Research on Child and Adolescent Psychopathology最新文献

Research on clinical trajectories of children with suicidal ideation (SI) and clinical worsening (CW) during cognitive behavioral therapy (CBT) for childhood trauma is limited. The current study utilized secondary data from a randomized clinical trial comparing Trauma-Focused CBT versus Stepped care CBT to examine (1) clinical profile and outcomes of children with SI, recurrent thoughts of death/dying, and past attempts; and (2) clinical worsening during treatment and difference in outcomes. Children (ages 4-12) and their parents (N = 183) participated and 132 completed treatment. Interviews assessing SI, thoughts of death/dying, past attempts, and number/type of trauma were conducted with children (ages 7-12) and parents. Outcome measures (baseline and post-treatment) completed by parents included child posttraumatic stress symptoms, impairment, and internalizing and externalizing problems and an independent evaluator rated overall severity. Children (ages 7-12), parents and therapists completed ratings during treatment that indicated CW. Results did not differ by treatment group; thus, the pooled sample was used. Children with SI at baseline had higher severity than children without. For completers, no children (n = 14) with SI at baseline had SI at post-treatment. Child (n = 3) and therapist (n = 5) ratings of CW were low. Eighteen children (13.64%) were rated as CW by parents. Most ratings occurred at the beginning of treatment. Children with therapist ratings of CW had higher internalizing problems. Findings suggest that children with SI and CW can improve from trauma-focused CBT. More research is needed on the clinical trajectory of children with SI and trauma, and on clinical tools to monitor CW. Clinical trial registration information: https://clinicaltrials.gov : NCT02537678.

Previous research has provided clues to the association between bullying victimization, non-suicidal self-injury (NSSI), and psychotic-like experiences (PLEs). However, these studies have been limited in their failure to examine both the directions of the associations and the underlying mediating mechanisms. Furthermore, there has been little investigation into the longitudinal associations among these variables in rural adolescents. This study aimed to address the aforementioned limitations by examining the bidirectional associations and the potential mediating mechanisms among bullying victimization, NSSI, and PLEs in a sample of Chinese rural adolescents. A total of 526 junior middle school students (42.6% males; average age = 14.62, SD = 1.15, age range = 12 to 16 years old) from a rural county in Guangdong province, China were recruited and assessed at three time points spanning one year. Cross-Lagged Panel Models (CLPMs) were employed to investigate the prospective focal longitudinal associations. CLPMs revealed that notable reciprocal associations were observed between bullying victimization and NSSI, as well as between NSSI and PLEs. Moreover, PLEs at Time 1 significantly predicted bullying victimization at Time 2. Additionally, only the indirect path from Time 1 PLEs to Time 3 bullying victimization via Time 2 NSSI was significant. This study sheds light on the bidirectional associations and underlying mediating mechanisms among bullying victimization, NSSI, and PLEs in rural adolescents. The findings highlight the importance of considering the complex interplay between these factors and the need for targeted interventions to address the mental health concerns in this population.

Body dysmorphic disorder (BDD) is a common and debilitating disorder in adolescents, yet there is little research on the disorder in young people. The current study aimed to investigate peer relationship factors in 26 adolescents (aged 12 to 17 years) with BDD, compared to 27 adolescents with anxiety disorders and 25 adolescents without mental disorders. Participants completed self-report measures on peer appearance and general victimisation, peer support, appearance co-rumination and social media use. Adolescents with BDD and anxiety disorders perceived significantly less peer support than adolescents in the non-clinical control group. Although the frequency of perceived appearance and general victimisation did not differ significantly between groups, adolescents with BDD reported significantly more distress due to appearance victimisation than the non-clinical control group. Adolescents with BDD and anxiety disorders reported spending more time on social media than the non-clinical control group, and the BDD group engaged in significantly more online appearance comparisons than both the anxiety and control group. The relationships between BDD, victimisation, social media use, and other peer factors require further empirical investigation.

