Pub Date : 2024-07-26DOI: 10.1016/j.jaac.2024.07.909
Ran Barzilay, Nadine Michel
Increasing evidence suggests that, as in other medical fields, there are pronounced pediatric mental health disparities with greater burden among marginalized racial and ethnic youth. The reasons for these disparities are not fully understood. One way to explain pediatric mental health disparities is through the lens of environmental stress as a driver of mental health burden, given that marginalized populations are exposed to more structural and individual stress. Although traditionally stress has been linked to specific psychiatric disorders that fall under the umbrella of "stress-related disorders" such as acute/post-traumatic stress disorder or adjustment disorder, broader conceptual frameworks include depression (including suicidality) and anxiety as stress related. More recently, there has been growing recognition of the contribution of early life stressful exposures (ie, childhood adversity) to psychosis spectrum disorders. As such, recognition of the role of stress exposure in psychotic presentations and the fact that exposure to adverse social determinants of health and stressful environments is more common among youth of color can serve as a potential mechanism to explain pediatric disparities in psychosis risk.
{"title":"Editorial: Understanding Adolescent Mental Health Disparities Through the Lens of Environmental Stress Exposure.","authors":"Ran Barzilay, Nadine Michel","doi":"10.1016/j.jaac.2024.07.909","DOIUrl":"10.1016/j.jaac.2024.07.909","url":null,"abstract":"<p><p>Increasing evidence suggests that, as in other medical fields, there are pronounced pediatric mental health disparities with greater burden among marginalized racial and ethnic youth. The reasons for these disparities are not fully understood. One way to explain pediatric mental health disparities is through the lens of environmental stress as a driver of mental health burden, given that marginalized populations are exposed to more structural and individual stress. Although traditionally stress has been linked to specific psychiatric disorders that fall under the umbrella of \"stress-related disorders\" such as acute/post-traumatic stress disorder or adjustment disorder, broader conceptual frameworks include depression (including suicidality) and anxiety as stress related. More recently, there has been growing recognition of the contribution of early life stressful exposures (ie, childhood adversity) to psychosis spectrum disorders. As such, recognition of the role of stress exposure in psychotic presentations and the fact that exposure to adverse social determinants of health and stressful environments is more common among youth of color can serve as a potential mechanism to explain pediatric disparities in psychosis risk.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1016/j.jaac.2024.06.010
Dana E Díaz, Stefanie R Russman Block, Hannah C Becker, K Luan Phan, Christopher S Monk, Kate D Fitzgerald
Objective: Clinically anxious youth are hypervigilant to emotional stimuli and display difficulty shifting attention from emotional to nonemotional stimuli, suggesting impairments in cognitive control over emotion. However, it is unknown whether the neural substrates of such biases vary across the clinical-to-nonclinical range of anxiety or by age.
Method: Youth aged 7 to 17 years with clinical anxiety (n = 119) or without an anxiety diagnosis (n = 41) matched emotional faces or matched shapes flanked by emotional face distractors during magnetic resonance imaging, probing emotion processing and cognitive control over emotion, respectively. Building from the National Institute of Mental Health Research Domain Criteria (RDoC) framework, clinically anxious youth were sampled across diagnostic categories, and non-clinically affected youth were sampled across minimal-to-subclinical severity.
Results: Across both conditions, anxiety severity was associated with hyperactivation in the right inferior parietal lobe, a substrate of hypervigilance. Brain-anxiety associations were also differentiated by attentional state; anxiety severity was associated with greater left ventrolateral prefrontal cortex activation during emotion processing (face matching) and greater activation in the left posterior superior temporal sulcus and temporoparietal junction (and slower responses) during cognitive control over emotion (shape matching). Age also moderated associations between anxiety and cognitive control over emotion, such that anxiety was associated with greater right thalamus and bilateral posterior cingulate cortex activation for children at younger and mean ages, but not for older youth.
