European Child & Adolescent Psychiatry最新文献

It is well-established in previous research that maternal psychological distress may have adverse effects on child social and emotional development. However, less is known about the environmental protective factors on child outcomes. This study aimed to explore the moderating role of Early Childhood Education and Care (ECEC) participation on the associations between maternal long-term prenatal, postnatal or current psychological distress and child social and emotional problems and competence. A total of 1,191 children (M_age = 24.54 months, SD = 0.59; 47.4% girls) were drawn from the FinnBrain Birth Cohort Study in Finland. Children participated either in center-based or family-based ECEC or they were cared for at home. Mothers had filled in self-reports of their long-term psychological distress during pregnancy, and postpartum, and the evaluation of their child social and emotional problems and competence at the child age of 2 years. The results showed that the ECEC participation played a protective role in the relation between current maternal psychological distress and child social and emotional problems. Associations between maternal symptoms and children's social and emotional problems was attenuated for children who participated in center-based ECEC (β = -0.37, [-0.64, -0.09], p = 0.008), or family-based ECEC (β = -0.75, [-1.11, -0.40], p < 0.001) when compared to children who were cared for at home. This study reinforces our understanding of the ECEC's potential buffering role in at-risk families and in particular in Nordic countries characterized by high-quality of ECEC and high enrollment rates during early childhood.

Background: While household dysfunction (HD) is associated with negative health outcomes, it remains unclear whether the duration or timing of exposure contribute to aggression. The underlying mechanisms in the HD-aggression relationship are also understudied. This study examined the effects of HD duration and timing on aggression while investigating potential mediating role of depressive symptoms. Sex differences were also explored.

Methods: Data were obtained from 7,800 participants in the Taiwan Birth Cohort Study (52.32% male, 47.68% female) followed to ages 17 or 18 years. HD were coded at five life stages: infancy, early childhood, middle childhood, late childhood, and early adolescence. A structured life course modeling approach was used to assess whether the accumulation of HD (duration), or the timing of exposure, including exposure during sensitive periods and more recent periods, exhibited the strongest association with aggression at age 17 or 18. Causal mediation analysis was conducted to evaluate the role of depressive symptoms in the pathway from HD to aggression.

Results: Among males, both HD accumulation (β = 0.04, 95% CI: 0.004-0.07) and middle childhood HD (β = 0.04, 95% CI: 0.01-0.07) were associated with increased adolescent aggression at age 17/18. Depressive symptoms at age 12 mediated the effects of both cumulative HD and middle childhood HD on aggression at ages 17/18, accounting for an estimated 33% and 20% of the total effects, respectively. No significant association between HD and aggression was observed among females.

Conclusions: Interventions should address HD early and sustain support throughout adolescence, while also targeting depressive symptoms, to effectively reduce aggression, particularly among males.

The COVID-19 pandemic brought unprecedented global challenges. Amid the crisis, the potential impact of COVID-19 exposure on the neurodevelopment of offspring born to infected mothers emerged as a critical concern. This is a prospective cohort study of pregnant women and their offspring enrolled in the Signature project at Hospital Universitario Virgen del Rocio in Seville, Spain, between 01/01/2024 and 08/31/2022. Participants were subsequently classified into SARS-CoV-2 exposed (mild or severe COVID-19) and non-exposed groups. Maternal stress was assessed through the Perceived Stress Scale; offspring neurodevelopment was screened through Ages & Stages Questionnaire, 3rd Edition (ASQ-3) at 6 months and 12 months. Association between COVID-19 severity and neurodevelopmental outcomes were analyzed with univariate and multivariate analysis. The cohort included 689 women categorized into three distinct groups based on COVID-19 severity: non-infected mothers (N = 277), mothers with mild COVID-19 (N = 358), and mothers with severe COVID-19 (N = 54). The reference category for the odds ratio (OR) analyses was the non-infected group. In utero exposure to mild or severe COVID-19, as well as maternal stress, was not significantly associated with risk of developmental concern in any ASQ-3 subdomain at 12-month follow-up. This study highlights the need for further research with longer follow-up periods to better understand the potential long-term impact of prenatal COVID-19 exposure on offspring neurodevelopment.

Background: Suicidality is a major public health concern worldwide. Evidence on the prevalence and risk factors of suicidality amongst unaccompanied young refugees (UYRs), a population already at risk for mental health disorders, is scarce.

Methods: Given the complexity of individual risk factor constellations influencing suicidality, machine learning (ML) methods offer a statistical approach that can detect complex relations within the data. Four ML classifiers, (logistic regression (LR), random forest (RF), support vector machines (SVM), and extreme gradient boosting (XGB)) were trained on a dataset of n = 623 UYRs (M_age=16.77, SD = 1.34, range: 12-21), retrieved from the large-scale randomized controlled trial Better Care to predict suicidal ideation. Features used in the classifiers were age, gender, asylum status, having contact with the family, and whether parents are alive as well as clinically elevated post-traumatic stress symptoms (PTSS), depressive symptoms and past suicide attempts. The classifiers were then tested on the independent dataset of n = 94 UYRs (M_age=16.31, SD = 2.03, range: 5-21) retrieved from the screening tool porta project to examine their predictive performance.

