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Risk factors of post-traumatic stress disorder after hospitalization in a pediatric intensive care unit: a systematic literature review. 儿科重症监护室住院后出现创伤后应激障碍的风险因素:系统性文献综述。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2023-02-05 DOI: 10.1007/s00787-023-02141-8
Alice de Pellegars, Cindy Cariou, Marine Le Floch, Philippe Duverger, Gérald Boussicault, Elise Riquin

The number of studies on post-traumatic stress disorder after hospitalization in a pediatric intensive care unit raised since 2004. The objective of this systematic review was to summarize and critically examine the literature about risk factors for these children to develop post-traumatic stress disorder following admission to an intensive care unit. The data sources were PubMed, Cochrane, Web of Science, PsycInfo, SUDOC, Scopus, and ScienceDirect. Studies were selected if they were in English or French and published between 01/01/2004 and 31/01/2022. Studies were excluded if patients were less than 1 month old and if no post-traumatic stress disorder was found. The internal validity and risk of bias were assessed using the National Institutes of Health Study Quality Assessment Tools for observational studies and the Ottawa Scale was used for the interventional study. The search yielded 523 results and 22 articles met inclusion criteria. Three common risk factors were identified from the data: parental post-traumatic stress disorder (especially in mothers), severity of illness and delusional memories. Internalizing behavior in children, acute parent and child stress, emergency admission and sepsis are also potential risk factors that require further investigation. The prevalence of this pathology is substantial (between 14 and 36%) and increasing awareness among pediatricians and psychologists seems necessary. Prevention programs are being studied to reduce the incidence of post-traumatic stress disorder in this population. Child and adolescent psychiatry liaison should collaborate with pediatric teams to support this objective.

自 2004 年以来,有关儿科重症监护病房住院后创伤后应激障碍的研究数量有所增加。本系统综述旨在总结和批判性地研究有关这些儿童在入住重症监护病房后出现创伤后应激障碍的风险因素的文献。数据来源包括 PubMed、Cochrane、Web of Science、PsycInfo、SUDOC、Scopus 和 ScienceDirect。入选研究的语言为英语或法语,发表时间为 2004 年 1 月 1 日至 2022 年 1 月 31 日。如果患者年龄不足 1 个月或未发现创伤后应激障碍,则排除这些研究。观察性研究采用美国国立卫生研究院研究质量评估工具评估内部有效性和偏倚风险,干预性研究采用渥太华量表。搜索结果有 523 项,22 篇文章符合纳入标准。从数据中发现了三个常见的风险因素:父母创伤后应激障碍(尤其是母亲)、病情严重程度和妄想性记忆。儿童的内化行为、父母和儿童的急性压力、紧急入院和败血症也是需要进一步调查的潜在风险因素。这种病症的发病率很高(在 14% 到 36% 之间),似乎有必要提高儿科医生和心理学家的认识。目前正在研究预防方案,以降低创伤后应激障碍在这一人群中的发病率。儿童和青少年精神病学联络员应与儿科团队合作,支持这一目标的实现。
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引用次数: 0
"You cannot just stop life for just that": a qualitative study on children's experiences on refugee journey to Sweden. "你不能因此而停止生活":关于儿童在前往瑞典的难民旅途中的经历的定性研究。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-15 DOI: 10.1007/s00787-024-02387-w
Erica Mattelin, Natalie Söderlind, Laura Korhonen

Children with refugee backgrounds are often exposed to violence and other adverse experiences with well-known detrimental consequences on mental health. However, the current group of approximately 40 million child refugees is heterogeneous, stressing the importance of first-person perspectives in understanding children's unique experiences and needs related to the migration process. Identifying contextual factors promoting health and resilience is also essential. For instance, the roles children play as active agents in constructing their own lives and adapting to different environments are poorly described in contemporary research on child refugees and their mental health. To address these knowledge gaps, we conducted qualitative interviews with a reflexive thematic analysis with eighteen children with refugee backgrounds in Sweden. This resulted in two main themes: Longing for a good life that cannot be taken for granted and Challenged agency and changing rights. The narratives indicate that children, although exposed to different challenges in different migration phases and based on gender and asylum status, have experiences of ordinary childhood with a desire for a good life with prospects. The results also show that children execute active and adaptable agency that is impacted by various factors. Reaching the full age appears to be a confusing and ambivalent transition due to changes in rights. The results pinpoint several possibilities to address factors that pose a risk to health and restrictions of rights among child refugees.

