Research on Child and Adolescent Psychopathology最新文献

Transgender and gender diverse (TGD) youth experience chronic and acute stress associated with their gender identity contributing to their increased risk of suicide and suicide ideation (SI) compared to non-TGD peers. This study examined how invalidating and accepting gender-related experiences with a parent impact SI severity among TGD adolescents cross-sectionally and longitudinally, within-person. Participants were 15 TGD adolescents with past month SI recruited across community and clinical settings. Adolescents completed a baseline assessment of validated interviews and self-report measures on parental invalidation and SI severity. Over a 14-day follow-up period, adolescents reported instances of parental gender invalidation and acceptance, relative stress of those experiences, and SI severity multiple times/day via ecological momentary assessment (EMA). Bivariate associations of parental invalidation and acceptance with SI were examined at baseline, while multilevel models examined the relationship within-person over follow-up. Cross-sectionally, greater perceived invalidation and non-affirmation by their parents was associated with more severe SI. Over the follow up, instances of perceived parental invalidation were associated with passive SI within-person. Findings partially support the minority stress theory and social safety perspective by showing that perceived gender-invalidation from parents affects SI in TGD adolescents, both cross-sectionally and longitudinally. Further research is needed to identify specific emotional and cognitive factors, such as perceived stress, that contribute to the risk of SI among TGD youth and inform the development of targeted interventions for this vulnerable population.

School attendance problems (SAPs) are associated with negative short- and long-term outcomes. Despite high prevalence of SAPs, there is a shortage of evidence-based interventions. Existing approaches often target either school refusal or truancy, leaving a gap in effective interventions addressing both types of SAPs. This randomized controlled trial (RCT) assessed the effectiveness of Back2School (B2S), a modular transdiagnostic cognitive behavioral therapy (CBT) for SAPs, compared to treatment as usual (TAU). Outcomes included youths' school attendance and mental health. A group (B2S, TAU) × time (Pre, Post, 3-Month Follow-Up) design involving 152 youths (B2S; n = 74, TAU; n = 78) with SAPs (i.e., ≥ 10% absence in the past three months), aged 6-16 years (M = 12.2, SD = 2.2, males = 60%) were used. B2S comprised three months of CBT with youths, parents, and school involvement, while TAU comprised public and/or private intervention services. On average, youths in B2S received 15.0, (SD = 3.9) hours of intervention, while those in TAU received 13.4, (SD = 21.6). Intervention effects were investigated using mixed linear models. Both B2S and TAU exhibited significant within-group improvements in school attendance, with no significant differences between them. However, the B2S group significantly outperformed TAU in reducing youths' emotional problems, conduct problems, problems with peers, the overall impact of problems, and increasing youths self-efficacy for attending school and parent self-efficacy for dealing with a SAP. This RCT represents the first evaluation of a modular transdiagnostic CBT for youths displaying SAPs, showing significant mental health and self-efficacy benefits.  (Clinical trial registration: ClinicalTrials.gov: NCT03459677).

Children with ADHD are theorized to experience increased negative emotional responses to punishment, compared to typically developing (TD) children, resulting in altered behavioral responding (Amsel, 1992). However, this has not been empirically tested. The current study evaluated the effects of punishment and reward on the behavioral and emotional responding of children with and without ADHD. Fifty-three children with ADHD (64.15% boys) and 46 TD children (47.83% boys), age 6-12, completed a task in which they chose between playing two simultaneously available games. Reward was arranged symmetrically across the games; responses on one game were punished four times as often as responses on the other game. Children's negative and positive emotional expressions were assessed during task completion with facial expression coding. Results indicated both groups showed a preference for playing the less punished game. Children with ADHD took longer to respond after punishment and reward compared to TD children. Negative emotional expressions increased with time on task for those with ADHD, the opposite pattern was seen in TD children. Children with ADHD showed more positive emotional expressions overall. The effect of ADHD on increased response times after reward was statistically fully mediated by increased positive facial expressions. Findings indicate children with ADHD do not show an altered response bias under punishment compared to TD children, but their cumulative negative emotional responding may indicate problems with building frustration tolerance as hypothesized by Amsel (1992). Results are theoretically important as they suggest increased emotional responding in ADHD is associated with slower responding.

