Child and Adolescent Mental Health最新文献

Background: The relationship between social media use (SMU) and adolescent mental health continues to garner considerable attention, yet findings remain inconsistent and contradictory. This umbrella review aims to synthesize recent evidence on this topic and explore whether inconsistencies may be due to inadequate statistical power.

Methods: A systematic literature review of peer-reviewed reviews and meta-analyses published between 2021 and 2025 was conducted across PubMed, PsycINFO, Web of Science, and Scopus. Eligible reviews and meta-analyses focused on SMU and mental health among adolescents, defined as individuals aged 10-24 years. Study-level power analyses were conducted using reported effect sizes from eligible meta-analyses.

Results: Seventy-two reviews met the inclusion criteria, including 20 meta-analyses, 25 systematic reviews, 16 narrative reviews, and 11 scoping reviews. Across reviews, general SMU showed weak and inconsistent associations with both well-being and ill-being, while problematic SMU was consistently linked to ill-being. Seventeen meta-analyses provided 1070 effect estimates from 452 empirical studies for power analyses. Studies examining ill-being and problematic SMU demonstrated consistent negative associations and high statistical power, with all meta-analyses reaching a median study-level power above 99%. In contrast, only 4 out of the 15 meta-analyses using general SMU reached a median study-level power above 80%. Across well-being outcomes, only 4 meta-analyses reached median study-level power above 80%.

Conclusion: Mixed findings in the literature may stem from limited statistical power rather than an absence of real effects, especially in studies of general SMU and well-being. Conceptual precision and adequately powered research are essential for advancing the field.

Background: As adolescents transition to increased independence, they may also begin to encounter financial difficulties, including debt, which may contribute to psychological distress. While financial difficulties and experienced financial scarcity have been well-documented contributors to suicidality in adults, their impact on adolescent populations remains underexplored. The current study aims to elucidate the relationship between late adolescents' own debts or their experienced financial scarcity and the prevalence of self-harm, including both nonsuicidal self-injury (NSSI) and suicidality (suicidal ideation/attempt).

Methods: Data from the first follow-up measurement (T1) of a population-based high-risk cohort in the Netherlands were utilized. For the present study, adolescents (n = 650, mean age at T1 = 17.9 years) provided self-reported data on unsecured debts, experienced financial scarcity, NSSI and suicidality. Hierarchical logistic regression analyses were conducted to examine the associations between these variables, adjusting for potential confounding factors, including individual, sociodemographic, and socioenvironmental influences.

Results: The presence of unsecured debts was associated with an increased prevalence of suicidality (adjusted OR = 1.94, p = .046), but not with NSSI (p = .068). In contrast, greater experienced financial scarcity was associated with a higher prevalence of both NSSI (adjusted OR = 1.09, p = .004) and suicidality (adjusted OR = 1.15, p < .001).

Conclusions: These results underscore the importance of addressing financial difficulties, particularly debts and experienced financial scarcity, in adolescents at-risk for NSSI and suicidality. Interventions aimed at mitigating the effects of financial strain - such as financial education or support programs - may be important in reducing the risk of self-harm in this population. Further research is needed to explore the efficacy of early intervention strategies.

Background: While numerous studies have explored factors contributing to poor mental health, few have examined the combined influence of multiple health and social factors and their cumulative effect. This study specifically aimed to analyze the cumulative effect of multiple health and social factors associated with poor mental well-being in school-aged adolescents (12-18 years old) in Central Catalonia during the 2021-2022 academic year.

Methods: Cross-sectional study using data from the 2021-2022 DESKcohort project, with a total sample of 9265 high-school aged students in Central Catalonia (49.2% boys and 50.8% girls). To identify factors associated with poor mental well-being (score < 44 on the Warwick-Edinburgh Mental Well-being Scale), Multilevel Poisson regression models with robust variance were estimated, obtaining prevalence ratios (PR) with their respective 95% confidence intervals (95% CI). The cumulative effect score was derived by summing the factors that were associated with poor mental well-being.

Results: We observe a gradient where the likelihood of experiencing poor mental well-being increases statistically significantly with exposure to a greater number of multiple health and social factors. In boys, the prevalence ratio increases statistically significantly from PR = 1.59 (p < .040) to PR = 24.52 (p < .001) for 1 and 10 health and social factors combined, and in girls, increases statistically significantly from PR = 2.56 (p < .001) to PR = 16.23 (p < .001) for 1 and 11 health and social factors combined, respectively.

