Research on Child and Adolescent Psychopathology最新文献

Justice-involved individuals often struggle to access adequate mental healthcare, highlighting the need for new therapeutic approaches. Mobile health (mHealth) applications offer a promising solution, but research on their use in this population is limited. This scoping review maps the current literature on mobile applications targeting mental health and substance use, and delinquent behavior in justice-involved and at-risk individuals. We included full-length empirical studies and conducted descriptive quantitative analyses to summarize study characteristics. In addition, we assessed the reporting quality of each study using the CONSORT-EHEALTH checklist. Finally, we examined implementation outcomes and effectiveness through a basic qualitative content analysis. Twenty-two records, covering eighteen unique applications, were included. Most studies focused on adults in ambulant settings. This adult-centered focus overlooks the distinct developmental needs of justice-involved youth, a population that remains largely underrepresented in mHealth research. While reporting quality generally met academic standards, many studies lacked mHealth-specific details, such as user engagement metrics and digital divide demographics. Preliminary findings suggest potential benefits, including behavioral improvements, enhanced patient-clinician communication, and increased insight for the patient. However, issues such as reliance on language, privacy concerns, and technical difficulties limit usability. Reported effectiveness was often short-term or showed no significant differences between groups, possibly due to small sample sizes, high attrition, and reliance on blended treatment formats. In conclusion, mobile applications show promise for forensic mental healthcare, but further methodologically robust research is needed to improve their real-world implementation.

Caregivers of detained adolescents often face significant stress and barriers to accessing resources needed to support their adolescents during community re-entry. This mixed-methods study used a participatory co-design approach to develop and pilot test a mobile health intervention aimed at reducing parenting stress among caregivers of detained adolescents with behavioral health needs. Eleven caregivers participated across two phases: co-design of the intervention (n = 6) and an open trial (n = 5). Co-design sessions engaged caregivers as equal partners to create an intervention (RAISE) tailored to their needs, incorporating mindfulness-based stress reduction, resources for navigating the juvenile legal system, and tools for improving family communication. Quantitative findings indicated high levels of caregiver engagement with the co-design process, with increased confidence in contributing to mobile app development and strong perceptions of the intervention's relevance. Qualitative thematic analysis highlighted caregiver priorities for intervention, including stress-management strategies, culturally relevant content, and mechanisms for community connection. Caregivers valued being recognized as integral collaborators and emphasized the importance of addressing structural barriers, such as stigma and systemic racism, within the app. The final RAISE app integrates evidence-based practices with user-driven features, offering a culturally relevant and accessible tool to support caregivers. Despite limitations, including a small sample size and technical challenges during the open trial, the study demonstrates the feasibility of participatory methods to address the unique needs of caregivers of detained adolescents. Future research will evaluate the efficacy of RAISE in reducing stress and improving outcomes for families of detained youth.Clinicaltrials.gov registration NCT05032742.

Callous-Unemotional behaviors (CU) can be seen in early childhood and are associated with negative developmental outcomes. The present study examined the genetic and environmental influences on the development of CU in the preschool period from both rank-order stability/instability and absolute-level developmental trajectories perspectives. A community sample of 310 twin pairs (MZ = 123; DZ = 187; 51% female) was longitudinally assessed with the Child Behavior Checklist 1¹/₂-5 reported by primary caregivers at ages 3, 4 and 5 years. Genetic and environmental contributions to rank-order stability/instability and absolute-level change in CU over time were assessed via biometric trivariate Cholesky and latent growth curve models, respectively. Age-to-age rank-order stability in CU was moderate and was mostly explained by genetic influences, whereas instability was due to genetic and nonshared environmental influences. Absolute-level change at the group level showed an overall pattern of decreasing CU across age, and individual differences in patterns of change were primarily due to nonshared environmental influences. Although rank-order change in CU was explained by genetic and nonshared environmental factors, within-individual changes in levels of CU were primarily influenced by nonshared environmental factors. These latter findings affirm that environmentally based intervention strategies in early childhood could affect CU trajectories.

Few studies have empirically tested if trait and behavioral impulsivity hinder treatment engagement (TE), which is unfortunate since TE is crucial for treatment success. Therefore, this study collected data from 16- to 17-year-old males (n = 322) and females (n = 110) residing in Flemish youth detention centers or residential (secured) care institutions. Dimensions of TE (i.e., readiness to change, bond with staff, collaboration on goals and tasks, and therapeutic engagement) and trait impulsivity (i.e., positive and negative urgency, sensation seeking, lack of premeditation, and lack of perseverance) were measured through self-report questionnaires, while behavioral impulsivity (i.e., response inhibition, choice impulsivity, and risk-taking) was assessed via computerized tasks. A series of multiple linear regressions was performed, including all facets of trait impulsivity and all indices of behavioral impulsivity as independent variables, and TE dimensions as dependent variables. Self-reported callous-unemotional traits showed a significant negative zero-order correlation with TE and were therefore included as a control variable. Findings showed that various facets of trait impulsivity and indices of behavioral impulsivity were significantly associated with different dimensions of TE in both males and females. Moreover, sex differences were observed in the associations between trait and behavioral impulsivity and TE. The results underscore the need to examine both trait and behavioral impulsivity in future research to clarify how they relate to TE and other treatment outcomes across sex and to inform targeted interventions, thereby potentially enhancing TE and improving treatment success.

