Developmental language disorder (DLD) is one of the most common neurodevelopmental disorders. Yet, it is a hidden disorder: it can go undetected for years and may not be uncovered until academic, behavioral, and/or mental health challenges begin to surface. In this review, we survey what is currently known about DLD across the lifespan, with a particular focus on its collateral effects in childhood and adulthood. We begin with a brief discussion of terminological issues that have contributed to the confusion about and lack of awareness of DLD. We then describe the development of DLD from infancy through adulthood, the ways in which its presentation shifts over time and with transitions to new developmental tasks and contexts, and some of the significant associated challenges outside of the language domain that are often faced by people with DLD. Next, we review current scientific knowledge about the neurobiological and genetic bases of DLD. In the final section, we provide an overview of some of the current best practices for screening and assessment and approaches to intervention for children, adolescents, and adults. We conclude by reflecting on challenges and opportunities for future research and offering some recommendations for clinical practice, particularly for mental health practitioners.
{"title":"Annual Research Review: Developmental language disorder - a hidden condition with lifelong impact.","authors":"Jana M Iverson,Diane L Williams","doi":"10.1111/jcpp.70067","DOIUrl":"https://doi.org/10.1111/jcpp.70067","url":null,"abstract":"Developmental language disorder (DLD) is one of the most common neurodevelopmental disorders. Yet, it is a hidden disorder: it can go undetected for years and may not be uncovered until academic, behavioral, and/or mental health challenges begin to surface. In this review, we survey what is currently known about DLD across the lifespan, with a particular focus on its collateral effects in childhood and adulthood. We begin with a brief discussion of terminological issues that have contributed to the confusion about and lack of awareness of DLD. We then describe the development of DLD from infancy through adulthood, the ways in which its presentation shifts over time and with transitions to new developmental tasks and contexts, and some of the significant associated challenges outside of the language domain that are often faced by people with DLD. Next, we review current scientific knowledge about the neurobiological and genetic bases of DLD. In the final section, we provide an overview of some of the current best practices for screening and assessment and approaches to intervention for children, adolescents, and adults. We conclude by reflecting on challenges and opportunities for future research and offering some recommendations for clinical practice, particularly for mental health practitioners.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"137 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saskia van der Oord,Tycho J Dekkers,Barbara J van den Hoofdakker,Manfred Döpfner,Edmund Sonuga-Barke
Behavioural parent training (BPT) has been recommended as part of multi-modal intervention strategies for children with attention-deficit/hyperactivity disorder (ADHD). The evaluation of its effectiveness, however, is challenging, as meta-analyses have indicated a discrepancy between effects on most proximal (MPROX) and probably blinded (PBLIND) outcome measures. In this editorial perspective, we provide five hypotheses that may explain this discrepancy. The first three hypotheses assume that the MPROX-PBLIND discrepancy demonstrates that BPT does not reduce actual ADHD characteristics and that MPROX is picking up a false positive. The final two focus on the limitations of the PBLIND assessments reported in the meta-analyses and the assumption that they are giving false negatives. We conclude that a hybrid approach, integrating parent ratings and observational measures within a multimethod assessment approach, may provide a path forward. In conclusion, we argue that for parents and clinicians, parent ratings of ADHD characteristics and other parent- or child-rated outcomes, such as mental health, quality of life and general well-being, are more important than 'objective' symptom change, which encourages us to shift the focus from the control of symptoms to the promotion of general functioning and well-being.
