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Editorial Perspective: A systems approach to addressing young people's mental health 编辑视角:解决青少年心理健康问题的系统方法
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-26 DOI: 10.1111/jcpp.14077
Tim Hobbs, Vashti Berry, Peter Fonagy
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.
这篇社论探讨了采用社会决定因素和系统性视角如何加强预防措施,以促进青少年的心理健康。社论认为,要有效提升青少年的心理健康水平,必须同时解决总体影响因素及其对当地的具体影响。我们认为,将系统思维与适合当地环境的证据和参与式设计相结合的战略是至关重 要的。
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引用次数: 0
Temperament and executive functioning correlates of ADHD symptom severity during early versus middle childhood 儿童早期与中期多动症症状严重程度的气质和执行功能相关性
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-26 DOI: 10.1111/jcpp.14083
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。
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引用次数: 0
Brain tissue microstructure in a prospective, longitudinal, population‐based cohort of preterm and term‐born young adults 前瞻性、纵向、基于人群的早产和足月出生青壮年队列中的脑组织微观结构
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-20 DOI: 10.1111/jcpp.14069
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.
背景每年有 1500 万婴儿早产,这使他们面临终生不良神经发育后果的高风险。早产儿伴随的脑组织异常是否会持续到成年后,并与长期的认知或精神发育结果相关,目前尚不清楚。方法我们对连续确定的早产儿及其匹配的足月对照进行了从婴儿期到成年后的人口抽样调查。早产儿组的平均胎龄为 31.5 ± 2.6 周。我们获得了弥散张量成像扫描结果,并对平均年龄为 19 岁(17.6-20.8 岁)的早产儿成年后的认知能力和精神状况进行了评估。结果早产与内囊深层白质束、脑梗、额下-枕束、矢状层和胼胝体脾以及尾状核、丘脑和丘脑灰质的分数各向异性(FA)较低和平均扩散系数(ADC)较高有关。胎龄越小,这些组织异常越明显。围产期特征,包括较低的5分钟APGAR评分、支气管肺发育不良病史、较多的补氧天数和多胎分娩,都会增加大脑深部白质束和灰质的ADC值。早产儿的全面智商明显较低,一生中患精神疾病的次数也更多。结论与早产有关的脑组织微观结构异常一直持续到青年期,很可能代表着髓鞘化紊乱和伴随的轴突病变。这些紊乱与成年后罹患精神疾病的可能性较高有关。早产儿和围产期出现感染和炎症并发症的婴儿的脑组织障碍更为严重。
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引用次数: 0
Editorial: Adolescent mental health in a rapidly changing world 社论:瞬息万变世界中的青少年心理健康。
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-14 DOI: 10.1111/jcpp.14065
Gonneke W. J. M. Stevens

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.