Immersive Virtual Reality (VR) offers plentiful opportunities for behavioral and mental health assessment and treatment, such as overcoming spatial restrictions, increasing treatment motivation, and reducing participant risk. We examine these opportunities through the lens of 'affordances', which refers to the specific possibilities a technology offers when users interact with it. This lens provides a frame of reference that can help researchers better understand and exploit the opportunities VR offers for the design of assessments and treatments, boost their effectiveness, and provide a shared vocabulary across disciplines. We illustrate the utility of this approach with a scoping review of VR applications in forensic settings. Most of the 25 studies that were included used multiple VR affordances. While all studies employed transportation (100%), i.e., sensory immersion in a virtual environment that differs from the current physical environment, fewer utilized transformation (30%), i.e., user-embodiment in avatars with characteristics that differ from their own. The proposed affordances-based approach offers a transdiagnostic and user-centered approach to guide development and design of VR-based assessment and treatment across diverse mental health domains. It provides a shared conceptual approach for the organization of intervention components as well as for communication between stakeholders, facilitating the conversion of an idea into a full intervention.

Evidence-based mental health services are difficult to access; telehealth and mobile health hold promise by removing barriers to traditional clinic-based interventions and enabling broader access. Behavioral parent training (BPT) is an evidence-based treatment for child disruptive behaviors. This project examined the feasibility, acceptability, and preliminary efficacy of using a mobile BPT app, Treks, with families as a standalone treatment (Study 1) or in combination with brief clinician consultation (Study 2). Study 1 participants included 20 caregivers of children with challenging behaviors who engaged with Treks for four weeks. Study 2 participants included 26 caregivers of autistic children with behavioral concerns; all parents received a one-session telehealth consultation followed by random assignment to four weeks of Treks engagement (Treks; n = 14) or access to online resources (consultation control: CC; n = 12). Across both studies, Treks was rated positively and was reported by parents as acceptable and appropriate for their concerns, as well as adequately feasible. In Study 1, 60% of participants fully completed Treks and 83% of completers showed reliable improvement in at least one main outcome (parenting stress, parent sense of competence, and child behavior problems). In study 2, there were significant improvements in Treks but not CC participants, showing moderate-to-large decreases in child disruptive behaviors and parent stress and increases in parent-perceived competency. Mobile app-delivered BPT has the capacity to support families as a feasible and acceptable standalone treatment and should be considered as part of a stepped-care approach or for families who cannot access clinician-delivered BPT.

How people respond when adolescents disclose their suicidal thoughts or behaviors may significantly shape their help-seeking and mental health outcomes. Drawing on the Intimacy Process Model and Interpersonal Theory of Suicide, the present study examined interpersonal needs as mediators of the relationship between adolescents' supportive and unsupportive experiences with suicide-related disclosure and future suicide ideation (SI) and attempts (SAs). Ethnoracially diverse adolescents (n = 119; 78% female), aged 12-19 years (M = 15.2, SD = 1.9), were recruited from hospitals and clinics following SI or SA and interviewed about how others responded to their disclosure of SI/SA. Interpersonal needs (perceived burdensomeness, thwarted belongingness) were measured at one-month follow-up, SI severity was measured at baseline and 3-month follow-up, and SA since baseline was assessed at 1-, 3-, and 12-month follow-up. Thirty-nine percent of adolescents (n = 47) did not disclose their SI/SA, 43% (n = 51) had a supportive disclosure experience, and 18% (n = 21) had an unsupportive disclosure experience. Perceived supportiveness vs. unsupportiveness of responses was not associated with interpersonal needs nor with SI. Only thwarted belongingness predicted SI at 3 months, adjusting for baseline SI, among adolescents who disclosed their SI or SA. However, a perceived supportive (vs. unsupportive) response to disclosure significantly predicted lower odds of making a SA by 12 months. Treatments should address thwarted belongingness to reduce SI severity among adolescents presenting for clinical care following SI or SA. Increasing supportive experiences with suicide-related disclosure may reduce adolescents' risk of SAs.

Parental rules have been curiously neglected from a conceptual and measurement perspective. The first half of this paper reviews the literature to show that there is no commonly used, standardized measure of rules. Rules are typically measured either with ad hoc unvalidated items or incidentally measured with 1-2 items on multi-item scales assessing a broader parenting construct (e.g., discipline). Construct definitions are rarely stated, often circular, and inconsistent between authors. As a result, the empirical literature on parental rules is difficult to appraise and synthesize. The second half of this paper proposes a new framework for conceptualizing parental rules that includes an explicit, non-circular construct definition and delineates 7 distinct dimensions along which a parental rule can vary. The framework is designed to be universally applicable across youth behaviors and scientific fields and enable a more rigorous empirical science of parental rules.

To improve assessment in forensic youth care, a virtual reality (VR) task was developed to assess behavior without the limitations associated with traditional self-report instruments. The aim of the current study was to examine the potential of this task to assess aggression and its origins, with a focus on hostile intent attribution and low self-control, and its predictive validity in explaining violent infractions during the stay in a juvenile detention facility. Participants were juveniles (N = 84; aged 15-23) residing at two all-boys Juvenile Detention Centers in the Netherlands. Responses to four social VR scenarios were observed and, to assess the role of hostile intent attribution (HIA) and low self-control in aggressive responses in these scenarios, participants answered scenario-specific questions about their emotions, thoughts, and motives immediately after each scenario. In addition, self-report questionnaires were used to assess aggression, HIA and self-control. Two months after participation, violent institutional infractions were retrieved from casefiles. Results showed that particularly the more provocative and emotionally engaging scenarios have the potential to elicit aggressive responses. Overall, VR responses and self-report questionnaires showed little convergence, which could not be explained by social desirability nor variation in VR engagement and immersion. Violent institutional infractions were predicted by reactive aggression and low self-control in one of the four scenarios. Concluding, despite little convergence between VR and self-report questionnaires, VR assessment provides potential important information about future violence, which makes it worthwhile to further experiment with and study VR assessment in forensic youth care.