Depressive symptoms are prevalent in adolescents, especially girls, underscoring the need for early detection and targeted interventions. Identifying initial symptoms and their temporal associations is vital for such interventions. This study used cross-lagged panel network (CLPN) analysis to examine the central depressive symptoms and their interconnections within a national cohort derived from the China Family Panel Study (CFPS). The participants included 2524 adolescents (45.8% girls), with depressive symptoms assessed using the Epidemiological Studies Depression Scale (CES-D-8) in 2016 (M_age = 12.30) and 2018 (M_age = 14.25). The CLPN model showed that "loneliness" and "not getting going (fatigue)" at T1 were the strongest predictors of subsequent depressive symptoms at T2, after controlling for demographic variables and depressive symptoms at T1. Conversely, depressed mood and anhedonia at T2 were most likely to be influenced by other symptoms at T1. Gender-stratified analyses identified "loneliness" as the initial symptom in girls and "fatigue" for boys. Additionally, girls exhibited stronger reciprocal associations among depressive symptoms than boys. The findings suggest that addressing interpersonal loneliness is crucial for adolescent girls, whereas somatic fatigue should be a focus for adolescent boys, highlighting the need for gender-specific approaches in early intervention strategies. This research provides insights into the distinct gendered networks of depressive symptomatology in adolescents, informing tailored prevention and intervention efforts.

The mortality rate among adolescents has been steadily increasing in recent years. Researchers have previously identified forms of externalizing psychopathology measured during adolescence associated with an increased risk for premature mortality, including attention-deficit/hyperactivity disorder (ADHD), substance use disorders (SUDs), oppositional defiant disorder (ODD), and conduct disorder (CD). The current study investigated whether additional personality traits (i.e., adolescent psychopathic traits, assessed via the Hare Psychopathy Checklist: Youth Version [PCL:YV]) were also associated with premature mortality risk among maximum-security incarcerated adolescents (N = 332). During a follow-up period ranging from 10 to 14 years, premature mortality was observed in n = 33 participants (9.94%), a mortality rate nearly ten times higher than population norms. We observed that adolescents scoring the highest on PCL:YV total scores exhibited significantly higher rates of premature mortality compared to adolescents scoring lower on PCL:YV total scores via Fisher's exact tests. Additionally, through univariate Cox proportional hazard regression analyses, PCL:YV total, Factor 2 (measuring lifestyle/behavioral and antisocial/developmental psychopathic traits), Facet 1 (measuring interpersonal psychopathic traits), and Facet 3 (measuring lifestyle/behavioral psychopathic traits) scores were associated with faster time to premature mortality. In supplemental analyses performed, we observed that adolescents meeting criteria for externalizing psychopathology (i.e., ADHD, SUDs, ODD, and CD) did not exhibit higher rates of premature mortality compared to control participants. The current study therefore identifies additional maladaptive personality traits to consider in relation to premature mortality risk (i.e., psychopathic traits) among a high-risk sample of incarcerated adolescents.

Mental health problems in adolescence are increasing and there is an urgent call for transdiagnostic interventions, as most adolescents experience problems across multiple domains. Research has identified a general psychopathology factor (p) capturing the shared variance across mental health problems. In parallel, there is empirical support for the transdiagnostic nature of emotion regulation. In the current study, we explore the associations between p and emotion regulation strategies to identify which strategies may be promising targets for intervention. Data from the population-based Youth and Mental Health Study (YAMHS) (N = 2,464, mean age 13.7 years, SD 0.6) was used. The fit of different structural models of emotion regulation and psychopathology were compared, and latent factors from the final models were included in multiple regression analyses to explore the associations between p and emotion regulation strategies. A bifactor exploratory structural equation model (B-ESEM) showed best fit for modelling p. For emotion regulation strategies, an ESEM model showed best fit, including Rumination, Reactive Impulsivity, Distraction, Non-Acceptance, Problem Solving, Social Support, and Proactive Behavior. Results showed that a higher score on p was predicted by higher scores on the emotion regulation strategies Rumination (β = .38, p < .001) and Reactive Impulsivity (β = .35, p < .001), and lower scores on Problem Solving (β = -.15, p < .001). The results indicate that Rumination and Reactive Impulsivity have the strongest associations with p and may be promising targets for mental health interventions for adolescents.

