{"title":"Letter to the Editor: What are the hidden challenges in implementing Social Stories™ for autistic children?","authors":"Cai Ai Lai, Yanfang Huang, Guangliang Luo","doi":"10.1111/camh.70010","DOIUrl":"https://doi.org/10.1111/camh.70010","url":null,"abstract":"","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alice Wickersham, William Bennett, Zoë Firth, Craig Colling, Jessica Penhallow, Johnny Downs, the CAMHS Digital Lab
As digital mental health research and technology continue to grow, a systematic approach to quickly and safely translating digital innovation into Child and Adolescent Mental Health Services (CAMHS) is needed. Here, we provide an overview of the CAMHS Digital Lab, a service in London, United Kingdom, which integrates operational, clinical and research expertise to support digital discovery and translate research into practice. The service is organized into four workstreams: Population and clinical analytics; Data science and discovery; Digital therapeutics and assessment; and Education, outreach and training. This service provides a model for integrating digital innovation into mental health services which could be adopted elsewhere.
{"title":"Technology Matters: A model for translating digital and data science innovations into Child and Adolescent Mental Health Services","authors":"Alice Wickersham, William Bennett, Zoë Firth, Craig Colling, Jessica Penhallow, Johnny Downs, the CAMHS Digital Lab","doi":"10.1111/camh.70003","DOIUrl":"10.1111/camh.70003","url":null,"abstract":"<p>As digital mental health research and technology continue to grow, a systematic approach to quickly and safely translating digital innovation into Child and Adolescent Mental Health Services (CAMHS) is needed. Here, we provide an overview of the CAMHS Digital Lab, a service in London, United Kingdom, which integrates operational, clinical and research expertise to support digital discovery and translate research into practice. The service is organized into four workstreams: Population and clinical analytics; Data science and discovery; Digital therapeutics and assessment; and Education, outreach and training. This service provides a model for integrating digital innovation into mental health services which could be adopted elsewhere.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"80-83"},"PeriodicalIF":5.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victor J. Avila-Quintero, Katie Malison, Miciah Wilkerson, José M. Flores, Jerome H. Taylor, Angeli Landeros-Weisenberger, Michael H. Bloch, Amalia Londoño Tobón
Background
We estimated associations between psychiatric providers' self-reported amount and valence of interaction with individuals of Black race/ethnicity during childhood and three implicit association tests (IATs) scores. Valence of interaction refers to the positive or negative nature of childhood interactions, capturing whether these interactions were reported as generally favorable or unfavorable.
Methods
In a cross-sectional study, psychiatric providers and trainees reported the amount and valence of interaction with (1) individuals of Black race/ethnicity during childhood, (2) colleagues, and (3) patients of Black race/ethnicity during medical practice. Providers also completed three IATs pairing Black or White faces and terms about psychiatric diagnosis, compliance, and treatment. Linear and logistic regression models estimated relationships between IAT D-scores and ratings of interaction amount and valence with individuals of Black race/ethnicity.
Results
Among 294 providers (medical students, residents, fellows, and board-certified psychiatrists), increased self-reported amount (βΔ Compliance = −.08, p < .01 and βΔ Treatment = −.09, p < .001) and valence (βΔ Compliance = −.08, p < .01 and βΔ Treatment = −.08, p < .01) of childhood interaction with individuals of Black race/ethnicity were significantly associated with lower D-scores on IAT tasks. In contrast, ratings of amount and valence of recent interaction with colleagues and patients of Black race/ethnicity were not statistically associated with IAT D-scores.
Conclusions
While amount and valence of interaction between providers and individuals of Black race/ethnicity during childhood were associated with lower implicit association scores, recent interactions with colleagues and patients of Black race/ethnicity were not significantly associated with implicit associations. Emerging research suggest that lower IAT D-scores may be associated with more unbiased behaviors and decisions in clinical settings. Considering this, our findings suggest that early-life interactions with individuals of Black race/ethnicity may influence implicit biases in adulthood, with potential implications for reducing racial disparities in psychiatric care. However, further research is needed to confirm these relationships and fully understand their impact in clinical contexts.
