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Narrative Matters: Adolescence in The Manosphere – A perfect storm? 叙事至关重要:庄园里的青春期——一场完美风暴?
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-07-14 DOI: 10.1111/camh.70012
Jane Gilmour

The Netflix drama ‘Adolescence’ brought ‘the manosphere’ (a virtual space defined by misogynist views) and its potential dangers for teenage boys into the mainstream narrative. This paper describes parallels between toxic masculinity communities and other extremist groups. It considers why so many teenage boys may be attracted to the manosphere and why a developmental context is crucial to an informed response. The unique characteristics of ‘the teenage brain’ offer a framework to guide professionals working with young people who are exploring this type of content.

Netflix的电视剧《青春期》(Adolescence)将“管理空间”(一个由厌恶女性的观点定义的虚拟空间)及其对十几岁男孩的潜在危险带入了主流叙事。这篇论文描述了有毒男子气概社区和其他极端主义团体之间的相似之处。它考虑了为什么这么多十几岁的男孩可能会被庄园所吸引,以及为什么发展背景对明智的反应至关重要。“青少年大脑”的独特特征提供了一个框架,指导专业人员与正在探索这类内容的年轻人一起工作。
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引用次数: 0
Debate: Are we over-pathologizing young people's mental health? The inflationary risk of autism diagnosis 辩论:我们是否把年轻人的心理健康过度病态化了?自闭症诊断的膨胀风险。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-07-11 DOI: 10.1111/camh.70013
Michele Poletti, Antonio Preti, Andrea Raballo

The concept of autism has undergone a significant transformation in recent decades, evolving from a narrowly defined, rare disorder into a broad and heterogeneous spectrum. This diagnostic expansion, while intended to improve recognition of diverse presentations, has led to a marked increase in prevalence and a dilution of autism's neurobiological distinctiveness. Two emerging trends may further contribute to this phenomenon: the rise in adult diagnoses without documented childhood traits, and the growing attribution of transdiagnostic social difficulties to subthreshold autistic traits. These trends risk conflating autism with general social dysfunction and undermining the validity of related clinical constructs. The diagnostic inflation of ASD may reflect a problematic overextension of criteria, compounded by the use of unstructured assessments and amplified by the growing influence of neurodiversity discourse. Moreover, it is facilitated by the absence of definitive neurobiological markers and remains at odds with autism's characterization as a neurodevelopmental condition with strong genetic roots. Whether this expansive reconceptualization constitutes progress or regression warrants deeper scientific debate.

