Child and Adolescent Mental Health最新文献

The rising use of digital technologies and social media means that individuals, including young people, are increasingly searching for and consuming health-related information online. Although there are benefits to this, there has also been an increase in health-related misinformation, with growing concerns about the impact of this in the context of child mental health. This debate article outlines what misinformation is and why it is an issue in child mental health, before considering the impact that misinformation can have in relation to decision-making, help-seeking, medical mistrust, and stigma. Drawing on experiences with science communication, five recommendations are then presented for combating misinformation, focusing on what individuals can do when confronted with misinformation, how to have conversations with others about misinformation, and what can be done to promote digital literacy.

Background: Body image and eating behaviours are common areas of concern for early adolescents. Artificial Intelligence (AI) interactions are becoming commonplace, including with chatbots that provide human-like communication. Adolescents may prefer using chatbots to anonymously ask sensitive questions, rather than approaching trusted adults or peers. It is unclear how chatbots answer such questions. We explored how chatbots would respond to eating, weight or appearance-related queries from adolescents.

Method: Ten fictitious adolescent personas and scripts were created to facilitate conversations with ChatGPT and Claude.AI. Personas asked questions about eating, body weight and/or appearance, presenting as 'curious', 'worried' or 'having a potential eating disorder'. Conversation outputs were analysed using reflexive thematic analysis to explore the content of chatbot responses.

Results: Five themes were identified: (1) Live a 'healthy' adolescent lifestyle; (2) Eat 'healthily'; (3) Promoting regular physical activity; (4) Seek support; (5) Focus on you. Advice was often framed within societal ideals relating to eating, body weight and/or appearance. Chatbots signposted to trusted adults and healthcare professionals for support, but not to regulated resources (e.g., NHS).

Conclusion: Framings around eating, weight and/or appearance may be problematic for adolescents with eating disorder symptomatology. A lack of prompting for further information or signposting to regulated support means vulnerable adolescents may receive unhelpful information or not reach adequate support. Understanding how AI could be supportive and/or unhelpful to adolescent users presenting with eating, body or appearance-related concerns is important. Findings can inform policy regulating AI chatbots' communications with adolescents.

Background: Anorexia nervosa has the potential to affect fetal neurodevelopment. We examined the association between maternal anorexia nervosa and mental, substance-related, and neurodevelopmental morbidity in offspring.

Methods: We conducted a retrospective cohort study of 1,269,370 children in Quebec, Canada, between 2006 and 2022. The main exposure was maternal anorexia nervosa requiring admission. The outcome was childhood hospitalization for mental, substance-related, or neurodevelopmental disorders between birth and age 17 years, with follow-up ending in 2023. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between maternal anorexia nervosa and child outcomes using Cox regression models adjusted for patient characteristics.

Results: In total, 2,447 (0.2%) children had a mother admitted for anorexia nervosa. Children of mothers with anorexia nervosa had higher hospitalization rates for mental, substance-related, and neurodevelopmental morbidity than other children (104.7 vs. 51.4 per 1,000 by age 17 years). Children whose mothers had anorexia nervosa were particularly at risk of mental health hospitalization (HR 2.30, 95% CI 1.52-3.49), especially for anorexia nervosa (HR 10.62, 95% CI 5.06-22.29) and anxiety and stress disorders (HR 1.84, 95% CI 1.09-3.08), compared with unexposed children. Maternal anorexia nervosa was associated with substance-related (HR 2.01, 95% CI 1.26-3.21) and neurodevelopmental morbidity in children (HR 1.55, 95% CI 1.19-2.01).

Conclusion: Maternal anorexia nervosa is associated with childhood hospitalization for mental health, substance-related, and neurodevelopmental morbidity, although results should be interpreted with caution owing to potential confounders. Mothers with anorexia nervosa may benefit from psychosocial support to prevent mental and neurodevelopmental morbidity in offspring.

Background: The present study aimed to analyze associations between device-measured physical activity and sedentary time during childhood with mental health-related outcomes throughout adolescence.

