European Child & Adolescent Psychiatry最新文献

Previous fMRI studies have documented links between internalizing problems in youth and brain functional connectivity of the default (DN), frontoparietal (FP), and salience (SA) networks. Characterized by a large symptom heterogeneity and comorbidity, it remains elusive how individual internalizing symptoms relate to DN, FP, and SA connectivity. Leveraging a large population-based sample of adolescents (N = 2426; mean age = 14.1 years) and an integrated network modelling approach, we identified symptom-specific associations between internalizing problems and functional connectivity and explored sex and timing-specific differences in these links. Our findings revealed small negative associations between self-reported feelings of worthlessness and guilt and DN within-network connectivity and positive associations between fearfulness and FP within-network connectivity. Moreover, sadness and fearfulness were positively associated with DN-SA between-network connectivity. Exploratory analyses revealed no significant sex differences but indicated that DN within-network connectivity around age 10 was negatively associated with self-reported worthlessness at age 14. Our findings show symptom-specific associations between internalizing problems and brain functional circuitry in youth and highlight the complex interplay of symptoms and brain networks.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder affecting up to 5.9% of youth. Characterised by inattention, hyperactivity, and impulsivity, it affects various aspects of functioning and is often accompanied with co-occurring diagnoses. While ADHD poses significant challenges, including academic and occupational impairments, it can also confer strengths like creativity and hyperfocus. Successfully navigating the transition to adulthood is crucial for improving long-term health and vocational outcomes for ADHD youth. The aim of this review is to identify and synthesise existing qualitative literature on the experiences of ADHD youth across life domains. A qualitative evidence synthesis, utilising meta-ethnographic methods, with purposive sampling was conducted. Thirty studies, across 11 countries, reporting the experiences of 805 ADHD youth were analysed. Themes generated were: (1) Navigating identity and authenticity (2) Diagnosis disclosure dilemma, (3) New ADHD manager reporting for duty, (4) The power of others, (5) Diverse healthcare journeys, (6) Impact on engagement in everyday activities, (7) Turning insight to action. Findings illustrate the wide-ranging impacts of ADHD across life domains, particularly education, employment and leisure. Transitioning to adulthood, youth assume responsibility for managing their ADHD, with differing levels of readiness. While social connections offer vital support, many struggle to form or maintain these relationships. The health service journeys of youth vary, in accessibility, continuity of care and patient-clinician relationship. Effective support requires strengths-based, collaborative, and continuity-focused approaches to education, employment, and healthcare transitions.

The ability to voluntarily control eye movements is part of the "executive function" domain, which includes working memory and is impaired in neuro-developmental disorders such as ADHD. The present study aimed to investigate two types of "executive" saccades - anti-saccades (AS) and memory-guided saccades (MGS) - as well as their relationships in samples of children and adolescents with ADHD and neurotypical controls. To that end, anti-saccades and memory-guided saccades were recorded in n = 65 participants with ADHD (age 9.2-17.1 years) and n = 74 neurotypical controls (aged 9.1-17.3 years) as part of a larger ocular-motor test battery, using the EyeLink 1000 + eye tracker (SR-Research). Results reveal less correct MGS with lower spatial accuracy as well as a trend for less correct AS with normal spatial accuracy in participants with ADHD, compared to neurotypical controls. Furthermore, the spatial accuracies of AS and MGS were significantly correlated in the control (r=.35) and ADHD (r=.26) groups, corresponding to medium effect sizes (eta2: control: 0.12, ADHD: 0.07). These findings suggest that the storage of spatial information in working memory, as required in the MGS task, is impaired in ADHD, while the processing of this information, as required in the AS task, remains largely intact. The correlations between the two task parameters in both groups confirm that storage and processing are related abilities in working memory and that this relationship is basically intact in ADHD.

The aim of this study was to identify the characteristics of adolescents and young adults with selective mutism (SM) and their specific (treatment) needs, as well as those of their environment. We conducted a mixed methods systematic review of scientific databases APA PsycINFO and MEDLINE until February 2025. Descriptive studies were included if they incorporated information on individuals between 10-24 years old with a current diagnosis of SM. Two independent reviewers extracted data using combined deductive and inductive coding, with categories finalized by consensus. Data were synthesized using a convergent segregated approach. A total of 749 records were identified, of which 40 studies (n = 54 participants) met inclusion criteria. Methodological quality varied, with 27.5% studies rated as high quality, 65% as moderate, and 7.5% as low. Key findings showed that SM manifests differently in adolescents and young adults compared to children, and therefore requires a different approach to treatment. The reviewed literature shows that adolescents and young adults with SM have a later onset, longer diagnostic delays, and a prolonged history of negative reinforcement of symptoms from accommodations by others. Consequently, SM tends to be more therapy-resistant, requiring greater patience and diligence from therapists.

While childhood trauma and neglect are generally found to be increased in clinical high-risk of psychosis (CHR-P), findings on life events (LEs) are so far inconclusive, with some indication of a stress sensitization effect in CHR-P, leading to generally higher stress appraisals of LEs, and a LE-reducing effect of negative symptoms. Thus, we studied 50 LEs and their appraisals as assessed with the Munich Life Event Scale in CHR-P patients according to ultra-high risk and basic symptom criteria and age- and sex-matched clinical inpatient (ClinS) and healthy controls (GPS; each n = 112, age 8-17 yrs., 57.1% female). LEs, particularly those of interpersonal nature, were increased in CHR-P compared to GPS but not ClinS, and their number and presence was positively related to subjective negative symptoms. Furthermore, appraisals rarely and only unsystematically differed between groups but correlated significantly in most cases with a more negative appraisal being related to a higher stress appraisal. Thus, there was no indication of a significant stress sensitization effect in CHR-P. Rather, the increased number of LEs, in particular interpersonal ones, likely increases the overall load of stress in terms of a stress accumulation and decreases the size of the supportive social network as well as increases negative symptoms. Thus, early interventions in CHR-P should also include improving strategies to deal with LEs, particularly those of interpersonal nature, to improve resilience and reduce burden of non-normative LEs.

Children with autism often show disruptive behavior problems, which may cause significant impairment. Behavioral parent training is an effective intervention for other children with disruptive behavior, but research in children with autism is relatively scarce. We here report the secondary outcomes of a three-arm randomized controlled trial, comparing face-to-face and blended parent training to a waitlist control condition for children with autism and disruptive behavior. We previously found that face-to-face, but not blended parent training, relative to waitlist control, significantly improved children's noncompliance and irritability. Knowledge about its effects on parental functioning and other domains of children's functioning is limited. Using linear regression analyses on an intention-to-treat basis, we investigated parent training effects on a range of parenting (parental satisfaction, parental efficacy, parenting stress, and lax, overreactive and verbose parenting styles) and child outcomes (hyperactivity, emotional problems, conduct problems, peer problems, prosocial behavior, and adaptive behavior). We found that face-to-face, but not blended parent training, improved parental self-efficacy and decreased overreactive parenting relative to the waitlist condition. We found no intervention effects of either parent training format on any of the other outcomes. Overall, our findings add to the evidence for face-to-face behavioral parent training as an effective intervention for disruptive behavior in children with autism by illustrating that not only children but also parents improve. This randomized controlled trial was registered in the Dutch Trial Register (#22,042).