有难民背景的儿童往往会遭受暴力和其他不利经历,对心理健康造成众所周知的不利影响。然而,目前约有 4000 万儿童难民,他们的情况各不相同,这就强调了第一人称视角在了解儿童与移徙过程有关的独特经历和需求方面的重要性。确定促进健康和复原力的背景因素也至关重要。例如,在有关儿童难民及其心理健康的当代研究中,对儿童作为积极参与者在构建自己的生活和适应不同环境方面所发挥的作用描述甚少。为了填补这些知识空白,我们对 18 名有难民背景的瑞典儿童进行了定性访谈,并进行了反思性主题分析。结果得出两大主题:对美好生活的向往,不能认为这是理所当然的;受到挑战的机构和不断变化的权利。叙事表明,虽然儿童在不同的移民阶段面临不同的挑战,而且基于性别和庇护身份,但他们都有普通童年的经历,渴望有前景的美好生活。研究结果还表明,儿童具有受各种因素影响的积极和适应能力。由于权利的变化,达到法定年龄似乎是一个令人困惑和矛盾的过渡。研究结果指出了解决危及儿童难民健康和限制其权利的因素的几种可能性。
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引用次数: 0
Changes in health-related quality of life and sleep habits after a 6-month non-randomised cluster-controlled trial among children with overweight or obesity. 在对超重或肥胖儿童进行为期 6 个月的非随机分组对照试验后,与健康相关的生活质量和睡眠习惯发生了变化。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-23 DOI: 10.1007/s00787-024-02375-0
Annette Løvheim Kleppang, Eirik Abildsnes, Kristin Haraldstad, Tonje Holte Stea

Being overweight or obese can have severe negative psychological impacts and reduce health-related functioning. To improve health-related quality of life (HRQoL) and sleep habits for children with overweight or obesity, it is important to design and implement effective interventions. The aim of this study was to evaluate the effects of a 6-month family-based lifestyle intervention on HRQoL and sleep habits in Norwegian children with overweight or obesity in a primary-care setting. This 6-month, non-randomised, cluster-controlled trial included Norwegian children aged 5-13 years with overweight or obesity and their parents. A questionnaire was filled out by the parents. A total of 33 and 52 children in the control group and 41 and 78 children in the intervention group answered the HRQoL and sleep habits questions, respectively, and were included. The intervention group received individual family counselling and participated in physical activity groups and nutrition courses. The Children's Sleep Habits Questionnaire (CSHQ) and Kidscreen-10 index were used to assess sleep habits and HRQoL. At baseline, the mean average scores for HRQoL were 50.0 [standard deviation (SD) 8.1] for the intervention group and 49.0 (SD 10.1) for the control group. For sleep habits at baseline, the mean average scores were 45.2 (SD 11.8) for the intervention group and 46.0 (SD 11.9) for the control group. No significant changes in HRQoL and sleep habits after the intervention were revealed. Overall, the family-based lifestyle intervention targeting overweight and obese children in a primary-care setting showed no significant effect on HRQoL or sleep quality.

超重或肥胖会产生严重的负面心理影响,并降低与健康相关的功能。为了改善超重或肥胖儿童的健康相关生活质量(HRQoL)和睡眠习惯,设计和实施有效的干预措施非常重要。本研究旨在评估为期6个月的家庭生活方式干预对挪威超重或肥胖儿童的健康相关生活质量(HRQoL)和睡眠习惯的影响。这项为期6个月的非随机分组对照试验包括5至13岁的挪威超重或肥胖儿童及其父母。家长填写了一份调查问卷。分别有33名和52名对照组儿童以及41名和78名干预组儿童回答了心身健康状况和睡眠习惯问题,并被纳入其中。干预组接受了个别家庭辅导,并参加了体育活动小组和营养课程。儿童睡眠习惯问卷(CSHQ)和Kidscreen-10指数用于评估睡眠习惯和HRQoL。基线时,干预组的 HRQoL 平均值为 50.0 [标准差(SD)8.1],对照组为 49.0 (SD 10.1)。在基线睡眠习惯方面,干预组的平均得分为 45.2(标准差 11.8),对照组为 46.0(标准差 11.9)。干预后,患者的 HRQoL 和睡眠习惯均无明显变化。总体而言,在初级保健环境中针对超重和肥胖儿童开展的家庭生活方式干预对心身健康质量和睡眠质量没有明显影响。
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引用次数: 0
Parental mental health and reporting of their child's behaviour: measurement invariance of the French version of the parental strengths and difficulties questionnaire. 父母的心理健康及其对子女行为的报告:父母优势与困难问卷法文版的测量不变性。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-25 DOI: 10.1007/s00787-024-02392-z
Arnaud Sapin, Antoine Vanier, Arthur Descarpentry, Gustave Maffre Maviel, Cécile Vuillermoz, Bruno Falissard, Cédric Galera, Josiane Warszawski, Camille Davisse-Paturet, Jean-Baptiste Hazo, Alexandra Rouquette

