This editorial explores how adopting a social determinants and systemic perspective can enhance preventative measures to boost the mental health of young people. It argues that to effectively elevate the mental health of young people, it is essential to tackle both the overarching influences and their specific local impacts. We maintain that a strategy combining systems thinking with evidence tailored to the local environment and participatory design is essential.
{"title":"Editorial Perspective: A systems approach to addressing young people's mental health","authors":"Tim Hobbs, Vashti Berry, Peter Fonagy","doi":"10.1111/jcpp.14077","DOIUrl":"https://doi.org/10.1111/jcpp.14077","url":null,"abstract":"This editorial explores how adopting a social determinants and systemic perspective can enhance preventative measures to boost the mental health of young people. It argues that to effectively elevate the mental health of young people, it is essential to tackle both the overarching influences and their specific local impacts. We maintain that a strategy combining systems thinking with evidence tailored to the local environment and participatory design is essential.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"7 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142713013","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}
Virginia Peisch, Erica Ferrara, Gaelle Gourdet, Matthew Zimon, Carissa Mastrangelo, Anne Arnett
BackgroundThis study investigated associations among temperament, executive functioning (EF), and attention‐deficit/hyperactivity disorder (ADHD) symptom severity at two developmental stages.MethodsParticipants were 61 4‐year‐old children and 165 8–11‐year‐old children (126 ADHD, 39 typically developing [TD]). Caregivers reported on temperament (effortful control [EC], negative affect, and surgency), and ADHD symptoms. Three aspects of EF (working memory, inhibitory control, and processing speed) were measured with neuropsychological tests.ResultsAmong 4‐year‐olds, variance in ADHD symptom severity was only explained by the temperament variables. EC was not significantly correlated with any of the EFs in this cohort. Among school‐aged children, low EC, high surgency, high negative affect, and reduced working memory were associated with greater ADHD symptom severity. EC was significantly and positively correlated with processing speed in the school‐aged children.ConclusionsResults are consistent with a neurodevelopmental model of ADHD, wherein dysregulated temperament is associated with ADHD in young children, while both dysregulated temperament and cognitive skills are associated with ADHD in middle childhood. Results could inform the selection of clinical tools for diagnostic evaluation of pediatric ADHD symptoms and clinical follow‐up.
背景本研究调查了两个发育阶段的儿童在气质、执行功能(EF)和注意缺陷/多动障碍(ADHD)症状严重程度之间的关系。方法参加研究的有61名4岁儿童和165名8-11岁儿童(126名ADHD儿童,39名典型发育[TD]儿童)。照顾者报告了他们的性情(努力控制 [EC]、消极情绪和急躁)和多动症症状。结果在 4 岁儿童中,ADHD 症状严重程度的差异只能通过气质变量来解释。在这个群体中,EC 与任何 EF 都没有明显的相关性。在学龄儿童中,低EC、高急躁情绪、高负面情绪和工作记忆减弱与ADHD症状严重程度相关。在学龄儿童中,EC 与处理速度呈明显的正相关。结论结果与多动症的神经发育模型一致,即气质失调与幼儿多动症相关,而气质失调和认知技能失调与中年多动症相关。研究结果可为选择诊断评估小儿多动症症状的临床工具和临床随访提供参考。
{"title":"Temperament and executive functioning correlates of ADHD symptom severity during early versus middle childhood","authors":"Virginia Peisch, Erica Ferrara, Gaelle Gourdet, Matthew Zimon, Carissa Mastrangelo, Anne Arnett","doi":"10.1111/jcpp.14083","DOIUrl":"https://doi.org/10.1111/jcpp.14083","url":null,"abstract":"BackgroundThis study investigated associations among temperament, executive functioning (EF), and attention‐deficit/hyperactivity disorder (ADHD) symptom severity at two developmental stages.MethodsParticipants were 61 4‐year‐old children and 165 8–11‐year‐old children (126 ADHD, 39 typically developing [TD]). Caregivers reported on temperament (effortful control [EC], negative affect, and surgency), and ADHD symptoms. Three aspects of EF (working memory, inhibitory control, and processing speed) were measured with neuropsychological tests.ResultsAmong 4‐year‐olds, variance in ADHD symptom severity was only explained by the temperament variables. EC was not significantly correlated with any of the EFs in this cohort. Among school‐aged children, low EC, high surgency, high negative affect, and reduced working memory were associated with greater ADHD symptom severity. EC was significantly and positively correlated with processing speed in the school‐aged children.ConclusionsResults are consistent with a neurodevelopmental model of ADHD, wherein dysregulated temperament is associated with ADHD in young children, while both dysregulated temperament and cognitive skills are associated with ADHD in middle childhood. Results could inform the selection of clinical tools for diagnostic evaluation of pediatric ADHD symptoms and clinical follow‐up.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"64 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142713147","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}