{"title":"Associations between childhood interactions with people of Black race/ethnicity and racial implicit association tasks in psychiatric providers in the United States – a cross-sectional study","authors":"Victor J. Avila-Quintero, Katie Malison, Miciah Wilkerson, José M. Flores, Jerome H. Taylor, Angeli Landeros-Weisenberger, Michael H. Bloch, Amalia Londoño Tobón","doi":"10.1111/camh.70001","DOIUrl":"10.1111/camh.70001","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We estimated associations between psychiatric providers' self-reported amount and valence of interaction with individuals of Black race/ethnicity during childhood and three implicit association tests (IATs) scores. Valence of interaction refers to the positive or negative nature of childhood interactions, capturing whether these interactions were reported as generally favorable or unfavorable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a cross-sectional study, psychiatric providers and trainees reported the amount and valence of interaction with (1) individuals of Black race/ethnicity during childhood, (2) colleagues, and (3) patients of Black race/ethnicity during medical practice. Providers also completed three IATs pairing Black or White faces and terms about psychiatric diagnosis, compliance, and treatment. Linear and logistic regression models estimated relationships between IAT <i>D</i>-scores and ratings of interaction amount and valence with individuals of Black race/ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 294 providers (medical students, residents, fellows, and board-certified psychiatrists), increased self-reported amount (β<sub>Δ Compliance</sub> = −.08, <i>p</i> < .01 and β<sub>Δ Treatment</sub> = −.09, <i>p</i> < .001) and valence (β<sub>Δ Compliance</sub> = −.08, <i>p</i> < .01 and β<sub>Δ Treatment</sub> = −.08, <i>p</i> < .01) of childhood interaction with individuals of Black race/ethnicity were significantly associated with lower <i>D</i>-scores on IAT tasks. In contrast, ratings of amount and valence of recent interaction with colleagues and patients of Black race/ethnicity were not statistically associated with IAT <i>D</i>-scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While amount and valence of interaction between providers and individuals of Black race/ethnicity during childhood were associated with lower implicit association scores, recent interactions with colleagues and patients of Black race/ethnicity were not significantly associated with implicit associations. Emerging research suggest that lower IAT <i>D</i>-scores may be associated with more unbiased behaviors and decisions in clinical settings. Considering this, our findings suggest that early-life interactions with individuals of Black race/ethnicity may influence implicit biases in adulthood, with potential implications for reducing racial disparities in psychiatric care. However, further research is needed to confirm these relationships and fully understand their impact in clinical contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 3","pages":"256-264"},"PeriodicalIF":5.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>I am writing to provide commentary on the recently published debate article by Birrell et al. (<span>2025</span>) titled ‘Debate: Where to next for universal school-based mental health interventions?’ In this commentary, the authors review two recent large-scale universal school interventions, and from this analysis, they conclude that universal school-based mental health interventions are ineffective. Following this article, four additional commentaries implicitly support these assertions, and one even calls for abandonment of universal school-based interventions. The two interventions that are reviewed are the MYRIAD trial in the United Kingdom (on which I was an investigator), and this intervention basically showed no effects of universal mindfulness program for early adolescents compared with other school programming (Montero-Marin et al., <span>2023</span>). Student's reports of their own experiences were clearly mixed, and the authors conclude that greater input from youth may have improved the programme and experience as noted by one of the following commentaries by Carter (<span>2025</span>). In addition, this programme was quite short (10 lessons) and may have been inadequate to create significant outcome.