Research on Child and Adolescent Psychopathology最新文献

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.

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.

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.

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.

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.