Bradley S. Peterson, Sahar Delavari, Jonathan Sadik, Lars Ersland, Irene B. Elgen, Siddhant Sawardekar, Ravi Bansal, Stein Magnus Aukland
BackgroundFifteen million infants annually are born prematurely, placing them at high risk for life‐long adverse neurodevelopmental outcomes. Whether brain tissue abnormalities that accompany preterm birth persist into young adulthood and are associated with long‐term cognitive or psychiatric outcomes is not known.MethodsFrom infancy into young adulthood, we followed a population‐based sample of consecutively identified preterm infants and their matched term controls. The preterm group was born at an average gestational age of 31.5 ± 2.6 weeks. We obtained Diffusion Tensor Imaging scans and assessed cognitive and psychiatric outcomes in young adulthood, at a mean age of 19 (range 17.6–20.8) years. Usable data were acquired from 180 participants (89 preterm, 91 term).ResultsPreterm birth was associated with lower fractional anisotropy (FA) and higher average diffusion coefficient (ADC) values in deep white matter tracts of the internal capsule, cerebral peduncles, inferior frontal‐occipital fasciculus, sagittal stratum and splenium of the corpus callosum, as well as in grey matter of the caudate, putamen and thalamus. A younger gestational age at birth accentuated these tissue abnormalities. Perinatal characteristics, including lower 5‐min APGAR score, history of bronchopulmonary dysplasia, more days of oxygen supplementation and multiple births all increased ADC values in deep white matter tracts and grey matter throughout the brain. Preterm individuals had significantly lower full‐scale IQ and more frequent lifetime psychiatric disorders. Those with psychiatric illnesses had significantly higher ADC and lower FA values throughout the deep posterior white matter.ConclusionsAbnormalities in brain tissue microstructure associated with preterm birth persist into young adulthood and likely represent disordered myelination and accompanying axonal pathology. These disturbances are associated with a higher likelihood of developing a psychiatric disorder by young adulthood. Brain tissue disturbances were accentuated in those born at younger gestational ages and in those with a history of perinatal complications associated with infection and inflammation.
{"title":"Brain tissue microstructure in a prospective, longitudinal, population‐based cohort of preterm and term‐born young adults","authors":"Bradley S. Peterson, Sahar Delavari, Jonathan Sadik, Lars Ersland, Irene B. Elgen, Siddhant Sawardekar, Ravi Bansal, Stein Magnus Aukland","doi":"10.1111/jcpp.14069","DOIUrl":"https://doi.org/10.1111/jcpp.14069","url":null,"abstract":"BackgroundFifteen million infants annually are born prematurely, placing them at high risk for life‐long adverse neurodevelopmental outcomes. Whether brain tissue abnormalities that accompany preterm birth persist into young adulthood and are associated with long‐term cognitive or psychiatric outcomes is not known.MethodsFrom infancy into young adulthood, we followed a population‐based sample of consecutively identified preterm infants and their matched term controls. The preterm group was born at an average gestational age of 31.5 ± 2.6 weeks. We obtained Diffusion Tensor Imaging scans and assessed cognitive and psychiatric outcomes in young adulthood, at a mean age of 19 (range 17.6–20.8) years. Usable data were acquired from 180 participants (89 preterm, 91 term).ResultsPreterm birth was associated with lower fractional anisotropy (FA) and higher average diffusion coefficient (ADC) values in deep white matter tracts of the internal capsule, cerebral peduncles, inferior frontal‐occipital fasciculus, sagittal stratum and splenium of the corpus callosum, as well as in grey matter of the caudate, putamen and thalamus. A younger gestational age at birth accentuated these tissue abnormalities. Perinatal characteristics, including lower 5‐min APGAR score, history of bronchopulmonary dysplasia, more days of oxygen supplementation and multiple births all increased ADC values in deep white matter tracts and grey matter throughout the brain. Preterm individuals had significantly lower full‐scale IQ and more frequent lifetime psychiatric disorders. Those with psychiatric illnesses had significantly higher ADC and lower FA values throughout the deep posterior white matter.ConclusionsAbnormalities in brain tissue microstructure associated with preterm birth persist into young adulthood and likely represent disordered myelination and accompanying axonal pathology. These disturbances are associated with a higher likelihood of developing a psychiatric disorder by young adulthood. Brain tissue disturbances were accentuated in those born at younger gestational ages and in those with a history of perinatal complications associated with infection and inflammation.