Symptomatic effects of mental disorders in parents could bias their reporting on their child's mental health. This study aimed to investigate the measurement invariance of the French version of the parental Strengths and Difficulties Questionnaire (SDQ) across parental mental health in a sample (N = 20,765) of parents of children aged 3 to 17 years in France. Confirmatory factor analysis (CFA) and Exploratory Structural Equation Modelling (ESEM) were used to evaluate the fit of three known alternative SDQ factor structures (five, three, or second-order factor structures). Invariance was tested across parental mental health (present anxiety and depressive symptoms, psychiatric history) and across socio-demographic characteristics (child's age, child's gender, parent's gender, parent's educational level). CFA models showed a poor fit, while all ESEM models achieved acceptable or good fit, with the five-factor model presenting the best fit. Invariance was observed for all characteristics tested, indicating that the SDQ can be used to study the links between parental mental health and their child's mental health without bias. However, ESEM showed that the hyperactivity/inattention and conduct problems dimensions were not well differentiated in the French version of the SDQ.

父母的精神障碍症状可能会影响他们对子女心理健康的报告。本研究以法国 3 至 17 岁儿童的父母为样本(样本数 = 20,765 人),旨在调查法文版父母优势与困难问卷(SDQ)在不同父母心理健康情况下的测量不变性。我们采用了确证因子分析(CFA)和探索性结构方程模型(ESEM)来评估三种已知的 SDQ 备选因子结构(五阶、三阶或二阶因子结构)的拟合度。对不同父母的心理健康状况(目前的焦虑和抑郁症状、精神病史)和不同社会人口特征(儿童年龄、儿童性别、父母性别、父母教育程度)进行了不变量测试。CFA 模型的拟合度较低,而所有 ESEM 模型的拟合度均可接受或良好,其中五因素模型的拟合度最高。所测试的所有特征均呈不变量,这表明 SDQ 可用于研究父母心理健康与其子女心理健康之间的联系,而不会产生偏差。然而,ESEM 显示,在法文版的 SDQ 中,多动/注意力不集中和行为问题两个维度没有得到很好的区分。
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引用次数: 0
Mental health provision for children affected by war and armed conflicts. 为受战争和武装冲突影响的儿童提供心理健康服务。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-06-15 DOI: 10.1007/s00787-024-02492-w
Panos Vostanis
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引用次数: 0
Do maternal anxiety and depressive symptoms predict anxiety in children with and without ADHD at 8 years? 母亲的焦虑和抑郁症状能否预测患有和未患有多动症的 8 岁儿童的焦虑情况?
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-20 DOI: 10.1007/s00787-024-02374-1
Christine Baalsrud Ingeborgrud, Beate Oerbeck, Svein Friis, Are Hugo Pripp, Pål Zeiner, Heidi Aase, Guido Biele, Søren Dalsgaard, Kristin Romvig Overgaard

Maternal anxiety and depression during pregnancy and early childhood have been associated with child anxiety and attention-deficit/hyperactivity disorder (ADHD). However, previous studies are limited by their short follow-up, few assessments of maternal symptoms, and by not including maternal and child ADHD. The present study aimed to fill these gaps by investigating whether maternal anxiety and depressive symptoms from pregnancy to child age 5 years increase the risk of child anxiety disorders at age 8 years. This study is part of the population-based Norwegian Mother, Father, and Child Cohort Study. Maternal anxiety and depressive symptoms were assessed by the Hopkins Symptom Checklist (SCL) six times from pregnancy through early childhood, and ADHD symptoms by the Adult Self-Report Scale (ASRS). At age 8 years (n = 781), symptoms of anxiety disorders and ADHD were assessed, and disorders classified by the Child Symptom Inventory-4. Logistic regression models estimated the risk of child anxiety depending on maternal symptoms. The mothers of children classified with an anxiety disorder (n = 91) scored significantly higher on the SCL (at all time points) and ASRS compared with the other mothers. In univariable analyses, maternal anxiety and/or depression and ADHD were associated with increased risk of child anxiety (odds ratios = 2.99 and 3.64, respectively), remaining significant in the multivariable analysis adjusted for covariates. Our findings link maternal anxiety, depression, and ADHD during pregnancy and early childhood to child anxiety at age 8 years.