</p><p>The second programme reviewed was a large-scale online programme intended to prevent anxiety and depression and reduce risk for substance abuse termed the ‘Climate Schools Combined’ study, which involved 71 schools in Australia. Although there were sustained effects on alcohol use at 72 months post intervention, there were no long-term effects on anxiety or depression (Teesson et al., <span>2024</span>). It is not surprising that a digital online universal programme did not have main effects that lasted 6 years, especially given that half of the intervention was led by teacher that had no training in the use of the programme.</p><p>Thus, to assert that universal school-based interventions are ineffective based on a sample of two programmes is problematic and premature. In fact, there have been over 10 meta-analyses of over 500 universal social and emotional learning programmes (SEL) that have shown effects on mental health, social competence and well-being. There are numerous reviews of these meta-analyses (Durlak, Mahoney, & Boyle, <span>2022</span>; Greenberg, <span>2023</span>). The most recent meta-analysis shows impacts on numerous outcomes related to child well-being, competence, mental health and academic success, examining 252 SEL interventions in 53 countries (Cipriano et al., <span>2023</span>). Thus, to conclude that universal school-based mental health programs are ineffective is a broad generalization from a sample of two that is not borne out by the large literature.</p><p>Further, implementation quality has been shown in many studies to be critically important in universal school interventions (Durlak, <span>2016</span>), and the CSC study has provided no data on either the quality of implementation or how i
我写这封信是为了评论Birrell等人最近发表的一篇辩论文章（2025），题为“辩论：全民学校心理健康干预的下一步是什么？”在这篇评论中，作者回顾了最近两次大规模的普遍学校干预，并从分析中得出结论，普遍的以学校为基础的心理健康干预是无效的。在这篇文章之后，另外四篇评论含蓄地支持这些断言，其中一篇甚至呼吁放弃普遍的以学校为基础的干预。我们回顾了两项干预措施，一项是英国的MYRIAD试验（我是该试验的研究者），与其他学校计划相比，该干预措施基本上没有显示普遍正念计划对早期青少年的影响（Montero-Marin et al., 2023）。学生对自己经历的报告显然是混杂的，作者得出结论，更多的年轻人的投入可能会改善项目和经验，正如卡特（2025）在以下评论中所指出的那样。此外，这个项目很短（10节课），可能不足以产生重大成果。审查的第二个方案是一个大型在线方案，旨在预防焦虑和抑郁，减少药物滥用的风险，称为“气候学校联合”研究，涉及澳大利亚的71所学校。虽然干预后72个月对酒精使用有持续影响，但对焦虑或抑郁没有长期影响（Teesson et al., 2024）。数字在线普遍计划没有持续6年的主要效果，这并不奇怪，特别是考虑到一半的干预是由没有接受过使用该计划培训的教师领导的。因此，根据两个方案的样本断言普遍的以学校为基础的干预是无效的是有问题的和不成熟的。事实上，对500多个通用社会和情感学习项目（SEL）进行的10多项荟萃分析显示，这些项目对心理健康、社会能力和幸福感有影响。这些荟萃分析有许多评论（Durlak, Mahoney, & Boyle, 2022; Greenberg, 2023）。通过对53个国家的252项SEL干预措施的研究，最近的荟萃分析显示了对儿童福祉、能力、心理健康和学业成功相关的许多结果的影响（Cipriano et al., 2023）。因此，得出普遍的以学校为基础的心理健康项目无效的结论，是两个样本的广泛概括，没有得到大量文献的证实。此外，许多研究表明，实施质量在普遍的学校干预措施中至关重要（Durlak, 2016）， CSC的研究没有提供关于实施质量或实施与结果之间关系的数据。在MYRIAD的研究中，有证据表明，教学质量更高的教师，其学生更有可能练习正念技能。在另一篇评论中，McCrone（2025）呼吁放弃普遍干预措施，因为它们不能预防大多数晚期精神健康问题。人们早就知道，普遍方案只是应协调使用的支助儿童和青年的三种模式（普遍的、选择性的和指明的）的一部分。它们可能对风险很小的参与者起到促进作用，对有一定风险的青少年起到预防作用，对那些已经达到诊断标准的人起到温和治疗的作用。此外，对普遍干预方案进行更仔细的分析，不仅关注主要影响，而且关注风险控制，结果经常表明，风险最大的年轻人最有可能从普遍方案中受益，特别是在正确分析的情况下（Greenberg & Abenavoli, 2017; Spilt, Koot, & van Lier, 2013）。虽然只使用二级/指示性或“高风险”策略可能至少使一些接受治疗的人受益，因为早期治疗将仅限于相对较小的一部分人口，但事实证明，它对儿童和青少年心理健康整体问题的总公共卫生负担的影响相对较小。这是英国流行病学家杰弗里·罗斯（Geoffrey Rose）的伟大见解，他在40年前创造了“预防悖论”一词（Rose, 1992）。以心脏病为例，罗斯证明了大量低风险人群可能比少数高风险人群产生更多的疾病病例。在青少年发展和物质使用领域也是如此（Greenberg & Abenavoli, 2017）。 鉴于普遍的以学校为基础的干预措施的有益效果的大量和持续的证据，未来的研究应该提高干预措施的质量，仔细研究教师的实施和培训，以及其他背景问题，以推动这一领域向前发展，造福所有人。Greenberg是PATHS课程的作者之一，并与PATHS Program llc有版税协议。本文没有资助者。不适用于本评注。
