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Innovations in Practice: Beyond the clinic – embracing natural environments in mental health care for children and young people 实践中的创新:超越诊所-在儿童和青少年的精神卫生保健中拥抱自然环境。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-06-04 DOI: 10.1111/camh.12768
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.

背景:在医疗保健中,让儿童和青少年(CYP)与自然环境接触可以提供显着的治疗益处。尽管有证据支持基于自然的干预措施,但它们在CYP医疗机构中的使用仍然不一致。本文概述了如何将生态-生物-心理-社会模型整合到医疗保健中,将生态方面与传统的生物-心理-社会框架相结合,以改善健康结果,将CYP置于其社会和生态环境中,并促进整体的、以人为本的护理。方法:通过一系列的会议,临床医生和从业人员参与自然为基础的方法(NBAs)项目在英国分享他们的专业知识。他们反思了自己的经验,并确定了与实施这些活动和将其纳入实践有关的学习模式。项目包括:(1)牛津健康NHS基金会信托。(2)康沃尔合作伙伴NHS基金会信托。(3) Alder Hey儿童NHS基金会信托基金。结果:我们讨论了NBAs在国家医疗保健框架中的重要性,并提供了牛津健康NHS基金会信托基金、康沃尔合作伙伴NHS基金会信托基金和Alder Hey儿童NHS基金会信托基金的成功案例。这些案例研究强调了对幸福感、适应力和员工满意度产生积极影响的潜力。实现该模型的关键策略包括关系、程序和环境因素,以创建基于自然的实践文化。结论:这篇实践中的创新文章强调了治理、评估和传播的必要性,以确保这些倡议的可持续性。通过采用这种综合方法,我们的目标是减少保健不平等现象,促进向保健领域的自然包容战略转变,从而促进土著居民的长期福祉,并支持更可持续的服务。
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引用次数: 0
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 短研究文章:家庭收入和家庭逆境与青少年和青年期双相情感障碍之间的独立关联——巴斯克地区的一项登记数据研究。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-06-02 DOI: 10.1111/camh.12780
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.

背景:本研究的目的是分别估计与家庭收入和户主就业状况(作为家庭逆境的指标)相关的额外风险,作为儿童、青少年和年轻人双相情感障碍发病率的社会经济风险因素。方法:采用真实世界的数据设计来识别巴斯克人群中30岁以下个体的双相情感障碍。使用药物共同支付类别,我们计算了按两个社会经济变量(a)家庭收入和(b)户主就业状况(作为家庭逆境指数)分类的性别调整发病率。采用aallen - johansen估计量和poisson负二项回归分析来测量家庭收入和户主就业状况的年龄和性别调整发生率比(IRR)。结果:研究人群包括609,281名年龄在1至30岁之间的个体。在这些个体中,698(0.11%)被诊断为双相情感障碍。每1000人年的总累积发病率在12岁时为0.4,18岁时为0.9,24岁时为2.0,30岁时为3.4。男性、生活在“无收入”家庭(与高收入家庭相比)以及生活在户主不工作的家庭中,患双相情感障碍的风险更高。家庭收入和户主工作状态呈现独立一致的梯度,中等收入和户主已退休等中间类别与中间风险相关(IRR分别为1.32和2.52)。所有irr均有统计学意义。结论:家庭收入和户主的工作状况(家庭逆境指标)是与双相情感障碍风险相关的独立因素。临床医生在治疗双相情感障碍患者时应考虑家庭逆境的可能性。
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引用次数: 0
Clinical research updates 临床研究进展
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-15 DOI: 10.1111/camh.12769
Marinos Kyriakopoulos, Eleni Vrigkou, Markos Kallinikos, Zinovia Maridaki
<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
该NMA强调,在中度证据的儿童和青少年BD-I急性治疗阶段,SGAs可能比MSs更有效,但与需要长期监测的显著副作用相关。维塔,克诺尔,V.B Ostuzzi, G。,Barbui, C,泰德,F。,豪雅,F.H。…,C.U.科雷尔(2025)。系统评价和网络荟萃分析:抗精神病药物与抗癫痫药物或锂治疗儿童和青少年急性躁狂的疗效和安全性。美国儿童与青少年精神病学学会杂志,64,143-157.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
Personality functioning in adolescents: exploring the links with childhood maltreatment types and internalizing and externalizing difficulties 青少年人格功能:探讨儿童虐待类型与内化和外化困难之间的联系。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-15 DOI: 10.1111/camh.12781
Elena Gaudiešiūtė, Gabrielė Skabeikytė-Norkienė, Rasa Barkauskienė

