Research on Child and Adolescent Psychopathology最新文献

Wearable technologies offer promising opportunities for non-invasive, continuous monitoring of physiological processes relevant to paediatric mental health. Although their use in adult psychiatry is growing, little is known about their application in mental health care for youth. This scoping review maps the current state of research on wearable technologies used to assess or support mental health in children and adolescents, with special attention to externalizing behaviours and forensic or residential settings. We systematically searched four databases (PubMed, PsychINFO, Web of Science, Embase) for peer-reviewed English-language studies involving participants aged 0 to 17, using wearable devices to assess physiological markers related to mental health. A total of 85 studies were included. Most studies focused on monitoring sleep (54) using wrist-worn actigraphy, particularly in youth with attention-deficit/hyperactivity disorder, autism spectrum disorder, or internalizing problems. A smaller number examined autonomic nervous system responses (19), motor activity (8), or brain activity and eye gazing (5). Of all 85 studies, 10 focused on externalizing behaviours or youth in forensic or residential care. Although feasibility was generally good, wearables were almost exclusively used for assessment, not intervention. Wearables are increasingly used to assess physiological parameters linked to mental health symptoms in youth. However, there is a lack of clinical implementation studies, particularly in high-risk populations. Future research should move beyond feasibility and direct assessment, and explore wearable-based interventions and just-in-time feedback strategies in clinical and forensic youth care.

Public speaking is one of the most commonly feared situations by socially anxious adolescents, often prompting behavioral anxiety markers including gaze avoidance and speech disruptions. While the potential adverse social consequences of behavioral anxiety markers in public speaking contexts have been established, research into how these markers might alter through cognitive behavior therapy is still in its infancy. In this preliminary study, we investigated changes in gaze behavior and speech disruptions from before to after 12 weeks of disorder-specific group cognitive behavior therapy among 41 adolescents aged 11-17 years (M = 14.46, 48.78% girls) with social anxiety disorder. Participants spoke for five minutes in front of a pre-recorded classroom audience while wearing an eye-tracker, before and after the Skills for Academic and Social Success program. Following treatment, we found an increase in frequency of gaze towards the faces of the audience while speaking, with greater changes among older participants. There were no changes in speech disruptions at the group level. We conclude that therapy may have a positive effect on gaze behavior, and discuss the clinical implications and opportunities for future research in this emerging field of study.

Youth suicide is increasingly prevalent, is a leading cause of death, and its public health burden is acute. Juvenile Legal System (JLS) involvement is an established correlate of suicidality; however, it is unclear how JLS involvement is nomologically associated with suicidality. Adolescents are situated within ecological contexts (i.e., family, schools, neighborhoods) that likely interact to modify the association of JLS involvement and suicidality. To improve predictive models, rigorous prosecution of this relationship must disentangle related risk/protective factors (i.e., sex/gender, race-ethnicity, discrimination, trauma, familism). Based on 2426 adolescents enrolled in a substudy of the Adolescent Brain and Cognitive Development Study (ABCD), we utilized propensity score matching to test the association of police contact at 10-13 years-old with suicidal outcomes (i.e., self-harm, suicidal ideation, suicide attempt) two years later, covarying for age, education, race-ethnicity, sex/gender, discrimination, adverse childhood events (ACEs), and familism. After adjusting for numerous demographic, experiential, and family-level correlates, police contact did not significantly predict suicidal outcomes two years later. Baseline ACEs positively predicted self-harm and suicidal ideation two years later. Lower familism predicted self-harm, suicidal ideation, and suicide attempts two years later. With inclusion of important risk and protective factors, JLS involvement did not uniquely predict suicidality. Factors closely related to JLS involvement (i.e., ACEs, familism) incremented risk. To address the increasing prevalence of suicidality and the disproportionate impact of suicide on JLS-impacted youth, it is critical to investigate individual and systemic factors, and how they interact, to increase risk for suicidality.

A growing body of research suggests sleep disturbances and depressive symptoms do not just co-occur but influence each other over time. While emerging evidence supports a bidirectional relationship, developmental pathways between sleep problems and depression remain understudied in youth. Rumination may serve as a potential modifiable cognitive mechanism linking these conditions. However, rumination's role in these developmental pathways remains largely unexplored, particularly across childhood and adolescence. This study employed a cross-lagged panel model (CLPM) to investigate prospective associations among sleep, depression, and rumination and test mediation effects. Participants were 364 youth aged 8 to 16 participating in three yearly assessments. A distinct pattern emerged in which rumination predicted later depression, and depression predicted later insomnia. Insomnia did not significantly predict later depression and was not associated with rumination. Examination of indirect effects identified support for a mediational pathway from rumination to insomnia through depression. Although prior research has framed early insomnia symptoms as a risk factor for later depression, the present investigation highlights an alternative developmental pathway. Results suggest that depressive rumination contributes to later depression which in turn contributes to later insomnia among youth. These findings may inform prevention and early intervention efforts by identifying rumination as a potential target to mitigate risk for depression and insomnia.

