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Long-term follow-up of a randomised controlled trial of a brief home-based parenting intervention to reduce behavioural problems in young children. 一项随机对照试验的长期随访研究,以家庭为基础的短期父母干预来减少幼儿的行为问题。
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-17 DOI: 10.1111/jcpp.70037
Paul Ramchandani,Jack Elkes,Victoria Cornelius,Sarah Byford,Laura Oxley,Daphne Babalis,Beth Barker,Erin Bibby,Brittney Chere,Poushali Ganguli,Sam Griffith,Zaheema Iqbal,Aiman Kamarudin,Katie Lui,Stephen Scott,Emma Tassie,Essi Viding,Christine O'Farrelly
BACKGROUNDBehaviour problems are common in childhood and are associated with higher rates of mental health problems, educational and relationship difficulties throughout life. This study assessed whether a Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) has sustained benefit 6 years after delivery. It had previously been shown to reduce behavioural problems in children aged 2 and 4 years old.METHODSThe Healthy Start, Happy Start study was a 2-arm, multisite randomised clinical trial conducted in 6 NHS trusts in England. Participants (N = 300) were parents/caregivers of children (aged 12-36 months) at risk of behaviour problems. Participants were randomised to receive either VIPP-SD (n = 151) or usual care (n = 149). Those allocated to VIPP-SD were offered 6 home-based video-feedback sessions. Six-year follow-up data were collected from May 2022 to July 2023. The primary outcome was the total score on Parental Account of Children's Symptoms (PACS). The analysis used prespecified longitudinal Bayesian models to handle missing data, and findings are reported as posterior probabilities of superiority alongside treatment effect estimates with 95% credible interval.RESULTSAnalysis included 294 of the 300 participants, with 6-year primary outcome data available for 244/300 (81%) (106 girls [43%]; mean age, 8.2 years). The probability of superiority for VIPP-SD on PACS was 86%. The mean difference in the total PACS score was -1.23 (95% Cred.I [-3.34, 0.90]); d = -0.11 (95% Cred.I [-0.032, 0.09]), with fewer behavioural problems in children in the VIPP-SD group (mean [SD] score of 25.30 [9.63] vs. 26.36 [11.05]).CONCLUSIONSThis trial found a probability of 86% that VIPP-SD was superior for reducing behaviour problems in children up to 6 years later. Taken together with the earlier positive trial findings, this suggests a small enduring positive impact of a brief early intervention with potential for scaling.
背景:行为问题在儿童时期很常见,并与一生中较高的心理健康问题、教育和人际关系困难有关。本研究评估了视频反馈干预促进积极育儿和敏感管教(VIPP-SD)是否在分娩后6年持续受益。之前的研究表明,它可以减少2岁和4岁儿童的行为问题。方法“健康开始,快乐开始”研究是一项在英国6家NHS信托机构进行的两组、多地点随机临床试验。参与者(N = 300)是有行为问题风险的儿童(12-36个月)的父母/照顾者。参与者被随机分配接受VIPP-SD (n = 151)或常规护理(n = 149)。分配到VIPP-SD的学生进行了6次家庭视频反馈。从2022年5月至2023年7月收集了六年的随访数据。主要结局是父母儿童症状报告(PACS)的总分。分析使用预先指定的纵向贝叶斯模型来处理缺失数据,研究结果报告为后验优势概率和治疗效果估计,可信区间为95%。结果纳入了300名参与者中的294名,其中244名(81%)有6年的主要结局数据(106名女孩[43%],平均年龄8.2岁)。VIPP-SD在PACS上的优势概率为86%。总PACS评分的平均差异为-1.23 (95% credit。I [-3.34, 0.90]);d = -0.11 (95%)I [-0.032, 0.09]), VIPP-SD组儿童的行为问题较少(平均[SD]评分为25.30[9.63]对26.36[11.05])。结论:该试验发现,在减少儿童6年后的行为问题方面,VIPP-SD的成功率为86%。结合早期的积极试验结果,这表明短暂的早期干预具有小规模的持久积极影响,并有可能扩大规模。
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引用次数: 0
Unraveling psychosis risk in sexual minorities: temporal dynamics of social defeat and suspiciousness in adolescence. 揭示性少数群体的精神病风险:青春期社会失败和怀疑的时间动态。
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-10 DOI: 10.1111/jcpp.70042
Margaux Sageot,Robin Achterhof,Anu P Hiekkaranta,Aleksandra Lecei,Kristof Vansteeland,Inez Myin-Germeys,Ruud van Winkel
BACKGROUNDPrevious research suggests that sexual minorities are at higher risk for psychotic experiences, possibly due to repeated social defeat experiences. However, empirical research investigating this hypothesis is largely lacking. This study examined how experiences of "feeling excluded" and "not belonging" impact the prospective development of psychotic experiences in an adolescent sexual minority group, defined here as non-heterosexual attraction to others.METHODSExperience sampling method (ESM) data from 1913 Flemish adolescents (aged 11-20) in the SIGMA study were analyzed. They reported their momentary feelings of exclusion when alone, belonging when in the company of