{"title":"Editorial Perspective: The challenge of evaluating ADHD parenting interventions - towards a hybrid approach.","authors":"Saskia van der Oord,Tycho J Dekkers,Barbara J van den Hoofdakker,Manfred Döpfner,Edmund Sonuga-Barke","doi":"10.1111/jcpp.70069","DOIUrl":"https://doi.org/10.1111/jcpp.70069","url":null,"abstract":"Behavioural parent training (BPT) has been recommended as part of multi-modal intervention strategies for children with attention-deficit/hyperactivity disorder (ADHD). The evaluation of its effectiveness, however, is challenging, as meta-analyses have indicated a discrepancy between effects on most proximal (MPROX) and probably blinded (PBLIND) outcome measures. In this editorial perspective, we provide five hypotheses that may explain this discrepancy. The first three hypotheses assume that the MPROX-PBLIND discrepancy demonstrates that BPT does not reduce actual ADHD characteristics and that MPROX is picking up a false positive. The final two focus on the limitations of the PBLIND assessments reported in the meta-analyses and the assumption that they are giving false negatives. We conclude that a hybrid approach, integrating parent ratings and observational measures within a multimethod assessment approach, may provide a path forward. In conclusion, we argue that for parents and clinicians, parent ratings of ADHD characteristics and other parent- or child-rated outcomes, such as mental health, quality of life and general well-being, are more important than 'objective' symptom change, which encourages us to shift the focus from the control of symptoms to the promotion of general functioning and well-being.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"44 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan Posner,Andrew Michael,Pratik Kashyap,Meredith Fay,Ana Carolina Coelho Milani,Ivaldo Silva,Nitamar Abdala,Célia Maria de Araújo,Aline Camargo Ramos,Yun Wang,Mateus Mazzaferro,Andrea Jackowski,Cristiane S Duarte
BACKGROUNDMaterial and emotional hardship during pregnancy can shape early brain development and behavior in infants. This study used the COVID-19 pandemic as a natural context in which such hardships were widespread, particularly in low-resource settings.METHODSThis cohort study examined associations between pandemic-related maternal emotional distress and material hardship during pregnancy and early neurodevelopmental outcomes in infants. A total of 235 mother-infant dyads from low-resource healthcare settings in Brazil were enrolled during the COVID-19 pandemic. Maternal hardships were assessed using a COVID-19-specific questionnaire, which included self-reported COVID-19 exposure/infection. Infant neurodevelopment was evaluated via MRI at 2-6 weeks of age and behavioral assessments at 14 months using the Bayley Scales of Infant Development.RESULTSMaterial hardship was associated with reduced hippocampal volumes in the left (pfdr = .008) and right (pfdr = .025) hemispheres. Among female infants, material hardship was linked to lower functional connectivity between the right hippocampus and the right rostral anterior cingulate cortex (p = .004). Smaller hippocampal volumes correlated with weaker gross motor skills at 14 months (r = .23; p = .02). Maternal emotional distress and self-reported COVID-19 exposure/infection were not significantly associated with infant neurodevelopmental outcomes.CONCLUSIONSMaterial hardship may adversely affect early neurodevelopment, particularly hippocampal structure and connectivity, with potential downstream effects on motor skills. These findings underscore the importance of addressing material hardship during the perinatal period to support infant brain health and development.
{"title":"Perinatal hardship and infant neurodevelopment: insights from a global pandemic.","authors":"Jonathan Posner,Andrew Michael,Pratik Kashyap,Meredith Fay,Ana Carolina Coelho Milani,Ivaldo Silva,Nitamar Abdala,Célia Maria de Araújo,Aline Camargo Ramos,Yun Wang,Mateus Mazzaferro,Andrea Jackowski,Cristiane S Duarte","doi":"10.1111/jcpp.70060","DOIUrl":"https://doi.org/10.1111/jcpp.70060","url":null,"abstract":"BACKGROUNDMaterial and emotional hardship during pregnancy can shape early brain development and behavior in infants. This study used the COVID-19 pandemic as a natural context in which such hardships were widespread, particularly in low-resource settings.METHODSThis cohort study examined associations between pandemic-related maternal emotional distress and material hardship during pregnancy and early neurodevelopmental outcomes in infants. A total of 235 mother-infant dyads from low-resource healthcare settings in Brazil were enrolled during the COVID-19 pandemic. Maternal hardships were assessed using a COVID-19-specific questionnaire, which included self-reported COVID-19 exposure/infection. Infant neurodevelopment was evaluated via MRI at 2-6 weeks of age and behavioral assessments at 14 months using the Bayley Scales of Infant Development.RESULTSMaterial hardship was associated with reduced hippocampal volumes in the left (pfdr = .008) and right (pfdr = .025) hemispheres. Among female infants, material hardship was linked to lower functional connectivity between the right hippocampus and the right rostral anterior cingulate cortex (p = .004). Smaller hippocampal volumes correlated with weaker gross motor skills at 14 months (r = .23; p = .02). Maternal emotional distress and self-reported COVID-19 exposure/infection were not significantly associated with infant neurodevelopmental outcomes.CONCLUSIONSMaterial hardship may adversely affect early neurodevelopment, particularly hippocampal structure and connectivity, with potential downstream effects on motor skills. These findings underscore the importance of addressing material hardship during the perinatal period to support infant brain health and development.