Pub Date : 2023-09-01DOI: 10.2174/2210676613666230901125251
Eunice Yuen, Susan Daily, Julie Sadhu, Janet Baek, Gabrielle Shapiro, Cynthia Pfeffer, Jonathan Dowben, Kamilah Jackson, B. Sarvet, Dorothy Stubbe
Background Objectives: Systemic racism and health inequality for Children and Adolescents of Color (CAoC) and their families need to be acknowledged and addressed in the provision of mental health treatment by child and adolescent psychiatrists. The lack of parity for behavioral health drives the lack of integration of “mental” health with overall health and the lack of funding, policy, planning, and practices to support the social and emotional health of children and their families. Additionally, the unequal treatment faced by Black, Indigenous, and People of Color (BIPOC) children and their families further impacts their overall health and mental health outcomes. Implicit biases, conscious and unconscious, influence clinical judgments, lead to errors in diagnostic and treatment decisions and impair child and adolescent psychiatrists’ ability to fully partner with families to treat, advocate for, and improve the clinical and life trajectories of this diverse group of young people and families that child and adolescent psychiatrists are called to serve. Methods: Using a case vignette, this paper discusses historical examples showing how child and adolescent psychiatrists’ implicit bias may manifest when working with CAoC. Medical training and clinical practice have paid scant attention to the broader impacts of systemic racism and inequities in healthcare until recent years. Discussion: This article provides clinical recommendations for clinicians to navigate these factors through trauma-centered and patient-centered care. Viewing through the lens of intergenerational racial trauma and acknowledging one’s own bias, clinicians can better help and support CAoC as they strive toward a brighter future.
{"title":"Clinical Considerations in Working with Children and Adolescents of Color: Past, Present and Future","authors":"Eunice Yuen, Susan Daily, Julie Sadhu, Janet Baek, Gabrielle Shapiro, Cynthia Pfeffer, Jonathan Dowben, Kamilah Jackson, B. Sarvet, Dorothy Stubbe","doi":"10.2174/2210676613666230901125251","DOIUrl":"https://doi.org/10.2174/2210676613666230901125251","url":null,"abstract":"\u0000\u0000Background Objectives: Systemic racism and health inequality for\u0000Children and Adolescents of Color (CAoC) and their families need to be\u0000acknowledged and addressed in the provision of mental health treatment by child and\u0000adolescent psychiatrists. The lack of parity for behavioral health drives the lack of\u0000integration of “mental” health with overall health and the lack of funding, policy,\u0000planning, and practices to support the social and emotional health of children and\u0000their families. Additionally, the unequal treatment faced by Black, Indigenous, and\u0000People of Color (BIPOC) children and their families further impacts their overall\u0000health and mental health outcomes. Implicit biases, conscious and unconscious,\u0000influence clinical judgments, lead to errors in diagnostic and treatment decisions and\u0000impair child and adolescent psychiatrists’ ability to fully partner with families to treat,\u0000advocate for, and improve the clinical and life trajectories of this diverse group of\u0000young people and families that child and adolescent psychiatrists are called to serve.\u0000\u0000Methods: Using a case vignette, this paper discusses historical examples showing\u0000how child and adolescent psychiatrists’ implicit bias may manifest when working\u0000with CAoC. Medical training and clinical practice have paid scant attention to the\u0000broader impacts of systemic racism and inequities in healthcare until recent years.\u0000\u0000Discussion: This article provides clinical recommendations for clinicians to navigate\u0000these factors through trauma-centered and patient-centered care. Viewing through the\u0000lens of intergenerational racial trauma and acknowledging one’s own bias, clinicians\u0000can better help and support CAoC as they strive toward a brighter future.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48279806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-23DOI: 10.2174/2210676613666230823121744
Tomos Redmond, Jasmine Lamonby, Lesley Harrington, A. Wood
Patients aged 12 – 18 years presenting to Community Eating Disorders Services (CEDS) commonly describe problematic use of the internet (PUI). Time spent on the internet, internet experiences of social comparison, looking at food and sites offering weight and shape and fitness advice are all described during the onset of eating disorders and continue through treatment. We found that there is a lack of a clinical tool to assess PUI and its role in the development of eating disorders, and thus developed the Eating Disorder Online Activity Questionnaire (EDOAQ). This qualitative study involved 10 adolescents accessing community treatment for eating disorders, who were invited to engage in a brief semi-structured interview, inquiring about their completion of the EDOAQ and experiences of the internet. Five clinicians, working with the patients were also invited to participate in a similar process. Interview data was thematically analysed. All participants described high use of the internet. Patient and clinician experience was generally positive regarding the clinical use of the EDOAQ, and modifications for the questionnaire were suggested. Participants also reported the necessity of online activity and the easy access to harmful content. Participants found the EDOAQ improved self-awareness, of this and led to healthier online use. Patients presenting with eating disorder need to be screened for PUI. Assessing clinicians found a questionnaire inquiring about the use of the internet extremely useful in assessment and treatment for eating disorder. Most patients found completing a questionnaire less intrusive and easier than talking.
