Journal of the Korean Academy of Child and Adolescent Psychiatry最新文献

This case report describes a 16-year-old female with body dysmorphic disorder (BDD), tics, and social withdrawal who intentionally abused risperidone to exploit its hyperprolactinemia-induced breast enlargement, perceiving it as beneficial to her body image. Initial treatment with sertraline improved social withdrawal; however, adjunctive risperidone (0.5 mg/day) reduced tics and BDD symptoms. Elevated prolactin levels (44.85 ng/mL) triggered breast enlargement, galactorrhea, and secondary amenorrhea. The patient continued risperidone despite medical advice to discontinue it. Switching to aripiprazole normalized prolactin levels (9.13 ng/mL) and resolved the side effects, with sustained symptom control at 3-month follow-up. This case highlights the risk of antipsychotic side effects reinforcing BDD pathology and adolescents' vulnerability to medication abuse when somatic changes align with dysmorphic goals. To the best of our knowledge, this is the first report of deliberate risperidone abuse for cosmetic hyperprolactinemia in BDD. Clinicians must monitor prolactin levels, prioritize prolactin-sparing agents (e.g., aripiprazole), and consider how adverse effects may perpetuate body image disturbances in adolescents.

Objectives: This rapid systematic review aimed to examine longitudinal studies that assessed pornography and problematic pornography use and their associations with specific features in adolescents.

Methods: This review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)guidelines. Longitudinal studies that examined pornography or problematic pornography use in adolescents were included.

Results: Forty-four longitudinal studies were included. The main themes explored were 1) sexual behaviors; 2) sexual risk behaviors; 3) sexual satisfaction; 4) permissiveness; 5) sexual aggression, dating victimization, and rape myths; 6) academic performance; 7) COVID-19 pandemic; 8) religiosity; 9) psychopathology, psychological well-being, and life satisfaction; and 10) other factors such as desensitization to sexual content, age of first exposure, types of pornography consumed, and individual and contextual variables. The findings were heterogeneous, with some studies indicating significant association between pornography use and these variables, whereas in other areas, the results were inconsistent.

Conclusion: These findings highlight the need for further longitudinal research to clarify the relationship between types and patterns of pornography use in adolescents.

Objectives: This study aimed to verify the diagnostic validity of the Comprehensive Learning Test (CLT) for children and adolescents with reading (RD) or mathematical disorders (MD).

Methods: To evaluate the diagnostic validity of the CLT-Reading (CLT-R) and CLT-Math (CLT-M), a total of 284 participants (142 in RD and 142 in the control group) and 184 participants (92 in MD and 92 in the control group) were recruited, respectively. The control groups were selected through one-to-one matching based on sex and grade. For the CLT-R, three criteria were established using accuracy and fluency measures (one impairment, one impairment or one borderline, and one impairment or two borderline scores). Two criteria were established for the CLT-M (one impairment, one impairment or one borderline score). The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were calculated for each criterion.

Results: In the CLT-R, when no impairment or borderline score presented in accuracy, applying the fluency criterion of "one impairment or one borderline score" yielded the highest diagnostic validity for RD, with a sensitivity of 0.963 and an NPV of 0.991. In the CLT-M, when no impairment or borderline score in accuracy, was present applying the fluency criterion of "impairment or borderline" resulted in the highest diagnostic validity for MD, with a sensitivity of 0.814 and specificity of 0.966.

Conclusion: These findings support that the CLT-R and CLT-M are highly valid tools for diagnosing RD and MD.

Objectives: Adolescent substance use remains a public health concern, and social media platforms may serve as potential intervention targets. The objective of this review is to characterize studies on anti-substance use and/or pro-recovery content on the TikTok social media platform.

Methods: PubMed, Scopus, and Web of Science were searched for articles using search strings related to TikTok and substance use. Studies that characterized substance use content on TikTok and provided information on the associated hashtags were included. Studies that did not include hashtags reflecting anti-substance use or pro-recovery sentiments were excluded.

Results: Seven studies included hashtags that expressed being against, quitting, and/or recovering from substance use. Most previous studies focused on nicotine use. The content was largely created by adults. General content themes included motivations for reducing substance use, barriers to, and advice on how to reduce substance use, and personal recovery journey stories that celebrated success and normalized the recurrence of use. Some studies found that content created by individuals with lived experience and content focused on the benefits of quitting (rather than the costs of using) received higher engagement. Most studies noted that videos identified using anti-substance use hashtags often contain irrelevant or antithetical content.

