Journal of Clinical Child and Adolescent Psychology最新文献

Objective: Dual-process theory suggests that implicit identification with death more strongly predicts self-injurious thoughts and behaviors under certain conditions. As reliance on implicit heuristics to guide behavior may increase in the context of poor sleep, the current study evaluated whether implicit identification with death alone, or in combination with self-reported sleep quality, predicted future levels of suicidal ideation and self-harm.

Methods: The sample consisted of 100 adolescents (M_age = 16.62; SD = 1.83, 91.0% females; 26.0% racial minority; 25.0% Hispanic/Latino/a/x) with histories of suicidal episodes and repeat self-harm behavior. Implicit identification with death and sleep quality were assessed at baseline. Outcomes (i.e. suicidal ideation and self-harm levels) were assessed at baseline, 6-, and 12-months. Multilevel structural equations were used to assess relations among study variables.

Results: At high and/or moderate levels of poor sleep quality, greater implicit identification with death positively predicted suicidal ideation and self-harm levels. Importantly, similar results were found with suicide attempts and non-suicidal self-injury as separate outcomes. As main effects, implicit identification with death and poor sleep quality only positively predicted suicidal ideation and suicide attempts, respectively.

Conclusions: The interaction between implicit identification with death and sleep quality may be an important predictor of future adolescent suicidal ideation and self-harm. Assessment of an adolescent's implicit identification with death and sleep quality may help identify those at greatest future risk.

Suicide is a leading cause of death worldwide, and is one of the most devastating, complex, and perplexing of all human behaviors. Unfortunately, despite centuries of scientific and scholarly inquiry, suicidal thoughts and behaviors remain exceedingly difficult to understand, predict, and prevent. Fortunately, recent advances in mathematical, computational, and digital methods are providing new opportunities to capture and model the immense complexity of suicidal thoughts and behaviors. In this paper, we first provide a brief review of existing literature and then identify four priorities for future research, including: 1) rigorous conceptual and descriptive research, 2) formal theory development and refinement, 3) measurement in context and over time, and 4) prediction of group- and individual-level suicide risk. Finally, we discuss cross-cutting considerations related to ethical dilemmas, enhancing diversity, and training the next generation of scientists. Together, these future directions offer an actionable agenda to guide the future of suicide research and make meaningful progress toward reducing its global burden.

Objective: Anhedonia is a risk factor for suicidal thoughts. Treatment for anhedonia (behavioral activation) involves engaging in rewarding activities. Social media use is a rewarding activity for adolescents, and thus, a possible behavioral activation tool for adolescents experiencing anhedonia, reducing further symptom escalation (e.g. suicidal thoughts).

The current study tested: (1) Is momentary anhedonia negatively associated with looking forward to checking social media (predicted pleasure)? (2) Is momentary anhedonia associated with subsequently experiencing less positive mood on social media (actual pleasure)? (3) Are within-person changes in positive mood on social media (actual pleasure) associated with reduced likelihood of suicidal thoughts, and does this vary by levels of anhedonia?

Method: Sixty-two adolescents (M_age = 16.15 (0.97); 49.3% girls, 16.4% boys, 34.4% nonbinary; 40.3% white) completed ecological momentary assessments three times daily for eight weeks. All prompts asked about anhedonia, predicted pleasure from social media, and actual pleasure on social media. Evening prompts assessed daily suicidal thoughts. Multilevel models tested the above research questions.

Results: Adolescents experiencing momentary anhedonia above their average levels looked forward to checking social media less. However, more-than-usual momentary anhedonia was not associated with positive mood on social media (actual pleasure). Experiencing above-average positive mood on social media was associated with decreased probability of suicidal thoughts at the daily level. This relationship was not moderated by anhedonia.

Conclusion: For adolescents experiencing more-than-usual anhedonia, using social media for positive mood-boosting activities could be a behavioral activation tool and may be an important protective factor against suicidal thoughts.

Objective: While Black adolescent girls use drugs at much lower rates than White and Hispanic girls, Black adolescent girls often have worse health outcomes due to drug use. This study seeks to highlight the voices of Black adolescent girls in order to understand their unique risk factors for substance use and misuse.

Methods: Utilizing the intersectionality and ecological systems theoretical frameworks, the research team conducted twelve focus groups among a sample of Black adolescent girls (N = 62) between the ages of 13-18 (M = 15.6 years SD = 1.50).

Results: Thematic analysis was conducted to analyze the participant narratives. Four main themes arose: 1) stereotypes of Black adolescent girls; 2) the role of the physical and social environment (feeling unsafe in neighborhoods where they reside); 3) using drugs as a coping mechanism; 4) input on prevention programming for girls with a sub-theme involving family as a protective factor.