{"title":"Developing The Eating Disorder Online Activity Questionnaire (EDOAQ) For Adolescents In Eating Disorder Services; A Qualitative Study","authors":"Tomos Redmond, Jasmine Lamonby, Lesley Harrington, A. Wood","doi":"10.2174/2210676613666230823121744","DOIUrl":"https://doi.org/10.2174/2210676613666230823121744","url":null,"abstract":"\u0000\u0000Patients aged 12 – 18 years presenting to Community Eating Disorders Services (CEDS) commonly describe problematic use of the internet (PUI). Time spent on the internet, internet experiences of social comparison, looking at food and sites offering weight and shape and fitness advice are all described during the onset of eating disorders and continue through treatment. We found that there is a lack of a clinical tool to assess PUI and its role in the development of eating disorders, and thus developed the Eating Disorder Online Activity Questionnaire (EDOAQ).\u0000\u0000\u0000\u0000This qualitative study involved 10 adolescents accessing community treatment for eating disorders, who were invited to engage in a brief semi-structured interview, inquiring about their completion of the EDOAQ and experiences of the internet. Five clinicians, working with the patients were also invited to participate in a similar process. Interview data was thematically analysed.\u0000\u0000\u0000\u0000All participants described high use of the internet. Patient and clinician experience was generally positive regarding the clinical use of the EDOAQ, and modifications for the questionnaire were suggested. Participants also reported the necessity of online activity and the easy access to harmful content. Participants found the EDOAQ improved self-awareness, of this and led to healthier online use.\u0000\u0000\u0000\u0000Patients presenting with eating disorder need to be screened for PUI. Assessing clinicians found a questionnaire inquiring about the use of the internet extremely useful in assessment and treatment for eating disorder. Most patients found completing a questionnaire less intrusive and easier than talking.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45153503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.2174/2210676613666230801153633
Valerie Dao, A. Oppetit, Hugues Pellerin, E. Chamboredon, Aveline Aouidad, G. Bronsard, Nicolas Campelo, David Cohen
Radicalization among adolescents is a rising phenomenon that has become a public health concern in Europe. According to some authors, violent radicalization by resorting to self-violence could be a form of suicidal behavior. However, evidence-based studies to support this assertion are lacking. The aim of this study was to investigate the issue of suicidality among adolescents engaged in violent radicalization. We compared a group of radicalized adolescents convicted of criminal association to commit terrorism (AMT) in France (N=15) with hospitalized adolescents who have attempted to end their lives (N=320). This comparative study is based on two samples from two studies that used the same instruments to assess psychiatric diagnoses, suicide risk, reasons for living, and coping. AMT adolescents were significantly less suicidal and less depressive/hopeless than adolescents with suicide attempts (SAs). AMT adolescents showed fewer instances of depressive and borderline personality disorders but more manic and psychotic episodes than SA adolescents. They also had much more efficient coping strategies than SA adolescents, especially for the following strategies: seeking professional help, relational support and spiritual support. All the subscores of the reasons for the living scale were significantly higher for AMT adolescents than for SA individuals, apart from the subscore on peer acceptance and support. Adolescents engaged in violent radicalization cannot be considered suicidal adolescents who have found an opportunity to end their lives through the process of radicalization. Understanding this phenomenon within a social, political and cultural context is necessary.