Conclusion: This review highlights the value of social media sites such as TikTok as potential platforms for encouraging reductions in substance use. Future studies should quantify whether viewing and engaging with such content leads to changes in real-world measures such as reduced consumption.

Objectives: While childhood experiences have been well-recognized as salient predictors of addictive behaviors, this scoping review aims to evaluate whether life history (LH) theory can offer a valid and reliable theoretical framework for elucidating the influence of childhood environment on problematic smartphone use (PSU). In particular, it examines existing empirical evidence to clarify the underlying internal processes, if any, from the LH perspective.

Methods: Following the PRISMA guidelines, a scoping review was conducted by searching 5 databases and screening relevant studies on February 18, 2025.

Results: Five articles, all of which were published in the last three years, met the inclusion criteria. Consistent empirical data were found in these five articles indicating the following: 1) significant correlations between childhood environment and PSU, with contradictory directions for the two dimensions of childhood environment; 2) LH strategy serving as a mediator between childhood environment and PSU; and 3) psychological processes, including motivation, emotion, and cognition, playing a role in the mediation, and their effects can be complex. It also identified some limitations of these studies, all of which were conducted as cross-sectional surveys of Chinese youth samples.

Conclusion: Despite being limited in number and design, empirical studies provide coherent support for the applicability of LH theory in understanding how childhood environment determines susceptibility to PSU in youth. Further investigation of the role(s) of other internal processes with multimodal and multi-method designs is called for.

Objectives: Maternal depression negatively affects depression and anxiety symptoms in the offspring. This study examined the association between maternal depression and their adolescent offspring depression and anxiety, as well as the mediating role of emotional trauma in determining the association.

Methods: Participants were 237 mothers (46.08±5.00 years) and their adolescent offspring (16.54±1.51 years). The participants completed the Beck Depression Inventory-II, Early Trauma Inventory Self Report-Short Form, Center for Epidemiological Studies Depression Scale for Children, and the Screen for Children's Anxiety Related Disorders. The mediating effect of emotional trauma on offspring was explored using mediation analysis.

Results: Maternal depressive symptoms were significantly correlated with adolescent offspring traumatic experiences, as well as with their depressive and anxiety symptoms. Mediation analysis results showed that emotional trauma of offspring significantly mediated the effect of maternal depression on their depressive and anxiety symptoms.

Conclusion: Findings indicate that maternal depression was significantly associated with depressive and anxiety symptoms in adolescent offspring, mediated by their emotional trauma. Future research is needed to investigate pathways and intervention strategies to prevent the intergenerational transmission of emotional problems.

Objectives: Digital therapeutics are becoming increasingly important in mental health due to their numerous advantages. One area that could benefit significantly is parenting education. To address this, we developed a short-term, smartphone-based parenting education program designed to support parents who lack access to relevant resources. This study analyzed baseline data from participants to identify factors influencing depressive symptoms in both parents and children.

Methods: Participants were recruited from a rural region of the Republic of Korea. The study included parents experiencing stress related to raising children aged 11 to 16 years. Data on psychological well-being and family relationships were collected and analyzed from 47 parent-child dyads. Participants engaged with a six-week parenting education application aimed at reducing parenting stress. This article does not include an analysis of the intervention's efficacy.

Results: The child perceived their families as more chaotic compared their parents (t=-2.55, p=0.01). Parental depression was significantly associated with their stress levels (B=0.70, p=0.004), anxiety (B=0.32, p=0.03), relational frustration (B=0.16, p=0.04), family enmeshment (B=-0.13, p=0.04) and the child's perception of family flexibility (B=0.10, p=0.04). In contrast, children's depression was associated with lower self-esteem (B=-0.55, p=0.02) and aggression (B=0.23, p=0.01).

Conclusion: These findings highlight the importance of individualized parenting education programs, particularly those that address the specific needs of both parents and children. Digital therapeutics hold significant potential for providing accessible, evidence-based parenting support aimed at improving mental health outcomes in families.

Self-harm is a prevalent phenomenon among children and adolescents, and its incidence has increased over time. This behavior is often a maladaptive coping mechanism caused by difficulties with emotional regulation. Self-harm behavior in children and adolescents is a predictor of future suicide attempts and requires comprehensive management. This study reviewed current holistic management of self-harm in children and adolescents. By synthesizing evidence-based practices, this study shows that management should include the recognition of risk factors for self-harm and suicidal behavior, early detection, pharmacological and non-pharmacological therapies, and prevention programs at all levels. This study aimed to increase awareness and encourage participation from all societal levels, including schools and policymakers, in handling self-harm in children and adolescents.