Parenting interventions are a front-line treatment for children with attention-deficit/hyperactivity disorder (ADHD). However, many parents of children with ADHD have elevated ADHD or depressive symptoms, which may impede their ability to engage in and benefit from such interventions. This secondary data analysis examined associations between parent mental health, treatment engagement, and parenting-related treatment outcomes within a randomized trial of 172 families of children with ADHD. Families received either Parental Friendship Coaching (PFC; a behavioral parent training program) or Coping with ADHD through Relationships and Education (CARE; a parent psychoeducation and social support intervention); both were parenting interventions that aimed to support parents to improve children's ADHD-related social impairments. Higher parent self-reported ADHD symptoms at baseline were associated with lower home practice completion in PFC, potentially greater perceived group social support in PFC, and higher attendance in CARE. In contrast, parent depressive symptoms were not associated with engagement in either intervention. Overall, higher parent ADHD or depressive symptoms demonstrated few associations with parenting behavior treatment outcomes at post-treatment or 8-month follow-up, and observed effects were both positive and negative in PFC and CARE. It is possible that accessibility-focused adaptations to PFC and CARE reduced the impact of higher parent mental health symptoms on poorer engagement and parenting treatment outcomes. Nevertheless, the generally low levels of ADHD and depressive symptoms in the sample limit the ability to detect possible stronger associations.

Callous-unemotional (CU) traits (i.e., low empathy, restricted guilt, limited prosociality) are associated with severe conduct problems (CP) across development. However, there is heterogeneity in how CP and CU traits manifest at different ages, between boys and girls, in different countries, and different measures. The current study investigated this heterogeneity by applying network analysis to two large mixed-gender samples from the United States (US) and Spain assessed at different ages, with parent ratings of CP, conduct disorder (CD) symptoms, and CU traits. Data were from the ABCD baseline study (US, N = 11,874, age M = 9.48, SD = 0.51, 47.8% girls) and social development sub-study (US, N = 2,426, age M = 11.52, SD = 0.73, 47.4% girls), as well as two waves of the ELISA study (Spain, N = 1,342, age M = 10.24, SD = 1.07, 50.2% girls; N = 1,259, age M = 10.92, SD = 1.01, 50% girls). There were similar rates of CP risk across countries and genders, with the exception that boys younger than age 12 had higher CP risk rates than girls in US. Boys also had higher CU traits than girls in both countries. Network analysis revealed stronger connectivity between items assessing CU traits than CP symptoms, which was consistent across measures and countries. Disobedience and deceitfulness were central symptoms across all samples. Relational aggression was more central among girls, and property destruction and theft were more central in the US. Results highlight the need for personalized interventions that target specific symptoms of CP and CU traits, which can help reduce the burden of antisocial conduct across the lifespan.

Peri-adolescence, the developmental window surrounding pubertal onset, is a critical period for the emergence and escalation of anxiety symptoms, making accurate assessment essential. While parent-reports are typically prioritized in childhood and youth self-reports in later adolescence, these perspectives often diverge during peri-adolescence, and such discrepancies are inconsistently linked to age. This study tested whether pubertal stage, rather than chronological age, accounts for differences between parent- and youth-reported anxiety, aiming to clarify how anxiety is experienced and perceived during this sensitive developmental transition. Two-hundred peri-adolescents (ages 10-13) and their parents completed clinical interviews, anxiety rating scales, and the Pubertal Development Scale. Mixed-effects models tested whether discrepancies varied as a function of pubertal stage, controlling for age. We also explored the utility of Principal Components Analysis (PCA) to extract shared variance across informants into a single multi-informant anxiety score. More advanced pubertal stage was associated with greater discrepancies in anxiety reports, driven by higher youth self-reports and stable parent ratings-especially among clinically anxious youth (n = 94). PCA identified a single cross-informant factor that captured shared variance and improved prediction of clinical severity and functioning. Puberty, rather than age, plays a key role in how caregivers and adolescents report on anxiety symptoms. These findings underscore the need to account for pubertal stage in peri-adolescent assessment and support the utility of dimensional, developmentally sensitive approaches for integrating multi-informant data.

Adolescence is an important social development period that is also marked by increased rates of depression. Positive social interactions are crucial for cultivating social skills and functioning, also known as social competence, and lower social competence has been related to greater depressive symptoms. Still, little is known about factors that impact why some adolescents with low self-perceptions of social competence develop depression while others do not. The present study addressed this gap by examining neural processing of social rewards as a potential moderator of the association between self-perceptions of social competence and depressive symptoms in adolescents. Data from 165 adolescents were collected using electroencephalography during a perceived peer interaction task, eliciting the reward positivity (RewP) event-related potential component in response to social acceptance versus rejection feedback. We identified a moderating effect of social RewP (b = 0.52, p = .039), such that the negative relation between self-perceived social competence and depressive symptoms was strongest for adolescents with a blunted social RewP. These results provide further evidence for the importance of social reward responsiveness in moderating the relation between risk factors and depressive symptoms in adolescents and highlight the utility of multi-method approaches to examining social processes in depression.