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"195 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142673343","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}
There is substantial evidence that adolescent mental health has deteriorated considerably since the early 2010s across many countries, and much more strongly among girls than boys. This is probably due to a combination of societal changes that strongly influenced the lives of adolescents. The societal changes include the rise of social media and of academic pressure, the COVID-19 pandemic and increasing worries about the future. Moreover, the decreasing trend in adolescent mental health might have resulted into more mental health awareness and a tendency to overinterpret negative psychological experiences as signs of mental health problems. Several suggestions for future research are provided to increase our understanding of the origins of the recent trends in adolescent mental health.
{"title":"Editorial: Adolescent mental health in a rapidly changing world","authors":"Gonneke W. J. M. Stevens","doi":"10.1111/jcpp.14065","DOIUrl":"10.1111/jcpp.14065","url":null,"abstract":"<p>There is substantial evidence that adolescent mental health has deteriorated considerably since the early 2010s across many countries, and much more strongly among girls than boys. This is probably due to a combination of societal changes that strongly influenced the lives of adolescents. The societal changes include the rise of social media and of academic pressure, the COVID-19 pandemic and increasing worries about the future. Moreover, the decreasing trend in adolescent mental health might have resulted into more mental health awareness and a tendency to overinterpret negative psychological experiences as signs of mental health problems. Several suggestions for future research are provided to increase our understanding of the origins of the recent trends in adolescent mental health.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"65 12","pages":"1551-1553"},"PeriodicalIF":6.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613071","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}
Lucy A. Tully, Adrienne I. Turnell, Bronte G. Morgan, David J. Hawes, Jenny Anderson, Anna Kean, Mark R. Dadds
BackgroundParenting interventions are effective for improving child conduct problems (CPs), but online self‐directed interventions are required to improve reach and impact. Mothers are the main users of such programmes; fathers show low participation rates despite evidence of increased efficacy when they participate.MethodsThis randomised controlled trial examined the efficacy of Family Man, a brief, self‐directed online parenting intervention for fathers and mothers of children with CPs. The intervention involves several innovative design features to maximise the engagement of fathers. Families (N = 103; 102 mothers, 78 fathers) seeking help with managing their 2‐ to 8‐year‐old child's CPs were randomly assigned to either the Family Man intervention condition (n = 53) or a 4‐week waitlist control group (n = 50). Primary outcomes were frequency and severity of child CPs and secondary outcomes included dysfunctional parenting, parenting efficacy, parenting stress, parental psychological distress, household disorganisation and interparental conflict.ResultsRepeated measures ANOVAs/MANOVAs found that at 4‐week post‐assessment, parents in the intervention group reported significantly lower levels of child CPs than waitlist. Significant effects for the intervention group relative to waitlist were also found across all secondary outcomes examined. Intervention effects were maintained at 2‐month follow‐up for the intervention group. Outcomes did not significantly differ for mothers and fathers.ConclusionsResults support the efficacy of this brief, self‐directed online parenting intervention in improving child CPs and a range of parent and family outcomes, both for fathers and mothers. Implications for improving the reach and impact of parenting interventions and increasing father engagement, are discussed.