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"2 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The study by Hegemann et al. advances understanding of the genetic architecture underlying early neurodevelopmental traits by distinguishing direct and indirect genetic effects using Trio-GCTA and polygenic score models. Findings reveal that indirect genetic effects are particularly pronounced for hyperactivity and restricted and repetitive behaviors, while direct effects dominate in language and motor development. Notably, associations between parental cognitive and educational attainment polygenic scores and child outcomes suggest potential protective genetic influences. However, several methodological considerations may affect interpretation. Excluding closely related individuals could limit the detection of extended familial effects, and reliance on polygenic scores derived from predominantly European GWAS may constrain generalizability. Furthermore, current PGS explain only a portion of trait heritability, possibly underrepresenting true genetic contributions. Future studies incorporating extended family structures, diverse populations, and alternative methods to model gene-environment interplay are essential for refining insights into early neurodevelopmental processes.
{"title":"Analyzing direct and indirect genetic effects on early neurodevelopmental traits - a commentary on Hegemann et al.","authors":"Yalan Li,Tianjiao Liu,Xin Li","doi":"10.1111/jcpp.70070","DOIUrl":"https://doi.org/10.1111/jcpp.70070","url":null,"abstract":"The study by Hegemann et al. advances understanding of the genetic architecture underlying early neurodevelopmental traits by distinguishing direct and indirect genetic effects using Trio-GCTA and polygenic score models. Findings reveal that indirect genetic effects are particularly pronounced for hyperactivity and restricted and repetitive behaviors, while direct effects dominate in language and motor development. Notably, associations between parental cognitive and educational attainment polygenic scores and child outcomes suggest potential protective genetic influences. However, several methodological considerations may affect interpretation. Excluding closely related individuals could limit the detection of extended familial effects, and reliance on polygenic scores derived from predominantly European GWAS may constrain generalizability. Furthermore, current PGS explain only a portion of trait heritability, possibly underrepresenting true genetic contributions. Future studies incorporating extended family structures, diverse populations, and alternative methods to model gene-environment interplay are essential for refining insights into early neurodevelopmental processes.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina K Zigler,Molly McFatrich,Nicole Lucas,Kate Plyler,Leslie Zapata-Leiva,Kelly Gordon,Harrison N Jones,Li Lin,Jennifer Kern,Abigail Radar,Dandan Chen,Elika Bergelson,Kate Still,Brigette Hinger,Christal G Delagrammatikas,Sarah Poliquin,Brittany P Short,Liz Marfia-Ash,Kimberly Stephens,Haley O Oyler,J Michael Graglia,Kali Worth,Charlene Son Rigby,James R Goss,Bo Bigelow,Geraldine Bliss,Karen Beatty,Leah Schust Myers,Melissa Thelen,Nuala Summerfield,Terry Jo Bichell,Bryce B Reeve
BACKGROUNDOur aim was to update an existing model of communication ability for children with rare neurodevelopmental disorders (NDDs) by centring caregiver and family perspectives. This project is part of a larger initiative to improve the measurement of communication ability for these children in the context of clinical trials.METHODSWe conducted concept elicitation interviews with purposively selected clinical experts and caregivers of children with 12 NDDs, focusing on a broad definition of communication ability based on the Observer-Reported Communication Ability (ORCA) measure, which is inclusive of different communication modalities and covers expressive, receptive and pragmatic communication concepts. Content-based and thematic analysis was performed on the qualitative data.RESULTSAltogether, 115 interviews were conducted with caregivers across the 12 NDDs and with 9 clinicians. Commonly mentioned concepts across NDDs included requesting an object, refusing an object, responding to familiar directions and seeking attention. There was notable heterogeneity within and across NDD groups in terms of the specific communication behaviours described for each communication concept. One common example was requesting; children used verbal speech, gestures, sign language, eye gaze, body movements and augmentative and assistive communication to ask for what they wanted. Novel communication concepts identified that were not part of the existing model were (1) feelings, emotions, and bodily sensations, (2) commenting on likes and dislikes, and (3) communicating and understanding humour.CONCLUSIONSCaregivers offered a detailed and nuanced picture of their child's day-to-day communication. There was a considerable overlap between the communication concepts discussed by caregivers in the interviews and the existing conceptual model of communication ability. Some newly identified concepts underscore the need for further adaptation of the model and subsequent validation of any clinical outcome assessment before communication ability can be confidently measured for these individuals in clinical trials.