孕期和幼儿期的母亲焦虑和抑郁与儿童焦虑和注意力缺陷/多动症(ADHD)有关。然而,以往的研究由于随访时间短、对母亲症状的评估较少以及未将母亲和儿童多动症包括在内而受到限制。本研究旨在填补这些空白,调查母亲从怀孕到孩子 5 岁期间的焦虑和抑郁症状是否会增加孩子 8 岁时患焦虑症的风险。这项研究是以人口为基础的挪威母亲、父亲和儿童队列研究的一部分。母亲的焦虑和抑郁症状由霍普金斯症状检查表(SCL)进行评估,从怀孕到幼儿期共进行了六次,多动症状由成人自我报告量表(ASRS)进行评估。对 8 岁儿童(n = 781)的焦虑症和多动症症状进行评估,并通过儿童症状量表-4 对症状进行分类。逻辑回归模型根据母亲的症状估算出儿童患焦虑症的风险。与其他母亲相比,焦虑症患儿的母亲(n = 91)在 SCL(所有时间点)和 ASRS 中的得分明显较高。在单变量分析中,母亲焦虑和/或抑郁以及多动症与儿童焦虑风险的增加有关(几率比分别为 2.99 和 3.64),在调整协变量后的多变量分析中仍然显著。我们的研究结果将孕期和幼儿期的母亲焦虑、抑郁和多动症与儿童 8 岁时的焦虑联系起来。
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引用次数: 0
Is neighbourhood deprivation in primary school-aged children associated with their mental health and does this association change over 30 months? 小学学龄儿童的邻里贫困是否与他们的心理健康有关,这种关联在 30 个月内是否会发生变化?
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-14 DOI: 10.1007/s00787-024-02385-y
Katie Finning, Amy Haeffner, Sohum Patel, Bryony Longdon, Rachel Hayes, Obioha C Ukoumunne, Tamsin Ford

As both socioeconomic deprivation and the prevalence of childhood mental health difficulties continue to increase, exploring the relationship between them is important to guide policy. We aimed to replicate the finding of a mental health gap that widened with age between those living in the most and least deprived areas among primary school pupils. We used data from 2075 children aged 4-9 years in the South West of England recruited to the STARS (Supporting Teachers and childRen in Schools) trial, which collected teacher- and parent-reported Strength and Difficulties Questionnaire (SDQ) at baseline, 18-month and 30-month follow-up. We fitted multilevel regression models to explore the relationship between Index of Multiple Deprivation (IMD) quintile and SDQ total difficulties score and an algorithm-generated "probable disorder" variable that combined SDQ data from teachers and parents. Teacher- and parent-reported SDQ total difficulties scores indicated worse mental health in children living in more deprived neighbourhoods, which was attenuated by controlling for special educational needs and disabilities but remained significant by parent report, and there was no interaction year group status (age) at baseline. We did not detect an association between probable disorder and IMD although an interaction with time was evident (p = 0.003). Analysis by study wave revealed associations at baseline (odds ratio 1.94, 95% confidence interval 0.97-3.89) and 18 months (1.96, 1.07-3.59) but not 30 months (0.94, 0.54-1.57). These findings augment the existing, highly compelling evidence demonstrating worse mental health in children exposed to socioeconomic deprivation.