背景育儿干预措施对改善儿童行为问题(CPs)很有效,但需要在线自我指导干预措施来提高覆盖率和影响力。母亲是此类项目的主要使用者;父亲的参与率较低,尽管有证据表明他们参与后效果会更好。方法这项随机对照试验研究了 "Family Man "的效果,"Family Man "是一项针对有行为问题儿童的父亲和母亲的简短、自主在线育儿干预项目。该干预措施采用了多项创新设计,以最大限度地提高父亲的参与度。寻求帮助的家庭(103 个;102 个母亲,78 个父亲)被随机分配到 Family Man 干预条件组(53 个)或为期 4 周的候补对照组(50 个)。结果重复测量方差分析/方差分析发现,在4周后的评估中,干预组家长报告的儿童抑郁症水平明显低于候补对照组。在所有次要结果中,干预组的效果也明显优于等待组。干预组的干预效果在 2 个月的随访中得以保持。结论研究结果表明,这种简短的、自我指导的在线育儿干预措施在改善儿童CPs以及一系列父母和家庭结果方面对父亲和母亲都很有效。本文还讨论了提高育儿干预的覆盖面和影响力以及增加父亲参与的意义。
{"title":"An online, father‐inclusive parenting intervention for reducing child conduct problems: a randomised controlled trial of family man","authors":"Lucy A. Tully, Adrienne I. Turnell, Bronte G. Morgan, David J. Hawes, Jenny Anderson, Anna Kean, Mark R. Dadds","doi":"10.1111/jcpp.14068","DOIUrl":"https://doi.org/10.1111/jcpp.14068","url":null,"abstract":"BackgroundParenting interventions are effective for improving child conduct problems (CPs), but online self‐directed interventions are required to improve reach and impact. Mothers are the main users of such programmes; fathers show low participation rates despite evidence of increased efficacy when they participate.MethodsThis randomised controlled trial examined the efficacy of Family Man, a brief, self‐directed online parenting intervention for fathers and mothers of children with CPs. The intervention involves several innovative design features to maximise the engagement of fathers. Families (<jats:italic>N</jats:italic> = 103; 102 mothers, 78 fathers) seeking help with managing their 2‐ to 8‐year‐old child's CPs were randomly assigned to either the Family Man intervention condition (<jats:italic>n</jats:italic> = 53) or a 4‐week waitlist control group (<jats:italic>n</jats:italic> = 50). Primary outcomes were frequency and severity of child CPs and secondary outcomes included dysfunctional parenting, parenting efficacy, parenting stress, parental psychological distress, household disorganisation and interparental conflict.ResultsRepeated measures ANOVAs/MANOVAs found that at 4‐week post‐assessment, parents in the intervention group reported significantly lower levels of child CPs than waitlist. Significant effects for the intervention group relative to waitlist were also found across all secondary outcomes examined. Intervention effects were maintained at 2‐month follow‐up for the intervention group. Outcomes did not significantly differ for mothers and fathers.ConclusionsResults support the efficacy of this brief, self‐directed online parenting intervention in improving child CPs and a range of parent and family outcomes, both for fathers and mothers. Implications for improving the reach and impact of parenting interventions and increasing father engagement, are discussed.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"3 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610133","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}
A substantial portion of interventions designed to support autistic children are also designed to be delivered by caregivers (i.e. are ‘caregiver‐mediated’). Brown et al. (Journal of Child Psychology and Psychiatry, 2024) are one of the first groups to critically examine the baseline skills that caregivers bring as they prepare to learn a class of interventions called Naturalistic Developmental Behavioral Interventions (NDBIs), which are designed to support social communication growth in young autistic children. This commentary commends Brown and colleagues for their focus on caregivers, a linchpin within the increasingly prominent caregiver‐mediated process of intervention delivery. However, it is imperative that future research understand the potential adverse effects and supports that are needed to bolster caregivers in this crucial role. We present six recommendations for research on caregiver‐mediated interventions that build on Brown and colleagues' work and address these needs, which involve: caregiver supports, equitable samples, community settings, adaptive designs, general principles, and implications for NDBI dissemination.
