Journal of Child Psychology and Psychiatry最新文献

Proliferation of the term "emotion dysregulation" in child psychopathology parallels the growing interest in processes that influence negative emotional reactivity. While it commonly refers to a clinical phenotype where intense anger leads to behavioral dyscontrol, the term implies etiology because anything that is dysregulated requires an impaired regulatory mechanism. Many cognitive, affective, behavioral, neural, and social processes have been studied to improve understanding of emotion dysregulation. Nevertheless, the defective regulatory mechanism that might underlie it remains unclear. This systematic review of research on processes that affect emotion dysregulation endeavors to develop an integrative framework for the wide variety of factors investigated. It seeks to ascertain which, if any, constitutes an impaired regulatory mechanism. Based on this review, we propose a framework organizing emotion-relevant processes into categories pertaining to stimulus processing, response selection and control, emotion generation, closed- or open-loop feedback-based regulation, and experiential influences. Our review finds scant evidence for closed-loop (automatic) mechanisms to downregulate anger arousal rapidly. Open-loop (deliberate) regulatory strategies seem effective for low-to-moderate arousal. More extensive evidence supports roles for aspects of stimulus processing (sensory sensitivity, salience, appraisal, threat processing, and reward expectancy). Response control functions, such as inhibitory control, show robust associations with emotion dysregulation. Processes relating to emotion generation highlight aberrant features in autonomic, endocrine, reward functioning, and tonic mood states. A large literature on adverse childhood experiences and family interactions shows the unique and joint effects of interpersonal with child-level risks. We conclude that the defective closed-loop regulatory mechanisms that emotion dysregulation implies require further specification. Integrating research on emotion-relevant mechanisms along an axis from input factors through emotion generation to corrective feedback may promote research on (a) heterogeneity in pathogenesis, (b) interrelationships between these factors, and (c) the derivation of better-targeted treatments that address specific pathogenic processes of affected youth.

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.

Maheux et al.s' annual review (2024) summarizes a rapidly evolving literature on the specific components (including content, features and functions) of social media that can help or hinder healthy adolescent development, highlighting how proposed effects of social media components appear to matter more for some adolescents than others. This commentary explores how conclusions of Maheux et al. (2024) can help shape future translational research on what components of social media may facilitate or undermine healthy adolescent development and who is most susceptible to these social media component effects. Future research must also address when and where social media components matter most, situating our understanding within temporal and physical context. Finally, the promise of future research is highlighted on why youth engage with social media components (motivations) and how specific components of social media exert their effects (mechanisms).

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.