有大量证据表明,自 2010 年代初以来,许多国家的青少年心理健康状况大幅恶化,而且女孩的情况比男孩严重得多。这可能是由于社会变革对青少年生活产生了强烈影响。这些社会变革包括社交媒体的兴起和学业压力的增加、COVID-19 的流行以及对未来的担忧与日俱增。此外,青少年心理健康呈下降趋势,这可能导致他们对心理健康有了更多的认识,并倾向于将消极的心理体验过度解读为心理健康问题的征兆。本文为今后的研究提出了若干建议,以加深我们对近期青少年心理健康趋势根源的理解。
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引用次数: 0
An online, father‐inclusive parenting intervention for reducing child conduct problems: a randomised controlled trial of family man 减少儿童行为问题的在线、父亲参与式育儿干预:家庭男子随机对照试验
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-13 DOI: 10.1111/jcpp.14068
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。
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引用次数: 0
Supporting caregivers within caregiver‐mediated interventions: a commentary on Brown et al. (2024) 在以照顾者为媒介的干预措施中支持照顾者:对 Brown 等人(2024)的评论
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-13 DOI: 10.1111/jcpp.14073
Sarah R. Edmunds, Robert Hock
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.
为支持自闭症儿童而设计的干预措施中,有相当一部分也是由照护者实施的(即 "以照护者为媒介")。布朗等人(《儿童心理学与精神病学杂志》,2024 年)是最早批判性地研究照顾者在准备学习一类名为 "自然发展行为干预"(NDBIs)的干预措施时所具备的基本技能的团体之一。这篇评论赞扬了布朗及其同事对照护者的关注,这是日益突出的以照护者为媒介的干预过程中的一个关键环节。然而,未来的研究必须了解潜在的不利影响,以及需要哪些支持来加强照顾者在这一关键角色中的作用。我们在布朗及其同事的工作基础上,针对这些需求提出了六项关于以护理者为媒介的干预研究建议,涉及:护理者支持、公平样本、社区环境、适应性设计、一般原则以及对 NDBI 传播的影响。
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引用次数: 0
Can a warm and supportive adult protect against mental health problems amongst children with experience of adversity? A twin‐differences study 温暖和支持性成人能否保护经历逆境的儿童免受心理健康问题的困扰?双胞胎差异研究
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-13 DOI: 10.1111/jcpp.14070
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.
背景童年时期的不良经历(ACE)与心理健康问题有关,但许多经历过 ACE 的儿童并没有发展成心理健康问题。童年时期成人的温暖和支持与遭遇 ACE 后出现心理健康问题的可能性较低有关。然而,由于之前的研究没有考虑到遗传和环境的混杂因素,因此目前还不清楚这种关联是否是因果关系。方法我们采用了双胞胎差分设计来加强因果推断,以确定温暖和支持性的成人陪伴是否能保护遭受 ACE 的儿童免受心理健康问题的影响。参与者来自环境风险(E-Risk)纵向双胞胎研究,该研究是英国一个具有人口代表性的出生队列,由2232对同性双胞胎组成。从 5 岁到 12 岁,对 ACE 进行了前瞻性测量。在 5 岁和 10 岁时,通过母亲的言语样本对母亲的温暖程度进行评估。成人的支持通过儿童 12 岁时的报告进行评估。结果在受到ACE影响的儿童中,那些经历过更多母性温暖和成人支持的儿童在12岁和18岁时的心理健康问题水平较低。在单卵双胎差异分析中,与表型分析相比,母性温暖和成人支持对心理健康的保护作用分别减弱了70%和81%。与同卵双胞胎相比,获得更多母性温暖和成人支持的双胞胎在心理健康方面的差异很小或没有差异,这与暴露于 ACE 的情况一致。这表明,在采取增强母亲温暖和成人支持的干预措施的同时,还应辅之以针对更广泛的家庭环境和逆境儿童遗传脆弱性的干预措施,以改善儿童的心理健康。
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引用次数: 0
Trajectories of attention problems in preschoolers born very preterm 早产学龄前儿童注意力问题的发展轨迹
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-11 DOI: 10.1111/jcpp.14074
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.
背景早产儿神经发育受损的风险较高,其中包括注意力方面的特殊缺陷。很少有研究调查入学前注意力问题随时间的变化。本研究旨在描述一组胎龄 30 周(GA)的早产儿从 2 岁到 5 岁期间注意力问题的变化轨迹,确定与注意力变化轨迹相关的社会人口学、医学和神经行为学特征,并检验注意力问题变化轨迹是否能预测注意力缺陷/多动障碍(ADHD)的诊断风险。方法我们研究了608名来自极早产儿新生儿神经行为和结果(NOVI)研究的婴儿,该研究是一项前瞻性、多地点研究,对象是出生后30周的婴儿。家长使用儿童行为检查表和儿童行为评估系统报告了孩子在 2、3、4 和 5 岁时的注意力问题。社会人口学和医学特征通过母亲访谈和病历审查进行评估。神经行为特征则通过新生儿和两岁评估来确定。我们还获得了家长对儿童多动症诊断的报告。我们使用潜在成长曲线(LGC)模型来检验我们的研究目的。注意力问题的平均轨迹显示,最初的症状水平较低,随着时间的推移变化不大,但最初的症状水平和随着时间的推移变化都存在显著的异质性。轨迹参数的个体差异与社会人口学、医学、环境和神经行为特征有关。最初注意力问题水平较高以及随着时间推移注意力问题急剧增加的儿童更有可能被诊断为多动症。结论出生后30周的儿童从2岁到5岁注意力问题的轨迹存在显著的异质性,这些差异具有临床意义。这些数据可为早产儿随访指南提供参考。
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引用次数: 0
Commentary: Using QbTest for monitoring pharmacological treatment response in ADHD – are we there yet? 评论:使用 QbTest 监测多动症的药物治疗反应--我们做到了吗?
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-08 DOI: 10.1111/jcpp.14071
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.
注意力缺陷/多动障碍(ADHD)患者对药物治疗(如兴奋剂和非兴奋剂)的反应各不相同。由于目前的监测主要依赖于主观评价,因此准确、及时地检测与治疗相关的改善、反应失败或恶化带来了巨大的挑战。在本评论中,我们对支持在临床实践中使用 QbTest 客观监测多动症治疗反应的证据进行了严格评估。我们还对未来的研究提出了建议,主张进行严格的临床试验和纵向研究,进一步探索使用 QbTest 和其他工具监测多动症患者治疗反应的可能性。
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引用次数: 0
Childhood predictors of avoidant personality disorder traits in adolescence: a seven-wave birth cohort study. 童年时期对青春期回避型人格障碍特征的预测:七波出生队列研究。
IF 6.5 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-04 DOI: 10.1111/jcpp.14064
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.

背景:尽管人们普遍认为回避型人格障碍(AvPD)起源于童年,但很少有前瞻性研究证实这一说法。因此,我们旨在确定假定的童年风险因素能否预测 16 岁时的回避型人格障碍特征:方法:我们每两年对挪威2003年和2004年出生队列中的人口样本(n = 1,077;50.9%为女性)进行一次从4岁到16岁的检查。通过DSM-5人格障碍结构化临床访谈评估了16岁时AvPD特征的数量,并对14岁前儿童风险和保护因素的截距和增长进行了回归:16岁时AvPD的患病率为3.2%(95% CI:2.2-4.1)。随着时间的推移,社交焦虑症状的水平越高、数量越多,以及消极情绪/神经质的增加,都预示着AvPD特征的数量越多。在对这些因素的水平和变化进行调整后,外向性的降低和减少预示着更多的AvPD特质,自我价值的下降、父母AvPD特质水平的升高和窥视行为的增加也预示着更多的AvPD特质:结论:神经质、低外向性、社交焦虑症状、被动观望行为和低自我价值预示着青少年时期会出现更多的AvPD特质,父母也会出现更多的AvPD特质。努力提高自我价值、减少社交焦虑和促进旁观儿童之间的同伴互动,可能会减少青春期AvPD特质的发展。
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引用次数: 0
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Journal of Child Psychology and Psychiatry
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