近几十年来,自闭症的概念经历了重大转变,从一个狭义的、罕见的疾病演变成一个广泛的、多样化的谱系。这种诊断的扩展,虽然旨在提高对不同表现的识别,但却导致了自闭症患病率的显著增加,并淡化了自闭症的神经生物学独特性。两种新趋势可能会进一步促成这一现象:成人诊断中没有记录的儿童特征的增加,以及越来越多的跨诊断社会困难归因于亚阈值自闭症特征。这些趋势有可能将自闭症与一般社会功能障碍混为一谈,并破坏相关临床结构的有效性。ASD的诊断膨胀可能反映了标准过度扩展的问题,非结构化评估的使用加剧了这一问题,神经多样性话语的影响日益扩大了这一问题。此外,由于缺乏明确的神经生物学标记物,它与自闭症作为一种具有强烈遗传根源的神经发育状况的特征仍然不一致。这种广泛的重新概念化是否构成进步或倒退,需要进行更深入的科学辩论。
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引用次数: 0
Clinical research updates 临床研究更新。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-07-11 DOI: 10.1111/camh.70014
Marinos Kyriakopoulos, Maria Papadaki, Aikaterini Zeza, Niki-Stavroula Panagiotopoulou
<p>Maria Papadaki</p><p>Understanding why some children exposed to adverse childhood experiences (ACEs) develop mental health difficulties while others remain resilient is important for designing effective preventive strategies. It has been suggested that the presence of a warm and supportive adult may protect against mental health difficulties in such cases by moderating the negative effects of early adversity. However, it remains unclear whether such an association is causal or whether it may be accounted for by genetic or environmental factors.</p><p>Stock et al. (2025) investigated this question using data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a representative UK-based birth cohort of 2232 same-sex twins. ACEs were assessed prospectively covering the period from age 5 to age 12 years. Maternal warmth was evaluated at two timepoints, at ages 5 and 10 years, using structured speech samples from mothers. Adult support in children's lives was gathered through self-reports at age 12. Mental health outcomes were assessed at age 12 through interviews with parents and teachers and at 18 years through self-reports from the participants using p-factor as a standardized index.</p><p>Initial phenotypic analyses revealed that, among children exposed to ACEs, those who experienced greater maternal warmth and adult support had lower levels of emotional and behavioral problems in early adolescence, as well as lower p-factor scores at 18 years. However, when a monozygotic twin-difference analysis was applied, the strength of these associations was significantly reduced: by about 70% for maternal warmth and 81% for adult support. In twin pairs equally exposed to ACEs, the twin who experienced more maternal warmth and support from adults tended to have similar mental health outcomes to their co-twin.</p><p>The authors identified some limitations to their investigation, including the measurement of adult support through children's self-report, which may be affected by genetically influenced perception bias, the use of difference scores in the twin differences design, which may induce error in the measurement of protective factors, and the possible non-generalisability to singletons.</p><p>Nevertheless, this study suggests that the observed effects of the support by a warm and supportive adult in children experiencing ACEs are largely due to genetic and environmental confounding rather than independent causal effects, which highlights the need for multifaceted interventions. Efforts to improve children's mental health after adversity should not focus exclusively on strengthening adult–child relationships but should also address broader family risk factors and inherited vulnerabilities.</p><p>Stock, S.E., Lacey, R.E., Arseneault, L., Caspi, A., Crush, E., Danese, A., & Baldwin, J.R. (2025). Can a warm and supportive adult protect against mental health problems amongst children with experience of adversity? A twin-differences study. <i>J
这些结果支持在儿科护理机构进行更广泛的常规自杀风险筛查的呼吁,这可能会允许及时干预。作者发现了一些局限性,包括样本主要是白人,研究没有评估自杀企图,以及筛查的最高频率是每周一次。此外,由于没有对照组,因此不可能评估筛查是否降低或增加了自杀念头的风险。尽管如此,在低风险儿童中新的自杀意念率很低,在高风险参与者中没有升级,这强烈表明了安全性和潜在的益处。这项研究增加了大量证据,表明自杀风险筛查在青春期前是安全的,即使在很长一段时间内定期进行。研究结果支持扩大筛查项目和开发监测青少年心理健康的数字工具,特别是对那些可能从早期和持续关注中受益的高风险儿童。Hennefield, L., Luking, k.r., Tillman, R., Barch, d.m., Luby, j.l., Thompson, R.J.(2025)。询问有关自杀的问题与增加自杀念头无关。美国儿童与青少年精神病学学会杂志:S0890-8567(25)00178-9。doi: 10.1016 / j.jaac.2025.03.025。抗精神病药物被广泛使用,包括在怀孕期间,这引起了对后代潜在长期影响的担忧。虽然这些药物不被认为是致畸的,但它们对儿童神经发育的影响仍不确定。这一领域的研究受到限制,因为缺乏涉及孕妇的临床试验,而且很难将药物的影响与母亲精神疾病的影响和其他混杂因素区分开来。Kaplan等人(2025)进行了一项系统综述,以评估产前暴露于抗精神病药物(AP)是否与儿童不良的神经发育结局有关。他们确定了16项研究,6项队列研究和10项基于登记册的研究,发表到2024年9月。这些研究检查了运动、认知、行为、精神和学术方面的结果。研究质量采用纽卡斯尔-渥太华量表进行评估,平均得分为7.1分(满分9分)。回顾发现,在调整了关键的混杂因素后,大多数研究没有报告暴露于ap和未暴露于ap的儿童之间的显著神经发育差异。大量基于人群的研究显示,ADHD、自闭症谱系障碍或其他神经发育障碍的风险没有增加。小规模的队列研究同样发现与认知或心理结果没有关联。早期运动或行为迟缓在短期随访期的研究中更常见,但这些影响在长期研究中并不持续。这表明这种早期缺陷可能是短暂的,可能与新生儿戒断或出生时停止接触AP后的暂时性神经发育影响有关。然而,母亲精神疾病对结果的影响仍然是一个关键的限制,特别是在缺乏适当对照组的研究中。解释这些发现需要仔细考虑混杂变量。患有严重精神疾病的母亲所生的孩子在发育方面面临的风险已经增加,这些风险可能与接触AP导致的结果重叠。包括精神病控制组在内的研究往往只报告了婴儿时期短暂的运动迟缓,在学习成绩或神经发育方面没有长期差异。其他混杂因素,如吸烟、药物使用、社会经济地位和母亲教育,在研究中没有得到一致的解决。在一些情况下,未调整分析中存在的关联在完全统计调整后消失。重要的是,对产妇精神疾病的药物治疗也可能提供保护作用。一项研究发现,母亲在怀孕期间继续接受AP治疗的孩子患ADHD的风险比停止治疗的孩子低。虽然关于抗精神病药物保护作用的研究有限,但抗抑郁药物研究的类似发现表明,有效的产妇治疗可能减轻发育风险。这突出了在评估妊娠期应用ap时,考虑潜在危害(包括代谢综合征和妊娠糖尿病)和对母亲和孩子的潜在益处的重要性。临床决策应个体化,并基于共同的风险-收益讨论。Kaplan CA, Poels EMP, van den Heuvel MI, Bijma HH, Bergink V, Rommel A-S, Robakis T,妊娠期抗精神病药物与儿童神经发育结局的系统评价,美国儿童学会杂志;青少年精神病学(2025),doi: 10.1016/j.j ajac .2025.04.008. m.k。是CAMH临床研究更新副主编。 编辑感谢本期《临床研究更新》的撰稿人。编辑已声明他没有竞争利益冲突或潜在利益冲突。这些更新不需要伦理批准。
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引用次数: 0
Commentary: Suggestions for guidance by academics who collaborate with digital companies – a commentary on Bourgaize et al. (2025) 评论:与数字公司合作的学者对指导的建议-对Bourgaize等人(2025)的评论。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-07-10 DOI: 10.1111/camh.70021
Natalia I. Kucirkova, Todd Cherner, Adam K. Dubé, Adrian Pasquarella, Nicola Pitchford, Helen Ross