Although research suggests that emotion dysregulation may underlie adolescents' social impairments, studies have focused almost exclusively on the dysregulation of negative emotions. The present study addressed this gap in the literature by examining whether behavioral manifestations of positive emotion dysregulation are also implicated. A sample of 13-18-year-old adolescents (56.8% female) with and without a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) was used, increasing variability in impairment profiles. Adolescents self-reported behavioral difficulties related to positive emotion dysregulation (i.e., impulse control difficulties, difficulties engaging in goal-directed behavior, and non-acceptance of positive emotions), negative emotion dysregulation, and social impairments (i.e., peer rejection, friendship quality, deviant peer affiliation, aggression, and victimization); parents rated adolescent's ADHD symptoms. Regression analyses indicated that impulse control difficulties when experiencing positive emotions uniquely predicted greater conflict in the best friend relationship, deviant peer affiliation, aggression, and victimization, even when accounting for negative emotion dysregulation and current ADHD symptoms. The significant effect of impulse control difficulties on these social impairments was consistent when accounting for oppositional defiant disorder and depression symptoms and when examining the main predictors only in adolescents with childhood or adolescent clinical elevations in ADHD symptoms. These results are the first to indicate that even for adolescents with ADHD, positive emotion dysregulation, and specifically impulse control difficulties, may significantly predict social challenges.

Maltreatment and autism can be associated with overlapping difficulties across functional domains (e.g., social, emotional, and sensory) and high rates of mental health problems. A cognitive approach focussing on affect-laden cognition, here on episodic future thinking (FT), could help inform cognitive assessments and adapt psychological interventions. Three groups of adolescents (N = 85), (i) maltreatment (n = 28), (ii) autism (n = 29), and (iii) typical development without maltreatment/autism (TD; n = 28), matched in age (10-16 years old), sex (assigned at birth), and socioeconomic status, completed a newly adapted online Autobiographical Future Thinking Test. As predicted, the maltreatment group generated significantly fewer specific future events relative to the TD group, however, the number of specific future events did not significantly differ between the autism and the other groups. Exploratory analyses showed that lower FT specificity was significantly associated with more depressive (but not anxiety) symptoms across the three groups. These findings shed light on the cognitive profiles of both maltreatment and autism during adolescence and signal FT as a potential therapeutic target for adolescents with these developmental differences. Our study lays the foundation for additional comparisons of maltreatment-related presentations versus autism with improved designs and a broader set of cognitive and clinical domains.

This study examined the moderating role of descriptive and status norms in the stability of youth's antisocial behavior, and the link between initial antisocial behavior and the development of depressive symptoms over the course of one academic year, while controlling for initial depression levels. A total of 1081 students (51.06% girls; grades 4 through 6) in schools in low to average socio-economic status neighborhoods completed self-reports and a peer nomination inventory in the fall (T1) and spring (T2) of one year. Descriptive norms were operationalized as the classroom- and sex-specific mean level of antisocial behavior. Status norms were operationalized as the classroom- and sex-specific correlation between antisocial behavior and social preference. Descriptive norms moderated the link between T1 and T2 antisocial behavior, such that youth exhibiting high levels of antisocial behavior showed a greater increase in antisocial behavior in classrooms where descriptive norms strongly favored such behavior (i.e., + 1 SD) than in classrooms with neutral or weak descriptive norms (i.e., - 1 SD). Status norms moderated the association between T1 antisocial behavior and T2 depressive symptoms, such that youth with high levels of antisocial behavior had higher depressive symptoms in classrooms where status norms disfavored antisocial behavior than in classrooms with neutral or favorable norms. No moderating effects of sex or grade were observed. These results suggest that both descriptive norms and status norms play important, albeit distinct, roles in exacerbating youth's depressive symptoms and antisocial behavior, but they may also mitigate these same outcomes in favorable contexts.