Conclusion: Aberrant function in brain regions implicated in stimulus-driven attention to emotional distractors may contribute to anxiety in youth. Results support the potential utility of attention modulation interventions for anxiety that are tailored to developmental stage.
Clinical trial registration information: Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety; https://clinicaltrials.gov; NCT02810171.
{"title":"Neural Substrates of Emotion Processing and Cognitive Control Over Emotion in Youth Anxiety: An RDoC-Informed Study Across the Clinical to Nonclinical Continuum of Severity.","authors":"Dana E Díaz, Stefanie R Russman Block, Hannah C Becker, K Luan Phan, Christopher S Monk, Kate D Fitzgerald","doi":"10.1016/j.jaac.2024.06.010","DOIUrl":"10.1016/j.jaac.2024.06.010","url":null,"abstract":"<p><strong>Objective: </strong>Clinically anxious youth are hypervigilant to emotional stimuli and display difficulty shifting attention from emotional to nonemotional stimuli, suggesting impairments in cognitive control over emotion. However, it is unknown whether the neural substrates of such biases vary across the clinical-to-nonclinical range of anxiety or by age.</p><p><strong>Method: </strong>Youth aged 7 to 17 years with clinical anxiety (n = 119) or without an anxiety diagnosis (n = 41) matched emotional faces or matched shapes flanked by emotional face distractors during magnetic resonance imaging, probing emotion processing and cognitive control over emotion, respectively. Building from the National Institute of Mental Health Research Domain Criteria (RDoC) framework, clinically anxious youth were sampled across diagnostic categories, and non-clinically affected youth were sampled across minimal-to-subclinical severity.</p><p><strong>Results: </strong>Across both conditions, anxiety severity was associated with hyperactivation in the right inferior parietal lobe, a substrate of hypervigilance. Brain-anxiety associations were also differentiated by attentional state; anxiety severity was associated with greater left ventrolateral prefrontal cortex activation during emotion processing (face matching) and greater activation in the left posterior superior temporal sulcus and temporoparietal junction (and slower responses) during cognitive control over emotion (shape matching). Age also moderated associations between anxiety and cognitive control over emotion, such that anxiety was associated with greater right thalamus and bilateral posterior cingulate cortex activation for children at younger and mean ages, but not for older youth.</p><p><strong>Conclusion: </strong>Aberrant function in brain regions implicated in stimulus-driven attention to emotional distractors may contribute to anxiety in youth. Results support the potential utility of attention modulation interventions for anxiety that are tailored to developmental stage.</p><p><strong>Clinical trial registration information: </strong>Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety; https://clinicaltrials.gov; NCT02810171.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1016/j.jaac.2024.06.009
Rachel G Kasdin, Mary D Sun, Alicia W Leong, Timothy Rice
Youth who hold both Asian American and Pacific Islander (AAPI) and sexual or gender minority (SGM) identities are frequently overlooked and underserved, and experience intersecting forms of discrimination, interpersonal stressors, and structural barriers.1 Amid heightened anti-AAPI and anti-SGM violence, these populations are particularly vulnerable to poor mental health outcomes. In 2023, over half of AAPI SGM reported experiences of depression, anxiety, and gender-based discrimination, and nearly half reported racial abuse.2 Despite growing need, there are few established best practices for supporting the mental health needs of AAPI SGM youth. Guidelines tailoring psychiatric care to this population's needs in outpatient settings1 have recently been complemented with considerations for SGM youth in the inpatient psychiatric setting.3 Building on this work, we identify 5 considerations that we believe to be key to the provision of high-quality mental health care to AAPI SGM youth and their families in both the acute emergency department (ED) and inpatient settings.
