NSSI (≥ 1 instance) and repetitive NSSI (≥ 5 instances) were observed between T2-T3 (any NSSI: 43-19%; repetitive NSSI: 21-10%; p <.001), but not T3-T4 (any NSSI: 19% to around 14%; repetitive NSSI: 10-5%; p ≥.078). Compared to reporting no NSSI in adolescence, stable repetitive NSSI (≥ 5 instances at T1 and T2), unstable repetitive NSSI (≥ 5 instances at T1 or T2), and infrequent NSSI (1-4 instances at T1 and/or T2) were significantly associated with any NSSI engagement (OR = 2.63-6.67) and elevated depression, anxiety, and stress levels at T3/T4 (β_robust = 0.14-0.39), while controlling for gender and adolescent psychological difficulties. For stable repetitive NSSI, this applied to emotion dysregulation as well (β_robust = 0.44). Additionally, stable/unstable repetitive NSSI was significantly associated with lower well-being when not controlling for gender and psychological difficulties (β_robust =-0.32--0.41). The findings indicate that adolescent NSSI, especially when repetitive and stable, predicts poorer health across the first decade of adulthood.

Early adversity is associated with an increased risk for psychopathology and behavioral difficulties among transnational adoptees. Pre-adoptive reflective functioning may be an important buffer in this relationship. However, no studies have investigated this in adoptive families. Using longitudinal data from the Leuven Adoption Study (N = 48 participating families), this study investigated whether anthropometric proxies of early adversity (assessed in terms of child age, body mass index (BMI), weight for age, and length for age, based on parental reports of child weight and height at placement) predicted child difficulties assessed with the Child Behavior Checklist 4 years after child placement. The study also investigated the potential moderating role of adoptive parents' pre-adoptive reflective functioning, as assessed by the Reflective Functioning Scale scored on the Adoption Expectations Interview. All associations were investigated controlling for the effects of child temperament, as measured by the short versions of the Infant Behavior Questionnaire or the Early Childhood Behavior Questionnaire. Results indicated that child age at placement and low BMI predicted socioemotional difficulties. Pre-adoptive reflective functioning among fathers, but not among mothers, buffered against the effect of early adversity on child socioemotional difficulties. Conversely, low paternal levels of reflective functioning were associated with greater effects of early adversity on socioemotional difficulties. This study identified fathers' capacity for reflective functioning as a buffer against socioemotional difficulties. Implications for future research and practice, in terms of effective early interventions, are discussed.