Journal of Clinical Child and Adolescent Psychology最新文献

Objective: This qualitative study seeks to explore community-level risk and protective factors influencing substance use and mental health among urban youth in Paterson, New Jersey, and to identify actionable targets for prevention and mental health interventions using a community trauma framework.

Methods: Purposive and venue-based sampling was used as a method to recruit youth (N = 90). Fifteen focus groups were conducted; a majority of the sample identified as Black (71.1%) and (16.7%) identified as Hispanic with an average age of 16 years old. The sample included 54.4% male participants and 45.6% female participants. All focus groups were audio-recorded and transcribed.

Results: Three major themes emerged from our focus groups with youth from Paterson, which include: 1) the socio-cultural environment and its impact on substance misuse; 2) physical and built environment, and 3) educational and economic environment, all major constructs of the Community Trauma framework, which was used as a guide to interpret findings.

Conclusions: Our findings demonstrate that youth in Paterson view substance use as deeply intertwined with their socio-cultural, physical, and economic environments. These results highlight the need for multilevel interventions such as improving neighborhood safety and increasing access to culturally responsive mental health services. Policy implications include enacting zoning ordinances to limit the density of tobacco, marijuana, and alcohol retailers near schools and implementing school-based mental health programs. Taken together, these strategies can reduce youth exposure to risk environments and promote healthier developmental trajectories for urban youth of color.

Objective: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder starting in childhood, often persisting into adulthood. Diagnosis rates have risen since the first U.S. estimates in the 1990s, with variations across sex, race/ethnicity, and other factors. This study explores ADHD diagnosis and treatment among U.S. children from 2016 to 2023, with a focus on identifying differences across sociodemographic and clinical characteristics.

Methods: Data from the National Survey of Children's Health (NSCH; 2016‒2023) on parent-reported ADHD diagnoses and treatments among non-institutionalized U.S. children aged 3‒17 years were analyzed. Trends over time and across sociodemographic and clinical subgroups were assessed using logistic regression models and joinpoint regression analysis.

Results: ADHD diagnosis prevalence estimates were stable from 2016 to 2019 (8.6% to 8.8%), rising after the onset of the COVID-19 pandemic in 2020 to 10.5% in 2023. Yet, from 2016 to 2023, overall ADHD treatment rates declined (76.9% to 70.8%), particularly for medication treatment (62.5% to 53.0%), while behavioral treatment stayed steady (47.3% to 48.2%). ADHD diagnosis trends differed by race, insurance status, and ADHD severity, increasing only for children in Asian, White, and multiracial groups; with private insurance, and with mild or moderate ADHD. Treatment prevalence differences by sex narrowed over time, as medication use decreased for males and behavioral treatment increased for females, specifically adolescent females.

Conclusions: With a widening gap between the prevalence of ADHD diagnosis and treatment, fewer children are receiving recommended care than in the past. These results may inform interventions to improve healthcare access and address systemic barriers to treatment for all children with ADHD.

Objective: Maternal depression is strongly linked to the development of depression in youth; however, most studies have examined this association as a unidirectional pathway over time. Emerging literature suggests that youth psychopathology, such as externalizing behaviors, can also influence parents' mood and symptoms, yet, the impact of youth depressive symptoms on parent depressive symptoms remains poorly understood.

Method: The current study included a sample of mother-child dyads (N = 2322) whose depressive symptoms were assessed across 5 time points, with measurements at 5 time points in early and middle adolescence. In terms of demographics, 47.7% of youth identified as female, 41.3% of participants identified as European American, 24.2% as African American, 12.4% as Latinx, and 12.8% as multiracial.

Results: Results show no significant effect of between-subjects, stable differences across time, but time-specific, within-dyad differences in depressive symptoms indicated bidirectional pathways between maternal and youth depressive symptoms across early and middle adolescence.

Conclusion: The results highlight the critical importance of examining bidirectional pathways of risk, which may implicate family functioning and interventions for youth depression. Interventions for youth depression typically do not reliably incorporate parents; however, as the current findings suggest, both parent and youth depression are mutually reinforcing, such a bidirectional perspective could prove to be beneficial in treatment.

Objective: Co-occurring anxiety affects 40-80% of autistic individuals; however, little is understood about how anxiety manifests in young autistic children, especially those with intellectual disability (ID), partly due to the paucity of measures designed to assess anxiety symptoms in this population. The present study examined the utility of the Modified Anxiety Dimensional Observation Scale (M-Anx-DOS), an observational measure of anxiety-related behaviors, in preschool-aged autistic children with and without ID.

Method: This study included 48 autistic children (Mean age = 43.96 months; 81.3% with ID) and 30 non-autistic (NA) controls (Mean age = 43.66 months). Anxiety-related behaviors were measured during the M-Anx-DOS. Parent-reported anxiety symptoms were assessed via the Preschool Anxiety Scale-Revised (PAS-R).

Results: Groups exhibited comparable scores on both the M-Anx-DOS and PAS-R. Within the autism group, a subset of M-Anx-DOS scores were related to age, autistic features, or IQ. The M-Anx-DOS exhibited excellent inter-rater reliability and acceptable internal consistency. Convergent validity was promising, with specific M-Anx-DOS scores correlated with parent-reported social, separation, and overall anxiety symptoms. M-Anx-DOS scores were not correlated with parent-reported ADHD or externalizing symptoms, suggesting strong discriminant validity.

Conclusions: This study provides preliminary evidence of the reliability and validity of the M-Anx-DOS. These findings are promising given the importance of observational measurement of anxiety and lack of existing measures for this critical developmental period. Given the sample size and the complexity of identifying prodromal signs of anxiety in young autistic preschoolers with ID, future longitudinal work is essential to replicate and extend this work.