{"title":"Are adolescents engaged in violent radicalization suicidal?","authors":"Valerie Dao, A. Oppetit, Hugues Pellerin, E. Chamboredon, Aveline Aouidad, G. Bronsard, Nicolas Campelo, David Cohen","doi":"10.2174/2210676613666230801153633","DOIUrl":"https://doi.org/10.2174/2210676613666230801153633","url":null,"abstract":"\u0000\u0000Radicalization among adolescents is a rising phenomenon that has become a public health concern in Europe. According to some authors, violent radicalization by resorting to self-violence could be a form of suicidal behavior. However, evidence-based studies to support this assertion are lacking.\u0000\u0000\u0000\u0000The aim of this study was to investigate the issue of suicidality among adolescents engaged in violent radicalization.\u0000\u0000\u0000\u0000We compared a group of radicalized adolescents convicted of criminal association to commit terrorism (AMT) in France (N=15) with hospitalized adolescents who have attempted to end their lives (N=320). This comparative study is based on two samples from two studies that used the same instruments to assess psychiatric diagnoses, suicide risk, reasons for living, and coping.\u0000\u0000\u0000\u0000AMT adolescents were significantly less suicidal and less depressive/hopeless than adolescents with suicide attempts (SAs). AMT adolescents showed fewer instances of depressive and borderline personality disorders but more manic and psychotic episodes than SA adolescents. They also had much more efficient coping strategies than SA adolescents, especially for the following strategies: seeking professional help, relational support and spiritual support. All the subscores of the reasons for the living scale were significantly higher for AMT adolescents than for SA individuals, apart from the subscore on peer acceptance and support.\u0000\u0000\u0000\u0000Adolescents engaged in violent radicalization cannot be considered suicidal adolescents who have found an opportunity to end their lives through the process of radicalization. Understanding this phenomenon within a social, political and cultural context is necessary.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44459694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-19DOI: 10.2174/2210676613666230619142223
Joshua White, T. Kohn, M. Rivero, A. Muthigi, Jamie Thomas, A. Ghomeshi, Francis Petrella, David Miller, M. Rueda-Lara, Ranjith Ramasamy
COVID-19 pandemic restrictions resulted in psychosocial stress and increased potential for psychiatric disorders in the adolescent population. Adolescent psychiatric disorders are increasingly managed with psychotropic medications. We aimed to evaluate the first-time prescription rates of psychotropic medications—antidepressants, antipsychotics, hypnotics, sedatives, mood stabilizers, and psychostimulants—in adolescent patients during the COVID-19 pandemic compared to the years immediately prior. We utilized electronic health records, claims data, and pharmaceutical data generated from 68 healthcare organizations stored within the TriNetX Research Network to conduct a retrospective matched cohort study. Adolescent patients aged 10-19 years presenting for outpatient evaluation were placed into two cohorts: 1) outpatient evaluation before (2017-2019) and 2) during (2020-2022) the COVID-19 pandemic. Patients with prior history of psychiatric disorders and/or prior use of psychotropic medications were excluded. The main outcome was first-time psychotropic medication prescription within 90 days of outpatient evaluation. We used propensity score matching with logistic regression to build cohorts of equal size based on covariates of interest. A total of 1,612,283 adolescents presenting before the COVID-19 pandemic and 1,008,161 adolescents presenting during the COVID-19 pandemic were identified. After matching on age, race/ethnicity, smoking status, and obesity status, a total of 1,005,408 adolescents were included in each cohort, each with an average age of 14.7 ± 2.84 years and 52% female and 48% male. The standardized differences between propensity scores were less than 0.1, suggesting a minimal difference between the two groups. Prescription rates for antipsychotics and benzodiazepines were increased for adolescents presenting during the pandemic (Risk Ratio (RR): 1.58, 95% confidence intervals (CI) 1.48-1.69). However, this group had decreased prescription rates for antidepressants (RR: 0.6, 95% CI 0.57-0.63), anxiolytics (RR: 0.78, 95% CI 0.75-0.81), psychostimulants (RR: 0.26, 95% CI 0.25-0.27), and mood stabilizers (RR: 0.44, 95% CI 0.39-0.49). Adolescents presenting for outpatient evaluation during the COVID-19 pandemic were prescribed antipsychotics and benzodiazepines at an increased rate relative to the years immediately prior, suggesting an increased need for sedation in this patient population. Given reduced access to care during the COVID-19 pandemic, the decreased prescription rate observed for other psychotropic medication classes does not necessarily reflect a decreased incidence of the associated psychiatric disorders.