{"title":"Intersectional Care for Asian American and Pacific Islander Youth With Sexual or Gender Minority Identities in the Acute Psychiatric Care Setting.","authors":"Rachel G Kasdin, Mary D Sun, Alicia W Leong, Timothy Rice","doi":"10.1016/j.jaac.2024.06.009","DOIUrl":"10.1016/j.jaac.2024.06.009","url":null,"abstract":"<p><p>Youth who hold both Asian American and Pacific Islander (AAPI) and sexual or gender minority (SGM) identities are frequently overlooked and underserved, and experience intersecting forms of discrimination, interpersonal stressors, and structural barriers.<sup>1</sup> Amid heightened anti-AAPI and anti-SGM violence, these populations are particularly vulnerable to poor mental health outcomes. In 2023, over half of AAPI SGM reported experiences of depression, anxiety, and gender-based discrimination, and nearly half reported racial abuse.<sup>2</sup> Despite growing need, there are few established best practices for supporting the mental health needs of AAPI SGM youth. Guidelines tailoring psychiatric care to this population's needs in outpatient settings<sup>1</sup> have recently been complemented with considerations for SGM youth in the inpatient psychiatric setting.<sup>3</sup> Building on this work, we identify 5 considerations that we believe to be key to the provision of high-quality mental health care to AAPI SGM youth and their families in both the acute emergency department (ED) and inpatient settings.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.1016/j.jaac.2024.06.008
Tina R Goldstein, Betsy D Kennard, Giovanna Porta, Alisha O Miller, Karen Aguilar, Katelyn Bigley, Rachel A Vaughn-Coaxum, Dana L McMakin, Antoine Douaihy, Satish Iyengar, Candice L Biernesser, Jamie Zelazny, David A Brent
Objective: We present results from a 2-site, randomized clinical trial to assess the efficacy of a brief intervention (As Safe As Possible [ASAP]), a safety plan phone application (BRITE), and their combination on suicide attempts, suicidal ideation, non-suicidal self-injury, re-hospitalizations. and suicidal events among adolescents.
Method: Adolescents (n= 240; 12-17 years of age) who were hospitalized for suicidal ideation with plan and/or intent, and/or suicide attempt, were assigned to 1 of 4 treatment conditions in a 2 by 2 design: ASAP+BRITE app+treatment as usual (TAU); (2) BRITE+TAU; (3) ASAP+TAU; and (4) TAU alone. Independent evaluators assessed suicidal ideation and behavior at 4, 12, and 24 weeks using the Columbia-Suicide Severity Rating Scale (C-SSRS) and re-hospitalization using the Child and Adolescent Services Assessment (CASA).
Results: No group differences were found on primary outcomes, except that ASAP participants were less likely to be re-hospitalized over 6 months (15.6%, vs 26.5%, p = .046). Participants hospitalized for an attempt and assigned to BRITE had a lower rate of subsequent attempts (odds ratio [OR] = 0.16, p = .01) and a greater time to attempt (hazard ratio [HR] = 0.20, p = .02). ASAP+BRITE, albeit not statistically significant, was most consistently associated with a reduction (60% reduction) in suicide attempts.
Conclusion: ASAP, BRITE, and their combination are equally effective at decreasing risk for suicidal events 6 months post hospital discharge among suicidal adolescents; the ASAP intervention (with or without BRITE) was associated with lower rates of re-hospitalization. The BRITE app in youth hospitalized for suicide attempt had promising outcomes in regard to future attempts.