others (both operationalizations of social defeat), and suspiciousness. Multilevel linear regression models tested the bidirectional, within- and between-person associations between social defeat and suspiciousness, and the effects of sexual minority status.RESULTSLower feelings of belonging when in company significantly predicted higher suspiciousness at the next beep [95% CI: -0.03, -0.01], whereas increased feelings of exclusion when alone did not. Moreover, suspiciousness did not significantly predict feelings of exclusion and belonging at the next beep, confirming the direction of effect. Sexual minority participants reported generally lower belonging in social settings [95% CI: -0.68, -0.29] and higher suspiciousness [95% CI: 0.16, 0.57], but not higher feelings of exclusion. The interaction between social defeat and sexual minority status was not significant, indicating no differential sensitivity to social defeat experiences.CONCLUSIONSThe experience of "not fitting in" when in company may be the most poignant social factor increasing risk for psychotic experiences in sexual minority youth. The findings highlight the need for inclusive environments where sexual minority individuals feel supported and integrated.
之前的研究表明,性少数群体患精神病的风险更高,可能是由于反复的社会失败经历。然而,调查这一假设的实证研究在很大程度上是缺乏的。本研究考察了“感觉被排斥”和“不属于”的经历如何影响青少年性少数群体精神病经历的未来发展,这里定义为对他人的非异性恋吸引力。方法采用经验抽样法(ESM)对1913例11 ~ 20岁佛兰德青少年的SIGMA研究数据进行分析。他们报告了独处时的短暂排斥感,和其他人在一起时的归属感(都是社会失败的操作化),以及怀疑感。多水平线性回归模型检验了社会失败与怀疑之间的双向、内部和人与人之间的联系,以及性少数地位的影响。结果:与同伴在一起时,较低的归属感显著预示着下一次蜂鸣声时较高的疑心[95% CI: -0.03, -0.01],而独自一人时,较高的排斥感则无此影响。此外,怀疑并不能显著预测下一次哔哔声时的排斥感和归属感,证实了效应的方向。性少数参与者普遍报告在社会环境中较低的归属感[95% CI: -0.68, -0.29]和较高的怀疑[95% CI: 0.16, 0.57],但没有较高的排斥感。社会失败与性少数身份之间的交互作用不显著,表明对社会失败经历的敏感性不存在差异。结论与人交往时的“不适应”体验可能是增加性少数青少年精神病经历风险的最尖锐的社会因素。研究结果强调,需要一个包容的环境,让性少数群体感到得到支持和融入。
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引用次数: 0
Emotional and behavioural difficulties in gender minority compared to cisgender adolescents: identity specific findings from a contemporary national study. 与顺性青少年相比,性别少数群体的情感和行为困难:来自当代国家研究的身份特异性发现。
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-10 DOI: 10.1111/jcpp.70050
Nicholas Page,Lianna Angel,Sophie Borgia,Colleen Reynolds,Dougie Zubizarreta,Honor Young,Max R Ashton,James White
BACKGROUNDGender minority adolescents are more likely to report emotional and behavioural difficulties compared to their cisgender peers. However, little is known about these experiences for adolescents with specific gender minority identities.METHODSCross-sectional data were obtained from the 2021/22 Student Health and Well-being survey, a national survey of 11-16-year-olds in Wales, UK. Emotional and behavioural difficulties were measured using the Strengths and Difficulties Questionnaire. Gender identity and assigned sex at birth were self-reported. Multivariable linear regressions with robust standard errors were used to examine associations between gender identity and emotional and behavioural difficulties, adjusting for age, ethnicity, household-level affluence and correction for multiple testing.RESULTSOf the 122,766 participants, 2.0% (2,455) identified as a person with a gender minority identity. Twenty-eight gender minority identities were self-reported, with the most prevalent being transgender boy and nonbinary assigned female at birth (both 0.6%). Young people assigned female at birth comprised 80% of gender minority adolescents. In the adjusted model, emotional and behavioural difficulties were reported most frequently by people who identified as non-binary (B = 7.66, 95% CI 7.25, 8.06) and another gender identity (B = 7.86, 95% CI 7.34, 8.38), then transgender (B = 5.05, 95% CI 4.58, 5.51), when compared to cisgender adolescents. Female sex assigned at birth was associated with more reported difficulties than male sex assigned at birth for adolescents with a transgender or cisgender identity, but not a nonbinary identity.CONCLUSIONSIn this population-based study, emotional and behavioural difficulties were reported most frequently by adolescents who identified as nonbinary and another gender identity, then transgender, then cisgender. Health and educational practitioners need to be aware that emotional and behavioural difficulties differ across gender minority identities.