{"title":"Commentary: Where to next for universal school-based mental health interventions? Don't through the baby out with the bathwater","authors":"Mark T. Greenberg","doi":"10.1111/camh.70009","DOIUrl":"10.1111/camh.70009","url":null,"abstract":"<p>I am writing to provide commentary on the recently published debate article by Birrell et al. (<span>2025</span>) titled ‘Debate: Where to next for universal school-based mental health interventions?’ In this commentary, the authors review two recent large-scale universal school interventions, and from this analysis, they conclude that universal school-based mental health interventions are ineffective. Following this article, four additional commentaries implicitly support these assertions, and one even calls for abandonment of universal school-based interventions. The two interventions that are reviewed are the MYRIAD trial in the United Kingdom (on which I was an investigator), and this intervention basically showed no effects of universal mindfulness program for early adolescents compared with other school programming (Montero-Marin et al., <span>2023</span>). Student's reports of their own experiences were clearly mixed, and the authors conclude that greater input from youth may have improved the programme and experience as noted by one of the following commentaries by Carter (<span>2025</span>). In addition, this programme was quite short (10 lessons) and may have been inadequate to create significant outcome.</p><p>The second programme reviewed was a large-scale online programme intended to prevent anxiety and depression and reduce risk for substance abuse termed the ‘Climate Schools Combined’ study, which involved 71 schools in Australia. Although there were sustained effects on alcohol use at 72 months post intervention, there were no long-term effects on anxiety or depression (Teesson et al., <span>2024</span>). It is not surprising that a digital online universal programme did not have main effects that lasted 6 years, especially given that half of the intervention was led by teacher that had no training in the use of the programme.</p><p>Thus, to assert that universal school-based interventions are ineffective based on a sample of two programmes is problematic and premature. In fact, there have been over 10 meta-analyses of over 500 universal social and emotional learning programmes (SEL) that have shown effects on mental health, social competence and well-being. There are numerous reviews of these meta-analyses (Durlak, Mahoney, & Boyle, <span>2022</span>; Greenberg, <span>2023</span>). The most recent meta-analysis shows impacts on numerous outcomes related to child well-being, competence, mental health and academic success, examining 252 SEL interventions in 53 countries (Cipriano et al., <span>2023</span>). Thus, to conclude that universal school-based mental health programs are ineffective is a broad generalization from a sample of two that is not borne out by the large literature.</p><p>Further, implementation quality has been shown in many studies to be critically important in universal school interventions (Durlak, <span>2016</span>), and the CSC study has provided no data on either the quality of implementation or how i","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 4","pages":"400-401"},"PeriodicalIF":5.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acamh.onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incorporation of artificial intelligence (AI) and machine learning (ML) into medicine has enhanced clinical information processing. ChatGPT, an AI language model, has demonstrated proficiency in generating human-like responses to complex medical queries. This study explores ChatGPT's potential to instruct parents on behavioral parent training (BPT) for managing attention-deficit hyperactivity disorder (ADHD) in children.
Methods
ChatGPT was prompted with three parent-focused questions regarding BPT for ADHD. An ADHD-specialized psychiatrist reviewed the model's responses to assess clarity, accuracy, and clinical relevance.
Results
ChatGPT provided responses that were easy to understand and included actionable behavioral strategies. The answers referenced professional literature; however, some references were outdated. Limitations were noted in the specificity and depth of the information provided.
Conclusion
AI tools like ChatGPT show promise as supplementary resources in patient education and caregiver support. While helpful, current limitations—particularly in depth and reference accuracy—indicate a need for refinement to maximize their effectiveness in clinical communication and patient management contexts.
