Journal of Child Psychology and Psychiatry最新文献

Background: Sexual and gender minority (SGM) youth are more susceptible to suicidal ideation and attempts compared to their heterosexual and cisgender peers. Yet, it is unclear how interpersonal and online victimization experiences account for the elevated suicide risks in this population. This study investigates the extent of peer and cyber victimization among SGM youth and its contribution to their higher risks of suicidal ideation and attempts longitudinally.

Methods: Data were from the first three waves of the Adolescent Brain Cognitive Development (ABCD) Study (5,596 9-10-year-old youth; 2,640 [47.2%] female; 3,107 [55.5%] non-Hispanic White). Youth reported sexual and gender identities and experiences of peer (overt, relational, reputational) and cyber victimization. Suicidal ideation and attempts were assessed using youth reports of Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5. We used mixed-effects logistic regression to quantify the association between SGM identity reported at waves 1-2 (9-11 years) and suicidal ideation and attempts at wave 3 (11-12 years) and longitudinal mediation analysis to determine whether peer and cyber victimization accounted for these associations.

Results: SGM youth were at greater risk for lifetime suicidal ideation (odds ratio [OR] 4.75, 95% CI 3.74-6.03), lifetime suicide attempts (OR 5.87, 95% CI 3.72-9.28), and current suicidal ideation or attempts (OR 4.94, 95% CI 3.19-7.68) compared to non-SGM youth. SGM youth experienced elevated peer (overt: β = 0.40, 95% CI 0.31-0.49; relational: β = 0.43, 95% CI 0.34-0.53; reputational: β = 0.51, 95% CI 0.42-0.60) and cyber victimization (OR 2.35, 95% CI 1.77-3.11). Around 22%-28% of the disparities in current suicidal ideation or attempts were mediated by peer or cyber victimization.

Conclusions: SGM youth are disproportionately affected by both interpersonal and online victimization, which are subsequently associated with their elevated suicide risks. Our findings underscore the urgent need for targeted interventions to foster safer school and online environments to reduce suicide among SGM youth.

Background: Criticism from parents is a risk factor for poor youth mental health, including self-harm and limited response to psychosocial interventions. We identified trajectories of change in parent criticism across treatment for youth self-harm (suicide attempts and non-suicidal self-injury) and compared these trajectories on treatment outcomes.

Methods: This is a preregistered secondary analysis of data from the Self-harm Intervention: Family Therapy trial. Participants (N = 831, 11-17 years; 89% girls, 11% boys; 84% White) were clinically referred for self-harm and randomly assigned to family therapy or usual care. A growth mixture model identified trajectories of parent self-reported criticism across baseline, 3, and 6 months. Trajectories were compared on youth self-harm, suicidal ideation, depression, and hopelessness, and parent mental distress (baseline, and change from baseline to 12 and 12-18 months).

Results: Four trajectories of parent criticism were identified: High and remaining elevated despite a small decrease (51.6%); sharply decreasing (7.6%); low/stable (37.2%); and increasing (3.6%). Youth with parents in the high with small decrease class had more severe baseline suicidal behavior. Treatment type was not related to criticism trajectory. Parent mental distress increased in the increasing criticism class. Youth with parents in the increasing class showed less improvement in suicidal ideation at 12-month follow-up compared to the high with small decrease and sharply decreasing classes.

Conclusions: Current treatments for youth self-harm may not reduce parent criticism to subclinical levels. Increasing parent criticism may forecast poorer response to a range of treatments for youth self-harm and be indicative of increases in parent mental distress.

Background: It has been proposed that early risk constellations link differentially to later developmental outcomes. However, existing studies often use a limited set of risk indicators, excluding genetic and child-based risks. It is also unclear if the protective effects of potential moderators, such as kindergarten experiences, differ across risk groups.

Methods: Using data from the Norwegian Mother, Father and Child (MoBa) cohort study (n = 7,478), we established latent early risk classes based on family, child, and genetic risk factors measured up to 3 years of age. The early risk classes were then compared on parent-rated internalizing and externalizing symptoms and academic performance at 8 years, as well as on registry outcomes reflecting child internalizing and externalizing diagnoses and national test scores at ages 11-14 years. Potential moderating effects of kindergarten protective factors (student-teacher closeness, social play behaviors and structured pre-academic activities) were examined.

Results: We identified five classes: a "low risk" group (41.1%) performed best across most behavioral and academic outcomes. A "resource risk" group (32.1%) struggled academically at 8 and 11 years, while a "family psychological risk" group (11.7%) showed mental health difficulties at 8 years and the highest levels of internalizing diagnoses at 12-14 years. A "developmental risk" group (7.6%) exhibited more pronounced academic and behavioral difficulties at 8 years only, while a "preterm birth" (7.5%) group showed moderate risk across most outcomes. Close student-teacher relationships and social play behaviors, but not structured pre-academic activities, predicted improved outcomes at small effect sizes across the whole sample, with limited evidence for differential responses across groups.