{"title":"Supporting caregivers within caregiver‐mediated interventions: a commentary on Brown et al. (2024)","authors":"Sarah R. Edmunds, Robert Hock","doi":"10.1111/jcpp.14073","DOIUrl":"https://doi.org/10.1111/jcpp.14073","url":null,"abstract":"A substantial portion of interventions designed to support autistic children are also designed to be delivered by caregivers (i.e. are ‘caregiver‐mediated’). Brown et al. (Journal of Child Psychology and Psychiatry, 2024) are one of the first groups to critically examine the baseline skills that caregivers bring as they prepare to learn a class of interventions called Naturalistic Developmental Behavioral Interventions (NDBIs), which are designed to support social communication growth in young autistic children. This commentary commends Brown and colleagues for their focus on caregivers, a linchpin within the increasingly prominent caregiver‐mediated process of intervention delivery. However, it is imperative that future research understand the potential adverse effects and supports that are needed to bolster caregivers in this crucial role. We present six recommendations for research on caregiver‐mediated interventions that build on Brown and colleagues' work and address these needs, which involve: caregiver supports, equitable samples, community settings, adaptive designs, general principles, and implications for NDBI dissemination.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"30 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601291","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}
Sarah E. Stock, Rebecca E. Lacey, Louise Arseneault, Avshalom Caspi, Eloise Crush, Andrea Danese, Rachel M. Latham, Terrie E. Moffitt, Joanne B. Newbury, Jonathan D. Schaefer, Helen L. Fisher, Jessie R. Baldwin
BackgroundAdverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding.MethodsWe used the twin‐difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E‐Risk) Longitudinal Twin Study, a UK population‐representative birth cohort of 2,232 same‐sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18.ResultsAmong children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin‐difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co‐twins, concordant for ACE exposure.ConclusionsThe apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health.
{"title":"Can a warm and supportive adult protect against mental health problems amongst children with experience of adversity? A twin‐differences study","authors":"Sarah E. Stock, Rebecca E. Lacey, Louise Arseneault, Avshalom Caspi, Eloise Crush, Andrea Danese, Rachel M. Latham, Terrie E. Moffitt, Joanne B. Newbury, Jonathan D. Schaefer, Helen L. Fisher, Jessie R. Baldwin","doi":"10.1111/jcpp.14070","DOIUrl":"https://doi.org/10.1111/jcpp.14070","url":null,"abstract":"BackgroundAdverse childhood experiences (ACEs) are associated with mental health problems, but many children who experience ACEs do not develop such difficulties. A warm and supportive adult presence in childhood is associated with a lower likelihood of developing mental health problems after exposure to ACEs. However, it is unclear whether this association is causal, as previous research has not accounted for genetic and environmental confounding.MethodsWe used the twin‐difference design to strengthen causal inference about whether a warm and supportive adult presence protects children exposed to ACEs from mental health problems. Participants were from the Environmental Risk (E‐Risk) Longitudinal Twin Study, a UK population‐representative birth cohort of 2,232 same‐sex twins. ACEs were measured prospectively from ages 5 to 12. Maternal warmth was assessed at ages 5 and 10 through maternal speech samples. Adult support was assessed through child reports at age 12. Mental health problems were assessed through interviews at age 12 with parents and teachers and participants at age 18.ResultsAmong children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of mental health problems at ages 12 and 18. In monozygotic twin‐difference analyses, the protective effects of maternal warmth and adult support on mental health were attenuated by 70% for maternal warmth and 81% for adult support, compared to phenotypic analyses. Twins who experienced greater maternal warmth and adult support had minimal or no difference in mental health compared to their co‐twins, concordant for ACE exposure.ConclusionsThe apparent protective effect of a warm, supportive adult against mental health problems following ACEs is largely explained by genetic and environmental confounding. This suggests that interventions which boost maternal warmth and adult support should be supplemented by components addressing wider family environments and heritable vulnerabilities in children exposed to adversity, to improve mental health.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"127 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601292","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}
