Journal of Child Psychology and Psychiatry最新文献

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.

Background: This longitudinal study with multi-informant (maternal, paternal, and experimenter) and multimethod (questionnaires, behavioral observations, and standardized assessments) data tests an intergenerational model from mothers' adverse childhood experiences (ACEs) to their children's socio-emotional and cognitive outcomes.

Methods: Participants were 501 children (50.7% male) and caregivers (56.5% white) followed from child age 2 months to 5 years. Mothers reported on their ACEs, as well as their postnatal socio-economic status (SES), marital conflict, and depressive symptoms. Observers rated maternal sensitivity using validated coding systems. Partners' history of childhood conduct problems and children's emotional and conduct problems were rated by mothers and fathers, and cognition was assessed by experimenters using standardized assessments.

Results: Maternal ACEs score was associated with children's socio-emotional and cognitive outcomes through unique intermediary pathways. Specifically, maternal ACEs were related to child emotion problems through SES, paternal history of conduct problems, and maternal depression. Maternal ACEs to child conduct problems operated via SES, paternal history of conduct problems, and marital conflict. Maternal ACEs to child cognitive skills operated through SES and maternal sensitivity.

Conclusions: Maternal ACEs, economic stress, and paternal history of conduct problems may collectively strain families, diverting caregiver attention and resources, which may impact childrearing and children's development. To effectively address root causes of intergenerational risks, it is critical to advocate for resources and supports that mitigate these hardship conditions. In addition, interventions that target modifiable individual and family factors may hold the greatest promise for breaking cycles of generational risk and promoting healthier outcomes for children and families.

In this editorial, I reflect on the implications of social, technological and cultural change for children and young people. Whilst we have a reasonably good understanding of trends in certain aspects of child development (e.g. height, weight, cognitive attainment), there are many unanswered questions. We do not know what explains the steep rise in mental health problems among young people, nor are we in position to evaluate and predict the consequences of different societal trends for current and future generations of young people. This is in part due to a reliance on older life course cohorts without adequate measurement of important aspects of children's lives (e.g. their online experiences). There are also some broader questions which require attention – what does it mean to be a child today? How is childhood changing? I consider possible implications and priorities for developmental research; in particular, the importance of listening to young people's perspectives, innovation in measurement in future life course cohorts, and developing more efficient real time monitoring of mental health at a population level.

Background: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental outcome among children with a history of early institutional care. Prior research on institutionalized children suggested that accelerated physical growth in childhood is a risk factor for ADHD outcomes.

Methods: The current study examined physical and neurophysiological growth trajectories among institutionalized children randomized to foster care treatment (n = 59) or care as usual (n = 54), and never institutionalized children (n = 64) enrolled in the Bucharest Early Intervention Project (NCT00747396, clinicaltrials.gov). Participants completed physical and electroencephalography (EEG) assessments at six time points from infancy through adolescence, as well as structured diagnostic interviews at the 54-month and 12-year time points. A series of multilevel growth models and cross-lagged path models were estimated to examine associations among physical and neurophysiological maturation, treatment group, age of foster care placement, and ADHD diagnostic outcomes.

Results: Twenty-seven percent of the institutionalized children met research criteria for ADHD at one or both time points. Slowed, prolonged growth of height and head circumference were associated with both ADHD and delayed foster care placement. Placement in foster care versus care as usual, but not ADHD, was associated with maturation of the peak alpha frequency. Among children randomized to foster care, average theta-beta ratio was lower among those with ADHD. There was no evidence that rapid physical maturation led to atypical cortical activity.

Conclusions: Delayed, prolonged physical growth and atypical neurophysiology from infancy through adolescence is associated with ADHD among institutionalized children, over and above the protective effects of foster care.