{"title":"The spectrum of communication abilities in children with 12 rare neurodevelopmental disorders: a qualitative study with caregivers.","authors":"Christina K Zigler,Molly McFatrich,Nicole Lucas,Kate Plyler,Leslie Zapata-Leiva,Kelly Gordon,Harrison N Jones,Li Lin,Jennifer Kern,Abigail Radar,Dandan Chen,Elika Bergelson,Kate Still,Brigette Hinger,Christal G Delagrammatikas,Sarah Poliquin,Brittany P Short,Liz Marfia-Ash,Kimberly Stephens,Haley O Oyler,J Michael Graglia,Kali Worth,Charlene Son Rigby,James R Goss,Bo Bigelow,Geraldine Bliss,Karen Beatty,Leah Schust Myers,Melissa Thelen,Nuala Summerfield,Terry Jo Bichell,Bryce B Reeve","doi":"10.1111/jcpp.70063","DOIUrl":"https://doi.org/10.1111/jcpp.70063","url":null,"abstract":"BACKGROUNDOur aim was to update an existing model of communication ability for children with rare neurodevelopmental disorders (NDDs) by centring caregiver and family perspectives. This project is part of a larger initiative to improve the measurement of communication ability for these children in the context of clinical trials.METHODSWe conducted concept elicitation interviews with purposively selected clinical experts and caregivers of children with 12 NDDs, focusing on a broad definition of communication ability based on the Observer-Reported Communication Ability (ORCA) measure, which is inclusive of different communication modalities and covers expressive, receptive and pragmatic communication concepts. Content-based and thematic analysis was performed on the qualitative data.RESULTSAltogether, 115 interviews were conducted with caregivers across the 12 NDDs and with 9 clinicians. Commonly mentioned concepts across NDDs included requesting an object, refusing an object, responding to familiar directions and seeking attention. There was notable heterogeneity within and across NDD groups in terms of the specific communication behaviours described for each communication concept. One common example was requesting; children used verbal speech, gestures, sign language, eye gaze, body movements and augmentative and assistive communication to ask for what they wanted. Novel communication concepts identified that were not part of the existing model were (1) feelings, emotions, and bodily sensations, (2) commenting on likes and dislikes, and (3) communicating and understanding humour.CONCLUSIONSCaregivers offered a detailed and nuanced picture of their child's day-to-day communication. There was a considerable overlap between the communication concepts discussed by caregivers in the interviews and the existing conceptual model of communication ability. Some newly identified concepts underscore the need for further adaptation of the model and subsequent validation of any clinical outcome assessment before communication ability can be confidently measured for these individuals in clinical trials.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"32 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With high twin concordance and sibling recurrence risk, the influence of genetic factors in the etiology of autism is not disputed. The contribution of environmental risk to the etiology of autism is less well established. While the prevalence increase observed worldwide has fueled beliefs of an epidemic driven by environmental changes, the evidence for such interpretations of the secular change in prevalence is lacking (Fombonne, 2025). In epidemiological surveys, no clustering in time or space has been reported that could point to candidate exposures. Thus, observational (cohort and case–control) studies have been wide-ranging and exploratory rather than hypothesis-driven. In light of growing evidence of atypical development occurring in the first months of life (Dawson et al., 2023, Lancet Neurology, 22, 244), environmental risk research in autism has focused on prenatal or periconceptional exposures. In the last 20 years, a myriad of associations have been reported between autism risk and prenatal exposure to: pesticides, phthalates, air pollutants, maternal fever or infection during pregnancy, inter-pregnancy interval, lack of folic acid supplementation, vitamin D deficiency, maternal diet, advancing parental age, exposure to heavy metals, prenatal exposure to antidepressants, valproic acid, benzodiazepines, acetaminophen, maternal smoking, cannabis or alcohol use during pregnancy, maternal obesity and excessive gestational weight gain, prematurity, low birth weight, maternal immune activation, C-section, use of oxytocin, assisted reproductive technologies, and countless others. With few exceptions (advanced parental age, prenatal exposure to valproic acid), associations have not been replicated, or when they have, their causal nature has not been established.
