Scandinavian Journal of Child and Adolescent Psychiatry and Psychology最新文献

Background: The foundation of a healthy life begins in pregnancy and early adversity can have detrimental long-term consequences for affected children.

Objective: This paper examines the effects of the Incredible Years Parents and Babies program (IYPB) at one-year follow-up when offered as a universal parenting intervention to parents with newborn infants.

Method: We conducted a pragmatic, two-arm, parallel pilot randomized controlled trial; 112 families with newborns were randomized to IYPB intervention (n = 76) or usual care (n = 36). The IYPB program is a group intervention with eight two-hour sessions. Follow-up outcomes collected a year after the intervention ended include parental stress, depression, well-being, reflective function, sense of competence, and child cognitive and socio-emotional development.

Results: There were no intervention effects on any of the primary or secondary parent-reported outcomes at one-year follow-up when the children were 18 months old. When examining the lowest-functioning mothers in moderator analyses, we found that mothers assigned to the IYPB group reported significantly lower scores for the interest and curiosity subscale of the parent reflective function scale than control mothers (β=-1,07 [-2.09,-0.06]).

Conclusion: We found no long-term effects of the IYPB when offered as a universal intervention for a relatively well-functioning group of parents with infants in a setting with a high standard of usual care. The intervention was developed for more vulnerable families in settings with a low level of universal care and the program may be effective for families in those circumstances.

Catatonia is a well-established psycho-motor disorder occurring in the background of various psychiatric and medical disorders. Catatonia is commonly associated with psychiatric disorders, especially affective disorders followed by schizophrenia. However, almost 20% occur in the background of different medical and neurological disorders which need to be properly examined and investigated. Catatonia is a serious medical and psychiatric emergency condition; most probably caused by alteration in GABAergic circuits and basal ganglia. If untreated, catatonia can cause life threatening complications like dyselectrolemia, respiratory aspiration, venous thromboembolism, acute renal failure and cardiac arrest because of poor oral intake, immobility and muscular rigidity. The risk of mortality or serious life threatening events further increases in cases of children and adolescents. In children and adolescents, thus, it becomes even more important to diagnose catatonia early and start appropriate treatment. Lorazepam is considered to be the first line treatment and is safe both in adults and children. But evidence is scarce for treatment of lorazepam-resistant adolescent Catatonia. In this report we discuss two adolescent patients diagnosed with catatonia with no medical or neurological disorders in the background. Neither of the patients responded to lorazepam alone or even after augmentation with second generation antipsychotic (olanzapine). Zolpidem, like lorazepam, has a positive allosteric effect on GABA A Receptors (GABAAR) and has been used in some cases successfully to treat resistant catatonia. Here we used zolpidem 30 mg/day in divided doses with marked improvement in few days in all the symptoms. Both cases were discharged on zolpidem extended release (ER) three times a day and maintained well through the next two follow ups in over a two month period. Zolpidem can be a good alternative for children and adolescents in resistant cases.

Background: Traditional bullying (or peer bullying) is considered a common and unpleasant experience among students and has serious consequences such as mental health problems and unhealthy behavior. In recent years, another type of bullying named cyberbullying has emerged as a growing problem with negative effects on school achievement, physiology, and mental health of its victims.

Objective: The purpose of this research is to examine and compare the roles of traditional and cyberbullying victimization in substance use, self-harm and suicide attempts.

Methods: This was a cross-sectional study and conducted in 2019. A total of 425 high school students were selected for the study in Kermanshah, Iran. For conducting the survey, a multi-stage cluster randomized procedure was used and 18 classes in six different high schools in three urban areas were selected. A total of 400 students (mean age 16.61 years, 53.2% girls) responded to the survey, and it provided usable information for the research. Data were analyzed through binary logistic regression analyses.

Results: The analysis results revealed that 54.2% of students (n = 217) have experienced traditional or cyber victimization. Any kind of victimization was associated with self-harm. Cyber victimization alone and the combination of cyber plus traditional victimization showed significant association with suicide and substance use. Risk of substance use, self-harm, and suicide was higher when students experienced both types of bullying than when they experienced just one kind of bullying alone.

Conclusions: The results of this study suggest that traditional and cyber victims may require immediate intervention to reduce the negative effects of victimization. Also, prevention programs should consider the possible relationship between traditional and cyber victimization and substance use, self-harm, and suicide.

Background: Conflict with parents is frequent in adolescent depression, and has been shown to predict poor treatment outcomes. Attachment Based Family Therapy (ABFT) is a manualised treatment for adolescent depression that may be robust to parent-adolescent conflict.

