Research on Child and Adolescent Psychopathology最新文献

Depressive symptoms increase in adolescence, especially for female adolescents at risk for depression due to dispositional factors, such as temperament. Emotion dynamics, or change in emotional experience over time, may serve as a mutable mechanistic factor for depression. In a sample of 117 adolescents assigned female at birth ages 11-13 (M[SD] = 12.22[0.81], 68% white, 21% Black, 10% Hispanic/Latino, 9% biracial), oversampled for temperamental risk for the development of depression, this study examined emotion variability in association with depressive symptoms, both concurrently and longitudinally over an 18-month period. Further, this study extends the literature by examining associations between emotion variability and depressive symptoms by accounting for individuals' typical levels of positive/negative emotion using two distinct methods: set-points or most frequent emotional state (i.e., mode adjustment) and average levels (i.e., mean adjustment). Results of mode-adjusted longitudinal growth curve models indicated that modal negative emotion, negative emotion variability, and positive emotion variability were all positively associated with adolescent females' depressive symptoms at baseline but were not associated with change in depressive symptoms over time. By contrast, in mean-adjusted models, mean negative emotion was associated with baseline depressive symptoms, whereas variability in negative emotion was not. By contrast, only positive emotion variability was associated with depressive symptoms at baseline, whereas mean positive emotion was not. Neither was associated with change in depressive symptoms over time. Findings suggest that the putative difficulties with reactivity and regulation captured by emotion variability measures are related to adolescent females' depressive symptoms - at least at non-clinical levels.

Exclusionary school discipline practices (EDPs), such as school suspensions, are increasingly linked to poorer academic outcomes and increased contact with the legal system. However, the short-term effects of EDPs on other aspects of adolescent well-being, including mental health concerns and perceived unfair treatment, have received limited attention. Using five waves of data from the Adolescent Brain Cognitive Development^SM Study^® (n = 11,831, 48% female, 52% White, 15% Black, 19% Hispanic), the current study examined how EDPs predict changes in externalizing and internalizing symptoms as well as perceived unfair treatment by a teacher. After adjusting for baseline EDPs, externalizing concerns, and covariates, we found that EDPs reported at follow-up waves were associated with increased odds of youth- and caregiver-reported externalizing symptoms, youth-reported internalizing symptoms, and youth-reported perceived unfair treatment by a teacher at the subsequent wave. These associations were observed above and beyond each outcome's predicted trajectory. However, baseline EDPs showed limited and inconsistent associations with overall symptom trajectories, suggesting that single time point EDP effects on adolescents' overall trajectories may underestimate the cumulative impact of repeated discipline over time. This is particularly concerning given that most disciplined adolescents experienced repeated EDPs. Race and ethnicity did not consistently or robustly moderate these associations. Findings underscore the need for interventions that minimize the repeated use of exclusionary discipline.

Adolescence is a critical developmental stage in which family dynamics strongly influence behaviors such as binge drinking and emotional regulation. This study examined whether future orientation mediates the effects of parental behaviors on adolescents' internalizing and externalizing problems, as well as binge drinking. Data came from a three-wave longitudinal study conducted at Social Assistance Reference Centers (SARCs) in 12 Brazilian municipalities. The sample included 1,610 participants from 805 families, each with one adolescent aged 10-14 years and one caregiver. Assessments occurred at baseline, six months, and 12 months. Parenting variables included positive parental relationships, family communication skills, problem-solving skills, and parental expectations. Models tested the direct and indirect effects of these variables on adolescent outcomes, with future orientation as a potential mediator. Future orientation mediated the association between positive parental relationships and externalizing problems. Positive parental relationships and problem-solving skills were directly linked to reductions in externalizing problems and binge drinking. Family communication skills and parental expectations also showed direct effects on externalizing problems, though without mediation by future orientation. These findings underscore the role of positive parenting practices in reducing behavioral problems and promoting healthy adolescent development. Interventions aimed at strengthening family relationships, problem-solving, and communication may effectively address externalizing behaviors and decrease binge drinking, particularly in socioeconomically vulnerable contexts.