Methods: Data from the Millennium Cohort Study were used. Device-measured physical activity (i.e., light and moderate-to-vigorous physical activity) and sedentary time were assessed at 7 years. Internalizing and externalizing symptoms were assessed at three time points (11 years, 14 years, and 17 years) via the Strengths and Difficulties Questionnaire. Depressive symptoms were estimated using the Mood and Feelings Questionnaire at 14 years. Psychological distress was assessed using the six-item Kessler psychological distress scale at 17 years. Negative binomial regression models, adjusting for potential confounders were used.

Results: Among boys, greater time spent in moderate-to-vigorous physical activity at 7 years was associated with higher hyperactivity and lower peer problems throughout adolescence. Higher moderate-to-vigorous (incidence rate ratio [IRR]: 0.95; 95% confidence interval [CI]: 0.93-0.98), light (0.90; 0.85-0.95), and total activity time (0.95; 0.93-0.98) at 7 years were associated with lower, while sedentary time was associated with higher (1.11; 1.07-1.16) psychological distress at 17 years in the adjusted models. Girls who spent more time in light physical activity at 7 years were more likely to have lower hyperactivity levels over adolescence, while higher sedentary time at the same age was associated with higher hyperactivity levels. Higher sedentary time at 7 years was associated with higher depressive symptoms at 14 years (1.06; 1.01-1.10), whereas light physical activity at 7 years (0.91; 0.85-0.97) was associated with lower depressive symptoms at 14 years in the adjusted models.

Conclusion: Higher moderate-to-vigorous, light physical activity, and lower sedentary time were associated with lower peer problems, depressive symptoms, and psychological distress throughout adolescence.

Background: Youth is a transitional period from 15 to 24 years involving developmental milestones that may be adversely affected by mental health (MH) concerns. Clinical interventions tend to focus on the reduction or cure of illness-based psychiatric symptoms. However, national and international mental policy focuses on promoting well-being and self-management through personal recovery. The leading framework of personal recovery in adults is CHIME, an acronym used to denote five key processes - Connectedness, Hope, Identity, Meaning and Empowerment. The extent to which CHIME reflects the experience of personal recovery in youth is under-researched, yet the framework often underpins youth mental health services.

Method: The present study uses a qualitative methodology to analyse interviews with 16 youth referred for treatment. Interviews focused on the lived experiences of youth recovery and its alignment with the CHIME processes and were analysed using a hybrid inductive and deductive reflexive thematic analysis.

Results: The CHIME framework was relevant to youth recovery in two ways: restoring what was perceived to be lost (restorative processes) and encouraging resilience (resilience processes). Adaptations to the CHIME framework for youth included an increased emphasis on the role of family and friends, support for grieving processes and support for identity formation during the recovery journey.

Conclusion: An adapted CHIME framework for youth can underpin targeted recovery-oriented care to support youth in moving towards emerging adulthood successfully while managing mental health concerns.

The journal's recent debate series ('are we overpathologising young people's mental health?') featured compelling articles regarding the pathologisation of emotional distress in young people. Much of the concern over overpathologising is that young people are overpathologising their own mental health (i.e. identifying as having mental illnesses when they are actually experiencing normative, non-clinical levels of emotional distress; Foulkes & Andrews, New Ideas Psychol., 69, 2023, 101010). I wish to briefly share a relevant finding from a recent study (on mental illness self-labelling in late adolescence) and highlight ways that new empirical work can move this debate forward.

Artificial intelligence may be able to improve the efficiency, accuracy and predictiveness of mental health assessments, and public perspectives are crucial to ensuring these tools are implemented with fairness and accountability. We developed an artificial intelligence-driven tool to automatically analyse parents' speech data, which if successful could be implemented in children and young people's mental health assessments. To engage stakeholders with this project, we worked with a science fiction writer to produce two stories about possible futures of our tool, which we discussed in workshops with young people and parents. Here, we summarise key themes arising from this novel method of engaging the public in mental health research, and highlight considerations for clinicians and researchers creating novel technologies for children and young people's mental healthcare.