背景:与顺性别同龄人相比,少数性别青少年更有可能报告情感和行为上的困难。然而,对于具有特定性别少数认同的青少年的这些经历,我们知之甚少。方法横断面数据来自2021/22学生健康与幸福调查,这是一项针对英国威尔士11-16岁学生的全国性调查。使用优势和困难问卷测量情绪和行为困难。出生时的性别认同和生理性别都是自我报告的。使用具有稳健标准误差的多变量线性回归来检查性别认同与情感和行为困难之间的关联,调整年龄、种族、家庭富裕程度,并对多重测试进行校正。结果在122,766名参与者中,2.0%(2,455人)认为自己是性别少数群体。28个性别少数认同是自我报告的,最普遍的是变性男孩和出生时非二元性别分配的女性(均为0.6%)。出生时被指定为女性的青少年占性别少数群体青少年的80%。在调整后的模型中,与顺性青少年相比,被认定为非二元(B = 7.66, 95% CI 7.25, 8.06)和另一性别认同(B = 7.86, 95% CI 7.34, 8.38)的人最常报告情绪和行为困难,然后是跨性别(B = 5.05, 95% CI 4.58, 5.51)。对于具有跨性别或顺性别认同的青少年来说,出生时性别分配的女性比出生时性别分配的男性有更多的困难,而非二元认同的青少年则没有。结论:在这项以人群为基础的研究中,情绪和行为困难最常见于非二元性和其他性别认同的青少年,其次是跨性别者,然后是顺性别者。保健和教育从业人员需要认识到,情感和行为困难因性别少数群体身份而异。
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引用次数: 0
Mid-childhood developmental and behavioural outcomes in infants with a family history of autism and/or attention deficit hyperactivity disorder. 有自闭症和/或注意缺陷多动障碍家族史的婴儿的童年中期发育和行为结果
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-09 DOI: 10.1111/jcpp.70048
Tony Charman,Tessel Bazelmans,Greg Pasco,Jannath Begum Ali,Mark H Johnson,Emily J H Jones,
BACKGROUNDProspective studies of autism family history infants primarily report recurrence and predictors of autism at 3 years. Less is known about ADHD family history infants and later childhood outcomes. We characterise profiles of mid-childhood developmental and behavioural outcomes in infants with a family history of autism and/or ADHD to identify potential support needs and patterns of co-occurrence across domains.METHODSTwo hundred and sixty-three infants (51% male; N = 198 autism/ADHD family history; N = 65 no family history) were assessed at 6-12 years. A latent profile analysis (LPA) with indicator variables measuring developmental abilities (IQ, adaptive function) and behavioural traits (autism, ADHD, anxiety) identified dimensional, data-derived outcome classes.RESULTSA seven-class solution was the most robust and clinically meaningful. Two classes (27% and 23%) had typical development; two classes had high autism, ADHD, and anxiety traits-one with low IQ and adaptive function (10%) and one with average IQ but low adaptive function (13%); one class had elevated autism and ADHD but not anxiety traits (10%); and the final two classes had elevated ADHD (9%) and anxiety (8%) traits in isolation. Sex distribution was balanced across all classes. Children with autism were found in all classes but predominantly in the classes with low IQ/adaptive functioning and high behavioural traits, as well as in the class with elevated autism and ADHD traits. We found only partial continuity between membership of similarly derived 3-year LPA classes and mid-childhood LPA classes.CONCLUSIONSMany autism/ADHD family history infants develop typically. However, by mid-childhood, in addition to those with autism, others show elevated neurodevelopmental (autism, ADHD) and neuropsychiatric (anxiety) behavioural traits. Lower developmental abilities (IQ and adaptive function) are primarily seen in children with an autism diagnosis. Family history infants should be monitored through childhood, and support provided should challenges emerge.