Conclusions: Our risk groups were differentially linked to later outcomes, suggesting potential diverging developmental pathways. The investigated Kindergarten factors exerted protective effects across groups, indicating that they may universally benefit children independent of their risk backgrounds.

Background: Sudden gains (rapid, large, stable improvements in symptoms) are common in psychological therapy and are associated with favourable outcomes, but no studies have investigated sudden gains in children and young people (CYP) with a chronic physical condition.

Methods: Within-group study nested in the Mental Health Intervention for Children with Epilepsy (MICE) randomised trial of modular cognitive-behavioural therapy for CYP with epilepsy, utilising goal-based outcomes (GBOs) and standardised session-by-session measures (including the brief parental self-efficacy scale and Strengths and Difficulties Questionnaire [SDQ] session-by-session measure). The occurrence and potential predictors of sudden gains, and the association of sudden gains with outcomes at final session and follow-up were investigated using multivariable logistic and linear regression.

Results: Among 147 participants (mean age: 10.4 years, 49% female) and across nine measures, 39% experienced between two and four sudden gains, most frequently on the mean GBO (occurrence, 44.9%). Characteristics such as intellectual disability, pretreatment scores and the number of sessions received were associated with significantly greater odds of sudden gains in some measures, whereas nonwhite ethnicity and nonemployment of the primary caregiver were associated with reduced odds. Sudden gains were associated with favourable final-session scores for mean GBO (GBO, adjusted mean difference [aMD]: 0.9, 95% CI: 0.3 to 1.6, p = .004, D = 0.63), parental self-efficacy (aMD: 1.2, 95% CI, 0.1 to 2.4, p = .027, D = 0.37) and the SDQ session-by-session measure (aMD: -1.7, 95% CI, -3.0 to -0.3, p = .014, D = -0.44), but not with 6-month adjusted SDQ total difficulties scores.

Conclusions: Sudden gains were common in this population, occurring most frequently on personalised measures, and were associated with favourable final-session scores. Personalised measures taken at each session with a focus on sudden gains may be a useful adjunct to treatment. Future research and clinical practice should investigate how to increase the occurrence of sudden gains in CYP with long-term conditions receiving psychological therapy.

Background: Although prior studies have established the relation between social interactions and behavioral adjustment, it remains unclear whether aspects of early social interactions are uniquely related to behavioral problems and the relative importance of each in predicting internalizing and externalizing problems. Using traditional theory-driven and novel data-driven perspectives, this longitudinal study simultaneously evaluated the role of preschool mother-child, teacher -child, and peer interactions in predicting internalizing and externalizing problems in early grade school.

Methods: At 36 months, the quality of children's social interactions with mothers, teachers, and peers were observed and coded (N = 1,028). Mothers later reported children's internalizing and externalizing problems in first grade. Theory-driven structural equation modeling (SEM) and data-driven machine learning models (i.e., random forests and support vector machines) were performed separately for data analysis.

Results: The results showed that machine learning models, particularly support vector machines, outperformed SEM in model performance. Regarding the relative importance of predictors, SEM suggested that indicators of early peer interactions uniquely predicted behavioral problems in early grade school when those of teacher-child and mother-child interactions were considered simultaneously. Machine learning models consistently demonstrated that indicators of early peer interactions had the highest feature importance and were among the highest ranking predictors of children's subsequent behavioral adjustment.

Conclusions: The findings contribute converging evidence from theory- and data-driven approaches to better understand the longitudinal associations between preschoolers' social interactions and later behavioral adjustments in early grade school.

Background: Anxiety symptoms among adolescents have been increasing globally. The present study aimed to better understand the role of parenting, which is believed to act as both a risk and protective factor for anxiety while also being impacted by adolescent anxiety. Specifically, this preregistered study examined the bidirectional associations between parental autonomy support, intrusiveness, and symptoms of generalized anxiety in adolescents.

Methods: We used meso-longitudinal data of Dutch adolescents (N = 256, M_age = 14.4, age range = 12-17, 71.5% female, t_mean = 17.7) and their parents (N = 176, M_age = 46.8, 82% female, t_mean = 22). They reported biweekly on parental intrusiveness and autonomy support and on adolescent generalized anxiety symptoms. Dynamic structural equation modeling (DSEM) was used to examine the associations at the between- and within-family levels.