Cannabis use is common among US youth who become involved in the juvenile legal system (JLS), yet substance use treatment rates remain low, particularly among youth diverted away from formal JLS involvement. Diverted youth encounter multiple barriers to receiving services in the community that could be addressed via digital approaches offered by the JLS. This multiphase work details development of the TECH (Teen Empowerment through Computerized Health) app, a tailored digital adjunct to usual JLS services. First, qualitative interviews with diverted youth (n = 14) aged 14-18 years and their caregivers (n = 8) established youths' cannabis-related treatment needs and preferences; youth were asked to specifically consider several theory-driven app components (personalization, behavior change, social interaction, gamification, and motivation enhancement). After building the TECH app, 10 diverted youth beta-tested the prototype over one month, to inform its preliminary feasibility (i.e., participation and app metadata) and acceptability (i.e., app quality and user satisfaction). Qualitative results indicated diverted youth and caregivers were open to an app to reduce cannabis use. Interviewed youth were divided about theoretically driven features, likely due to their unique preferences and needs. Prototype beta testing demonstrated diverted youth were willing to engage; metadata indicated all beta-testers used TECH independently after their baseline appointment, demonstrating feasibility. Participants rated satisfaction as slightly above average, reporting the app was of good quality and recommending ways to increase acceptability. We discuss implications of these preliminary findings on the app itself and the broader field of digital health for youth diverted from the JLS.

Evidence supports the efficacy of transdiagnostic interventions to prevent emotional problems in adolescents. Recently, the role of booster sessions on treatment gains over time has been suggested. However, the underlying mechanisms that explain treatment outcomes after booster dosage are unknown. This study examined possible mediation effects of booster in a sample of 100 adolescents at risk of developing emotional problems who received the selective, personalised, preventive, transdiagnostic intervention named as PROCARE+. Participants were allocated into three conditions according to the number of booster sessions received after PROCARE + was implemented: none, one (at 6 months) or two (one at 6 and another at 12 months). Mediation models were conducted to examine the role of changes in emotional regulation and resilience on several outcome measures: self-perceived and parent-rated emotional risk, emotional symptomatology and quality of life. Results showed that emotional regulation, but not resilience, significantly mediated the improvements observed after receiving the booster sessions, emerging as a key psychological mechanism. In particular, participants who received one booster session compared to those who received no booster session evidenced improvements in their levels of emotional regulation, which partially mediated the effects on emotional symptomatology and quality of life. In addition to benefits after one booster dosage, adolescents who received two booster dosage also expressed a decrease of their risk of developing emotional problems.

The study examined neurodevelopmental and psychosocial outcomes in adolescents aged 12 and 16 with childhood diagnoses of ADHD, autism, dyscalculia, or dyslexia. Participants were drawn from the Twins Early Development Study based on parent-reported diagnoses between ages 7 and 9 of ADHD (n = 54), autism (n = 50), dyscalculia (n = 282), and dyslexia (n = 695). A comparison group included 6,882 participants without neurodevelopmental diagnoses. Differences in ADHD and autistic traits, academic challenges, peer difficulties, and internalizing issues were explored between the comparison group and each neurodivergent group at ages 12 and 16. Across timepoints, neurodivergent groups showed distinct patterns of difficulties across domains relative to the comparison group. The ADHD group had higher levels of inattention and hyperactivity/impulsivity at 12 and 16, lower academic performance at 16, and elevated mental health challenges at 12. The autism group showed higher degrees of inattention, hyperactivity/impulsivity, autistic traits, and peer difficulties at 12 and 16. The dyscalculia group had challenges in all domains except for peer relationships at 12, with only mathematical underachievement persisting to 16. The dyslexia group showed difficulties in all domains at 12 with issues related to inattention, hyperactivity/impulsivity, academic achievement, and peer relationship persisting to 16. Whereas at age 12 the neurodivergent groups showed diagnosis-specific difficulties and broader neurodevelopmental and psychosocial challenges, by age 16 they were characterized by distinctive trajectories with persisting and resolved difficulties. These findings underscore the need for repeated, broad-based assessments to understand the changing needs of children with early neurodevelopmental diagnoses.

Biofeedback-based digital games offer an engaging solution to the burgeoning youth mental health crisis. This review identified and evaluated empirical evidence of biofeedback-based digital games in the treatment of youth mental health challenges and the promotion of youth well-being. A systematic search of four electronic databases (CINAHL, PsycInfo, PubMed Central, and Web of Science) was conducted from the publication's year of inception. We identified 604 unique studies, 16 of which were included in the review based on eligibility criteria. The results of 7 studies were deemed generalizable due to their design. Participants in these 7 studies played Dojo, emWave, Mightier, RAGE-Control, or Wild Divine, all of which utilized a form of cardiac biofeedback. These games proved effective in reducing internalizing symptoms, externalizing behaviors, and general psychopathology, especially within clinical populations. In addition, there is promising evidence of their ability to promote emotion regulation skills as a universal intervention. Future directions include further evaluation of biofeedback-based digital games in school-based settings, as an interim treatment for waitlisted families in outpatient settings, as an add-on to existing evidence-based treatments, and of the cost-benefits to promote insurance coverage of biofeedback-based digital interventions.