背景:对自闭症家族史婴儿的前瞻性研究主要报告了3岁时自闭症的复发和预测因素。对于多动症的家族史,婴儿和儿童后期的结果,我们所知较少。我们对有自闭症和/或ADHD家族史的婴儿的童年中期发育和行为结果进行特征描述,以确定潜在的支持需求和跨领域共发生的模式。方法对6-12岁的263名婴儿进行评估,其中男性占51%,有自闭症/ADHD家族史的198例,无家族史的65例。潜在轮廓分析(LPA)与指标变量测量发展能力(智商,适应功能)和行为特征(自闭症,多动症,焦虑)确定维度,数据派生的结果类别。结果tsa 7级溶液稳健性最强,具有临床意义。两类(27%和23%)发展典型;两类具有高自闭症、多动症和焦虑特征——一类具有低智商和低适应功能(10%),另一类具有平均智商但低适应功能(13%);一个班级的自闭症和注意力缺陷多动症升高,但没有焦虑特征(10%);最后两类单独出现ADHD(9%)和焦虑(8%)特征升高。性别分布在所有阶层中都是平衡的。所有班级都有自闭症儿童,但主要出现在智商/适应功能低、行为特征高的班级,以及自闭症和多动症特征较高的班级。我们发现类似衍生的3年LPA班级和儿童中期LPA班级的成员之间只有部分连续性。结论许多有自闭症/ADHD家族史的婴儿发育典型。然而,到了儿童中期,除了那些患有自闭症的人,其他人表现出神经发育(自闭症、多动症)和神经精神(焦虑)行为特征的升高。较低的发展能力(智商和适应功能)主要见于被诊断为自闭症的儿童。有家族史的婴儿应该在童年时期进行监测,并在出现挑战时提供支持。
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引用次数: 0
Editorial: Supporting families in the first 1,000 days of life – a balancing act 社论:在生命最初的1000天里支持家庭——一种平衡的行为。
IF 7 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-08 DOI: 10.1111/jcpp.70041
Maartje P.C.M. Luijk, Tessa J. Roseboom

From the moment of fertilization, human development takes a phenomenal pace. In no other period of life are more biological and developmental milestones met than in the first 1,000 days after conception. All organs and systems are formed, and children start to discover the world, learn whom to trust and where to find comfort in times of distress. Evidence from biological, psychological, social and economic research shows that the environment in the first 1,000 days significantly impacts a person's ability to reach their full potential. Children who grow up in unpredictable and unsafe environments often struggle with the consequences for the rest of their lives. Investments in this critical period of human development have proven to be the most cost-effective way to improve lifelong health and well-being. Therefore, this period has gained interest both in political debate and society at large. In this contribution, we demonstrate that while the focus on the first 1,000 days is scientifically sound and historically grounded, it is time to reflect on its societal impact. We focus on its unintended negative consequences for parental well-being. Evidence for the importance of the first 1,000 days should drive collective action rather than reinforce individual blame. Parenting is not just a private matter; governments have a duty to provide parents with the resources to give their children the best start in life.

从受精的那一刻起,人类就以惊人的速度发展。怀孕后的头1000天是生命中最具生物学和发育里程碑的时期。所有的器官和系统都形成了,孩子们开始发现世界,学会信任谁,在痛苦的时候去哪里寻找安慰。来自生物学、心理学、社会和经济研究的证据表明,人生最初1000天的环境对一个人充分发挥潜力的能力有重大影响。在不可预测和不安全的环境中长大的儿童往往会在其余生中与这些后果作斗争。事实证明,在人类发展的这一关键时期进行投资是改善终身健康和福祉的最具成本效益的方式。因此,这一时期在政治辩论和整个社会都引起了人们的兴趣。在这篇文章中,我们证明,虽然对前1000天的关注在科学上是合理的,并且有历史依据,但现在是时候反思其社会影响了。我们关注的是它对父母幸福的意想不到的负面影响。证明前1000天重要性的证据应该推动集体行动,而不是强化个人指责。养育子女不仅仅是一件私事;政府有责任为父母提供资源,让他们的孩子有一个最好的人生开端。
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引用次数: 0
How are children's perceptions of the home environment associated with a general psychopathology factor across childhood? 儿童对家庭环境的感知如何与童年时期的一般精神病理因素相关联?
IF 7 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-08 DOI: 10.1111/jcpp.70046
Jack K Nejand, Margherita Malanchini, Ivan Voronin, Thalia C Eley, Kaili Rimfeld

Background: Comorbidity and heterogeneity in psychiatric disorders may stem from a general psychopathology (p) factor influenced by both genetic and environmental factors. Although the relative contributions of these influences on psychopathology are established, the longitudinal associations between the p-factor and specific environmental exposures and the aetiology of these associations across development are not well understood. Here, we examine whether twin-rated home environment contributes to changes in the p-factor over time or, conversely, whether the p-factor influences twin-rated home environment, reflecting potential evocative gene-environment processes.