Marie Camerota, Francisco Xavier Castellanos, Brian S. Carter, Jennifer Check, Jennifer Helderman, Julie A. Hofheimer, Elisabeth C. McGowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Thomas Michael O'Shea, Carmen J. Marsit, Barry M. Lester
BackgroundChildren born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born <30 weeks of gestational age (GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention‐deficit/hyperactivity disorder (ADHD) diagnosis.MethodsWe studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of infants born <30 weeks of GA. Parents reported on child attention problems at ages 2, 3, 4, and 5 years using the Child Behavior Checklist and the Behavior Assessment System for Children. Sociodemographic and medical characteristics were assessed via maternal interview and medical record review. Neurobehavioral characteristics were determined using neonatal and 2‐year assessments. Parent report of child ADHD diagnosis was obtained. We used latent growth curve (LGC) modeling to test our study aims.ResultsA linear LGC model provided the best fit to the data. The average trajectory of attention problems evidenced low initial levels of symptoms and little change over time, yet there was significant heterogeneity in both initial levels and change over time. Individual differences in trajectory parameters were associated with sociodemographic, medical, environmental, and neurobehavioral characteristics. Children with higher initial levels of attention problems as well as steeper increases in attention problems over time were more likely to have a reported ADHD diagnosis.ConclusionsThere is significant heterogeneity in trajectories of attention problems from age 2 to 5 in children born <30 weeks of GA and these differences have clinical relevance. These data could inform follow‐up guidelines for preterm infants.
{"title":"Trajectories of attention problems in preschoolers born very preterm","authors":"Marie Camerota, Francisco Xavier Castellanos, Brian S. Carter, Jennifer Check, Jennifer Helderman, Julie A. Hofheimer, Elisabeth C. McGowan, Charles R. Neal, Steven L. Pastyrnak, Lynne M. Smith, Thomas Michael O'Shea, Carmen J. Marsit, Barry M. Lester","doi":"10.1111/jcpp.14074","DOIUrl":"https://doi.org/10.1111/jcpp.14074","url":null,"abstract":"BackgroundChildren born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born <30 weeks of gestational age (GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention‐deficit/hyperactivity disorder (ADHD) diagnosis.MethodsWe studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of infants born <30 weeks of GA. Parents reported on child attention problems at ages 2, 3, 4, and 5 years using the Child Behavior Checklist and the Behavior Assessment System for Children. Sociodemographic and medical characteristics were assessed via maternal interview and medical record review. Neurobehavioral characteristics were determined using neonatal and 2‐year assessments. Parent report of child ADHD diagnosis was obtained. We used latent growth curve (LGC) modeling to test our study aims.ResultsA linear LGC model provided the best fit to the data. The average trajectory of attention problems evidenced low initial levels of symptoms and little change over time, yet there was significant heterogeneity in both initial levels and change over time. Individual differences in trajectory parameters were associated with sociodemographic, medical, environmental, and neurobehavioral characteristics. Children with higher initial levels of attention problems as well as steeper increases in attention problems over time were more likely to have a reported ADHD diagnosis.ConclusionsThere is significant heterogeneity in trajectories of attention problems from age 2 to 5 in children born <30 weeks of GA and these differences have clinical relevance. These data could inform follow‐up guidelines for preterm infants.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598227","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}
Alessio Bellato, Valeria Parlatini, Madeleine J. Groom, Charlotte L. Hall, Chris Hollis, Emily Simonoff, Anita Thapar, Samuele Cortese
Individuals with attention‐deficit/hyperactivity disorder (ADHD) exhibit varied responses to pharmacological treatments (e.g. stimulants and non‐stimulants). Accurately and promptly detecting treatment‐related improvements, response failure, or deterioration poses significant challenges, as current monitoring primarily relies on subjective ratings. In this commentary, we critically evaluate the evidence supporting the use of QbTest for objectively monitoring ADHD treatment response in clinical practice. We also offer recommendations for future research, advocating for rigorous clinical trials and longitudinal studies to further explore the potential utilisation of QbTest and other tools for monitoring treatment responses in individuals with ADHD.