由于社会经济贫困和儿童心理健康问题的发生率都在持续上升,探索两者之间的关系对于指导政策的制定非常重要。我们的目标是复制一项发现,即生活在最贫困地区和最不贫困地区的小学生之间的心理健康差距随着年龄的增长而扩大。我们使用了英格兰西南部 2075 名 4-9 岁儿童的数据,这些儿童参加了 STARS(学校支持教师和儿童)试验,该试验在基线、18 个月和 30 个月的随访中收集了教师和家长报告的 "优势和困难问卷"(SDQ)。我们建立了多层次回归模型,以探讨多重贫困指数(IMD)五分位数与 SDQ 总困难得分之间的关系,以及结合教师和家长的 SDQ 数据通过算法生成的 "可能失调 "变量之间的关系。教师和家长报告的 SDQ 总困难得分表明,生活在较贫困社区的儿童心理健康状况较差,在控制了特殊教育需求和残疾后,这种情况有所减弱,但家长报告的得分仍然显著,而且基线年级组状况(年龄)不存在交互作用。尽管与时间的交互作用很明显(p = 0.003),但我们并未发现可能的失调与 IMD 之间存在关联。按研究波次进行的分析表明,基线(几率比 1.94,95% 置信区间 0.97-3.89)和 18 个月(1.96,1.07-3.59)时存在关联,但 30 个月(0.94,0.54-1.57)时不存在关联。这些发现增强了现有的、极具说服力的证据,这些证据表明,社会经济贫困儿童的心理健康状况更差。
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引用次数: 0
A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe. 关于欧洲儿童和青少年精神障碍患病率的系统回顾和荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2022-12-30 DOI: 10.1007/s00787-022-02131-2
Rosemarie Sacco, Nigel Camilleri, Judith Eberhardt, Katja Umla-Runge, Dorothy Newbury-Birch

Most mental disorders appear by age 14, but in most cases, they remain undiagnosed and untreated well into adulthood. A scoping review showed an absence of systematic reviews that address prevalence rates of mental disorders among children and adolescents in Europe that are based on community studies conducted between 2015 and 2020. To estimate the updated pooled prevalence of Anxiety Disorder, Depressive Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Autism Spectrum Disorder, Eating Disorders, Substance Use Disorders (SUD), among children and adolescents living in Europe, a search strategy was conducted using MEDLINE, Embase and Psych Info and studies were also identified from reference lists and gray literature. Eligible studies were evaluated for reliability, validity, and bias. Trends of prevalence rates for each mental disorder were calculated. Almost one in five young people in Europe were found to suffer from a mental disorder, with a pooled prevalence rate of 15.5%. Anxiety disorders had the highest pooled prevalence rate (7.9% (95% CI 5.1-11.8%, I2: 98.0%)), followed by ADHD (2.9% (95% CI 1.2-6.9%, I2 = 94.3%)), ODD (1.9% (95% CI 1.0-3.7%, I2 = 98.4%)), depressive disorder (1.7% (95% CI 1.0-2.9%, I2 = 97.7%)), CD (1.5% (95% CI 0.6-3.8%, I2 = 98.8%)) and ASD (1.4% (95% CI 0.4-5.4%, I2 = 99.7%). No studies on SUD were identified. The mental health of children and adolescents may be improved by introducing routine screening, refining diagnostic sensitivity, raising awareness of mental disorders, minimizing stigma and socioeconomic inequality, as well as developing early intervention services. These facilitators of good mental health need to be prioritized, especially at a time of unprecedented risk factors for poor mental health.

大多数精神障碍在 14 岁之前就已出现,但在大多数情况下,直到成年后仍未得到诊断和治疗。一项范围界定审查显示,目前缺乏针对欧洲儿童和青少年精神障碍患病率的系统性审查,这些审查基于 2015 年至 2020 年间开展的社区研究。为了估算焦虑症、抑郁症、注意力缺陷多动障碍 (ADHD)、行为障碍 (CD)、对立违抗障碍 (ODD)、自闭症谱系障碍、进食障碍、药物使用障碍 (SUD) 在欧洲儿童和青少年中的最新汇总患病率,我们使用 MEDLINE、Embase 和 Psych Info 进行了检索,并从参考文献列表和灰色文献中找到了相关研究。对符合条件的研究进行了可靠性、有效性和偏差评估。对每种精神障碍的患病率趋势进行了计算。在欧洲,几乎每五个年轻人中就有一人患有精神障碍,综合患病率为 15.5%。焦虑症的综合患病率最高(7.9% (95% CI 5.1-11.8%, I2: 98.0%)),其次是多动症(2.9% (95% CI 1.2-6.9%, I2 = 94.3%))、定向障碍(1.9% (95% CI 1.0-3.7%,I2 = 98.4%)、抑郁障碍(1.7%(95% CI 1.0-2.9%,I2 = 97.7%))、CD(1.5%(95% CI 0.6-3.8%,I2 = 98.8%))和 ASD(1.4%(95% CI 0.4-5.4%,I2 = 99.7%)。没有发现有关 SUD 的研究。通过引入常规筛查、提高诊断敏感性、提高对精神障碍的认识、尽量减少污名化和社会经济不平等,以及发展早期干预服务,可以改善儿童和青少年的心理健康。需要优先考虑这些促进良好心理健康的因素,尤其是在心理健康不良的风险因素前所未有的时候。
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引用次数: 0
Randomized controlled trial of individualized arousal-biofeedback for children and adolescents with disruptive behavior disorders (DBD). 针对患有破坏性行为障碍(DBD)的儿童和青少年的个性化唤醒生物反馈随机对试验。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-08 DOI: 10.1007/s00787-023-02368-5
Pascal-M Aggensteiner, Boris Böttinger, Sarah Baumeister, Sarah Hohmann, Stefan Heintz, Anna Kaiser, Alexander Häge, Julia Werhahn, Christoph Hofstetter, Susanne Walitza, Barbara Franke, Jan Buitelaar, Tobias Banaschewski, Daniel Brandeis, Nathalie E Holz