{"title":"The Impact of COVID-19 on Psychotropic Medication Prescriptions in Adolescents: Analysis of a Federated Research Network","authors":"Joshua White, T. Kohn, M. Rivero, A. Muthigi, Jamie Thomas, A. Ghomeshi, Francis Petrella, David Miller, M. Rueda-Lara, Ranjith Ramasamy","doi":"10.2174/2210676613666230619142223","DOIUrl":"https://doi.org/10.2174/2210676613666230619142223","url":null,"abstract":"\u0000\u0000COVID-19 pandemic restrictions resulted in psychosocial stress and increased potential for psychiatric disorders in the adolescent population. Adolescent psychiatric disorders are increasingly managed with psychotropic medications. We aimed to evaluate the first-time prescription rates of psychotropic medications—antidepressants, antipsychotics, hypnotics, sedatives, mood stabilizers, and psychostimulants—in adolescent patients during the COVID-19 pandemic compared to the years immediately prior.\u0000\u0000\u0000\u0000We utilized electronic health records, claims data, and pharmaceutical data generated from 68 healthcare organizations stored within the TriNetX Research Network to conduct a retrospective matched cohort study. Adolescent patients aged 10-19 years presenting for outpatient evaluation were placed into two cohorts: 1) outpatient evaluation before (2017-2019) and 2) during (2020-2022) the COVID-19 pandemic. Patients with prior history of psychiatric disorders and/or prior use of psychotropic medications were excluded. The main outcome was first-time psychotropic medication prescription within 90 days of outpatient evaluation. We used propensity score matching with logistic regression to build cohorts of equal size based on covariates of interest.\u0000\u0000\u0000\u0000A total of 1,612,283 adolescents presenting before the COVID-19 pandemic and 1,008,161 adolescents presenting during the COVID-19 pandemic were identified. After matching on age, race/ethnicity, smoking status, and obesity status, a total of 1,005,408 adolescents were included in each cohort, each with an average age of 14.7 ± 2.84 years and 52% female and 48% male. The standardized differences between propensity scores were less than 0.1, suggesting a minimal difference between the two groups. Prescription rates for antipsychotics and benzodiazepines were increased for adolescents presenting during the pandemic (Risk Ratio (RR): 1.58, 95% confidence intervals (CI) 1.48-1.69). However, this group had decreased prescription rates for antidepressants (RR: 0.6, 95% CI 0.57-0.63), anxiolytics (RR: 0.78, 95% CI 0.75-0.81), psychostimulants (RR: 0.26, 95% CI 0.25-0.27), and mood stabilizers (RR: 0.44, 95% CI 0.39-0.49).\u0000\u0000\u0000\u0000Adolescents presenting for outpatient evaluation during the COVID-19 pandemic were prescribed antipsychotics and benzodiazepines at an increased rate relative to the years immediately prior, suggesting an increased need for sedation in this patient population. Given reduced access to care during the COVID-19 pandemic, the decreased prescription rate observed for other psychotropic medication classes does not necessarily reflect a decreased incidence of the associated psychiatric disorders.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44946354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-12DOI: 10.2174/2210676613666230503094501
M. LaCasse, Ryan M. Loh, C. Thurstone
In the current opioid epidemic, little is known about differences in treatment structure for youth with opioid use disorder (OUD) and youth with other substance use disorders. This study analyzed baseline characteristics and outcome data comparing youth who suffer from OUD vs. those with other substance use disorders in an urban Denver, Colorado clinic. A retrospective cohort review was conducted, analyzing clinical data between February 2017 and March 2021. Two groups were created and compared: those with OUD (n = 59) and those with other substance use disorders (n = 417). The primary outcome variable was achieving a negative urine drug screen within 16 weeks of baseline assessment. We hypothesized that there would be no difference between the groups in the primary outcome variable. Youth with OUD were slightly older and had more co-morbid stimulant use disorder. No difference between the groups was observed in achieving a negative urine drug screen within 16 weeks. A multimodal, generalized treatment approach yielded similar outcomes for those suffering from OUD compared to those with other substance use disorders. There might not need to be significant variances in treatment approach depending on the specific substance use disorder.