Impairments in social cognition, in particular empathy, have been associated with childhood psychopathology, though previous investigations have yielded inconsistent results. Measures of social attention can reveal processes involved in responses to emotional stimuli and highlight deficits in empathy, or emotional biases in those with anxiety. The current study examined symptoms of anxiety, cognitive and affective empathy scores, and eye-gaze patterns in a pediatric sample of children (n = 178; 51-98 months-old) referred by their teachers for emerging psychopathology symptoms at school. We used eye-tracking metrics to capture gaze patterns during a dynamic video task designed to elicit empathic responses. Anxiety symptomology was reported by parents using the Screen for Child Anxiety Related Disorders scale (SCARED). Associations between eye-tracking variables, cognitive and affective empathy, and anxiety scores were analysed dimensionally in accordance with the Research and Domain Criteria (RDoC) framework. Higher levels of anxiety were associated with lower cognitive empathy and shorter first and total fixation durations to the eyes, across emotions (happiness, sadness, fear). No such associations were found between affective empathy and anxiety. Hierarchical multiple regression analyses revealed that across emotion conditions, first fixation duration negatively predicted anxiety scores. Our results indicate that children high in anxiety display cognitive empathy impairments and shorter attention to the eyes. These findings could inform early intervention programs for individuals at risk of developing anxiety disorders, as educating those high in anxiety on ways to identify emotions in others through changes in social attention could help to reduce anxiety.

Misophonia is a condition involving decreased tolerance and intense responses to specific sounds, often those that are human-generated and repetitive in nature. Misophonia frequently onsets during childhood and is associated with significant distress, impairment, and diminished quality of life. While misophonia research remains nascent and no definitive practice guidelines exist at present, extant studies offer several promising potential avenues in intervention development for adults with misophonia. However, such research is comparatively limited for youth. Before widespread adoption of promising treatments, it is important to consider the potential for harm or non-beneficence that may arise from the mis-informed application of such treatments. In this article, we identify several potential pitfalls within intervention development for pediatric misophonia and provide recommendations to circumvent them. To that end, we focus on the following three topic areas: (a) challenges arising when psychological mechanisms are not considered in intervention development, (b) importation of a cognitive-behavior therapy (CBT) framework for obsessive-compulsive spectrum disorders without nuanced tailoring to misophonia, and (c) neglecting to include individuals with lived experience in the process of intervention development research. Considering these key areas within misophonia intervention development will be critical for upholding beneficence and minimizing harm in treatment of misophonia across the lifespan.

Engagement in nonsuicidal self-injury (NSSI) often begins in adolescence, and commonly occurs when a person is emotionally dysregulated. Parental emotion socialization (ES) plays a key role in shaping children's emotional expression, experience, and regulation. Longitudinal work is needed to understand how links between parental ES and adolescent clinical outcomes unfold over time. In this longitudinal study (N = 118; all assigned female at birth with a range of NSSI - from none to severe; age 12-17 years, Mage = 14.98 at the first assessment), for the Time 1 (T1) and Time 2 (T2) annual assessments; adolescents reported NSSI and adolescents and parents reported depressive symptoms. Parents (primarily mothers) reported on their supportive and unsupportive ES responses to youth expressions of sadness, anger, and happiness. We examined (1) concurrent relationships across time points, (2) longitudinal models (T1 to T2 change in parental ES and its associated T1 to T2 changes in adolescent clinical outcomes), and (3) prediction models (T1 parental ES predicting changes in adolescent clinical outcomes). Concurrent associations between parental supportive ES responses to sadness and anger were inversely related to adolescent's depressive symptoms and NSSI episodes. Longitudinal analyses showed that increases in unsupportive responses to sadness correspond with increases in depressive symptoms from T1 to T2. The findings underscore the importance of examining how parents respond to their children's emotions. Next steps are to investigate potential mechanisms of risk and consider interventions that enhance adaptive responses of parents to adolescents embroiled in negative emotional states.