Diversity & inclusion statement: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. The research was performed with permission from the University of Pittsburgh Institutional Review Board and the University of Texas Institutional Review Board. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of
{"title":"Bridging Gaps in Care Following Hospitalization for Suicidal Adolescents: As Safe As Possible (ASAP) and BRITE App.","authors":"Tina R Goldstein, Betsy D Kennard, Giovanna Porta, Alisha O Miller, Karen Aguilar, Katelyn Bigley, Rachel A Vaughn-Coaxum, Dana L McMakin, Antoine Douaihy, Satish Iyengar, Candice L Biernesser, Jamie Zelazny, David A Brent","doi":"10.1016/j.jaac.2024.06.008","DOIUrl":"10.1016/j.jaac.2024.06.008","url":null,"abstract":"<p><strong>Objective: </strong>We present results from a 2-site, randomized clinical trial to assess the efficacy of a brief intervention (As Safe As Possible [ASAP]), a safety plan phone application (BRITE), and their combination on suicide attempts, suicidal ideation, non-suicidal self-injury, re-hospitalizations. and suicidal events among adolescents.</p><p><strong>Method: </strong>Adolescents (n= 240; 12-17 years of age) who were hospitalized for suicidal ideation with plan and/or intent, and/or suicide attempt, were assigned to 1 of 4 treatment conditions in a 2 by 2 design: ASAP+BRITE app+treatment as usual (TAU); (2) BRITE+TAU; (3) ASAP+TAU; and (4) TAU alone. Independent evaluators assessed suicidal ideation and behavior at 4, 12, and 24 weeks using the Columbia-Suicide Severity Rating Scale (C-SSRS) and re-hospitalization using the Child and Adolescent Services Assessment (CASA).</p><p><strong>Results: </strong>No group differences were found on primary outcomes, except that ASAP participants were less likely to be re-hospitalized over 6 months (15.6%, vs 26.5%, p = .046). Participants hospitalized for an attempt and assigned to BRITE had a lower rate of subsequent attempts (odds ratio [OR] = 0.16, p = .01) and a greater time to attempt (hazard ratio [HR] = 0.20, p = .02). ASAP+BRITE, albeit not statistically significant, was most consistently associated with a reduction (60% reduction) in suicide attempts.</p><p><strong>Conclusion: </strong>ASAP, BRITE, and their combination are equally effective at decreasing risk for suicidal events 6 months post hospital discharge among suicidal adolescents; the ASAP intervention (with or without BRITE) was associated with lower rates of re-hospitalization. The BRITE app in youth hospitalized for suicide attempt had promising outcomes in regard to future attempts.</p><p><strong>Diversity & inclusion statement: </strong>We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. The research was performed with permission from the University of Pittsburgh Institutional Review Board and the University of Texas Institutional Review Board. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of ","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.1016/j.jaac.2024.06.007
Victor Buitron, Nubia A Mayorga, Michael J Zvolensky
According to the US Centers for Disease Control and Prevention, 17% of Latinx high school students report considering attempting suicide within the United States. Given that a large proportion of Latinx youth have an immigrant caregiver, there is a clinical need to address the sociocultural, practical, and resource-related barriers of immigrant Latinx families who have youth experiencing acute suicide risk. To support effective and culturally aligned clinical approaches at the acute, indicated level of care (eg, emergency department, psychiatric hospitalization), we present 3 recommendations contextualized within the flexible and often time-limited nature of clinical responses to acute youth suicidality. The recommendations assume the presence of suicide risk assessment, safety planning, and disposition planning for a level of care that is optimally therapeutic and least restrictive (referred to as standard care).1.