Objective: To evaluate the hypothesis that parent-adolescent conflict moderates the outcome of Attachment-Based Family Therapy compared with treatment as usual.

Methods: Data were obtained from a randomised trial comparing 16 weeks of ABFT to treatment as usual, in Norwegian Child and Adolescent Mental Health Services. Sixty adolescents with moderate to severe depression and their parents were recruited. Change in Grid-Hamilton Depression Rating Scale scores from baseline to week 16 was modelled using linear mixed models, and a three-way interaction of time, treatment allocation and a continuous measure of parent-adolescent conflict was fitted to estimate a moderator effect. The moderator model was compared to simpler models using leave-one-out cross-validation.

Results: Better outcomes were predicted for Attachment-Based Family Therapy at high levels of mother-adolescent conflict, and for treatment as usual at low levels of mother-adolescent conflict, giving preliminary support to the moderator hypothesis. Findings for father-adolescent conflict were mixed. Cross-validation did not clearly support the moderator model over a simple effect of time, indicating that the replicability of these findings is uncertain.

Conclusion: The results suggest that parent-adolescent conflict should be further studied as a moderator of outcome in Attachment-Based Family Therapy. The trial did not meet its recruitment target and had high attrition, limiting the conclusions that may be drawn.

Background: The transition to primary school is often a complex and uncertain time for autistic children and their families. Understanding how best to develop school readiness and support transition to primary school for autistic children is essential. School readiness and transition planning are influenced by a range of personal and contextual factors, and it is important to understand the perspectives of the various stakeholders involved in the transition process.

Methods: A qualitative exploration employing focus groups and interviews was undertaken with early intervention (EI) staff (n = 45) and parents (n = 18) across Australia to understand their perspectives on school readiness and the transition to primary school.

Results: Thematic analysis identified four emerging themes facilitating transition including: 1) building the child; 2) building the parents; 3) building the receiving school; and, 4) connecting the system.

Conclusion: Findings highlight the need to consider school readiness and transition planning from a holistic perspective, ensuring clear, collaborative and ongoing communication between parents, teachers and EI staff, using a strength-based approach, and individualizing transition planning.

Background: Help-seeking is considered a constructive coping style. However, the threshold at which many adolescents seek help is relatively high, and the outcomes are not necessarily always positive.

Objective: The main aim of this study was to examine if bullying and cyberbullying victimization predicted help-seeking behavior among Norwegian adolescents.

Method: Help-seeking behavior was predicted using three different Generalized Linear Mixed Models. In addition to demographic characteristics and mental health, these models controlled for bullying and cyberbullying, respectively.

Results: 2054 adolescents answered questions on help-seeking behavior and if they had felt the need to seek outside help with their problems, feelings, behavior, or emotional troubles within the past 6 months. Two hundred (9.7%) reported seeking outside help. Being exposed to bullying increased the likelihood of help-seeking behavior, while being exposed to cyberbullying did not. Only when forms of bullying or cyberbullying, respectively, were added to the models, did the threat of having rumors spread, both in real life and online, increase the likelihood for seeking help.

Conclusions: Many factors affect whether adolescents seek help for a problem. The fact that adolescents exposed to bullying seek help more often than those not exposed may be considered a success, as this behavior is encouraged by many adults, mental health professionals, and anti-bullying interventions. However, adolescents exposed to cyberbullying did not seem to seek help. Future studies should identify factors that lead to more and successful help-seeking among bullied and cyberbullied adolescents.

Background: There is increasing evidence that compassion is linked to mental health and well-being while difficulties in receiving and expressing compassion to self and others is associated with mental health and social difficulties. For the most part the self-report scales that measure these processes have been developed for adults and little is known how they function in adolescents. This study investigates a Swedish adaption for adolescents of the Compassionate Engagement and Action Scales (CEAS), developed by Gilbert et al. (2017) for adults. This assesses different competencies associated with being compassionate to others, the experience receiving compassion from others, and being compassionate with one-self.

Objective: To evaluate the psychometric properties and gender differences of CEAS for Youths - Swedish version (CEASY-SE), in a school-sample of adolescents (n = 316) aged 15-20 years.

Method: The Compassionate Engagement and Action Scales were translated into Swedish. A back-translation method was used. It was then adapted for adolescents with age-appropriate language. Adolescents were recruited by research assistants at two public high schools.