Discussion: Study findings deepen our qualitative understanding of risk and protective factors for substance use among Black adolescent girls. These findings provide insight on girls' lived experiences for researchers and intervention development to create and implement substance abuse prevention programs that are race- and gender-specific for Black adolescent girls.

Objective: Cognitive Disengagement Syndrome (CDS; previously called Sluggish Cognitive Tempo) refers to a constellation of cognitive and motor behaviors characterized by a predisposition toward mind wandering (cognitive subdomain) and slowed motor behavior (hypoactive). While there are a number of studies linking CDS traits to greater global impairment in children with attention-deficit/hyperactivity disorder (ADHD) and autistic children, there are few studies examining the prevalence and impact of CDS traits in autistic children with co-occurring ADHD (Autistic+ADHD). The current study explored CDS traits in autistic children with and without co-occurring ADHD, children with ADHD, and neurotypical children.

Methods: Participants were 196 children between 3- and 7-years-of-age comprising four groups: Neurotypical (N = 44), ADHD (N = 51), Autistic (N = 55), and Autistic+ADHD (N = 46). CDS traits, social and communication skills, repetitive behaviors, and sensory processing were all assessed via parent report.

Results: Children diagnosed with ADHD, autistic children, and Autistic+ADHD children exhibited similar levels of overall CDS traits. However, when explored separately, Autistic+ADHD children had higher cognitive CDS trait scores compared to children with ADHD alone. Both overall CDS traits and the cognitive subdomain were associated with greater social difficulties, particularly social withdrawal, higher levels of repetitive behaviors, and more sensory sensitivities, regardless of diagnosis.

Conclusions: Findings suggest that CDS traits may be an additional factor directly impact functional outcomes in both autistic and ADHD children. As such, clinicians should be assessing CDS traits in addition to other clinical domains associated with ADHD and autism when developing intervention plans for young neurodiverse children.

Objective: This evidence base update investigates the empirical support of psychosocial interventions for self-injurious thoughts and behaviors (SITBs) in youth, focusing on the period since the prior review.

Method: Two major scientific databases (PsycInfo and PubMed) were systematically searched to identify randomized controlled trials (RCTs) published or in press between June 1, 2018 and May 31, 2024.

Results: The search yielded 11 RCTs new to this update and 1 new SITB outcome to an RCT included in the prior review. Since the prior review, Dialectical Behavior Therapy for Adolescents (DBT-A) was reclassified as Level 1: Well-established intervention for reducing adolescent suicide attempts, and Family Therapy was reclassified as Level 2: Probably efficacious for reducing youth suicide ideation (SI). Cognitive behavioral therapy-individual + family was reclassified as Level 4: Experimental for reducing youth suicide attempts. Four new RCTs examining adjunctive skills or boosters for brief interventions were rated as Level 2: Probably Efficacious for reducing SI (adjunctive mindfulness skills + Psychodynamic therapy, adjunctive skills - emotion regulation) or Level 3: Possibly Efficacious for reducing SITBs (adjunctive safety planning interventions).

Conclusions: DBT-A remains the sole well-established intervention for reducing SITBs, with replication by multiple independent research teams. Half the RCTs identified in this review aimed to replicate or extend prior interventions. Several newly identified trials in this review were primarily adjunctive or brief, demonstrating greater efforts to enhance the availability of interventions for SITBs in youth. Further replication of these adjunctive treatments is needed to clarify their effectiveness and potential for widespread implementation.

Objective: While daring-impulsive (DI) traits have been deemed an important concept in subtyping youth with conduct disorder (CD) as part of a multispecifier model, no work has examined whether DI traits add to the existing practice of designating youth with CD beyond co-occurring attention-deficit/hyperactivity disorder (ADHD).

Method: This study examined the utility of DI traits (versus ADHD features) in a sample of 322 justice-involved adolescent boys (ages 16-17 years). In addition to a diagnostic interview to determine severity of CD, adolescents completed measures of DI, ADHD, as well as other relevant characteristics.

Results: Findings revealed differential associations between DI and ADHD in relation to indices of CD, externalizing psychopathology (i.e. reactive aggression, proactive aggression, substance use), internalizing psychopathology (i.e. anxiety, depression), and domains of impulsivity (i.e. positive urgency, negative urgency, sensation seeking, premeditation, perseverance). Additionally, over and above ADHD, DI contributed incremental information in explaining CD, externalizing psychopathology, positive urgency, sensation seeking, and lack of premeditation, but not internalizing psychopathology nor negative urgency and lack of perseverance. Of the 286 adolescents with CD, 114 (39.9%) were in the DI group and only 81 (28.3%) were in the ADHD group. Finally, differential correlates emerged between adolescents exhibiting CD alone, high CD and high DI traits, and high CD and high ADHD features.