Conclusion: The findings of this study highlight the multifaceted nature of mental health and the co-presence of multiple axes of inequality, where overall health, family and psychosocial factors, and health behaviors form a cumulative association with adolescents' poor mental well-being.

For the last 10 years, the journal Child and Adolescent Mental Health has included ‘Narrative Matters’, a regular section for essays on humanities topics relevant to child mental health practitioners. This editorial provides a broad context of developments in the medical humanities and reviews the themes that have emerged in the section over the decade.

Recent evidence shows that school-based interventions to reduce screen time yield only modest effects, suggesting a need to reconsider how digital behavior change is approached in educational settings. Current programs often emphasize individual restriction, overlooking the broader social and cultural environments that shape children's screen habits. We argue for a shift from "screen time reduction" toward promoting Digital Well-Being Literacy, which entails developing students' capacity for mindful, balanced, and critical digital engagement. This direction aligns with 21st-century education priorities, emphasizing autonomy, digital citizenship, and self-regulation rather than avoidance. Screen use is influenced not only by personal choices but also by family routines, teacher modeling, school digital policies, and community expectations. Therefore, future interventions should adopt ecological, multi-level strategies that integrate school, home, and community contexts. Promoting digital self-regulation rather than restriction offers a more sustainable and developmentally meaningful approach to supporting children's well-being in an increasingly digital world.

This letter comments on the longitudinal study by Schaeffer et al. (Child and Adolescent Mental Health, 2025) regarding emotional reactivity, parent-child conflict resolution, and suicidal ideation among Hispanic/Latino adolescents. While confirming the predictive role of emotional reactivity, the study's nonsignificant finding regarding parent-child conflict resolution invites critical reflection. We argue that this result may stem from the limitations of generic assessment tools, such as the PACHIQ-R, in capturing culturally nuanced relational processes. Core cultural values, particularly familismo, respeto, and simpatía, fundamentally shape conflict navigation, often through harmony, indirect communication, and nonverbal understanding, rather than the explicit problem-solving that standard scales measure. This measurement gap may lead to an incomplete understanding of protective family processes and limit the relevance of clinical interventions. We therefore call for future research to adopt culturally grounded measures and multi-method assessments to more accurately elucidate the role of family factors in adolescent suicide risk, advancing more inclusive and precise research practices.

The recent stimulating debate series in CAMH has highlighted how efforts to raise mental health awareness have resulted in a paradox: overpathologisation is a concern, and yet timely recognition and access to evidence-based support remain insufficient. Often those who need help most are least likely to access it. In response, I extend on the solutions offered by Gega et al. I contend that especially where supports and interventions are intended for use at early help stage, we should reconsider the use of diagnostic framing. Rather than describing interventions using diagnostic terms like depression and anxiety, we should use normalising language to describe these supports. To illustrate, I offer an example of a suite of self-guided single-session interventions (SSIs), not framed in diagnostic language but instead developed to be normalising. This reduces potential harm from requiring individuals to identify with a specific diagnostic construct to see such interventions as relevant to and suitable for them.

Young people from ethnic minority backgrounds in the United Kingdom are less likely to seek psychological support than their white peers. When they do engage with services, a disproportionate number leave, often prematurely. Intercultural frameworks have been developed to help clinicians engage sensitively with diverse populations and improve outcomes. For decades, ‘cultural competence’ has been an accepted intercultural framework across the United Kingdom and beyond (North America, Europe and Australia). However, despite its wide application, ethnic disparities in mental healthcare remain virtually unchanged, exposing a gap between the promise of cultural competence and what it delivers. This article endorses ‘cultural humility’: a different approach to intercultural practice, inviting a ‘way of being’ embedded into practice rather than an acquired skill set. It will outline theoretical principles and describe how this model can be applied to clinical settings, using real-life scenarios involving ethnic minority young people.

In 2025, the Coalition of Autism Scientists was formed to counter the misinformation and pseudoscience that was being advanced at the highest levels of the federal government in the United States. The background and history of how the Coalition was formed and its major activities, which include regular meetings, issuing public statements, and providing information and interviews to the media, are described. The importance of engaging in active advocacy in support of autism science is discussed along with some examples of the Coalition's impact. Given the direction that politics is going, sowing greater dissent between science and the public, continued vigilance in support of the highest quality research is critical if we are to meet the urgent needs of autistic people and their families.