{"title":"Baseline and Outcome Comparison of Adolescents in Treatment for Opioid and Non-opioid Use Disorder","authors":"M. LaCasse, Ryan M. Loh, C. Thurstone","doi":"10.2174/2210676613666230503094501","DOIUrl":"https://doi.org/10.2174/2210676613666230503094501","url":null,"abstract":"\u0000\u0000In the current opioid epidemic, little is known about\u0000differences in treatment structure for youth with opioid use disorder (OUD) and\u0000youth with other substance use disorders.\u0000\u0000\u0000\u0000This study analyzed baseline characteristics and outcome data\u0000comparing youth who suffer from OUD vs. those with other substance use disorders\u0000in an urban Denver, Colorado clinic.\u0000\u0000\u0000\u0000A retrospective cohort review was conducted, analyzing clinical data\u0000between February 2017 and March 2021. Two groups were created and compared:\u0000those with OUD (n = 59) and those with other substance use disorders (n = 417).\u0000The primary outcome variable was achieving a negative urine drug screen within 16\u0000weeks of baseline assessment. We hypothesized that there would be no difference\u0000between the groups in the primary outcome variable.\u0000\u0000\u0000\u0000Youth with OUD were slightly older and had more co-morbid stimulant\u0000use disorder. No difference between the groups was observed in achieving a\u0000negative urine drug screen within 16 weeks.\u0000\u0000\u0000\u0000A multimodal, generalized treatment approach yielded similar\u0000outcomes for those suffering from OUD compared to those with other substance\u0000use disorders. There might not need to be significant variances in treatment\u0000approach depending on the specific substance use disorder.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42749499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-26DOI: 10.2174/2210676613666230126115646
Mayank Gupta, Nihit Gupta, Yuli Fradkin, T. Petti
Sleep disorders in autism spectrum disorders (ASD/SD) are distinct, broad, and highly variable clinical entities that ubiquitously affect core symptomatology, development of comorbid disorders, and overall quality of life for affected children and families. High genetic predisposition and the presence of co-occurring disorders present significant challenges in assessment and appropriate interventions. The study aimed to review the best available evidence and address the clinical gaps in the knowledge about sleep disorders in children and adolescents with autism spectrum disorders. The review provides a comprehensive literature search of 1622 articles and summarizes 110 selected for empirical evidence to methodically consider critical aspects of sleep disorders in ASD for informing clinicians of useful information. Clinicians have insufficient guidance and support to effectively manage sleep disruptions in ASD youth in practice. Prevalence of sleep disruption in ASD, close to 80%, is characterized by unique subtypes, including but not limited to obstructive sleep apnea, circadian rhythm disorders, and sleep-related movement disorders. Greater awareness of sleep disruption, its neurodevelopmental basis, scope, and impact allows for improved treatment and prevention efforts of these conditions, and is critical for clinical practice and future research. The bidirectional nature of disruptive sleep and ASD is considered a major area requiring further clarification. Clinician-friendly screening tools are needed for everyday office practice to identify ASD/SD conditions and interventions, and mitigate harmful effects. Psychoeducational and cognitive-behavioral approaches for improving and supporting healthy sleep hygiene, considered the first line of treatment, are detailed. The weak database for the use of psychopharmacologic agents is summarized, and the strength of prescribing prolonged-release melatonin for optimal results is described. The promise of other medications is discussed.