Background

The reconceptualization of the personality disorder model brought by the DSM-5 and ICD-11 introduced the level of personality functioning as the main criterion of PD, which encompasses a set of intrapsychic functions necessary for self-other understanding in interpersonal contexts. Research interest has been growing in examining the relationship between childhood traumatic experiences and personality functioning, predominantly with adult populations; however, there is a notable scarcity of studies exploring these associations in adolescents.

Aims

The aim of the present study was to analyze the association between different types of childhood maltreatment and personality functioning and to test internalizing and externalizing difficulties as potential mediators in this link.

Methods

A total of 1048 adolescents, aged 11–17, 65.7% of whom were females (855 from public schools, 193 clinically referred), completed a set of questionnaires measuring childhood maltreatment, level of personality functioning, and internalizing and externalizing difficulties. Mediation analysis was used to explore the potential mediating effects.

Results

Significant mediating effects of internalizing and externalizing problems were found in the relationship between different types of childhood maltreatment and personality functioning: emotional abuse (β1 = .269, CI1 0.226–0.312; β2 = .033, CI2 0.011–0.055), physical abuse (β1 = .165, CI1 0.123–0.206; β2 = .031, CI2 0.010–0.052), sexual abuse (β1 = .100, CI1 0.060–0.140; β2 = .018, CI2 0.006–0.030); emotional neglect (β1 = .324, CI1 0.280–0.368; β2 = .028, CI2 0.007–0.049), and physical neglect (β1 = .119, CI1 0.079–0.159; β2 = .020, CI2 0.007–0.032).

Conclusions

These findings have the potential to enrich the understanding of personality functioning impairments in adolescents in the context of childhood maltreatment and highlight the importance of focusing attention on the impact of emotional maltreatment.