Methods: Data were obtained from the Twins Early Development Study (TEDS). Cross-lagged panel analyses were conducted separately to ascertain the direction of associations between parent-rated p, twin-rated p, and twin-rated home environment (chaos at home and parental discipline) at ages 9, 12, and 16 (N = 6,213). Biometric autoregressive cross-lagged twin models were used to assess the aetiology of these associations, and MZ differences analyses were used to control for familial effects.

Results: Both parent-rated and twin-rated p-factor and twin-rated home environment were stable over time, although the twin-rated p-factor (r = .44 [0.42, 0.46]-.40 [0.37, 0.41]) was more variable than the parent-rated p-factor (r = .72 [0.71, 0.74]-.63 [0.61, 0.64]). Twin-rated home environment was more variable than p-factor in all cross-lagged models (phenotypic and MZ differences). Small, significant bidirectional associations were found between the p-factor and twin-rated home environment, with stronger cross-lagged paths from the p-factor to the twin-rated home environment than vice versa. These longitudinal associations persisted over time, though attenuated for parent-rated p-factor. Genetic analyses revealed that bidirectional cross-lagged paths were largely explained by shared environmental factors, with a smaller proportion explained by genetic factors. This pattern of results was confirmed in MZ difference analyses.

Conclusions: Our findings suggest a dynamic and bidirectional relationship between p-factor and twin-rated home environment across development, predominantly influenced by shared environmental factors. Changes in one can affect the other, highlighting the complexity of psychopathology's environmental influences. This underscores the need for further investigation into gene-environment interplay to inform prevention and intervention strategies for psychopathology.

背景:精神疾病的共病和异质性可能源于遗传和环境因素共同影响的一般精神病理学因素。虽然这些影响对精神病理的相对贡献已经确立,但p因子与特定环境暴露之间的纵向关联以及这些关联在整个发展过程中的病因学尚未得到很好的理解。在这里,我们研究了双评分家庭环境是否有助于p因子随时间的变化,或者相反,p因子是否影响双评分家庭环境,反映了潜在的唤起性基因-环境过程。方法:数据来自双胞胎早期发育研究(TEDS)。分别进行交叉滞后面板分析,以确定9岁、12岁和16岁时父母评级p、双评级p和双评级家庭环境(家庭混乱和父母纪律)之间的关联方向(N = 6,213)。使用生物特征自回归交叉滞后双胞胎模型来评估这些关联的病因,并使用MZ差异分析来控制家族效应。结果:父母和双评p因子和双评家庭环境随时间的推移都是稳定的,尽管双评p因子(r =。44[0.42, 0.46]- 0.40[0.37, 0.41])比父母评定的p因子变化更大(r =。72[0.71, 0.74]- 0.63[0.61, 0.64])。在所有交叉滞后模型(表型和MZ差异)中,双评分家庭环境比p因子更具变数。在p因子和双评分家庭环境之间发现了小的、显著的双向关联,从p因子到双评分家庭环境的交叉滞后路径比相反的路径更强。这些纵向关联随着时间的推移而持续存在,尽管在父母评定的p因子中有所减弱。遗传分析表明,双向交叉滞后路径主要由共享环境因素解释,遗传因素解释的比例较小。这种结果模式在MZ差异分析中得到证实。结论:我们的研究结果表明p因子与双评家庭环境在整个发展过程中存在动态的双向关系,主要受共同环境因素的影响。其中一个的变化会影响另一个,这凸显了精神病理学环境影响的复杂性。这强调了进一步研究基因-环境相互作用的必要性,以便为精神病理学的预防和干预策略提供信息。
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引用次数: 0
Subclinical hypomania, psychiatric and neurodevelopmental diagnoses: phenotypic and aetiological overlap 亚临床轻躁、精神病学和神经发育诊断:表型和病因重叠
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-06 DOI: 10.1111/jcpp.70045
Georgina M. Hosang, Miriam I. Martini, Angelica Ronald, Henrik Larsson, Sebastian Lundström, Paul Lichtenstein, Mark J. Taylor
BackgroundSubclinical hypomanic symptoms are fairly common in the general population but are linked to psychiatric and neurodevelopmental conditions. However, the genetic and environmental origins of these associations are unclear. This twin study examined the phenotypic and aetiological associations between subclinical hypomania and psychiatric and neurodevelopmental diagnoses.MethodsParticipants were 4,932 twin pairs from the Child and Adolescent Twin Study in Sweden. Hypomanic symptoms were assessed using the parent‐rated Mood Disorders Questionnaire when the twins were aged 18. Specialist diagnoses of 14 conditions and symptoms were ascertained from Swedish population registries. Phenotypic associations between hypomania and these conditions/symptoms were investigated, and their aetiological overlap was examined using the twin method.ResultsSubclinical hypomania was significantly associated with all 14 diagnoses. The highest odds were for psychotic disorders (odds ratio [OR] = 1.48, 95% confidence intervals [CI] = 1.33–1.64, p < .001). The genetic correlations between subclinical hypomania and these diagnoses ranged from 0.12 (95% CI: 0.04–0.33) for eating disorders (other than anorexia) to 0.58 (95% CI: 0.28–1.00) for drug misuse disorders. The nonshared environmental correlations were highest for psychotic disorders (0.52, 95% CI: −0.02 to 0.92) and lowest for body dissatisfaction (0.04, 95% CI: −0.01 to 0.08). For bipolar disorder, psychotic disorders, and attention deficit hyperactivity disorder, genetic, and nonshared environmental correlations with subclinical hypomania were of a similar magnitude.ConclusionsThe association between subclinical hypomania and the diagnosis of multiple psychiatric phenotypes highlights its important role in the developmental pathway to clinical disorders, its complex origins, and that it may represent a quantitative trait for various psychiatric phenotypes.