{"title":"Sleep Disturbances in Children and Adolescents with Autism Spectrum Disorder:\u0000An Overview for Clinicians","authors":"Mayank Gupta, Nihit Gupta, Yuli Fradkin, T. Petti","doi":"10.2174/2210676613666230126115646","DOIUrl":"https://doi.org/10.2174/2210676613666230126115646","url":null,"abstract":"\u0000\u0000Sleep disorders in autism spectrum disorders (ASD/SD) are distinct, broad, and highly variable clinical entities that ubiquitously affect core symptomatology, development of comorbid disorders, and overall quality of life for affected children and families. High genetic predisposition and the presence of co-occurring disorders present significant challenges in assessment and appropriate interventions.\u0000\u0000\u0000\u0000The study aimed to review the best available evidence and address the clinical gaps in the knowledge about sleep disorders in children and adolescents with autism spectrum disorders.\u0000\u0000\u0000\u0000The review provides a comprehensive literature search of 1622 articles and summarizes 110 selected for empirical evidence to methodically consider critical aspects of sleep disorders in ASD for informing clinicians of useful information.\u0000\u0000\u0000\u0000Clinicians have insufficient guidance and support to effectively manage sleep disruptions in ASD youth in practice. Prevalence of sleep disruption in ASD, close to 80%, is characterized by unique subtypes, including but not limited to obstructive sleep apnea, circadian rhythm disorders, and sleep-related movement disorders. Greater awareness of sleep disruption, its neurodevelopmental basis, scope, and impact allows for improved treatment and prevention efforts of these conditions, and is critical for clinical practice and future research. The bidirectional nature of disruptive sleep and ASD is considered a major area requiring further clarification.\u0000\u0000\u0000\u0000Clinician-friendly screening tools are needed for everyday office practice to identify ASD/SD conditions and interventions, and mitigate harmful effects. Psychoeducational and cognitive-behavioral approaches for improving and supporting healthy sleep hygiene, considered the first line of treatment, are detailed. The weak database for the use of psychopharmacologic agents is summarized, and the strength of prescribing prolonged-release melatonin for optimal results is described. The promise of other medications is discussed.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41593218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.2174/2210676611666211105120645
Natalia Ramos, Alexis Burgess, Elizabeth Ollen
Background: Adolescents today have unprecedented and uninterrupted access to news and current events through broadcast and social media. Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) adolescents may be especially cognizant of media and public discourse pertaining to law and policy changes affecting the legal rights of their communities. The minority stress framework explains how sociopolitical discourse impacts mental health among sexual and gender minority youths.
Objectives: This paper identifies and describes contemporary sociopolitical and legal issues that may impact LGBTQ adolescents' mental health.
Methods: Authors describe the minority stress framework as applied to gender and sexual identity and explore key sociopolitical and legal topics relevant to LGBTQ adolescents, including employment; medical care bans; health insurance coverage; conversion therapy; religious exemptions in health care; housing rights; and rights in schools and school districts, including participation in sports.
Results: LGBTQ youth experience rejection, prejudice, and discrimination directly through adverse legislative or administrative action and more pervasively through the dominant cultural beliefs and sociopolitical messaging that such developments manifest.