{"title":"Editorial: The acetaminophen scare: association vs causation","authors":"Eric Fombonne","doi":"10.1111/jcpp.70064","DOIUrl":"10.1111/jcpp.70064","url":null,"abstract":"<p>With high twin concordance and sibling recurrence risk, the influence of genetic factors in the etiology of autism is not disputed. The contribution of environmental risk to the etiology of autism is less well established. While the prevalence increase observed worldwide has fueled beliefs of an epidemic driven by environmental changes, the evidence for such interpretations of the secular change in prevalence is lacking (Fombonne, 2025). In epidemiological surveys, no clustering in time or space has been reported that could point to candidate exposures. Thus, observational (cohort and case–control) studies have been wide-ranging and exploratory rather than hypothesis-driven. In light of growing evidence of atypical development occurring in the first months of life (Dawson et al., 2023, <i>Lancet Neurology</i>, 22, 244), environmental risk research in autism has focused on prenatal or periconceptional exposures. In the last 20 years, a myriad of associations have been reported between autism risk and prenatal exposure to: pesticides, phthalates, air pollutants, maternal fever or infection during pregnancy, inter-pregnancy interval, lack of folic acid supplementation, vitamin D deficiency, maternal diet, advancing parental age, exposure to heavy metals, prenatal exposure to antidepressants, valproic acid, benzodiazepines, acetaminophen, maternal smoking, cannabis or alcohol use during pregnancy, maternal obesity and excessive gestational weight gain, prematurity, low birth weight, maternal immune activation, C-section, use of oxytocin, assisted reproductive technologies, and countless others. With few exceptions (advanced parental age, prenatal exposure to valproic acid), associations have not been replicated, or when they have, their causal nature has not been established.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 11","pages":"1621-1626"},"PeriodicalIF":7.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acamh.onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Serena Defina, Charlotte A.M. Cecil, Janine F. Felix, Esther Walton, Henning Tiemeier
BackgroundDepressive symptoms and cardio‐metabolic risk factors often co‐occur. However, our understanding of the potential mechanisms and temporal dynamics underlying their co‐development remains elusive.MethodsThis population‐based cohort study examined bidirectional longitudinal associations between depressive symptoms and cardio‐metabolic risk factors from age 10 to 25 years, using prospective data from the ALSPAC Study. Participants with at least one (of six) follow‐up measurement for each outcome were included in the analyses. We measured depressive symptoms through self‐ as well as parent‐reports, and assessed several cardio‐metabolic risk factors (including adiposity measures, lipid profiles, and inflammation).ResultsAmong our 7,970 (47% male, 96% White) participants, we found bidirectional, within‐person associations between self‐reported depressive symptoms and adiposity (i.e., fat/lean mass index, but not body mass index), across the study period. Adiposity was more stable over time (β [range] = 0.75 [0.54; 0.84]), compared to depressive symptoms (0.26 [0.12; 0.38]), and it had a stronger prospective (i.e., cross‐lagged) association with future depressive symptoms (0.07 [0.03, 0.13]) compared to that between depressive symptoms and future adiposity (0.04 [0.03, 0.06]). The magnitude of these associations reached its peak between 14 and 16 years. We did not find evidence of cross‐lagged associations in either direction between depressive symptoms and waist circumference, insulin, triglycerides, LDL cholesterol, or C‐reactive protein.ConclusionsThese findings suggest a bidirectional relationship between depressive symptoms and cardio‐metabolic risk factors, particularly adiposity (i.e., fat/lean mass). Adiposity showed a stronger prospective association with future depressive symptoms than vice versa; however, their relationship revealed more reciprocal than previously thought.