背景:亚临床轻躁狂症状在普通人群中相当常见,但与精神和神经发育状况有关。然而,这些关联的遗传和环境起源尚不清楚。这项双胞胎研究检查了亚临床轻躁症与精神和神经发育诊断之间的表型和病因学关联。方法研究对象为来自瑞典儿童和青少年双胞胎研究的4932对双胞胎。当双胞胎年满18岁时,使用父母评定的情绪障碍问卷对轻度躁狂症状进行评估。从瑞典人口登记中确定了14种疾病和症状的专家诊断。研究了轻躁狂和这些症状之间的表型关联,并使用双胞胎方法检查了它们的病因重叠。结果亚临床轻躁与14种诊断均有显著相关性。最高的几率是精神障碍(优势比[OR] = 1.48, 95%可信区间[CI] = 1.33-1.64, p < .001)。亚临床轻躁症与这些诊断之间的遗传相关性从饮食失调(厌食症除外)的0.12 (95% CI: 0.04-0.33)到药物滥用障碍的0.58 (95% CI: 0.28-1.00)不等。非共享环境相关性在精神障碍方面最高(0.52,95% CI: - 0.02至0.92),在身体不满意方面最低(0.04,95% CI: - 0.01至0.08)。对于双相情感障碍、精神障碍和注意缺陷多动障碍,遗传和非共享环境与亚临床轻躁狂的相关性相似。结论亚临床轻躁狂与多种精神疾病表型诊断之间的关联突出了其在临床障碍的发育途径中的重要作用,其复杂的起源,并可能代表了多种精神疾病表型的数量特征。
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引用次数: 0
Sex-specific pathways from early irritability trajectories to later suicidal ideations and behaviors: Findings from the ABCD study®. 从早期易怒轨迹到后来的自杀意念和行为的性别特异性途径:来自ABCD研究的发现。
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-04 DOI: 10.1111/jcpp.70044
Nellia Bellaert,Angelique Simeone,Lanting Zhang,Haoran Zhuo,Massimiliano Orri,Zeyan Liew,Wan-Ling Tseng
BACKGROUNDPrevious studies have demonstrated that children with high irritability are at increased risk for suicidal ideations and behaviors. However, they have mostly relied on teacher reports and shown mixed findings regarding sex differences. We aimed to identify developmental trajectories of childhood irritability, test their direct and indirect (through psychopathology) associations with adolescent suicidal ideations and behaviors, and examine whether these associations differed by sex.METHODSThis study used five waves of data from the adolescent brain cognitive development (ABCD) Study (N = 4,583). Parents rated their children's irritability yearly from ages 9-10 to ages 11-12, internalizing (e.g. depression) and externalizing (e.g. aggression) symptoms at ages 12-13, and suicidal ideations and behaviors (SIBs) at ages 13-14 using the child behavior checklist. Subgroups of irritability trajectories were derived using growth mixture modeling. Path analysis was conducted to test the total, direct, and indirect pathways from irritability trajectories to SIBs through internalizing and externalizing symptoms, and sex differences in those paths.RESULTSFour irritability trajectories were identified: low-stable (73.01%), rising (12.04%), declining (10.28%), and high-stable (4.67%). Compared with the other trajectories, children on the high-stable irritability trajectory were at higher risk for suicidal ideations (β = .13, p < .001), directly (β = .03, p = .04) and indirectly through internalizing and externalizing (β = .04 and 0.05, respectively, p's < .001) symptoms. Sex differences emerged for the rising and declining trajectories: pathways to suicidal ideations were mainly mediated by internalizing symptoms in females and externalizing symptoms in males. Pathways from all irritability trajectories to suicidal behaviors were mediated by internalizing and externalizing symptoms and were stronger in females than males.CONCLUSIONSDistinct trajectories of parent-reported irritability in childhood are differentially associated with suicidal ideation and behavior in adolescence, with the high-stable trajectory conferring the greatest risk. Internalizing and externalizing symptoms play key mediating roles, with notable sex differences in children following rising and declining irritability trajectories. Females with high irritability at any time point in preadolescence were at particular risk for suicidal behaviors.