{"title":"Short Research Article: Evaluation of an artificial intelligence language model in psychiatric patient education","authors":"Aditya Sathe, Harish Chikanna","doi":"10.1111/camh.70000","DOIUrl":"10.1111/camh.70000","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The incorporation of artificial intelligence (AI) and machine learning (ML) into medicine has enhanced clinical information processing. ChatGPT, an AI language model, has demonstrated proficiency in generating human-like responses to complex medical queries. This study explores ChatGPT's potential to instruct parents on behavioral parent training (BPT) for managing attention-deficit hyperactivity disorder (ADHD) in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ChatGPT was prompted with three parent-focused questions regarding BPT for ADHD. An ADHD-specialized psychiatrist reviewed the model's responses to assess clarity, accuracy, and clinical relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ChatGPT provided responses that were easy to understand and included actionable behavioral strategies. The answers referenced professional literature; however, some references were outdated. Limitations were noted in the specificity and depth of the information provided.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI tools like ChatGPT show promise as supplementary resources in patient education and caregiver support. While helpful, current limitations—particularly in depth and reference accuracy—indicate a need for refinement to maximize their effectiveness in clinical communication and patient management contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 3","pages":"265-271"},"PeriodicalIF":5.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This Letter provides commentary on the recent study by Brieant and Burt (Child and Adolescent Mental Health, 30(2), 140–148), which explored the protective role of community cohesion in mitigating mental health problems among youth facing socioeconomic disadvantage across rural and urban contexts.
Commentary
While commending the authors for their valuable contribution, I highlight methodological concerns regarding the rural subgroup's limited sample size, suggesting that marginal significance in rural contexts should be interpreted cautiously. I also discuss the possibility that protective effects on internalizing symptoms may emerge later in adolescence.
Implications
Recommendations are provided for future research to incorporate more nuanced, context-sensitive measures of adversity relevant to rural settings. Finally, I emphasize the need for scalable and culturally informed community interventions and call for increased representation of rural populations in resilience research.
{"title":"Letter to the Editor: Does community cohesion matter everywhere? Further reflections on Brieant and Burt's rural–urban findings","authors":"Xuehao Huang","doi":"10.1111/camh.70005","DOIUrl":"10.1111/camh.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This Letter provides commentary on the recent study by Brieant and Burt (Child and Adolescent Mental Health, 30(2), 140–148), which explored the protective role of community cohesion in mitigating mental health problems among youth facing socioeconomic disadvantage across rural and urban contexts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Commentary</h3>\u0000 \u0000 <p>While commending the authors for their valuable contribution, I highlight methodological concerns regarding the rural subgroup's limited sample size, suggesting that marginal significance in rural contexts should be interpreted cautiously. I also discuss the possibility that protective effects on internalizing symptoms may emerge later in adolescence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Recommendations are provided for future research to incorporate more nuanced, context-sensitive measures of adversity relevant to rural settings. Finally, I emphasize the need for scalable and culturally informed community interventions and call for increased representation of rural populations in resilience research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"87-88"},"PeriodicalIF":5.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexa X.D. Zhang, Olga Osokina, Sanju Silwal, Norbert Skokauskas, Andre Sourander, Matthew Hodes
Given the high level of exposure of children and adolescents (CA) to war and associated adversities (1 in 6 children live in war zones at the time of writing) and very detrimental effects on their mental health, we argue for the need to involve them in mental health research. Although there is abundant literature on CA mental health research in nonwar and postwar settings, the findings cannot be directly extrapolated to war contexts. Viewing CA as too vulnerable, as well as ethical and methodological challenges are among the reasons for the low level of research on this topic. Drawing on the available literature and our experience conducting epidemiological studies on the impact of the war following the Russian invasion of Ukraine, we highlight the complexity and importance of conducting CA mental health research during wars and the key ethical and methodological considerations. We advocate the active inclusion of CA as research participants and beneficiaries as a first step to building an evidence base for treatment and services.