{"title":"Longitudinal co‐development of mental and cardio‐metabolic health from childhood to young adulthood","authors":"Serena Defina, Charlotte A.M. Cecil, Janine F. Felix, Esther Walton, Henning Tiemeier","doi":"10.1111/jcpp.70065","DOIUrl":"https://doi.org/10.1111/jcpp.70065","url":null,"abstract":"BackgroundDepressive symptoms and cardio‐metabolic risk factors often co‐occur. However, our understanding of the potential mechanisms and temporal dynamics underlying their co‐development remains elusive.MethodsThis population‐based cohort study examined bidirectional longitudinal associations between depressive symptoms and cardio‐metabolic risk factors from age 10 to 25 years, using prospective data from the ALSPAC Study. Participants with at least one (of six) follow‐up measurement for each outcome were included in the analyses. We measured depressive symptoms through self‐ as well as parent‐reports, and assessed several cardio‐metabolic risk factors (including adiposity measures, lipid profiles, and inflammation).ResultsAmong our 7,970 (47% male, 96% White) participants, we found bidirectional, within‐person associations between self‐reported depressive symptoms and adiposity (i.e., fat/lean mass index, but not body mass index), across the study period. Adiposity was more stable over time (β [range] = 0.75 [0.54; 0.84]), compared to depressive symptoms (0.26 [0.12; 0.38]), and it had a stronger prospective (i.e., cross‐lagged) association with future depressive symptoms (0.07 [0.03, 0.13]) compared to that between depressive symptoms and future adiposity (0.04 [0.03, 0.06]). The magnitude of these associations reached its peak between 14 and 16 years. We did not find evidence of cross‐lagged associations in either direction between depressive symptoms and waist circumference, insulin, triglycerides, LDL cholesterol, or C‐reactive protein.ConclusionsThese findings suggest a bidirectional relationship between depressive symptoms and cardio‐metabolic risk factors, particularly adiposity (i.e., fat/lean mass). Adiposity showed a stronger prospective association with future depressive symptoms than vice versa; however, their relationship revealed more reciprocal than previously thought.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Increasing awareness of mental health problems, including that of young people, is generally seen as positive, and many interventions to increase awareness are underway internationally. Yet, a principled evaluation of the benefits and harms of increasing awareness is still lacking. Here, we present a conceptual framework for the evaluation of information interventions that are aimed at increasing public awareness of mental health problems. We borrow concepts from dynamic systems, such as infection spread and related population growth, to ask how benefits, but also harms of information on mental health, may accrue over time. We argue that as information spreads, several cascades of events are set off that involve members of the general public but also clinicians and healthcare services. These cascades entailinvolve positive and negative feedback loops. We discuss not only how increased diagnoses can lead to positive outcomes (e.g. increasing diagnostic rates and appropriate treatments in those who would otherwise have remained undiagnosed) but also how increased awareness can lead to decreases in diagnostic accuracy, to service overload, and how they may expose people to unnecessary or harmful treatments. We argue that the need for a framework founded on modelling societal dynamics is needed to ensure that both the benefits and the downsides of mental health information are accurately gauged and to help the planning of better public health campaigns.