Our collective article argues for the development of a clear, shared guidance to support responsible collaborations between academic researchers and digital technology companies, particularly in the fields of education and youth mental health. Drawing on longstanding experience in edtech research, we argue that effective academia–industry collaboration requires clearer institutional support, with explicit guidance at both the contractual and community engagement levels to ensure transparency, fair reporting and the inclusion of all stakeholders. We highlight the challenges researchers face, such as limited legal support and difficulties in publishing negative results, and the need for strong contractual safeguards that protect against the suppression of negative results, define data ownership and set transparent terms for data use, publication timelines and study termination. We also advocate for formalized data-sharing protocols and a centralized, anonymized data repository governed by shared principles, enabling more rigorous cross-study analyses and supporting funders, researchers and policymakers in making evidence-based decisions.

我们的集体文章主张制定一个明确的、共享的指导方针,以支持学术研究人员和数字技术公司之间负责任的合作,特别是在教育和青少年心理健康领域。根据教育技术研究的长期经验,我们认为,有效的学术与产业合作需要更明确的制度支持,在合同和社区参与层面都有明确的指导,以确保透明度、公平报告和所有利益相关者的参与。我们强调了研究人员面临的挑战,例如有限的法律支持和发表负面结果的困难,以及需要强有力的合同保障措施,以防止负面结果被压制,定义数据所有权,并为数据使用、发表时间表和研究终止设定透明的条款。我们还提倡形式化的数据共享协议和由共享原则管理的集中式匿名数据存储库,从而实现更严格的交叉研究分析,并支持资助者、研究人员和政策制定者做出基于证据的决策。
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引用次数: 0
Technology Matters: The ESSENCE of holistic neurodivergent identification in a digital age 技术问题:数字时代整体神经分化识别的本质。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-07-03 DOI: 10.1111/camh.70011
Guy Chadwick, Claire Davidson, Jason Lang, Sara Landberg, Stephen Koepplinger, Maryan Broadbent, Mike Fordham, Christopher Gillberg, Helen Minnis

There is growing recognition that neurodivergence encompasses overlapping and co-occurring neurodevelopmental traits rather than isolated diagnostic categories. However, clinical services often struggle to adopt holistic, needs-based assessments due to reliance on condition-specific pathways. This article introduces ESSENCE-D, a digital tool designed to support neurodevelopmental formulation by surveying traits across multiple neurotypes without a pre-defined diagnostic focus. ESSENCE-D generates visual profiles that help clinicians and families better understand an individual's strengths and needs, guiding multidisciplinary decision-making. Preliminary piloting suggests the tool is sensitive, user-friendly and could help streamline emerging holistic neurodevelopmental pathways. With ongoing clinical trials underway, ESSENCE-D represents a promising step towards aligning neurodevelopmental services with the principles of neurodiversity and improving care for neurodivergent individuals.