背景:DSM-5和ICD-11对人格障碍模型的重新概念化引入了人格功能水平作为PD的主要标准,它包含了一组在人际环境中自我-他者理解所必需的心理内功能。研究兴趣一直在研究儿童创伤经历和人格功能之间的关系,主要是成年人;然而,在青少年中探索这些关联的研究明显缺乏。目的:本研究的目的是分析不同类型的儿童虐待与人格功能之间的关系,并测试内化和外化困难在这一联系中的潜在中介作用。方法:对1048名11-17岁青少年(其中女性占65.7%,公立学校855名,临床转诊193名)进行童年虐待、人格功能水平、内化和外化困难问卷调查。采用中介分析探讨潜在的中介效应。结果:内化和外化问题在不同类型儿童虐待与人格功能的关系中具有显著的中介作用:情绪虐待(β1 =;269, ci1 0.226-0.312;β2 =。033, CI2 0.011-0.055),身体虐待(β1 =。165, ci1 0.123-0.206;β2 =。031, CI2 0.010-0.052),性侵(β1 =。100, ci1 0.060-0.140;β2 =。018, ci2 0.006-0.030);情感忽视(β1 =。324, ci1 0.280-0.368;β2 =。0.28, CI2 0.007-0.049),身体忽视(β1 =。119, ci1 0.079-0.159;β2 =。[020];结论:这些发现有可能丰富对儿童虐待背景下青少年人格功能障碍的理解,并强调关注情绪虐待的影响的重要性。
{"title":"Personality functioning in adolescents: exploring the links with childhood maltreatment types and internalizing and externalizing difficulties","authors":"Elena Gaudiešiūtė,&nbsp;Gabrielė Skabeikytė-Norkienė,&nbsp;Rasa Barkauskienė","doi":"10.1111/camh.12781","DOIUrl":"10.1111/camh.12781","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The reconceptualization of the personality disorder model brought by the DSM-5 and ICD-11 introduced the level of personality functioning as the main criterion of PD, which encompasses a set of intrapsychic functions necessary for self-other understanding in interpersonal contexts. Research interest has been growing in examining the relationship between childhood traumatic experiences and personality functioning, predominantly with adult populations; however, there is a notable scarcity of studies exploring these associations in adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of the present study was to analyze the association between different types of childhood maltreatment and personality functioning and to test internalizing and externalizing difficulties as potential mediators in this link.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1048 adolescents, aged 11–17, 65.7% of whom were females (855 from public schools, 193 clinically referred), completed a set of questionnaires measuring childhood maltreatment, level of personality functioning, and internalizing and externalizing difficulties. Mediation analysis was used to explore the potential mediating effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant mediating effects of internalizing and externalizing problems were found in the relationship between different types of childhood maltreatment and personality functioning: emotional abuse (<i>β</i><sub>1</sub> = .269, CI<sub>1</sub> 0.226–0.312; <i>β</i><sub>2</sub> = .033, CI<sub>2</sub> 0.011–0.055), physical abuse (<i>β</i><sub>1</sub> = .165, CI<sub>1</sub> 0.123–0.206; <i>β</i><sub>2</sub> = .031, CI<sub>2</sub> 0.010–0.052), sexual abuse (<i>β</i><sub>1</sub> = .100, CI<sub>1</sub> 0.060–0.140; <i>β</i><sub>2</sub> = .018, CI<sub>2</sub> 0.006–0.030); emotional neglect (<i>β</i><sub>1</sub> = .324, CI<sub>1</sub> 0.280–0.368; <i>β</i><sub>2</sub> = .028, CI<sub>2</sub> 0.007–0.049), and physical neglect (<i>β</i><sub>1</sub> = .119, CI<sub>1</sub> 0.079–0.159; <i>β</i><sub>2</sub> = .020, CI<sub>2</sub> 0.007–0.032).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings have the potential to enrich the understanding of personality functioning impairments in adolescents in the context of childhood maltreatment and highlight the importance of focusing attention on the impact of emotional maltreatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 3","pages":"238-246"},"PeriodicalIF":5.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081478","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}
引用次数: 0
Debate: What guidance is needed by academics who collaborate with digital companies to improve youth mental health? 辩论:与数字公司合作以改善青少年心理健康的学者需要什么指导?
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-04-22 DOI: 10.1111/camh.12779
Jake Bourgaize, Jacob Andrews, Camilla Babbage, Marianne E. Etherson, Joanne Gregory, Chris Hollis, Kareem Khan, Sieun Lee, Joanna Lockwood, Josimar Mendes, Jen Martin, Emma Nielsen, Adam Parker, Ellen Townsend, A. Jess Williams, Rebecca Woodcock, Sonia Livingstone, the Digital Youth Research Programme

In a recent debate piece, Livingstone, Orben and Odgers (Child and Adolescent Mental Health, 2023, 28, 150) asked whether and when it is advisable for academics researching youth mental health to collaborate with digital companies. Such collaborations arise when researchers seek to identify risks and opportunities associated with youth digital engagement or to develop research-based interventions that leverage digital technologies to improve young people's mental health. However, young people's digital experiences, the associated data records and the prospects of testing interventions in situ are often under the control of digital providers and inaccessible to researchers. There is growing optimism that collaboration with companies may allow independent researchers access to proprietary resources along with opportunities to test and scale up beneficial digital interventions. Understandably, such optimism is tempered by scepticism about the processes, trust, and interests at stake during collaboration between researchers and companies. Given these often opposed positions, it is clear that professional guidance is required for academics so they understand the potential costs and benefits of choosing to enter into such collaborations and the terms on which this is advisable. This article highlights what information already exists for researchers and what guidance is needed to ensure that youth mental health researchers can successfully collaborate with digital companies.