{"title":"Editorial Perspective: How spreading mental health information can be (un-) helpful - a dynamic systems approach.","authors":"Daniele Marcotulli,Lucy Foulkes,Argyris Stringaris","doi":"10.1111/jcpp.70055","DOIUrl":"https://doi.org/10.1111/jcpp.70055","url":null,"abstract":"Increasing awareness of mental health problems, including that of young people, is generally seen as positive, and many interventions to increase awareness are underway internationally. Yet, a principled evaluation of the benefits and harms of increasing awareness is still lacking. Here, we present a conceptual framework for the evaluation of information interventions that are aimed at increasing public awareness of mental health problems. We borrow concepts from dynamic systems, such as infection spread and related population growth, to ask how benefits, but also harms of information on mental health, may accrue over time. We argue that as information spreads, several cascades of events are set off that involve members of the general public but also clinicians and healthcare services. These cascades entailinvolve positive and negative feedback loops. We discuss not only how increased diagnoses can lead to positive outcomes (e.g. increasing diagnostic rates and appropriate treatments in those who would otherwise have remained undiagnosed) but also how increased awareness can lead to decreases in diagnostic accuracy, to service overload, and how they may expose people to unnecessary or harmful treatments. We argue that the need for a framework founded on modelling societal dynamics is needed to ensure that both the benefits and the downsides of mental health information are accurately gauged and to help the planning of better public health campaigns.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"83 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Schools are important settings for intervention to improve mental health. Much school mental health research has focused on schools as an avenue to reach large numbers of young people with new interventions, added on top of what schools currently do. However, research is increasingly focused on changing the school system itself to improve mental health, with a growing emphasis on improving school climate. This article begins by exploring wider debates on the benefits and harms of school-based interventions, before focusing on school climate as a target for intervention. It reviews evidence from intervention studies and systematic reviews to understand effectiveness, how interventions reduce or amplify inequalities, and real-world impacts. School climate research has grown rapidly since the turn of the century. It remains difficult to define. Definitions vary in whether they include focus on physical environments and educational instruction. However, they converge on focus on positive relationships among a school community and safety. Several large trials of interventions to improve mental health, by improving school climate, have been conducted in a range of international contexts. While many have not been effective, recent trials provide evidence that interventions can improve school climate and mental health, as well as a range of risk behaviours. Few studies examine effects on inequalities in mental health, with tentative evidence that school climate interventions have been more effective for some groups than others (e.g., bigger effects for boys than for girls). Evidence on scalability and sustainability indicates that typically small effects from trials may not fully translate into real-world change. There is growing evidence that improving school climate interventions can improve child and adolescent mental health. More research is needed on how such interventions can contribute to reducing inequalities. Further work is needed to understand how effects translate into real-world public health impact.
{"title":"Annual Research Review: Improving school climate to improve child and adolescent mental health and reduce inequalities.","authors":"Graham Moore","doi":"10.1111/jcpp.70061","DOIUrl":"https://doi.org/10.1111/jcpp.70061","url":null,"abstract":"Schools are important settings for intervention to improve mental health. Much school mental health research has focused on schools as an avenue to reach large numbers of young people with new interventions, added on top of what schools currently do. However, research is increasingly focused on changing the school system itself to improve mental health, with a growing emphasis on improving school climate. This article begins by exploring wider debates on the benefits and harms of school-based interventions, before focusing on school climate as a target for intervention. It reviews evidence from intervention studies and systematic reviews to understand effectiveness, how interventions reduce or amplify inequalities, and real-world impacts. School climate research has grown rapidly since the turn of the century. It remains difficult to define. Definitions vary in whether they include focus on physical environments and educational instruction. However, they converge on focus on positive relationships among a school community and safety. Several large trials of interventions to improve mental health, by improving school climate, have been conducted in a range of international contexts. While many have not been effective, recent trials provide evidence that interventions can improve school climate and mental health, as well as a range of risk behaviours. Few studies examine effects on inequalities in mental health, with tentative evidence that school climate interventions have been more effective for some groups than others (e.g., bigger effects for boys than for girls). Evidence on scalability and sustainability indicates that typically small effects from trials may not fully translate into real-world change. There is growing evidence that improving school climate interventions can improve child and adolescent mental health. More research is needed on how such interventions can contribute to reducing inequalities. Further work is needed to understand how effects translate into real-world public health impact.