背景先前的研究表明,高易怒的儿童有自杀意念和自杀行为的风险增加。然而,他们主要依赖于教师的报告,并在性别差异方面显示出复杂的发现。我们的目的是确定儿童易怒的发展轨迹,测试其与青少年自杀意念和行为的直接和间接(通过精神病理学)联系,并检查这些联系是否因性别而异。方法采用青少年大脑认知发展(ABCD)研究的5波数据(N = 4583)。父母在9-10岁至11-12岁期间每年对孩子的易怒程度进行评分,在12-13岁期间对孩子的内化(如抑郁)和外化(如攻击)症状进行评分,在13-14岁期间对孩子的自杀意念和行为(sib)进行评分。使用生长混合模型推导出易怒轨迹的亚组。本研究采用通径分析方法,通过内化和外化症状检验易怒轨迹到sib的总、直接和间接通路,以及这些通路的性别差异。结果共发现低稳定型(73.01%)、上升型(12.04%)、下降型(10.28%)和高稳定型(4.67%)4种易怒轨迹。与其他轨迹相比,高稳定易怒轨迹的儿童有更高的自杀意念风险(β =。13、p <。001),直接(β =。3、p =。04)和间接通过内部化和外部化(β =。p < 0.05, p < 0.05。001)症状。上升和下降的轨迹出现了性别差异:自杀意念的途径主要由女性的内化症状和男性的外化症状介导。从所有易怒轨迹到自杀行为的途径都是由内化和外化症状介导的,并且女性比男性更强。结论童年时期父母报告的不同易怒轨迹与青少年自杀意念和行为存在差异,且高稳定轨迹的自杀风险最大。内在化和外在化症状起着关键的中介作用,儿童在烦躁情绪上升和下降的轨迹上存在显著的性别差异。在青春期前的任何时间点具有高易怒的女性都有特别的自杀行为风险。
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引用次数: 0
Understanding the link between adolescent depression and precarious employment in adulthood: evidence from a sibling fixed effects analysis 了解青少年抑郁与成年后不稳定就业之间的联系:来自兄弟姐妹固定效应分析的证据
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-03 DOI: 10.1111/jcpp.70047
Jinho Kim, Hayun Jang, Keun Young Kwon, Hansol Park
BackgroundAdolescent depressive symptoms may mark the beginning of long‐term trajectories of socioeconomic disadvantage, yet their role in shaping labor market outcomes remains understudied. This study investigates the longitudinal association between depressive symptoms in adolescence and precarious employment in adulthood and explores the mediating roles of persistent depressive symptoms and educational attainment.MethodsUsing a sample of 3,703 individuals from full sibling pairs in the National Longitudinal Study of Adolescent to Adult Health, we employed sibling fixed effects models to control for unobserved family‐level confounding. Precarious employment in adulthood was measured using a multidimensional index reflecting job instability, material insecurity, lack of benefits, and limited decision‐making autonomy.ResultsAdolescent depressive symptoms were positively associated with precarious employment in adulthood (b = 0.0165, p < .01), even after adjusting for family‐level confounders. No significant gender differences were observed. Mediation analyses revealed that subsequent depressive symptoms in young adulthood mediated approximately 23.0% of this association, while educational attainment accounted for an additional 18.9%, independent of later depressive symptoms.ConclusionsThese findings highlight adolescent depressive symptoms as a significant early risk factor for employment precarity in adulthood. The results underscore the importance of early mental health interventions and suggest that improving emotional well‐being and educational outcomes during adolescence may reduce long‐term socioeconomic disadvantage.