Conclusions: Findings tentatively suggest DI traits and ADHD features are empirically distinct from each other in relation to CD and relevant characteristics and, therefore, improved clinical care for adolescents with CD will likely require differential consideration of DI and ADHD.

Objective: We examined the longitudinal effects of internet-delivered PCIT (iPCIT) on caregiver and child imitation in young Hispanic/Latine children with developmental delay (DD). We also examined the moderating roles of acculturation and enculturation on such treatment effects.

Method: Three-year-old, Hispanic/Latine children aging out of early intervention services for developmental delay (n = 98) and their primary caregivers were randomized to receive iPCIT or referrals as usual (RAU) in the community. Caregiver and child imitation were observationally coded during a 5-min child-directed play situation, which occurred during home-based evaluations at four timepoints - i.e. Baseline, Post, 6-month follow-up, and 12-month follow-up.

Results: Treatment effects were significantly moderated by caregiver acculturation. Specifically, iPCIT was associated with greater caregiver and child imitation among families reporting higher, but not lower, levels of caregiver acculturation. However, caregiver enculturation did not moderate the effects of iPCIT on either caregiver or child imitation.

Conclusions: Findings suggest parenting intervention effects on levels of imitation were particularly strong for Hispanic/Latine caregivers reporting higher levels of acculturation. This highlights the promotive role acculturative identity can play in boosting parenting intervention effects, particularly those of caregiver and child imitation. Findings also underscore the importance of assessing cultural factors to better inform personalized care and skill acquisition among Hispanic/Latine samples. Future research is needed to identify mechanisms that help explain precisely how cultural identity factors, such as acculturation and enculturation, can boost treatment-related imitation gains for Hispanic/Latine children with DD and their families.

Objective: To determine the proportion and profile of preschoolers on the autism spectrum who do not acquire spoken language despite receiving evidence-supported interventions that target spoken language.

Methods: We examined an aggregate dataset comprising 707 preschoolers on the autism spectrum who had received evidence-supported interventions to determine the proportion and profile of those who experienced limited progress in spoken language. Interventions were delivered through programs affiliated with university research settings and ranged in duration from 6 to 24 months. Spoken language outcomes were determined from parent-report measures, which were validated against direct assessments and natural language samples.

Results: Approximately two-thirds of children who were non-speaking at baseline were using single words or more complex spoken language by intervention exit. Those who remained non-speaking had lower baseline motor imitation scores, derived mainly from parent reports. Approximately half of the children who were minimally speaking (i.e. had single words or no words) at baseline were combining words by intervention exit. Those who did not acquire word combinations had lower baseline scores in cognitive, social, adaptive and motor imitation measures, and shorter intervention duration. Age at intervention start influenced spoken language advancement differently depending on the initial spoken language level. The odds of acquiring spoken language did not differ based on the intervention received.

Conclusions: Approximately one-third of children who had limited or no spoken language at baseline did not advance to spoken language stages following intervention. Development of spoken language was associated with modifiable factors at the child and intervention level.

Objective: While suicidal behaviors among adolescents declined from 1991 to 2017, suicides among Black youth increased. There is limited research on suicidal help-seeking behaviors among Black adolescents, which is essential for effective suicide prevention and intervention. This study examined suicidal help-seeking behaviors and treatment preferences among Black youth and caregivers, using the Psychological Framework of Radical Hope to explore strategies for fostering hope and healing.

Methods: This qualitative study included Black youth (ages 14-19), caregivers, health and mental health providers, and community members (N = 55). Participants were predominantly Black (96%) and female (53%), with ages ranging from 14 to 68 years. Semi-structured interviews, conducted in 60-90-min virtual focus groups, explored experiences with suicidal help-seeking, service needs, and support preferences. Constant comparative methodology was employed to organize and categorize data into themes.

Results: Youth balanced ideas of faith and agency toward help-seeking behaviors. In contrast, caregivers, providers, and community members were less optimistic about the service needs of Black youth being met largely due to historical and current experiences with systemic barriers. Participant groups discussed how collective memory informs their experiences and inspires them to have hope for positive change.

Discussion: Suicide-specific interventions should integrate strategies for fostering hope, faith, and agency individually and collectively with diverse groups to support Black youth suicidal help-seeking behaviors. Clinical strategies are provided to support the design of interventions to effectively address suicidal help-seeking behaviors for Black youth and their caregivers.