Street Temptations is a virtual reality-enhanced training program developed as an add-on intervention for adolescents with disruptive behavior problems. Using mentalization as a primary treatment mechanism, the program aims to address cognitive distortions and increase motivation for behavior change. This study provides an initial evaluation of Street Temptations in a forensic youth care setting, utilizing both quantitative and qualitative data within an A-B-A' single-case experimental design. Throughout a baseline, intervention, and follow-up phase, adolescents completed daily measurements on cognitive distortions and motivation for behavior change. Secondary outcomes were assessed before baseline, after intervention, and after follow-up, which included mentalization and perspective-taking. Qualitative data were collected after the intervention through separate interviews with adolescents and Street Temptations therapists. A total of 8 adolescents were included in the study, 5 of whom dropped out, leaving 3 who provided sufficient data for visual inspection of the outcomes. The observed patterns suggested an increase in adolescents' awareness of others' perspectives during participation in Street Temptations, potentially indicating a positive effect on cognitive distortions. However, daily assessments did not show an increase in adolescents' motivation for behavior change. Positive effects of Street Temptations and virtual reality, as well as areas for improvement, were highlighted in all interviews. Recommendations for further development and implementation are discussed. Overall, this study provides preliminary support for the use of Street Temptations as an add-on intervention in forensic youth care.

Technologies such as virtual reality, wearables, and mobile apps have the potential to improve forensic psychiatric treatment of youths. Meanwhile, these technological advancements have given rise to new, complex ethical challenges. Paying attention to ethics is especially relevant in forensic psychiatric youth settings because of the often coercive context of treatment and the vulnerable patient population. The goal of this viewpoint paper is to identify and discuss important ethical challenges regarding the use of technology in forensic psychiatric youth care. In line with approaches within the domain of ethics, an analysis of relevant scholarly literature was used for this viewpoint paper. First, a general description, an overview of research on effectiveness, and examples from practice are provided for six technologies that can be used in forensic psychiatric youth care: virtual reality, internet-based interventions, mobile apps, wearables, neurotechnology, and games. Next, ethical challenges that are relevant for these technologies are explored, related to informed consent, privacy and data security, reliability and validity, equity, accessibility and usability, undesirable side effects, acceptability of content, persuasiveness, and evidence-based interventions. Interdisciplinary collaboration between researchers, patients, therapists, ethicists, technology developers, and forensic organizations is recommended for timely identification of ethical challenges and suitable solutions. We suggest that patients and therapists should be actively involved throughout all phases of the process, from development of the technology via co-creation to active participation in implementation and evaluation in practice.

The parent-child emotion regulation dynamics model posits that child emotion regulation develops in the context of the parent-child relationship across multiple levels of functioning. Such a conceptualization dovetails newer conceptualizations of psychopathology, which argue that to most effectively understand and treat psychological problems, evaluation of individual and dyadic indicators across behavioral, physiological, and neural indicators is crucial. The present study adopted this multimethod, multilevel approach to examine the interacting role of maternal affect experiences with dyadic neurophysiological processes in relation to child emotion dysregulation - a transdiagnostic risk factor for both child internalizing and externalizing psychopathology. Eighty mothers (M_age = 35.97, SD = 5.46) and their school-age children (M_age = 5.88, SD = 0.80; 54% girl; 46% boys) completed a dyadic stress task. Across the entire task, respiratory sinus arrythmia (RSA) and dorsolateral prefrontal cortex (dlPFC) activation were measured for both mothers and children. Mother-child temporal concordance (i.e., synchrony) was then computed for each modality. Mothers also reported on their own affect experiences and children's emotion dysregulation. In the context of positive RSA synchrony and positive left and right dlPFC synchrony, maternal positive affect experience was most strongly and negatively associated with child emotion dysregulation. Conversely, the relation between maternal positive affect and child emotion dysregulation was negative and weakest in the context of negative RSA synchrony and left dlPFC synchrony. Findings provide empirical support for the parent-child emotion regulation dynamics model, suggesting that multilevel synchrony processes have significant implications for child emotion dysregulation, a robust transdiagnostic indicator of psychopathology.