{"title":"Editorial Perspective: Prioritizing child and adolescent mental health research in the context of war","authors":"Alexa X.D. Zhang, Olga Osokina, Sanju Silwal, Norbert Skokauskas, Andre Sourander, Matthew Hodes","doi":"10.1111/camh.70002","DOIUrl":"10.1111/camh.70002","url":null,"abstract":"<p>Given the high level of exposure of children and adolescents (CA) to war and associated adversities (1 in 6 children live in war zones at the time of writing) and very detrimental effects on their mental health, we argue for the need to involve them in mental health research. Although there is abundant literature on CA mental health research in nonwar and postwar settings, the findings cannot be directly extrapolated to war contexts. Viewing CA as too vulnerable, as well as ethical and methodological challenges are among the reasons for the low level of research on this topic. Drawing on the available literature and our experience conducting epidemiological studies on the impact of the war following the Russian invasion of Ukraine, we highlight the complexity and importance of conducting CA mental health research during wars and the key ethical and methodological considerations. We advocate the active inclusion of CA as research participants and beneficiaries as a first step to building an evidence base for treatment and services.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 3","pages":"275-277"},"PeriodicalIF":5.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acamh.onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Francis Hunt, Gemma R. Morshead, Rachel Hayes, Siobhan Mitchell, Beth Chapman, Carl Dutton, Anna Adlam, Catriona Mellor
Background
Engaging children and young people (CYP) with natural environments while in healthcare can offer significant therapeutic benefits. Despite evidence supporting nature-based interventions, their use in CYP healthcare settings remains inconsistent. This article outlines how to integrate an eco-biopsychosocial model in healthcare, combining ecological aspects with traditional biopsychosocial frameworks to improve health outcomes, placing CYP within their social and ecological contexts, and promoting holistic, person-centred care.
Methods
Through a series of meetings, clinicians and practitioners involved in nature-based approaches (NBAs) projects in the UK shared their expertise. They reflected on their experiences and identified patterns in the learning related to implementing these activities and embedding them into practice. The projects included: (1) Oxford Health NHS Foundation Trust. (2) Cornwall Partnership NHS Foundation Trust. (3) Alder Hey Children's NHS Foundation Trust.
Results
We discuss the importance of NBAs within national healthcare frameworks and provide successful examples from Oxford Health NHS Foundation Trust, Cornwall Partnership NHS Foundation Trust and Alder Hey Children's NHS Foundation Trust. These case studies highlight the potential for a positive impact on wellbeing, resilience and staff satisfaction. Key strategies for implementing the model include relational, procedural, and environmental factors for creating a culture of nature-based practice.
Conclusions
This innovation in practice article emphasises the need for governance, evaluation and dissemination to ensure the sustainability of these initiatives. By adopting this integrative approach, we aim to reduce health inequalities and promote a shift towards a nature-inclusive strategy in healthcare, which promotes the long-term wellbeing of CYP as well as supports more sustainable services.
{"title":"Innovations in Practice: Beyond the clinic – embracing natural environments in mental health care for children and young people","authors":"David Francis Hunt, Gemma R. Morshead, Rachel Hayes, Siobhan Mitchell, Beth Chapman, Carl Dutton, Anna Adlam, Catriona Mellor","doi":"10.1111/camh.12768","DOIUrl":"10.1111/camh.12768","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Engaging children and young people (CYP) with natural environments while in healthcare can offer significant therapeutic benefits. Despite evidence supporting nature-based interventions, their use in CYP healthcare settings remains inconsistent. This article outlines how to integrate an eco-biopsychosocial model in healthcare, combining ecological aspects with traditional biopsychosocial frameworks to improve health outcomes, placing CYP within their social and ecological contexts, and promoting holistic, person-centred care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Through a series of meetings, clinicians and practitioners involved in nature-based approaches (NBAs) projects in the UK shared their expertise. They reflected on their experiences and identified patterns in the learning related to implementing these activities and embedding them into practice. The projects included: (1) Oxford Health NHS Foundation Trust. (2) Cornwall Partnership NHS Foundation Trust. (3) Alder Hey Children's NHS Foundation Trust.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We discuss the importance of NBAs within national healthcare frameworks and provide successful examples from Oxford Health NHS Foundation Trust, Cornwall Partnership NHS Foundation Trust and Alder Hey Children's NHS Foundation Trust. These case studies highlight the potential for a positive impact on wellbeing, resilience and staff satisfaction. Key strategies for implementing the model include relational, procedural, and environmental factors for creating a culture of nature-based practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This innovation in practice article emphasises the need for governance, evaluation and dissemination to ensure the sustainability of these initiatives. By adopting this integrative approach, we aim to reduce health inequalities and promote a shift towards a nature-inclusive strategy in healthcare, which promotes the long-term wellbeing of CYP as well as supports more sustainable services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 4","pages":"422-429"},"PeriodicalIF":5.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acamh.onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorea Mar-Barrutia, Igor Larrañaga, Juan Pablo Chart-Pascual, Iñaki Zorrilla, Daniel Abejas-Diez, Alba Gomez-Prieto, Javier Mar, Ana Gonzalez-Pinto
Background
The objective of this study was to estimate separately the excess risk associated with household income and head of household employment status (as an index of family adversity) as socioeconomic risk factors for the incidence of bipolar disorder in children, adolescents, and young adults.