青少年抑郁症状可能标志着长期社会经济劣势轨迹的开始,但其在塑造劳动力市场结果方面的作用仍未得到充分研究。本研究探讨青少年抑郁症状与成年后不稳定就业的纵向关系,并探讨持续抑郁症状与受教育程度的中介作用。方法采用全国青少年至成人健康纵向研究中的3703名全兄弟姐妹样本,采用兄弟姐妹固定效应模型来控制未观察到的家庭水平混杂。成年后的不稳定就业是通过一个多维指数来衡量的,该指数反映了工作不稳定、物质不安全、缺乏福利和有限的决策自主权。结果青少年抑郁症状与成年后不稳定就业呈正相关(b = 0.0165, p < 0.01),即使在调整了家庭混杂因素后也是如此。没有观察到显著的性别差异。中介分析显示,青年期随后出现的抑郁症状约占该关联的23.0%,而受教育程度又占18.9%,与后来的抑郁症状无关。结论青少年抑郁症状是成年后就业不稳定的重要早期风险因素。研究结果强调了早期心理健康干预的重要性,并表明在青春期改善情绪健康和教育成果可能会减少长期的社会经济劣势。
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引用次数: 0
Associations between genetic predisposition to mental health problems and academic achievement: a developmental perspective using two population‐based cohorts 心理健康问题的遗传易感性与学业成就之间的关系:基于两个人群队列的发展视角
IF 7.6 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-09-02 DOI: 10.1111/jcpp.70043
Marie‐Pier Larose, Isabel Schuurmans, Edward D. Barker, Liliana Garcia Mondragon, Henning Tiemeier, Irwin Waldman, Charlotte Cecil
BackgroundChildren's cognitive abilities play an important role throughout their academic career, but recent studies highlight the negative impacts of aggression, inattention, and impulsivity on academic success. These behaviors and traits are central to most externalizing (EXT) and neurodevelopmental (NDD) problems, which are substantially genetically influenced. We examined the mechanisms by which high levels of genetic predispositions to EXT and NDD problems associate with elevated mental health symptoms and subsequently lead to lower levels of academic achievement in two developmental periods (i.e., childhood and adolescence).MethodsAnalyses were performed on a subset of participants from the Generation R Study (N = 2,992) and the Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 5,099). Using structural equation modeling, we simultaneously tested for indirect pathways between polygenic scores for externalizing and neurodevelopmental problems (PGS‐EXT and PGS‐NDD) and academic achievement (age 12 in the Generation R Study and age 16 in ALSPAC) via children's symptomatology for conduct, attention, social, and oppositional defiant problems reported by mothers during early childhood (Generation R Study) and from childhood to adolescence (ALSPAC study). Our models were adjusted for children's sex, exposure to adversity, cognitive abilities, early school achievement (only in ALSPAC), and genetic predisposition to educational attainment.ResultsIn both cohorts, we found that higher levels of PGS‐NDD were associated with lower levels of academic achievement via higher attention problems. In adolescence only, we found that higher levels of PGS‐NDD and PGS‐EXT were associated with lower academic achievement via higher levels of conduct problems.ConclusionsGenetic predispositions to EXT and NDD were indirectly associated with academic achievement beyond the PGS for educational attainment, highlighting the need for sustained efforts to support children with attention problems in educational settings and to intervene on conduct problems, particularly during adolescence.Pre‐registration numberDoi: 10.17605/OSF.IO/SQTJH.
儿童的认知能力在他们的学业生涯中扮演着重要的角色,但最近的研究强调了攻击性、注意力不集中和冲动对学业成功的负面影响。这些行为和特征是大多数外化(EXT)和神经发育(NDD)问题的核心,这些问题在很大程度上受遗传影响。我们研究了高水平的EXT和NDD问题遗传易感性与心理健康症状升高相关的机制,并随后导致两个发育时期(即童年和青春期)学业成绩较低。方法对来自R世代研究(N = 2992)和雅芳父母与儿童纵向研究(N = 5099)的参与者进行分析。使用结构方程模型,我们同时通过母亲在儿童早期(R代研究)和从童年到青春期(ALSPAC研究)报告的行为、注意力、社会和对立违抗问题的儿童症状,测试了外化和神经发育问题(PGS‐EXT和PGS‐NDD)的多基因得分与学业成就(R代研究中为12岁,ALSPAC研究中为16岁)之间的间接途径。我们的模型根据儿童的性别、逆境暴露、认知能力、早期学校成绩(仅在ALSPAC中)和受教育程度的遗传倾向进行了调整。结果在这两个队列中,我们发现较高水平的PGS - NDD与较高的注意力问题导致的较低的学业成绩相关。仅在青春期,我们发现较高水平的PGS - NDD和PGS - EXT通过较高水平的行为问题与较低的学业成绩相关。结论:EXT和NDD的遗传易感性与学业成绩间接相关,这突出了在教育环境中持续努力支持有注意力问题的儿童,并干预他们的行为问题,特别是在青春期。预注册号doi: 10.17605/OSF.IO/SQTJH。
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引用次数: 0
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Journal of Child Psychology and Psychiatry
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