Conclusion: Mental health clinicians who are aware of legal issues and sociopolitical debate pertinent to LGBTQ rights are better prepared to address their significant impact on LGBTQ adolescents' mental health.
{"title":"The Current Status of Sociopolitical and Legal Issues Faced by Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Youth.","authors":"Natalia Ramos, Alexis Burgess, Elizabeth Ollen","doi":"10.2174/2210676611666211105120645","DOIUrl":"https://doi.org/10.2174/2210676611666211105120645","url":null,"abstract":"<p><strong>Background: </strong>Adolescents today have unprecedented and uninterrupted access to news and current events through broadcast and social media. Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) adolescents may be especially cognizant of media and public discourse pertaining to law and policy changes affecting the legal rights of their communities. The minority stress framework explains how sociopolitical discourse impacts mental health among sexual and gender minority youths.</p><p><strong>Objectives: </strong>This paper identifies and describes contemporary sociopolitical and legal issues that may impact LGBTQ adolescents' mental health.</p><p><strong>Methods: </strong>Authors describe the minority stress framework as applied to gender and sexual identity and explore key sociopolitical and legal topics relevant to LGBTQ adolescents, including employment; medical care bans; health insurance coverage; conversion therapy; religious exemptions in health care; housing rights; and rights in schools and school districts, including participation in sports.</p><p><strong>Results: </strong>LGBTQ youth experience rejection, prejudice, and discrimination directly through adverse legislative or administrative action and more pervasively through the dominant cultural beliefs and sociopolitical messaging that such developments manifest.</p><p><strong>Conclusion: </strong>Mental health clinicians who are aware of legal issues and sociopolitical debate pertinent to LGBTQ rights are better prepared to address their significant impact on LGBTQ adolescents' mental health.</p>","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10104455/pdf/nihms-1882181.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9379508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-09DOI: 10.2174/18749445-v15-e221209-2022-233
Lakhdar Chadli, Farooq Haq, A. Okasha, Rafik Attou
A current need in journalistic frontline work is to understand the potential psychological and physical traumatic consequences that may result from on-duty appointments. Journalists are active in frontline zones to report on conflicts, crisis, and natural disasters. In the Middle East and North Africa [MENA] region, reporters are not equipped or trained mentally or emotionally to handle stressful events. Most journalists suffer from certain degrees of post-traumatic mental and physical disorders associated with their frontline duties. The objective of this exploratory study is to provide comprehensive insights into challenges faced by journalists reporting in conflict zones in the MENA region. This research study is based on a qualitative research approach where data was collected by directly interviewing eight journalists who have covered frontline conflicts and disasters in the MENA region. The collected qualitative data was analysed by conducting the thematic analysis to appreciate emerging categories. The ontology of critical realism was adopted to recognise the realistic feelings and experiences of the responding journalists. This original study presents six themes emerging from the data and researcher triangulation. The health and social issues in MENA are found to be most critical for high-risk reporting. Amidst the psychological and physical problems, all journalists did not give up their jobs or ask for privileges. Media houses could consider a more robust training plan based on health and safety to prepare these journalists.
