Research on Child and Adolescent Psychopathology最新文献

The current study investigated the relationship between CU traits, autistic traits, and empathic disequilibrium, which reflects the imbalance between cognitive empathy (CE) and affective empathy (AE). Based on previous findings with adults, we hypothesized that children with elevated CU or autistic traits exhibit either AE or CE dominance in their empathy profiles. A total of 163 children aged 4 to 10 years (Mage = 7.30) participated in the study and were evaluated using reliable parent-report instruments. Polynomial regression with response surface analysis (PRRSA) was used to analyse the relationships between empathic disequilibrium and trait scores, while adjusting for age, sex, and overall empathy levels. The results indicated a notable association between AE dominance and autistic traits, reinforcing previous findings that suggest a different developmental profile of children with autistic characteristics. Conversely, lower levels of empathic disequilibrium (both AE and CE dominance) were linked to CU traits. CU traits were also related to a general reduction in empathy across both empathy types, indicating a broader empathic deficit. Additionally, age showed a positive correlation with both CU and autistic traits, while no gender differences were observed for either trait. These findings imply that empathic disequilibrium could serve as a valuable framework for understanding the emotional profiles of children with autistic traits and CU traits.

Callous-unemotional (CU) traits (i.e., blunted affect, low guilt) develop through the interplay of neurophysiological and environmental factors. However, critical gaps remain in understanding the relative importance of different physiological systems and early experiences over time. The goal of the current study is to identify which early-life biological and environmental features at which time points most strongly predict later CU traits in middle childhood. Using prospective longitudinal data from a rural community sample (N = 725; 48% female; 34% Black) and machine learning models, this study examined the relative predictive influence of biological stress systems (Sympathetic Nervous System (SNS), Hypothalamic-Pituitary-Adrenal (HPA) axis) and adversity indices (exposure to intimate partner violence (IPV), economic hardship, and lack of socially and cognitively stimulating toys or activities in the home) between 6 and 48 months on CU traits and conduct disorder (CD) at age 7. Models explained 7.3% of the variance in CU traits at 7 years. Exposure to IPV and sociocognitive resources across several time points, particularly in toddlerhood, emerged as influential predictors of later CU traits. Additionally, SNS functioning (i.e., salivary alpha-amylase) in early childhood was the most influential physiological predictor of CU traits. Prediction for CD was limited, with the final model explaining only 3.4% of the variability. Findings highlight the role of sympathetic regulation and early life experiences in shaping CU traits, providing important insights for the development of targeted interventions.

Prenatal tobacco (PTE) and tobacco cannabis co-exposure (PTCE) are associated with higher risk for child externalizing problems. However, developmental mechanisms for the PTE association and the PTCE related associations are poorly understood. We tested multiple mechanistic developmental pathways (emotion regulation, temperament, maternal negative mood, and continued postnatal tobacco exposure) from PTE and PTCE to early school age externalizing problems. The sample consisted of 293 diverse (48% Black, 27% White, 14% Hispanic, and 11% other or mixed race; 64.8% WIC recipients) mother-child dyads grouped as: PTE (n = 89; 62.92% male), PTCE (n = 105; 47.62% male), and demographically similar non-substance-exposed mother-child dyads (n = 99; 43.43% male). Substance exposure was assessed using multiple methods, maternal negative mood using self-report, emotion regulation using physiological methods in infancy and observations in toddlerhood, temperament with maternal-report in infancy and toddlerhood, and child postnatal tobacco exposure using salivary cotinine across time points. Externalizing problems were assessed in toddlerhood and early school age using maternal-report and at school age using teacher-report. PTCE was associated with an emotion regulation pathway and PTE was associated with a combined maternal negative mood and temperament pathway to externalizing problems. Although both PTE and PTCE were associated with heightened externalizing problems at early school age, PTE and PTCE were significantly related to unique underlying pathways to externalizing problems. Therefore, targets for prevention efforts for children with PTE and PTCE may need to vary based on the type of exposure a child experiences.

Social anxiety disorder is one of the most common disorders in adolescence. It is associated with severe distress, negative long-term consequences, and chronicity. Cognitive behavioral treatment (CBT) is the recommended treatment for social anxiety disorder. However, adolescents with social anxiety disorder consistently show poorer outcomes than any other anxiety disorder. The aim of the study was to compare the efficacy of a disorder-specific group CBT to a generic group CBT in treating adolescents with social anxiety disorder. The disorder-specific group CBT was specifically enhanced for adolescents with social anxiety disorder, while the generic group CBT was based on traditional CBT methods designed for all types of anxiety disorders. Ninety adolescents aged 12-17 with social anxiety disorder as their primary disorder participated in the randomized controlled trial. Semi-structured diagnostic interviews and questionnaires were completed at baseline, post-treatment, and 3-month follow-up. The disorder-specific group CBT and the generic group CBT showed no significant difference over time. However, both the disorder-specific group CBT and the generic group CBT showed significant improvements in outcomes over time equivalent to medium to large effect sizes. These results indicated that, regardless of treatment condition, the group format exclusively for adolescents with primary social anxiety disorder could be a feasible approach.Trial registrationClinicalTrials.gov. Identifier NCT03986827.