Disruptive behavior disorders [including conduct disorder (CD) and oppositional defiant disorder (ODD)] are common childhood and adolescent psychiatric conditions often linked to altered arousal. The recommended first-line treatment is multi-modal therapy and includes psychosocial and behavioral interventions. Their modest effect sizes along with clinically and biologically heterogeneous phenotypes emphasize the need for innovative personalized treatment targeting impaired functions such as arousal dysregulation. A total of 37 children aged 8-14 years diagnosed with ODD/CD were randomized to 20 sessions of individualized arousal biofeedback using skin conductance levels (SCL-BF) or active treatment as usual (TAU) including psychoeducation and cognitive-behavioral elements. The primary outcome was the change in parents´ ratings of aggressive behavior measured by the Modified Overt Aggression Scale. Secondary outcome measures were subscales from the Child Behavior Checklist, the Inventory of Callous-Unemotional traits, and the Reactive-Proactive Aggression Questionnaire. The SCL-BF treatment was neither superior nor inferior to the active TAU. Both groups showed reduced aggression after treatment with small effects for the primary outcome and large effects for some secondary outcomes. Importantly, successful learning of SCL self-regulation was related to reduced aggression at post-assessment. Individualized SCL-BF was not inferior to active TAU for any treatment outcome with improvements in aggression. Further, participants were on average able to self-regulate their SCL, and those who best learned self-regulation showed the highest clinical improvement, pointing to specificity of SCL-BF regulation for improving aggression. Further studies with larger samples and improved methods, for example by developing BF for mobile use in ecologically more valid settings are warranted.

破坏性行为障碍(包括品行障碍(CD)和对立违抗障碍(ODD))是常见的儿童和青少年精神疾病,通常与唤醒改变有关。推荐的一线治疗方法是多模式疗法,包括社会心理和行为干预。这些治疗方法的效果并不显著,而且在临床和生物学上存在异质性表型,因此需要针对唤醒失调等受损功能进行创新的个性化治疗。共有 37 名 8-14 岁被诊断为 ODD/CD 的儿童被随机分配到 20 个疗程的个性化唤醒生物反馈治疗(使用皮肤电导水平 (SCL-BF))或积极的常规治疗(TAU)(包括心理教育和认知行为元素)中。主要结果是父母对攻击行为的评分变化,采用改良的外显攻击量表进行测量。次要结果测量是儿童行为检查表、冷酷无情-情绪特质量表和反应-主动攻击问卷的子量表。SCL-BF疗法既不优于也不劣于积极的TAU疗法。治疗后,两组的攻击行为都有所减少,对主要结果的影响较小,而对一些次要结果的影响较大。重要的是,在治疗后的评估中,成功学习 SCL 自我调节与攻击行为的减少有关。在改善攻击行为的任何治疗结果上,个体化的 SCL-BF 都不逊色于积极的 TAU。此外,参与者平均能够自我调节他们的SCL,而那些最善于学习自我调节的人表现出了最高的临床改善,这表明SCL-BF调节在改善攻击性方面具有特异性。我们有必要利用更多的样本和改进的方法开展进一步的研究,例如在生态学上更有效的环境中开发移动使用的 BF。
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引用次数: 0
Integrating European contexts and needs into WHO guiding principles on online mental health content for young people: five recommendations. 将欧洲背景和需求纳入世卫组织关于青少年在线心理健康内容的指导原则:五项建议。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-29 DOI: 10.1007/s00787-024-02566-9
Helena Ludwig-Walz, Martin Bujard, Jonas Fegert, Jörg M Fegert
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引用次数: 0
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European Child & Adolescent Psychiatry
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