Journal of Child Psychology and Psychiatry最新文献

Background: The impact of maternal sleep disturbances during pregnancy on long-term neurodevelopment and the role of metabolites in this process are not well understood. In a prospective cohort study, we aimed to investigate the associations between maternal sleep disturbances during each trimester and child intelligence quotient (IQ) at the age of 4 years and to identify metabolites that might mediate these relationships.

Methods: This study included 1,870 mother-child pairs from the Shanghai Birth Cohort (SBC). Maternal sleep quality was assessed using the Pittsburgh sleep quality index (PSQI) questionnaire in the first and second trimesters, and a simplified version of the PSQI was used in the third trimester. Child IQ was evaluated at age 4 using the Wechsler Primary and Preschool Scale of Intelligence-Fourth Edition (WPPSI-IV). We conducted untargeted analyses of maternal serum metabolomics in the first trimester in 1,461 subjects. We employed multiple linear regression models to examine the associations between maternal sleep disturbances during each trimester and child IQ. Additionally, we utilized longitudinal latent class analysis (LLCA) to identify patterns of sleep quality changes throughout the three trimesters and employed multiple linear regression models to investigate how these sleep patterns across the entire pregnancy were associated with child IQ. We applied a 'meet-in-the-middle' approach to identify potential metabolites linking maternal sleep disturbances during early pregnancy with child IQ.

Results: Longer sleep latency was associated with lower child Full-Scale IQ (FSIQ) and verbal comprehension index (VCI) for the first trimester, while lower child fluid reasoning index (FRI) for the second trimester. Longer sleep latency throughout the pregnancy was associated with decreased FSIQ (β = -4.68; 95% CI: -8.32, -1.03), VCI (β = -6.38; 95% CI: -10.39, -2.37), and FRI (β = -4.29; 95% CI: -7.96, -0.63). We found that inositol, indoleacrylic acid, and 4-hydroxyquinoline emerged as potential biomarkers that play an intermediary role in the association between maternal sleep disturbances and child IQ.

Conclusions: Sleep disturbance during pregnancy may be a risk factor for compromised IQ in preschool-aged offspring. Alterations in inositol and tryptophan metabolism might be the mediator for the link between maternal sleep disturbances and child IQ.

Since the debate surrounding controversial theories, such as the refrigerator mother theory, the influence of parenting on the course of neurodevelopmental conditions has been a taboo topic for many years. However, recent research analyzing the complex interplay between genetics and the environment has introduced new approaches to examining the role of parenting. Several articles in this issue examine the new directions in the field of parenting and parent–child interactions. A key shift in perspective is the recognition that the relationship between parenting and child development is not unidirectional. Instead, the child's characteristics may also influence parental responses (evocative gene–environment), which in turn can shape the child's developmental trajectory. Moreover, parent–child interactions are not restricted to mother–child dyads, but also involve fathers and triadic interactions between both parents and the child. Experiences within these interactions are likely to transfer to other contexts, contributing to the child's language and social development. A better understanding of the time course and the mechanisms underlying parent–child interactions will enhance the design of interventions targeting parenting behavior. Although caregiver-mediated interventions have proven effective, they must take caregivers' skills into account and may need to incorporate alternative support systems beyond primary caregivers.

Background: Effective face-to-face treatments for Post-Traumatic Stress Disorder (PTSD) are available, but most young people with PTSD do not receive effective treatment. Therapist-supported online Cognitive Therapy has the potential to improve accessibility of effective treatment. This early-stage trial gathered data on the feasibility, acceptability, and initial signal of clinical efficacy of a novel online Cognitive Therapy program for young people with PTSD.

Methods: A two-arm, parallel-groups, single-blind, early-stage feasibility RCT compared online Cognitive Therapy to a waitlList condition. Participants were N = 31 adolescents (12-17 years-old) with a diagnosis of PTSD, randomised in a 1:1 ratio using minimisation. Thresholds for progression to a larger trial were set a priori for recruitment rate, data completeness, and the initial signal of clinical efficacy. The primary clinical outcome was PTSD diagnosis at 16 weeks post-randomisation. Secondary clinical outcomes were continuous measures of PTSD, depression, and anxiety at 16 weeks; and at 38 weeks in the online Cognitive Therapy arm.

Results: All pre-determined feasibility thresholds for progression to a larger trial were met. We recruited to target at a rate of 1-2 participants/month. No patient dropped out of therapy; 94% of all participants were retained at 16 weeks. At 16-weeks, the intention-to-treat (ITT) effect adjusted odds ratio was 0.20 (95% CI, 0.02, 1.42), indicating that the odds of meeting PTSD caseness after online therapy were 80% lower than after the waitlist (10/16 participants met PTSD caseness after therapy compared to 11/13 after WL). Effect-size estimates for all secondary clinical outcomes were large-moderate; improvements were sustained 38 weeks after online Cognitive Therapy.