Methods
A real-world data design was applied to identify bipolar disorder in individuals under 30 years of age in the Basque population. Using pharmaceutical copayment categories, we calculated sex-adjusted incidence rates disaggregated by two socioeconomic variables (a) household income and (b) head of household's employment status (as an index of family adversity). The Aalen-Johansen estimator and Poisson-negative binomial regression analyses were used to measure age and sex-adjusted incidence rate ratios (IRR) for household income and head of household's employment status.
Results
The study population comprised 609,281 individuals aged between 1 and 30 years. Of these individuals, 698 (0.11%) had a diagnosis of bipolar disorder. The total cumulative incidence per 1000 person-years was 0.4 at 12 years, 0.9 at 18 years, 2.0 at 24 years, and 3.4 at 30 years. A higher risk of bipolar disorder was associated with being male, living in families classified as having ‘no income’ (compared with those with high income) and living in families where the heads of the households were not working. Household income and head of household's working status showed an independent and consistent gradient, with intermediate categories such as medium income and head of household having retired from work being associated with intermediate risks (IRR = 1.32 and IRR = 2.52, respectively). All IRRs were statistically significant.
Conclusions
Household income and working status of the head of household (an index of family adversity) are independent factors associated with the risk of bipolar disorder. Clinicians should consider the possibility of family adversity when working with patients with bipolar disorder.
{"title":"Short Research Article: Independent association between household income and family adversity and bipolar disorder in adolescence and young adulthood – a registry-data study in the Basque Country","authors":"Lorea Mar-Barrutia, Igor Larrañaga, Juan Pablo Chart-Pascual, Iñaki Zorrilla, Daniel Abejas-Diez, Alba Gomez-Prieto, Javier Mar, Ana Gonzalez-Pinto","doi":"10.1111/camh.12780","DOIUrl":"10.1111/camh.12780","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study was to estimate separately the excess risk associated with household income and head of household employment status (as an index of family adversity) as socioeconomic risk factors for the incidence of bipolar disorder in children, adolescents, and young adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A real-world data design was applied to identify bipolar disorder in individuals under 30 years of age in the Basque population. Using pharmaceutical copayment categories, we calculated sex-adjusted incidence rates disaggregated by two socioeconomic variables (a) household income and (b) head of household's employment status (as an index of family adversity). The Aalen-Johansen estimator and Poisson-negative binomial regression analyses were used to measure age and sex-adjusted incidence rate ratios (IRR) for household income and head of household's employment status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population comprised 609,281 individuals aged between 1 and 30 years. Of these individuals, 698 (0.11%) had a diagnosis of bipolar disorder. The total cumulative incidence per 1000 person-years was 0.4 at 12 years, 0.9 at 18 years, 2.0 at 24 years, and 3.4 at 30 years. A higher risk of bipolar disorder was associated with being male, living in families classified as having ‘no income’ (compared with those with high income) and living in families where the heads of the households were not working. Household income and head of household's working status showed an independent and consistent gradient, with intermediate categories such as medium income and head of household having retired from work being associated with intermediate risks (IRR = 1.32 and IRR = 2.52, respectively). All IRRs were statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Household income and working status of the head of household (an index of family adversity) are independent factors associated with the risk of bipolar disorder. Clinicians should consider the possibility of family adversity when working with patients with bipolar disorder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 4","pages":"392-396"},"PeriodicalIF":5.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Eleni Vrigkou</p><p>One of the key developmental tasks in early childhood is to adapt to the social environment of preschool. The social and communication challenges of autistic children can make this process more demanding compared to typically developing (TD) children. Empirical data, mainly from TD children, suggest that the social skills they acquire through parent–child interactions can be associated with their ability to form adequate social abilities in preschool, but a question remains of whether the same could apply to autistic children as well.