{"title":"Post-Traumatic Mental And Physical Consequences Of Frontline Reporting In Mena Region","authors":"Lakhdar Chadli, Farooq Haq, A. Okasha, Rafik Attou","doi":"10.2174/18749445-v15-e221209-2022-233","DOIUrl":"https://doi.org/10.2174/18749445-v15-e221209-2022-233","url":null,"abstract":"\u0000 \u0000 A current need in journalistic frontline work is to understand the potential psychological and physical traumatic consequences that may result from on-duty appointments. Journalists are active in frontline zones to report on conflicts, crisis, and natural disasters. In the Middle East and North Africa [MENA] region, reporters are not equipped or trained mentally or emotionally to handle stressful events. Most journalists suffer from certain degrees of post-traumatic mental and physical disorders associated with their frontline duties.\u0000 \u0000 \u0000 \u0000 The objective of this exploratory study is to provide comprehensive insights into challenges faced by journalists reporting in conflict zones in the MENA region.\u0000 \u0000 \u0000 \u0000 This research study is based on a qualitative research approach where data was collected by directly interviewing eight journalists who have covered frontline conflicts and disasters in the MENA region. The collected qualitative data was analysed by conducting the thematic analysis to appreciate emerging categories. The ontology of critical realism was adopted to recognise the realistic feelings and experiences of the responding journalists.\u0000 \u0000 \u0000 \u0000 This original study presents six themes emerging from the data and researcher triangulation. The health and social issues in MENA are found to be most critical for high-risk reporting.\u0000 \u0000 \u0000 \u0000 Amidst the psychological and physical problems, all journalists did not give up their jobs or ask for privileges. Media houses could consider a more robust training plan based on health and safety to prepare these journalists.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43968121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.2174/2210676613666221027124554
Lauren Salvatore Farkas, I. Dancyger, Shervin Shadianloo, V. Fornari
The treatment of transgender youth with an eating disorder presents particular considerations due to the unique combination of body dissatisfaction, drive for thinness, malnutrition coupled with the evolving gender identity in the midst of biological and physical changes. At this time, public awareness, societal acknowledgment and legislative initiatives have led to wider acceptance of Lesbian, Gay, Bi-sexual and Transgender rights. However, at the same time, transgender youth are at increased risk for mental health problems, including eating disorders. To describe two cases of trans adolescents with anorexia nervosa treated in a day treatment program. In this paper, the two clinical vignettes of transgender adolescent with anorexia nervosa will be discussed. The focused care included specific attention to the initial disclosure of gender identity in a safe space, name and pronoun preferences as well as wardrobe and hair style changes. In addition, treatment focused on the reduction of social anxiety around meal consumption with special attention given to the impact of weight on the development of secondary sex characteristics. Themes of identity, rejection and secrecy were explored. In summary, the treatment of transgender youth with anorexia nervosa is more complex than treatment of cis gender youth. Additional issues, such as hormonal treatments, the development of secondary sexual characteristics as well as social and cultural factors can exacerbate eating disorder symptoms. Treatment should focus on understanding the etiology and the trajectory of the disorder within this lens.
{"title":"Caring for Transgender Youth with Eating Disorders in a Day Treatment Program","authors":"Lauren Salvatore Farkas, I. Dancyger, Shervin Shadianloo, V. Fornari","doi":"10.2174/2210676613666221027124554","DOIUrl":"https://doi.org/10.2174/2210676613666221027124554","url":null,"abstract":"\u0000\u0000The treatment of transgender youth with an eating disorder presents particular considerations due to the unique combination of body dissatisfaction, drive for thinness, malnutrition coupled with the evolving gender identity in the midst of biological and physical changes. At this time, public awareness, societal acknowledgment and legislative initiatives have led to wider acceptance of Lesbian, Gay, Bi-sexual and Transgender rights. However, at the same time, transgender youth are at increased risk for mental health problems, including eating disorders.\u0000\u0000\u0000\u0000To describe two cases of trans adolescents with anorexia nervosa treated in a day treatment program.\u0000\u0000\u0000\u0000In this paper, the two clinical vignettes of transgender adolescent with anorexia nervosa will be discussed. The focused care included specific attention to the initial disclosure of gender identity in a safe space, name and pronoun preferences as well as wardrobe and hair style changes. In addition, treatment focused on the reduction of social anxiety around meal consumption with special attention given to the impact of weight on the development of secondary sex characteristics. Themes of identity, rejection and secrecy were explored.\u0000\u0000\u0000\u0000In summary, the treatment of transgender youth with anorexia nervosa is more complex than treatment of cis gender youth. Additional issues, such as hormonal treatments, the development of secondary sexual characteristics as well as social and cultural factors can exacerbate eating disorder symptoms. Treatment should focus on understanding the etiology and the trajectory of the disorder within this lens.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42863214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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