Conclusions: Therapist-supported online Cognitive Therapy for PTSD is acceptable to young people and has potential for meaningful and sustained clinical effects. A larger trial appears feasible to deliver. Further work is needed to refine the intervention and its delivery and to evaluate it in a larger confirmatory trial.

Kaniusonyte and Laursen (2024) make an important contribution to our understanding of parental prohibitions of peer relationships and their relationship to other aspects of adolescent social functioning. This commentary develops several possible extensions to this interesting line of research with a goal of more specifically identifying the mechanisms that account for the relationships between prohibitions and adolescents' peer adjustment. Future investigations can build on this research by considering the role of conflict between parents and adolescents as a potential mediator or moderator in the process of prohibiting and considering the meaning of restrictive peer access to adolescents' peers across the developmental period. Further, investigations could consider daily diary and observational approaches to expand the field to better understand prohibitions at a microlevel. The commentary also encourages investigators to more fully examine bidirectionality, specifically child effects, which have received relatively little attention in this area.

Background: Systematic reviews have suggested mixed effects of the COVID-19 pandemic on the mental health of children and young people. However, most included studies focused on the general population and were cross-sectional. The long-term impact on those with pre-existing mental health and/or neurodevelopmental conditions remains unclear. Thus, we conducted a systematic review and meta-analysis to examine the longitudinal impact of the pandemic on the mental health of this clinical population and potential explanatory factors.

Methods: Ovid Medline, Embase, APA PsycInfo and Global Health databases were searched between 1 January 2020 and 3 August 2023 (PROSPERO CRD42022383546). We included longitudinal studies that compared mental health symptoms between pre- and during pandemic and/or during pandemic timepoints in children and young people (≤18 years old) with pre-existing mental and/or neurodevelopmental conditions. Outcomes included internalising, externalising and other symptoms. Risk of bias was rated using an adapted tool. Included studies were narratively synthesised and multi-level meta-analyses were conducted where the number of studies was sufficient.

Results: We identified 21 studies (N = 2,617) from 6,083 records. Studies differed across countries, diagnoses, measures, informants and timepoints. All had overall moderate-to-high risk of bias. Narrative synthesis found mixed evidence of symptom change, with individual studies showing increase/reduction/no change. Factors such as diagnosis, baseline symptom severity, age and sex/gender may explain variation in outcomes. Multi-level meta-analyses were feasible for a limited number of outcomes and found no significant changes in internalising and externalising symptoms pre- versus during pandemic or internalising symptoms between 2020 pandemic phases, and high heterogeneity was noted.

Conclusions: The impact of the pandemic on the mental health of children and young people with pre-existing conditions varied according to individual and contextual vulnerabilities, which were not fully captured in pooled analyses. Further research needs to investigate longer-term impacts and better stratify this vulnerable population.

Background: Neurodevelopmental conditions are highly heritable. Recent studies have shown that genomic heritability estimates can be confounded by genetic effects mediated via the environment (indirect genetic effects). However, the relative importance of direct versus indirect genetic effects on early variability in traits related to neurodevelopmental conditions is unknown.

Methods: The sample included up to 24,692 parent-offspring trios from the Norwegian MoBa cohort. We use Trio-GCTA to estimate latent direct and indirect genetic effects on mother-reported neurodevelopmental traits at age of 3 years (restricted and repetitive behaviors and interests, inattention, hyperactivity, language, social, and motor development). Further, we investigate to what extent direct and indirect effects are attributable to common genetic variants associated with autism, ADHD, developmental dyslexia, educational attainment, and cognitive ability using polygenic scores (PGS) in regression modeling.

Results: We find evidence for contributions of direct and indirect latent common genetic effects to inattention (direct: explaining 4.8% of variance, indirect: 6.7%) hyperactivity (direct: 1.3%, indirect: 9.6%), and restricted and repetitive behaviors (direct: 0.8%, indirect: 7.3%). Direct effects best explained variation in social and communication, language, and motor development (5.1%-5.7%). Direct genetic effects on inattention were captured by PGS for ADHD, educational attainment, and cognitive ability, whereas direct genetic effects on language development were captured by cognitive ability, educational attainment, and autism PGS. Indirect genetic effects on neurodevelopmental traits were primarily captured by educational attainment and/or cognitive ability PGS.

Conclusions: Results were consistent with differential contributions to neurodevelopmental traits in early childhood from direct and indirect genetic effects. Indirect effects were particularly important for hyperactivity and restricted and repetitive behaviors and interests and may be linked to genetic variation associated with cognition and educational attainment. Our findings illustrate the importance of within-family methods for disentangling genetic processes that influence early neurodevelopmental traits, even when identifiable associations are small.