</p><p>Oppenheim et al. (2025) conducted a study in autistic preschooler boys to assess the boy's engagement in dyadic (mother–child and father-child) and triadic (mother–father-child) interactions and its association with their social skills in preschool, while controlling for the severity of their autism symptomatology and their IQ. A particular focus was added on the importance of triadic interactions over and above their dyadic ones. The study was conducted in 2 time-points (T1 and T2), 12 months apart. Seventy-five boys, 29–68 months old, and their parents participated in T1 time-point and 68 in T2. T1 included 4 laboratory and preschool visits, where dyadic and triadic interactions observations, autism and cognitive functioning assessments, and social skills assessments were conducted. T2 included only one preschool observation visit for social skills evaluations. The boys' behavior in the dyadic interactions was assessed using the Child Responsiveness to Child Involvement with Parent scales in free and social play. Triadic interactions were observed in the Lausanne Triadic Play procedure. Their social skills were assessed using the Social Skills Q-sort (SSQ) completed by teachers and observers and the Social Responsiveness Scale (SRS) completed by teachers.</p><p>The authors found that the boys' dyadic engagement predicted the observers' SSQ in T1 and T2, and the teachers SRS in T1. Their triadic engagement did not explain additional variance in any social skill measure in T1 but accounted for additional variance in all social skills measures in T2. Their findings suggest that dyadic engagements are important for the boys' social skills in preschool, and that triadic engagements seem to be particularly significant, above and beyond dyadic contexts, especially over time. The contributions of the dyadic and triadic engagements were not different for children with different levels of social abilities at T1.</p><p>The authors identified two strengths of the study: the longitudinal design that allowed the assessment of the boys' social abilities over time and the fact that all children were in the autism group. Study limitations were also identified, including the small added variance of the triadic engagements over the dyadic ones in some cases, the fact that possible mechanisms that connect children's family interactions with their interactions in social environments beyond the family were
{"title":"Clinical research updates","authors":"Marinos Kyriakopoulos, Eleni Vrigkou, Markos Kallinikos, Zinovia Maridaki","doi":"10.1111/camh.12769","DOIUrl":"10.1111/camh.12769","url":null,"abstract":"<p>Eleni Vrigkou</p><p>One of the key developmental tasks in early childhood is to adapt to the social environment of preschool. The social and communication challenges of autistic children can make this process more demanding compared to typically developing (TD) children. Empirical data, mainly from TD children, suggest that the social skills they acquire through parent–child interactions can be associated with their ability to form adequate social abilities in preschool, but a question remains of whether the same could apply to autistic children as well.</p><p>Oppenheim et al. (2025) conducted a study in autistic preschooler boys to assess the boy's engagement in dyadic (mother–child and father-child) and triadic (mother–father-child) interactions and its association with their social skills in preschool, while controlling for the severity of their autism symptomatology and their IQ. A particular focus was added on the importance of triadic interactions over and above their dyadic ones. The study was conducted in 2 time-points (T1 and T2), 12 months apart. Seventy-five boys, 29–68 months old, and their parents participated in T1 time-point and 68 in T2. T1 included 4 laboratory and preschool visits, where dyadic and triadic interactions observations, autism and cognitive functioning assessments, and social skills assessments were conducted. T2 included only one preschool observation visit for social skills evaluations. The boys' behavior in the dyadic interactions was assessed using the Child Responsiveness to Child Involvement with Parent scales in free and social play. Triadic interactions were observed in the Lausanne Triadic Play procedure. Their social skills were assessed using the Social Skills Q-sort (SSQ) completed by teachers and observers and the Social Responsiveness Scale (SRS) completed by teachers.</p><p>The authors found that the boys' dyadic engagement predicted the observers' SSQ in T1 and T2, and the teachers SRS in T1. Their triadic engagement did not explain additional variance in any social skill measure in T1 but accounted for additional variance in all social skills measures in T2. Their findings suggest that dyadic engagements are important for the boys' social skills in preschool, and that triadic engagements seem to be particularly significant, above and beyond dyadic contexts, especially over time. The contributions of the dyadic and triadic engagements were not different for children with different levels of social abilities at T1.</p><p>The authors identified two strengths of the study: the longitudinal design that allowed the assessment of the boys' social abilities over time and the fact that all children were in the autism group. Study limitations were also identified, including the small added variance of the triadic engagements over the dyadic ones in some cases, the fact that possible mechanisms that connect children's family interactions with their interactions in social environments beyond the family were ","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 2","pages":"202-204"},"PeriodicalIF":5.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12769","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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