根据美国疾病控制和预防中心(US Centers for Disease Control and Prevention)的数据,17% 的拉美裔高中生表示考虑在美国尝试自杀。鉴于很大一部分拉美裔青少年的照顾者是移民,因此临床上需要解决有青少年面临急性自杀风险的拉美裔移民家庭在社会文化、实践和资源方面的障碍。为了支持在急性期、指定护理级别(如急诊科、精神病院)采取有效且与文化相一致的临床方法,我们针对临床应对急性期青少年自杀的灵活且通常有时间限制的特点,提出了 3 项建议。这些建议假定存在自杀风险评估、安全规划和处置规划,以达到最佳治疗效果和最少限制的护理水平(称为标准护理)。
{"title":"Responding to Acute Suicidality Among Latinx Youth From Immigrant Families.","authors":"Victor Buitron, Nubia A Mayorga, Michael J Zvolensky","doi":"10.1016/j.jaac.2024.06.007","DOIUrl":"10.1016/j.jaac.2024.06.007","url":null,"abstract":"<p><p>According to the US Centers for Disease Control and Prevention, 17% of Latinx high school students report considering attempting suicide within the United States. Given that a large proportion of Latinx youth have an immigrant caregiver, there is a clinical need to address the sociocultural, practical, and resource-related barriers of immigrant Latinx families who have youth experiencing acute suicide risk. To support effective and culturally aligned clinical approaches at the acute, indicated level of care (eg, emergency department, psychiatric hospitalization), we present 3 recommendations contextualized within the flexible and often time-limited nature of clinical responses to acute youth suicidality. The recommendations assume the presence of suicide risk assessment, safety planning, and disposition planning for a level of care that is optimally therapeutic and least restrictive (referred to as standard care).<sup>1</sup>.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1016/j.jaac.2024.05.026
Meghan M Mallya, Jasmine Liu-Zarzuela, Isreal Bladimir Munoz, Joseph Shotwell
This Letter to the Editor reports the findings of a study we undertook to assess the quality and content of the mental health information that is provided to children via YouTube Kids. For videos on depression and anxiety, we found that all videos were useful or neutral (neither useful nor misleading). In contrast, most videos on attention-deficit/hyperactivity disorder (ADHD) were useful or neutral, but few were deemed misleading. Many of the videos on depression, anxiety, and ADHD promoted supportive statements and help-seeking behavior. Recommendations include calling on social media platforms to continue moderating content and involving more health care professionals and/or individuals with lived experiences to create accurate but engaging videos.
{"title":"Assessing the Educational Value of YouTube Kids Videos Related to Anxiety, Depression, and ADHD.","authors":"Meghan M Mallya, Jasmine Liu-Zarzuela, Isreal Bladimir Munoz, Joseph Shotwell","doi":"10.1016/j.jaac.2024.05.026","DOIUrl":"10.1016/j.jaac.2024.05.026","url":null,"abstract":"<p><p>This Letter to the Editor reports the findings of a study we undertook to assess the quality and content of the mental health information that is provided to children via YouTube Kids. For videos on depression and anxiety, we found that all videos were useful or neutral (neither useful nor misleading). In contrast, most videos on attention-deficit/hyperactivity disorder (ADHD) were useful or neutral, but few were deemed misleading. Many of the videos on depression, anxiety, and ADHD promoted supportive statements and help-seeking behavior. Recommendations include calling on social media platforms to continue moderating content and involving more health care professionals and/or individuals with lived experiences to create accurate but engaging videos.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-10DOI: 10.1016/j.jaac.2024.04.020
Erica Bell, Gin S Malhi
We read with great interest the article by Srinivasan et al.,1 and we are heartened to see a renewed focus on irritability as an important phenomenon that necessitates better understanding. In particular, the hypothesis that irritability in childhood may signal the development of psychiatric problems later in life is a persuasive concept that aligns with our thinking.
{"title":"Understanding Irritability From Childhood to Adolescence.","authors":"Erica Bell, Gin S Malhi","doi":"10.1016/j.jaac.2024.04.020","DOIUrl":"10.1016/j.jaac.2024.04.020","url":null,"abstract":"<p><p>We read with great interest the article by Srinivasan et al.,<sup>1</sup> and we are heartened to see a renewed focus on irritability as an important phenomenon that necessitates better understanding. In particular, the hypothesis that irritability in childhood may signal the development of psychiatric problems later in life is a persuasive concept that aligns with our thinking.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1016/j.jaac.2024.04.019
Christina M Hogan, Sarah M Merrill, Evelyn Hernandez Valencia, Allison A McHayle, Michaela D Sisitsky, Jennifer M McDermott, Justin Parent
Objective: To examine longitudinal associations between early life threat and deprivation on epigenetic age acceleration at ages 9 and 15 years, and to examine associations of age acceleration on later internalizing and externalizing symptoms.