Emotional reactivity has been linked to adolescent psychopathology and mental health problems. However, limited research has investigated the distinct associations between emotional reactivity in multiple interpersonal contexts and the development of adolescent psychopathology. The current study examined emotional reactivity to interparental conflict, parent-adolescent conflict, and school problems as predictors of adolescent internalizing problems, depressive symptoms, and anxiety symptoms six months later. The sample included 139 adolescents (54% girls; M_age = 13.30, SD_age = 0.73) and their parents who completed 10-day daily reports and 6-month follow-up assessments in Taiwan. Results showed that negative emotional reactivity to interparental conflict was associated with increased internalizing problems, depressive symptoms, and anxiety symptoms, after controlling for emotional reactivity to parent-adolescent conflict and school problems, outcomes at baseline, mean negative emotions, and sex. Furthermore, the associations between both positive and negative emotional reactivity to interparental conflict and adolescent anxiety symptoms was stronger for girls than boys. Findings suggested that heightened emotional reactivity to interparental conflict is a risk factor for predicting adolescent psychopathology, especially for girls' anxiety symptoms. Results highlight the importance of emotional reactivity across multiple interpersonal contexts in adolescence.

Crying is a typical infant behavior that activates parental caregiving behaviors, acting as "human alarms" important for the infant's survival. When living under war-related threat, the auditory system may be sensitized given its importance for survival, potentially impacting maternal cry processing. Children living in armed-conflict zones are at increased risk for behavior problems, which may relate to both direct exposure and indirect effects through their parents' perceptions and behaviors. This hypothesis was examined in a sample of mothers and their first-born children (aged 10-45 months) living in the Gaza vicinity area in Israel, chronically exposed to missile alarms (high-exposure; n = 45), and a comparison group (low-exposure; n = 86). Group differences in child behavior problems and maternal perceptions of and responsiveness to cry were investigated. A moderated indirect-effect of maternal cry perceptions on child behavior problems via maternal responsiveness to cry was examined. In the high-exposure group, children had more externalizing problems and mothers rated cries as more aversive. Maternal cry perception was indirectly related to child behavior problems via responsiveness to cry only in the high-exposure group: higher perceptions of cry as aversive or the child as distressed were related to faster responding to crying, and faster cry responsiveness was linked with fewer behavior problems. Results suggest that in armed-conflict zones with auditory warning signals, the parental caring system may be easily activated by cries due to the strong association between alarms and threat. Furthermore, children may need their mothers to react faster when feeling distressed, possibly because of the surrounding threat.

Stepping Together for Children after Trauma (ST-CT) is the first step of the promising intervention Stepped Care CBT for Children after Trauma. In ST-CT, the task of leading treatment is partially shifted to the parents, and the child and parent work together to complete therapeutic tasks from a workbook with therapist supervision. We aimed to investigate the feasibility of ST-CT in Norwegian first line services and explore child factors predicting outcome. Eighty-two children (mean age 9.9 years, 56% girls) participated. Feasibility was defined by treatment completion, reductions of child posttraumatic stress symptoms (PTSS) mid- and post-treatment, and client treatment satisfaction. Predictors included child baseline PTSS, depressive symptoms, posttraumatic cognitions, externalizing symptoms, number of different traumatic events, and type of trauma. Results showed that rates of completion (78.0%) and response (81% of completers/59.8% intention-to-treat) were comparable to previous studies by the ST-CT developer. Overall treatment effect was d = 2.46 and client treatment satisfaction was high (mean score child: 8.3, parent: 9.0, on a scale from 0 - 10). Higher baseline PTSS and depressive symptoms predicted poorer outcome at both mid- and post-treatment, while more posttraumatic cognitions, and exposure to interpersonal trauma predicted poorer outcome at mid-treatment only. These associations were no longer significant in the fully adjusted models. In conclusion, ST-CT shows promise as an effective first line treatment in this new context, with two of three children responding to the treatment. Baseline PTSS, depression, post-traumatic cognitions and type of trauma may be related to outcomes and should be explored further. (Trial registration:  ClinicalTrials.gov Identifier: NCT04073862. Retrospectively registered June 3rd 2019, first patient recruited May 19th 2019).