越来越多的人认识到,神经分化包括重叠和共同发生的神经发育特征,而不是孤立的诊断类别。然而,由于依赖于具体情况的途径,临床服务往往难以采用全面的、基于需求的评估。本文介绍了ESSENCE-D,这是一种数字工具,旨在通过调查多种神经类型的特征来支持神经发育公式,而无需预先定义诊断焦点。ESSENCE-D生成可视化档案,帮助临床医生和家庭更好地了解个人的优势和需求,指导多学科决策。初步试验表明,该工具是敏感的,用户友好的,可以帮助简化新兴的整体神经发育途径。随着正在进行的临床试验,ESSENCE-D代表了将神经发育服务与神经多样性原则结合起来并改善神经分化个体护理的有希望的一步。
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引用次数: 0
Technology matters: Co-developing & evaluating digital support for young people with depression and anxiety, MoodHwb. 技术问题:共同开发和评估对患有抑郁症和焦虑症的年轻人的数字支持,MoodHwb。
IF 6.8 3区 医学 Q1 PEDIATRICS Pub Date : 2025-07-02 DOI: 10.1111/camh.70004
Rhys Bevan Jones

Depression and anxiety are common in young people, yet many do not receive adequate support. Current guidelines recommend digital interventions as an effective approach; however, there is a need for more accessible, evidence-based programmes that are co-developed with young people and rigorously evaluated. The bilingual digital programme, MoodHwb, was co-designed with young people with depression and in collaboration with parents, carers, professionals and a digital media company. MoodHwb aims to support young people in managing their mood and well-being. An early evaluation study provided initial support for the programme theory and indicated its acceptability among users. The programme has since been refined based on feedback, and a feasibility randomised controlled trial has been completed.

抑郁和焦虑在年轻人中很常见,但许多人没有得到足够的支持。目前的指南建议将数字干预措施作为一种有效方法;然而,有必要与年轻人共同制定并进行严格评估的更容易获得的、基于证据的规划。这款名为MoodHwb的双语数字节目是与患有抑郁症的年轻人共同设计的,并与父母、护理人员、专业人士和一家数字媒体公司合作。MoodHwb旨在帮助年轻人管理自己的情绪和健康。一项早期评价研究为方案理论提供了初步支持,并表明用户可以接受方案理论。此后,该方案根据反馈进行了改进,并完成了可行性随机对照试验。
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引用次数: 0
Commentary: The wars within – uncomfortable truths about the bullying of girls in conflict-affected societies 评论:内心的战争——在受冲突影响的社会中,女孩遭受欺凌的令人不安的真相。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-07-02 DOI: 10.1111/camh.70006
Mina Fazel

This commentary reflects on a timely and methodologically significant study by Silwal et al., which investigates bullying victimization among adolescents in conflict-affected Eastern Ukraine. Conducted in a context of fragility, social fragmentation, and resource scarcity, the study offers vital insights into how war and its aftermath shape adolescent experiences. It reveals higher rates of bullying in conflict-affected regions, with girls disproportionately targeted—an uncomfortable finding that challenges conventional gender patterns in bullying. Drawing on emerging evidence, the commentary considers the role of desensitization, emotional regulation, and digital exposure in shaping youth aggression. It also highlights the need to address the structural stressors facing adolescents in both post-conflict and post-migration contexts, particularly within disrupted school systems. In response, the commentary calls for integrated and context-responsive interventions that strengthen emotional and social competencies without reinforcing stigma. It further urges researchers and policymakers to acknowledge the politicized nature of post-migration violence discourse and to maintain commitment to nuanced and context-sensitive analysis. The findings underscore that bullying in such settings is a social indicator of wider systemic pressures—an expression of the hidden wars adolescents carry in their daily lives and into their schools.

这篇评论反映了Silwal等人对受冲突影响的乌克兰东部青少年中欺凌受害者的及时和方法上的重要研究。该研究在脆弱性、社会分裂和资源稀缺的背景下进行,为战争及其后果如何影响青少年的经历提供了重要见解。报告显示,受冲突影响地区的欺凌率更高,以女孩为目标的比例过高——这一令人不安的发现挑战了欺凌中的传统性别模式。根据新出现的证据,该评论考虑了脱敏、情绪调节和数字暴露在塑造青少年攻击性方面的作用。报告还强调,需要解决冲突后和移徙后背景下青少年面临的结构性压力因素,特别是在学校系统中断的情况下。对此,评注呼吁采取综合的、因时制宜的干预措施,在不加重污名的情况下加强情感和社会能力。它还敦促研究人员和政策制定者承认移民后暴力言论的政治化性质,并继续致力于细致入微和对具体情况敏感的分析。研究结果强调,这种情况下的欺凌行为是更广泛的系统压力的社会指标,是青少年在日常生活和学校中隐藏的战争的一种表现。
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引用次数: 0
Review Article: The acceptability and effectiveness of standardised diagnostic assessment approaches in children and young people's mental health services – an updated systematic review 综述文章:标准化诊断评估方法在儿童和青少年心理健康服务中的可接受性和有效性——一项更新的系统综述。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-06-27 DOI: 10.1111/camh.70007
Salah Basheer, Sue Fen Tan, Ranjitha David, Pallab Majumder, Kapil Sayal