Method: The study examines a large (n = 2,039) and racially diverse (Black/African American = 44%, Latino = 18%, White = 5%) sample from a national dataset. Epigenetic age acceleration was estimated using the pediatric buccal epigenetic clock. Early life threat and deprivation were measured using composites from the Parent-Child Conflict Tactics Scale and county-level violent and property crime rate data. Internalizing and externalizing symptoms came from parent-reported Child Behavior Checklist. Path analysis models examined associations of threat and deprivation at age 3 years on epigenetic age acceleration at ages 9 and 15. Experiences of threat were further broken down into threat experienced in the home and in the community.
Results: Home threat experienced at age 3 years predicted age acceleration at 9 and 15, and community threat experienced at 3 predicted age acceleration at 15, but not at 9. Deprivation was not a significant predictor of accelerated aging. Age acceleration at age 9 predicted externalizing, but not internalizing, symptoms at age 15. Community threat had a direct effect on externalizing. No association emerged with internalizing.
Conclusion: Findings revealed that threat, not deprivation, was predictive of age acceleration, demonstrating support for this pattern longitudinally, using an epigenetic clock that is accurate in children. The findings provide critical nuance to the examination of threat, and highlight associated risks and possible intervention points for externalizing symptoms.
{"title":"The Impact of Early Life Adversity on Peripubertal Accelerated Epigenetic Aging and Psychopathology.","authors":"Christina M Hogan, Sarah M Merrill, Evelyn Hernandez Valencia, Allison A McHayle, Michaela D Sisitsky, Jennifer M McDermott, Justin Parent","doi":"10.1016/j.jaac.2024.04.019","DOIUrl":"10.1016/j.jaac.2024.04.019","url":null,"abstract":"<p><strong>Objective: </strong>To examine longitudinal associations between early life threat and deprivation on epigenetic age acceleration at ages 9 and 15 years, and to examine associations of age acceleration on later internalizing and externalizing symptoms.</p><p><strong>Method: </strong>The study examines a large (n = 2,039) and racially diverse (Black/African American = 44%, Latino = 18%, White = 5%) sample from a national dataset. Epigenetic age acceleration was estimated using the pediatric buccal epigenetic clock. Early life threat and deprivation were measured using composites from the Parent-Child Conflict Tactics Scale and county-level violent and property crime rate data. Internalizing and externalizing symptoms came from parent-reported Child Behavior Checklist. Path analysis models examined associations of threat and deprivation at age 3 years on epigenetic age acceleration at ages 9 and 15. Experiences of threat were further broken down into threat experienced in the home and in the community.</p><p><strong>Results: </strong>Home threat experienced at age 3 years predicted age acceleration at 9 and 15, and community threat experienced at 3 predicted age acceleration at 15, but not at 9. Deprivation was not a significant predictor of accelerated aging. Age acceleration at age 9 predicted externalizing, but not internalizing, symptoms at age 15. Community threat had a direct effect on externalizing. No association emerged with internalizing.</p><p><strong>Conclusion: </strong>Findings revealed that threat, not deprivation, was predictive of age acceleration, demonstrating support for this pattern longitudinally, using an epigenetic clock that is accurate in children. The findings provide critical nuance to the examination of threat, and highlight associated risks and possible intervention points for externalizing symptoms.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.1016/j.jaac.2024.06.004
Deanna Swain, Yi Li, Hallie R Brown, Eva Petkova, Catherine Lord, Sally J Rogers, Annette Estes, Connie Kasari, So Hyun Kim
Objective: Naturalistic developmental behavioral interventions for children with autism spectrum disorder show evidence for effectiveness for specific social communication targets such as joint attention or engagement. However, combining evidence from different studies and comparing intervention effects across those studies have not been feasible due to lack of a standardized outcome measure of broader social communication skills that can be applied uniformly across trials. This investigation examined the usefulness of the Brief Observation of Social Communication Change (BOSCC) as a common outcome measure of general social communication skills based on secondary analyses of data obtained from previously conducted randomized controlled trials of 3 intervention models, Early Social Intervention (ESI), Early Start Denver Model (ESDM) and Joint Attention Symbolic Play Engagement and Regulation (JASPER).