Results: The between-family level associations indicated that adolescents from families with lower levels of parental autonomy support and higher levels of parental intrusiveness exhibited higher levels of generalized anxiety symptoms. Within families, during weeks when parents were less autonomy supportive or more intrusive, adolescents also experienced more generalized anxiety symptoms. Regarding the bidirectional time-lagged effects, adolescent-driven, but not parent-driven, effects emerged. Specifically, when adolescents experienced more generalized anxiety symptoms than usual, their parents were less autonomy supportive and more intrusive 2 weeks later.

Conclusions: Although further research is needed, these findings underscore the negative impact of adolescents' mental health issues on parenting. To prevent the further escalation of family problems, it seems vital to promote positive and adaptive parent-child interactions when adolescents face mental health issues.

As the incoming editor of JCPP's Annual Research Review (ARR), I first would like to extend my appreciation to the outgoing editor, Sara Jaffee, who for 6 years assembled consistently strong, cutting-edge reviews for the ARR during a time of upheaval in the world in general and child psychology and psychiatry in particular. Personally, I am indebted to Sara for providing invaluable insights into the many facets of editing the ARR as I attempt to maintain the elite bar of quality she established.

Although awareness of the role of environmental exposures in children's cognitive development is increasing, learning difficulties have not yet been a major focus of environmental health science. Learning difficulties disproportionately affect children living in economic disadvantage, yielding an ‘achievement gap.’ Studies examining the neurobiology of reading and math have mostly included economically advantaged youth, leaving a great deal unknown about the neural underpinnings of reading and math difficulties in youth living in disadvantaged contexts. Critically, due to environmental injustice, these youth are disproportionately exposed to environmental neurotoxicants. Herein, we review literature supporting a theoretical framework of environmentally associated phenotypes of learning difficulties. We propose that prenatal exposure to neurotoxicants and early-life exposure to psychosocial stressors increases risk for learning difficulties via effects on neural circuits that support cognitive processes which, in addition to literacy and numeracy, are integral to acquiring and performing academic skills. We describe models in which (1) prenatal exposure to air pollution has a main effect on learning via brain structure and function or associated domain-general cognitive processes and (2) a joint ‘two-hit’ pathway in which prenatal air pollution exposure followed by early life stress—when combined and sequential—increases risk for learning difficulties also via effects on brain structure, function, and/or associated cognitive processes. We review a select literature documenting effects of exposure to pollutants and early life stress on relevant neural circuits and associated cognitive processes in animal models and parallel findings in human epidemiologic studies. We advocate for team science in which researchers, practitioners, and policymakers collaborate to increase health literacy about environmentally associated phenotypes of learning difficulties and support the development of precision-oriented instructional and environmental intervention methods for youth living in economic disadvantage.

Background: The Autism Diagnostic Interview, Revised (ADI-R) is a caregiver interview that is widely used as part of the diagnostic assessment for Autism Spectrum Disorder (ASD). Few large-scale studies have reported the sensitivity and specificity of the ADI-R algorithms, which are based on DSM-IV Autistic Disorder criteria. Kim and Lord (Journal of Autism and Developmental Disorders, 2012, 42, 82) developed revised DSM-5-based toddler algorithms, which are only applicable to children under 4 years. The current study developed DSM-5-based algorithms for children ages 4-17 years and examined their performance compared to clinical diagnosis and to the original DSM-IV-based algorithms.

Methods: Participants included 2,905 cases (2,144 ASD, 761 non-ASD) from clinical-research databanks. Children were clinically referred for ASD-related concerns or recruited for ASD-focused research projects, and their caregivers completed the ADI-R as part of a comprehensive diagnostic assessment. Items relevant to DSM-5 ASD criteria were selected for the new algorithms primarily based on their ability to discriminate ASD from non-ASD cases. Algorithms were created for individuals with and without reported use of phrase speech. Confirmatory factor analysis tested the fit of a DSM-5-based two-factor structure. ROC curve analyses examined the diagnostic accuracy of the revised algorithms compared to clinical diagnosis.

Results: The two-factor structure of the revised ADI-R algorithms showed adequate fit. Sensitivity of the original ADI-R algorithm ranged from 74% to 96%, and specificity ranged from 38% to 83%. The revised DSM-5-based algorithms performed similarly or better, with sensitivity ranging from 77% to 99% and specificity ranging from 71% to 92%.

Conclusions: In this large sample aggregated from US clinical-research sites, the original ADI-R algorithm showed adequate diagnostic validity, with poorer specificity among individuals without phrase speech. The revised DSM-5-based algorithms introduced here performed comparably to the original algorithms, with improved specificity in individuals without phrase speech. These revised algorithms offer an alternative method for summarizing ASD symptoms in a DSM-5-compatible manner.