A subset of trauma-exposed youth follows a "delayed" posttraumatic stress disorder (PTSD) trajectory, where initially low symptoms escalate over time. This pattern poses a significant clinical challenge as these individuals resemble the resilient group and are often missed by early screening, requiring sensitive identification. This study aimed to identify youth on delayed versus resilience trajectories using specific symptom dimensions from the refined 8-factor model of DSM-5 PTSD symptoms. 659 middle-school students exposed to a major chemical explosion accident were assessed at 4, 8, and 13 months post-trauma using the PTSD Checklist-5. First, latent class growth analysis identified four distinct trajectories, including delayed and resilience trajectories. Second, using baseline demographics and eight symptom dimensions, logistic regression predicted the odds of membership in the delayed trajectory (vs. resilience). The primary model (dichotomous predictors) found female gender (OR = 2.38), internally-cued intrusions (OR = 2.77), dysphoric arousal (OR = 2.61), and anxious arousal (OR = 2.77) were significant predictors. A subsequent sensitivity analysis (continuous scores) confirmed internally-cued intrusions and anxious arousal as robust predictors but revealed that the gender effect was no longer significant. Our results suggest that current severity-based screening can be enhanced by incorporating profile-based approaches. Internally-cued intrusions and anxious arousal are potent early predictors for the delayed trajectory, even among individuals with low total symptom scores. Our findings highlight the need for integrating profile-based strategies into early identification and targeted prevention, while the role of gender in this process warrants further investigation.

Parents of children with special needs often face persistent mental health challenges. Acceptance and Commitment Therapy (ACT) has shown promise via the psychological flexibility framework, but reported effects have been heterogeneous. We systematically searched PubMed, Web of Science, and the Cochrane Library for randomized controlled trials of ACT delivered to parents of children with special needs that reported standardized effect sizes for parental anxiety. Eleven studies (n = 768) met the inclusion criteria. A fixed-effects meta-analysis revealed that ACT significantly alleviated parental anxiety symptoms (standardized mean difference (SMD) = - 0.26; 95% CI - 0.40 to - 0.12; P = 0.0003). Subgroup analyses indicated that the most substantial effects were observed among parents of children with neurodevelopmental disorders (SMD = - 0.50). Interventions conducted four times a week, lasting 120 min per session over 6-8 weeks, resulted in more pronounced effects (SMD = - 0.42). Integrated intervention approaches also produced positive results (SMD = - 0.35). Meta-regression analysis highlighted mean parent age and child condition as key moderators; studies involving parents of children with neurodevelopmental disorders exhibited greater effects (β = -0.37, p = 0.021), while each additional year of parent age correlated with a 0.05-unit increase in SMD (indicating a slightly reduced treatment effect). In summary, ACT seems effective in reducing parental anxiety symptoms among parents of children with special needs, with the most significant advantages noted in high-frequency/high-intensity standardized programs and among those caring for children with neurodevelopmental disorders.

The latent structure of posttraumatic stress symptoms (PTSS) in early childhood remains poorly understood. This study aimed to assess PTSS in young children, identify underlying latent constructs, and evaluate their construct validity. Participants included 190 children (M_age = 5.4 years, 53.7% female) and their mothers (M_age = 35.4 years), recruited from local communities and domestic violence shelters in an urban-suburban region of the U.S. Northeast. All children had experienced at least one potentially traumatic event (25.3% violence exposed). Mothers completed a semi-structured clinical interview and questionnaires at baseline and six months later. Exploratory structural equation modeling of early childhood PTSS did not support the four-factor structure adopted by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, nor did it replicate any individual symptom cluster. Instead, findings provided preliminary evidence for two distinct, interrelated latent dimensions: Avoidance/Arousal and Intrusions/Fear. These dimensions included developmentally specific symptoms not currently represented in prevailing diagnostic frameworks. Both factor-derived scales demonstrated strong internal consistency and were significantly associated with various trauma exposure types, convergent symptom measures, and concurrent impairment indicators. Notably, only the Intrusions/Fear factor predicted impairment at follow-up. These results raise questions about the applicability of existing posttraumatic stress disorder symptom clusters for preschool-aged children and highlight the need for developmentally sensitive, dimensional approaches to understanding early childhood posttraumatic stress and related psychopathology.

Although substantial research has focused on the academic outcomes of youth with attention deficit/hyperactivity disorder (ADHD), less is known about factors that promote positive adaptation among these youth in the school setting. Perceived fairness, a subcomponent of school climate, is associated with improved academic functioning and may play an important role among youth with ADHD who have been shown to display heightened reactions to injustice. This study examined perceived fairness in relation to academic functioning in early adolescents and whether this association differed for adolescents with or without ADHD. Participants were 341 early adolescents (ages 10-12), with approximately half (48.7%) diagnosed with ADHD. Teachers completed measures of learning problems and study skills, and adolescents completed measures assessing perceived fairness and attitude to school. Students with ADHD perceived their school to be less fair than students without ADHD, though the effect size was small. Regression analyses controlling for adolescent medication use, demographic characteristics, and co-occurring psychopathology revealed significant main effects wherein higher levels of perceived fairness predicted lower negative attitude to school, and ADHD status predicted a more negative attitude to school and lower study skills. A significant perceived fairness × ADHD interaction was found in relation to learning problems, wherein higher perceived school fairness was more strongly associated with fewer learning problems for students with ADHD than for students without ADHD. These findings contribute to research exploring promotive factors among adolescents with and without ADHD and have implications for interventions aiming to improve academic functioning.