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"11 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDThere is limited evidence from systematic nationwide studies evaluating the impact of cannabis legalization on cannabis-related exposures among the pediatric population. Using the National Poison Data System (NPDS), we calculated the effects of medical and recreational cannabis dispensaries on reported pediatric cannabis exposures.METHODSWe analyzed data from 36,161 reported cannabis-related exposures for individuals aged 2-20 between 2016 and 2021, comparing states with and without open medical cannabis dispensaries and states with open recreational cannabis dispensaries to states with open medical cannabis dispensaries. Using a difference-in-difference design, we estimated the effects of cannabis dispensary openings on semi-annual cannabis exposures by age group: young children (2-6 years old), children (7-11), adolescents (12-17), and young adults (18-20).RESULTSPatients aged 2-6 (96.3%) and 7-11 (82.4%) frequently incurred unintentional exposures, while patients aged 12-17 (79.9%) and 18-20 (77.5%) more often incurred intentional exposures. Medical cannabis dispensary openings were associated with a 52.3% increase (CI 37.5-67.0; p < .001) in cannabis-related exposure rates in individuals aged 2-6. However, we found a 42.4% decrease (95% CI: -62.2 to -22.6; p < .001) in the number of exposures occurring per 100,000 population when recreational dispensaries opened, relative to states with only medical cannabis dispensaries open. While we did not find statistically significant increases among children aged 7-11 following medical cannabis dispensary openings, we did see a 26.6% (95% CI: -45.1 to -8.1) decrease following recreational cannabis dispensary openings. We did not find statistically significant effects for other age groups.CONCLUSIONSOur findings indicate policymakers may need to invest in providing cannabis safety education when medical cannabis dispensaries open to avoid unintended exposures, though some of that effect appears to be mitigated by the time recreational dispensaries (eventually) open. Professionals that provide medical cannabis or provide care in medical cannabis states should consider providing education about how to safely use and store cannabis in the household to prevent cannabis-involved exposures.
{"title":"Cannabis and pediatric cannabis exposure - evidence from America's Poison Centers.","authors":"Shelby R Steuart,Victoria Bethel,W David Bradford","doi":"10.1111/jcpp.70058","DOIUrl":"https://doi.org/10.1111/jcpp.70058","url":null,"abstract":"BACKGROUNDThere is limited evidence from systematic nationwide studies evaluating the impact of cannabis legalization on cannabis-related exposures among the pediatric population. Using the National Poison Data System (NPDS), we calculated the effects of medical and recreational cannabis dispensaries on reported pediatric cannabis exposures.METHODSWe analyzed data from 36,161 reported cannabis-related exposures for individuals aged 2-20 between 2016 and 2021, comparing states with and without open medical cannabis dispensaries and states with open recreational cannabis dispensaries to states with open medical cannabis dispensaries. Using a difference-in-difference design, we estimated the effects of cannabis dispensary openings on semi-annual cannabis exposures by age group: young children (2-6 years old), children (7-11), adolescents (12-17), and young adults (18-20).RESULTSPatients aged 2-6 (96.3%) and 7-11 (82.4%) frequently incurred unintentional exposures, while patients aged 12-17 (79.9%) and 18-20 (77.5%) more often incurred intentional exposures. Medical cannabis dispensary openings were associated with a 52.3% increase (CI 37.5-67.0; p < .001) in cannabis-related exposure rates in individuals aged 2-6. However, we found a 42.4% decrease (95% CI: -62.2 to -22.6; p < .001) in the number of exposures occurring per 100,000 population when recreational dispensaries opened, relative to states with only medical cannabis dispensaries open. While we did not find statistically significant increases among children aged 7-11 following medical cannabis dispensary openings, we did see a 26.6% (95% CI: -45.1 to -8.1) decrease following recreational cannabis dispensary openings. We did not find statistically significant effects for other age groups.CONCLUSIONSOur findings indicate policymakers may need to invest in providing cannabis safety education when medical cannabis dispensaries open to avoid unintended exposures, though some of that effect appears to be mitigated by the time recreational dispensaries (eventually) open. Professionals that provide medical cannabis or provide care in medical cannabis states should consider providing education about how to safely use and store cannabis in the household to prevent cannabis-involved exposures.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"8 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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