Background

Standardised diagnostic assessment (SDA) tools are designed to comprehensively evaluate various mental health disorders and support accurate diagnoses. While evidence for their routine use in child and adolescent mental health services (CAMHS) remains limited, increasing service demands underscore the need for efficient clinical assessments. This updated review examines the acceptability and clinical utility of SDA tools in CAMHS.

Method

A systematic review of 464 studies published between January 2013 and February 2025 was conducted (PROSPERO: CRD42024494051). Ten studies met the inclusion criteria, comprising eight cross-sectional studies and two randomised controlled trials.

Results

SDA tools reviewed included Development and Wellbeing Assessment (DAWBA), Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS). DAWBA improved referral decision accuracy, while both DAWBA and MINI-KID had acceptable agreements with expert consensus diagnoses. MINI-KID and KSADS were able to identify more cases than routine clinical assessments. However, DAWBA did not show effectiveness in changing diagnostic practice. Clinicians were favourable of SDA tools' psychometric properties but less favourable of diagnostic labels and feasibility in practice. Psychiatrists and psychologists were more likely than other healthcare professionals to use these tools in practice.

Conclusions

This review highlights that while SDA tools may aid referral decisions, evidence supporting their overall effectiveness in CAMHS is lacking. Clinician concerns pose barriers to routine use, requiring further research before implementation.

背景:标准化诊断评估(SDA)工具旨在全面评估各种精神健康障碍并支持准确诊断。虽然在儿童和青少年心理健康服务(CAMHS)中常规使用它们的证据仍然有限,但不断增加的服务需求强调了有效临床评估的必要性。这篇最新的综述探讨了SDA工具在CAMHS中的可接受性和临床应用。方法:对2013年1月至2025年2月间发表的464项研究进行系统回顾(PROSPERO: CRD42024494051)。10项研究符合纳入标准,包括8项横断面研究和2项随机对照试验。结果:SDA工具包括发展和健康评估(DAWBA)、迷你国际儿童和青少年神经精神病学访谈(MINI-KID)和儿童情感障碍和精神分裂症时间表(KSADS)。DAWBA提高了转诊决策的准确性,而DAWBA和MINI-KID均与专家共识诊断有可接受的一致性。MINI-KID和KSADS能够识别比常规临床评估更多的病例。然而,DAWBA在改变诊断实践方面没有显示出有效性。临床医生赞成SDA工具的心理测量特性,但不赞成诊断标签和实践中的可行性。精神病学家和心理学家在实践中比其他医疗保健专业人员更有可能使用这些工具。结论:本综述强调,虽然SDA工具可能有助于转诊决策,但缺乏证据支持其在CAMHS中的整体有效性。临床医生的担忧对常规使用构成了障碍,在实施前需要进一步研究。
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引用次数: 0
Letter to the Editor: What are the hidden challenges in implementing Social Stories™ for autistic children? 给编辑的信:在为自闭症儿童实施社会故事™的过程中,隐藏的挑战是什么?
IF 6.8 3区 医学 Q1 PEDIATRICS Pub Date : 2025-06-27 DOI: 10.1111/camh.70010
Cai Ai Lai, Yanfang Huang, Guangliang Luo
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引用次数: 0
Technology Matters: A model for translating digital and data science innovations into Child and Adolescent Mental Health Services 技术问题:将数字和数据科学创新转化为儿童和青少年心理健康服务的模型。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-06-26 DOI: 10.1111/camh.70003
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.

随着数字心理健康研究和技术的不断发展,需要一种系统的方法来快速安全地将数字创新转化为儿童和青少年心理健康服务。在这里,我们提供了CAMHS数字实验室的概述,这是一项位于英国伦敦的服务,它整合了运营,临床和研究专业知识,以支持数字发现并将研究转化为实践。该服务分为四个工作流程:人口和临床分析;数据科学与发现;数字治疗和评估;教育、外联和培训。这项服务为将数字创新融入精神卫生服务提供了一种模式,可在其他地方采用。
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引用次数: 0
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Child and Adolescent Mental Health
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