Method: The subset of datasets from the 3 randomized controlled trials was created to examine differences in the BOSCC scores between intervention and control groups over the course of the interventions.
Results: Based on 582 videos from 207 caregiver-child dyads, the BOSCC noted significant differences between intervention vs control groups in broad social communication skills within 2 of the 3 intervention models, which were longer in duration and focused on a broad range of developmental skills.
Conclusion: The BOSCC offers the potential to take a uniform measurement approach across different intervention models to capture the effect of intervention on general social communication skills but may not pick up the effects of some brief interventions targeting proximal outcomes.
Clinical trial registration information: Comparing Parent-Implemented Interventions for Toddlers With Autism Spectrum Disorders; https://www.
Clinicaltrials: gov/; NCT00760812. Intensive Intervention for Toddlers With Autism (EARLY STEPS); https://www.
Clinicaltrials: gov/; NCT00698997. Social and Communication Outcomes for Young Children With Autism; https://www.
{"title":"Implementing a Uniform Outcome Measurement Approach for Early Interventions of Autism Spectrum Disorders.","authors":"Deanna Swain, Yi Li, Hallie R Brown, Eva Petkova, Catherine Lord, Sally J Rogers, Annette Estes, Connie Kasari, So Hyun Kim","doi":"10.1016/j.jaac.2024.06.004","DOIUrl":"10.1016/j.jaac.2024.06.004","url":null,"abstract":"<p><strong>Objective: </strong>Naturalistic developmental behavioral interventions for children with autism spectrum disorder show evidence for effectiveness for specific social communication targets such as joint attention or engagement. However, combining evidence from different studies and comparing intervention effects across those studies have not been feasible due to lack of a standardized outcome measure of broader social communication skills that can be applied uniformly across trials. This investigation examined the usefulness of the Brief Observation of Social Communication Change (BOSCC) as a common outcome measure of general social communication skills based on secondary analyses of data obtained from previously conducted randomized controlled trials of 3 intervention models, Early Social Intervention (ESI), Early Start Denver Model (ESDM) and Joint Attention Symbolic Play Engagement and Regulation (JASPER).</p><p><strong>Method: </strong>The subset of datasets from the 3 randomized controlled trials was created to examine differences in the BOSCC scores between intervention and control groups over the course of the interventions.</p><p><strong>Results: </strong>Based on 582 videos from 207 caregiver-child dyads, the BOSCC noted significant differences between intervention vs control groups in broad social communication skills within 2 of the 3 intervention models, which were longer in duration and focused on a broad range of developmental skills.</p><p><strong>Conclusion: </strong>The BOSCC offers the potential to take a uniform measurement approach across different intervention models to capture the effect of intervention on general social communication skills but may not pick up the effects of some brief interventions targeting proximal outcomes.</p><p><strong>Clinical trial registration information: </strong>Comparing Parent-Implemented Interventions for Toddlers With Autism Spectrum Disorders; https://www.</p><p><strong>Clinicaltrials: </strong>gov/; NCT00760812. Intensive Intervention for Toddlers With Autism (EARLY STEPS); https://www.</p><p><strong>Clinicaltrials: </strong>gov/; NCT00698997. Social and Communication Outcomes for Young Children With Autism; https://www.</p><p><strong>Clinicaltrials: </strong>gov/; NCT00953095.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Study Preregistration: Targeting Parental Risk Factors for Children’s Anxiety: A Factorial Experiment With Three Intervention Components","authors":"Karen Rienks MSc , Elske Salemink PhD , Patty Leijten PhD","doi":"10.1016/j.jaac.2024.01.013","DOIUrl":"10.1016/j.jaac.2024.01.013","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":9.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0890856724001114/pdfft?md5=da0ecc37c08dcd38d72aa0cc7f617721&pid=1-s2.0-S0890856724001114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}