Journal of the American Academy of Child and Adolescent Psychiatry最新文献

Globally, suicide and suicidal behaviors among adolescents and other youth continue to be a serious public health concern.^1-3 The influence of war events such as displacement, injuries, continuous bombardments, witnessing atrocities and deaths, the relentless exposure to violent images and messages in the media is associated with acute stress, increased post-traumatic stress disorder (PTSD), and functional impairments.⁴ Similarly, lack of schooling and support systems in war settings and the associated risk of psychopathology put war-affected populations, especially adolescents and young adults, at an increased risk of suicidal ideation and behaviors and self-harm.².

Objective: Suicides continue to increase among youth, with substantial disparities among Black youth. Culturally responsive evidence-based interventions for Black youth are urgently needed to disrupt these inequities. This study aims to identify evidence-based psychotherapy interventions for suicidal thoughts and behaviors (STBs) among Black youth and examine how existing intervention manuals have integrated culturally- relevant content to Black youth.

Method: Literature searches were conducted to identify relevant articles comparing the effectiveness of interventions for STBs, study population with >30% Black youth, and youth participants up to the age of 25. Published articles and therapy manuals were analyzed on cultural adaptation and on seven content domains for cultural adaptation. Meta-analysis used a random-effects model and explored potential moderators.

Results: Of the 755 screened records, 13 studies met eligibility criteria and featured eight manualized interventions. Meta-analysis revealed significant effects in reducing STBs between treatment groups (Hedges' g=1.08 with 95% CI [.07, 2.09])) but low-quality evidence, significant heterogeneity, small sample sizes, and inconsistencies in outcome measures. Only one intervention, Adapted Coping with Stress (A-CWS), specifically focused on Black youth. Culturally relevant content was predominantly absent or contained brief descriptions. The most frequently included content was provider cultural competency training.

Conclusions: The lack of representation of Black youth in treatment studies and sparse literature on culturally responsive treatments for Black youth and their families continues to stall significant advancements to disrupt current suicide trends disproportionately impacting Black youth. We identified several opportunities for implementing cultural adaptations of suicide interventions among Black youth.

As editors of the Book Forum, we have seen an increased interest in authors writing reviews in other media sources besides books. This is not a surprise as we find more media sources that we go to for information as well as entertainment. On top of that, for better or worse, our patients are spending more of their time on other sources of media besides books. We are often unfamiliar with these media sources and are unable to engage meaningfully with our patients. This can be important in rapport building, which was a consideration when we had people review, for example, the video games Fortnite and Among Us. It can also be important in understanding the safety concerns of a media source, preparing our readership of child and adolescent psychiatrists to talk about controversial, potentially triggering topics with patients (ie, Thirteen Reasons Why). The goal of the Book Forum has always been to introduce child and adolescent psychiatrists to materials that would be important for their education or enjoyment and to understand the materials that our patients may be perusing. In an effort to continue this mission, we worked with Journal staff to rebrand the Book Forum as the Media Forum. We hope that this move will only add to the opportunities you all have as writers and readers, as we still welcome books, but now we welcome movies, TV shows, short videos, articles, video games, and anything else you think would be relevant. As you can see from this month's reviews of books, we continue to encourage reading and the submission of book reviews. We look forward to your suggestions for future reviews.

Objective: Few studies have explored the interplay of how individual identity, parental, familial, and contextual factors impact associations between Latinx adolescent adversities and psychopathology. This study aimed to examine whether these factors mediate the relationship between adversities and psychopathology in Latinx youth.

Method: Latinx youth (n = 2,411) data from the Adolescent Brain Cognitive Development (ABCD) Study were used to examine path models with adverse childhood experiences (ACEs) as the predictor and either youth- or caregiver-rated internalizing/externalizing scores over 4 timepoints as the outcome (ages 9-13 years). Models examined 3 potential mediators: (1) ethnic identity, (2) familial context (comprising parental monitoring, family conflict, and caregiver acceptance), and (3) community cohesion. Models were conducted separately for internalizing and externalizing symptoms.

Results: Greater adversity was associated with greater youth- and caregiver-rated internalizing/externalizing psychopathology over time. Greater adversity was associated with lower family functioning and lower ethnic identity, and greater family functioning was associated with lower psychopathology. Family functioning mediated associations between adversity and psychopathology over time (youth-reported internalizing: 95% CI = 0.012-0.019; youth-reported externalizing: 95% CI = 0.020-0.028). In contrast, there was not strong evidence for ethnic identity and community cohesion mediating associations between adversities and psychopathology over time.

Conclusion: Unlike previous studies, ethnic identity did not influence the relationship between ACEs and psychopathology over time. Additional research is needed to identify whether possible tensions rise as Latinx youth acculturate into US culture and achieve optimal levels of ethnic identity formation. Providers need to assess specific Latinx parental and familial contexts that may interfere with youth identity formation.

Youth represents a vulnerable developmental period associated with significant sleep and circadian changes. One notable change is increased eveningness, which refers to a tendency for later sleep and daily activities. Eveningness has been associated with various adverse outcomes in youth, including compromised sleep, mental health, and physical well-being.^1,2 As such, it is imperative to develop effective interventions to address these issues. While some evidence suggests short-term benefits of interventions targeting circadian problems,³ the extent of our knowledge regarding the long-term impact on youth remains uncertain. In this issue of the Journal, Susman et al.⁴ shed light on this crucial question through their study that examined the effects of the Transdiagnostic Sleep and Circadian Intervention for Youth (TranS-C), a modular cognitive-behavioral intervention that specifically targets sleep and circadian issues.