{"title":"Commentary: Using QbTest for monitoring pharmacological treatment response in ADHD – are we there yet?","authors":"Alessio Bellato, Valeria Parlatini, Madeleine J. Groom, Charlotte L. Hall, Chris Hollis, Emily Simonoff, Anita Thapar, Samuele Cortese","doi":"10.1111/jcpp.14071","DOIUrl":"https://doi.org/10.1111/jcpp.14071","url":null,"abstract":"Individuals with attention‐deficit/hyperactivity disorder (ADHD) exhibit varied responses to pharmacological treatments (e.g. stimulants and non‐stimulants). Accurately and promptly detecting treatment‐related improvements, response failure, or deterioration poses significant challenges, as current monitoring primarily relies on subjective ratings. In this commentary, we critically evaluate the evidence supporting the use of QbTest for objectively monitoring ADHD treatment response in clinical practice. We also offer recommendations for future research, advocating for rigorous clinical trials and longitudinal studies to further explore the potential utilisation of QbTest and other tools for monitoring treatment responses in individuals with ADHD.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"70 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596910","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}
Lars Wichstrøm, Theresa Wilberg, Elfrida Hartveit Kvarstein, Silje Steinsbekk
Background: Although it is widely assumed that avoidant personality disorder (AvPD) originates in childhood, there is little prospective research to substantiate this claim. We therefore aimed to determine whether presumed childhood risk factors predict AvPD traits at 16 years.
Methods: A population-based sample (n = 1,077; 50.9% female) from the 2003 and 2004 birth cohorts in (blinded for review) Norway was examined biennially from 4 to 16 years. The number of AvPD traits at the age of 16 was assessed with the structured clinical interview for DSM-5 personality disorders and regressed on the intercept and growth in child risk and protective factors until the age of 14.
Results: The prevalence of AvPD at the age of 16 was 3.2% (95% CI: 2.2-4.1). Higher levels and an increased number of social anxiety symptoms over time, as well as increased negative affectivity/neuroticism, predicted a higher number of AvPD traits. When the levels and changes in these factors were adjusted for, less and decreasing extraversion forecasted more AvPD traits, as did declining self-worth, higher levels of parental AvPD traits, and increased onlooking behavior.
Conclusions: Neuroticism, low extraversion, social anxiety symptoms, passive onlooking behavior, and low self-worth predicted a higher number of AvPD traits in adolescence, as did more AvPD traits in parents. Efforts to enhance self-worth, reduce social anxiety, and promote peer interaction among onlooking children may reduce the development of AvPD traits in adolescence.
{"title":"Childhood predictors of avoidant personality disorder traits in adolescence: a seven-wave birth cohort study.","authors":"Lars Wichstrøm, Theresa Wilberg, Elfrida Hartveit Kvarstein, Silje Steinsbekk","doi":"10.1111/jcpp.14064","DOIUrl":"https://doi.org/10.1111/jcpp.14064","url":null,"abstract":"<p><strong>Background: </strong>Although it is widely assumed that avoidant personality disorder (AvPD) originates in childhood, there is little prospective research to substantiate this claim. We therefore aimed to determine whether presumed childhood risk factors predict AvPD traits at 16 years.</p><p><strong>Methods: </strong>A population-based sample (n = 1,077; 50.9% female) from the 2003 and 2004 birth cohorts in (blinded for review) Norway was examined biennially from 4 to 16 years. The number of AvPD traits at the age of 16 was assessed with the structured clinical interview for DSM-5 personality disorders and regressed on the intercept and growth in child risk and protective factors until the age of 14.</p><p><strong>Results: </strong>The prevalence of AvPD at the age of 16 was 3.2% (95% CI: 2.2-4.1). Higher levels and an increased number of social anxiety symptoms over time, as well as increased negative affectivity/neuroticism, predicted a higher number of AvPD traits. When the levels and changes in these factors were adjusted for, less and decreasing extraversion forecasted more AvPD traits, as did declining self-worth, higher levels of parental AvPD traits, and increased onlooking behavior.</p><p><strong>Conclusions: </strong>Neuroticism, low extraversion, social anxiety symptoms, passive onlooking behavior, and low self-worth predicted a higher number of AvPD traits in adolescence, as did more AvPD traits in parents. Efforts to enhance self-worth, reduce social anxiety, and promote peer interaction among onlooking children may reduce the development of AvPD traits in adolescence.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575024","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}