Results: After removing one item of each subscale, the dimensionalities of the three scales were good. Confirmatory factor analysis showed that engagement and action constituted different dimensions in each scale. Internal consistency was good to excellent in all three sub-scales (α from 0.74 to 0.92). Intra Class Correlations demonstrated good to excellent test-retest reliability over a period of three weeks (0.67 to 0.85). Convergent and divergent validity were as expected, except for Compassion for others, which did not correlate with anxiety and depression symptoms as expected. Girls showed less self-compassion compared to boys and more compassion for others.

Conclusions: Present study suggests that CEASY-SE has good to excellent psychometric properties and further study is needed for more definite establishment of the psychometric properties. Girls and boys have different patterns of compassion.

Background: Wearable technology (WT) to measure and support social and non-social functioning in Autism Spectrum Disorder (ASD) has been a growing interest of researchers over the past decade. There is however limited understanding of the WTs currently available for autistic individuals, and how they measure functioning in this population.

Objective: This scoping review explored the use of WTs for measuring and supporting abilities, disabilities and functional skills in autistic youth.

Method: Four electronic databases were searched to identify literature investigating the use of WT in autistic youth, resulting in a total of 33 studies being reviewed. Descriptive and content analysis was conducted, with studies subsequently mapped to the ASD International Classification of Functioning, Disability and Health Core-sets and the ICF Child and Youth Version (ICF-CY).

Results: Studies were predominately pilot studies for novel devices. WTs measured a range of physiological and behavioural functions to objectively measure stereotypical motor movements, social function, communication, and emotion regulation in autistic youth in the context of a range of environments and activities.

Conclusions: While this review raises promising prospects for the use of WTs for autistic youth, the current evidence is limited and requires further investigation.

Background: The long-term negative consequences of mental health problems during adolescence highlight the need for effective treatments. Compassion-focused therapy (CFT) aims to help individuals to enhance their ability to support and care for themselves and to alleviate shame and self-stigmatization.

Objective: This non-randomized controlled trial examined the effectiveness of group-based CFT on perceived stress and the extent of self-compassion in a clinical sample of adolescents receiving psychiatric care for complex mental health difficulties and their parents.

Method: The participants were 43 adolescents (ages 14-17; 83.7 % female) under treatment at a child and adolescent psychiatric outpatient clinic in Sweden and their parents (n = 77; 61 % female). The adolescents volunteered for group-based CFT (n = 19); if they did not want to participate, they were asked to join the control group receiving treatment as usual (TAU, n = 24). The CFT parents were given the same treatment as their children in parallel parent groups. The participants completed questionnaires measuring self-compassion and perceived stress before and after treatment. Paired samples t-tests and independent samples t-tests assessed the within-group and between-group differences via change scores.

Results: The fathers scored highest on self-compassion and had less perceived stress at both times than the adolescents or mothers. There were no significant differences between the CFT and TAU groups in self-compassion or perceived stress at either time, and the effect sizes were small (g ≤ 0.25). The TAU mother group was the only group with a significantly changed mean self-compassion score post-treatment.

Conclusions: Some patients seem to benefit from group-based CFT in ways similar to the benefits of specialized therapeutic approaches. Further research into the utility of CFT for adolescents with MH problems and their parents, as well as the long-term clinical effects of CFT for this group is needed.

Background and objective: Cyberbullying is increasingly turning into a significant problem for children and adolescents due to its adverse psychological and academic outcomes. In the present study, the protective and risk factors for cyberbullying has been investigated. One of the aims of the study was to examine the relationship between peer relations, negative emotion regulation strategies, and cyberbullying. The successful identity development process is thought to influence both cyberbullying behaviors as well as adolescents' peer relations and emotion regulation. Also, cyber victimization is seen as a risk factor for cyberbullying. The second aim of the study is to investigate the causal relationship between cyber victimization and cyberbullying.

Method: The study is a descriptive research in which both cross-sectional and longitudinal data were used. In the cross-sectional part of the study, 1,151 adolescents have participated, and the data of the second wave was obtained from 322 of them four months later. Data were analyzed through structural equation modeling (SEM) and hierarchical regression analyses.

Results and conclusion: According to the results of SEM, good peer relations predicted less cyberbullying. The expressive repression explained the cyberbullying through peer relationships. For identity development, contrary to expectations, commitment dimension of identity seemed to be positively related to more cyberbullying and so did higher reconsideration of commitment. Cross-lagged panel analyses revealed that Time 1 cyber victimization predicted Time 2 cyberbullying. Given the pattern of cross-lagged relationships, it was tentatively inferred that cyber victimization was the temporal precursor to cyberbullying. The results of the study have implications for the prevention of cyberbullying.