Results: The prevalence of past-week suicidal ideation in the combined sample of N = 717 was 18.13%. All classifiers yielded good predictive performance (accuracy 0.734-0.840, sensitivity 0.857, AUC 0.853-0.880). The most relevant features were past suicide attempts, PTSS and depressive symptoms as risk factors, and having a living mother as protective factor.

Conclusions: Suicidal ideation is prevalent amongst UYRs, and using ML approaches, the classifiers were able to classify roughly 85% of the cases with suicidal ideation in the past week correctly as suicidal. Building on the findings of this study, screening for suicidality could be further improved by implementing ML classifiers in the assessment to highlight potential at risk cases early, and suitable interventions be developed.

Research on complex posttraumatic stress disorder (CPTSD) among individuals with refugee backgrounds is limited, and its validity within this group remains underexplored. This study aimed to assess the prevalence and discriminant validity of posttraumatic stress disorder (PTSD) and CPTSD, as well as the risk factors for CPTSD, in a community sample of adolescents with refugee backgrounds residing in Sweden. This study involved 296 adolescents. Probable diagnoses were evaluated according to DSM-5 and ICD-11 criteria. Latent class analysis was employed to examine the discriminant validity of PTSD and CPTSD, while logistic regression analysis was used to explore risk factors for CPTSD. The findings indicated that 24.1% had a probable diagnosis of PTSD according to the DSM-5. For ICD-11, the equivalent proportions were 7.1% for PTSD and 10.8% for CPTSD. Latent class analysis identified three distinct classes: Low symptoms (46.9%), PTSD (29.6%), and CPTSD (23.6%). Compared to the PTSD class, membership in the CPTSD class was predicted by exposure to more types of violence and child maltreatment. It was also associated with higher posttraumatic stress symptoms, worse general functioning, poorer mental well-being, increased suicidal thoughts, more treatment-seeking behavior, and greater comorbidity. This study found a high prevalence of PTSD and CPTSD among adolescents with refugee backgrounds living in Sweden. Distinct classes aligned with the ICD-11 formulation of PTSD and CPTSD were identified, with exposure to violence and child maltreatment emerging as key risk factors for CPTSD. Results underscore the importance of identifying and addressing posttraumatic stress in adolescents with refugee backgrounds. Future research should aim to further validate the CPTSD diagnosis in larger samples of adolescents with refugee backgrounds.

The use of online pornography is widely prevalent among adolescents. This study presents a systematic review and meta-analysis to explore the relationship between online pornography use and psychopathological symptoms in this population. The study was conducted in accordance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive literature search was conducted in PubMed, Scopus and Web of Science for studies published between 2005 and 2024. Eligible studies included quantitative research examining the association between online pornography use and psychopathological symptoms as defined by the DSM-5-TR, with samples comprising adolescents aged 10-19 years. Fourteen studies were included in the systematic review, and twelve were incorporated into the meta-analysis. The meta-analyses revealed a moderate positive correlation between online pornography use and psychopathological symptoms among adolescents. Subgroup analyses indicated no significant differences based on gender. The findings suggest that, in its most problematic manifestations, online pornography use among adolescents may serve as a maladaptive coping strategy for managing underlying distress. An empathetic approach with adolescents displaying problematic online pornography use has the potential to improve the outcomes of therapeutic interventions. These interventions might enhance adolescents' personal and relational resources, thus facilitating the discovery of healthier alternatives that effectively address their psychological needs.

Low parental education has been suggested as a risk factor for attention-deficit hyperactivity disorder (ADHD), but the associations may differ by gender and age, as boys are diagnosed more often and earlier than girls. Parental education might also not predict offspring ADHD diagnosis similarly if parents themselves have ADHD. We examined how maternal and paternal education level predicts offspring ADHD diagnosis at ages 4-17 and whether these associations are modified by gender, age (4-12 vs. 13-17), and family history of ADHD (biological parent and/or full sibling vs. none). We used data on 419,152 individuals born in Finland between 1994 and 2003, identified ADHD diagnosis from national registers with first clinical diagnosis or ADHD medication purchase, and estimated incidence rate ratios (IRR) in Poisson regression. Compared to tertiary education, basic parental education predicted a higher than twofold likelihood of ADHD diagnosis in offspring (maternal IRR 2.17, 95% confidence interval 2.07-2.28; paternal 2.36, 2.26-2.48). The likelihood was about threefold in childhood and twofold or less in adolescence, and mostly similar for boys and girls. Among those with family history of ADHD, the associations were weaker in childhood (highest IRR 1.85, 1.30-2.64) and negligible in adolescence. These findings suggest that low parental education is more strongly associated with an increased likelihood of offspring ADHD diagnosis in childhood than adolescence and in families without an identified history of ADHD. Improving diagnostic processes may help ensure appropriate access to diagnosis and care at any age, irrespective of parental education level and family history of ADHD.