在最近的一篇辩论文章中,Livingstone, Orben和Odgers(儿童和青少年心理健康,2023,28,150)询问研究青少年心理健康的学者是否以及何时与数字公司合作是可取的。当研究人员试图确定与青年数字参与相关的风险和机会,或开发基于研究的干预措施,利用数字技术改善年轻人的心理健康时,就会出现这种合作。然而,年轻人的数字体验、相关数据记录和现场测试干预措施的前景往往在数字提供商的控制之下,研究人员无法获得。越来越多的人乐观地认为,与公司的合作可能会让独立研究人员获得专有资源,并有机会测试和扩大有益的数字干预措施。可以理解的是,这种乐观情绪受到了对研究人员和公司之间合作过程、信任和利害关系的怀疑。鉴于这些经常对立的立场,很明显,需要对学者进行专业指导,以便他们了解选择进入这种合作的潜在成本和收益,以及这种合作的可取条件。这篇文章强调了研究人员已经存在的信息,以及需要哪些指导来确保青少年心理健康研究人员能够成功地与数字公司合作。
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引用次数: 0
Home Fae Home: A case study in co-designing trauma-informed community spaces with young people in Dundee, Scotland Home Fae Home:与苏格兰邓迪的年轻人共同设计创伤知情社区空间的案例研究
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-04-18 DOI: 10.1111/camh.12765
Charis Robertson, Gary Kennedy, Linsey McIntosh, Anne McKechnie

Background

Home Fae Home was an action research project, working with young people in Dundee, Scotland, to redesign the interior environment of a community-based youth work facility, through the lens of trauma-informed practice. Multi-disciplinary in nature, the project integrated the fields of psychology, architecture and spatial design with youth and community work.

Methods

Over 150 young people were engaged over 4 years in the co-design process through a range of creative workshops. As part of these workshops, a multi-methods approach to data collection was used, with semi-structured interviews and focus groups, as well as more creative and informal engagements.

Results

Spatially, the project has provided six new/additional diverse and adaptable youth work spaces, each thoughtfully designed by young people, to help them feel safe, process complex emotions, support recovery, avoid re-traumatization and reduce stress levels. Through the process, important new knowledge was also generated by the young people, highlighting the importance of expression and culture for adolescents and their need to have choice and ownership of their space.

Conclusions

The project clearly demonstrated that young people should be trusted as experts of their own experience of trauma and recovery and evidenced the crucial need for professionals who work with young people to deliberately redress power imbalances in order to facilitate this.

Home Fae Home是一个行动研究项目,与苏格兰邓迪的年轻人合作,通过创伤知情实践的镜头重新设计社区青年工作设施的内部环境。该项目是跨学科的,将心理学、建筑和空间设计与青年和社区工作相结合。方法在4年多的时间里,150多名年轻人通过一系列创意工作坊参与了共同设计过程。作为这些讲习班的一部分,采用了多种方法收集数据,包括半结构化访谈和焦点小组,以及更具创造性和非正式的参与。在空间上,该项目提供了六个新的/额外的多样化和适应性强的青年工作空间,每个空间都是由年轻人精心设计的,帮助他们感到安全,处理复杂的情绪,支持恢复,避免再次创伤和减少压力水平。通过这个过程,年轻人也产生了重要的新知识,突出了表达和文化对青少年的重要性,以及他们对自己空间的选择和所有权的需求。该项目清楚地表明,应该信任年轻人作为他们自己的创伤和恢复经验的专家,并证明了与年轻人一起工作的专业人员故意纠正权力不平衡以促进这一点的重要性。
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引用次数: 0
How can nature connectedness and behaviours for learning be deliberately developed in children, adolescents and young adults? A systematic literature review 如何在儿童、青少年和年轻人中有意识地培养自然联系和学习行为?系统的文献综述。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-04-07 DOI: 10.1111/camh.12774
Nicole M. Harris, Brettany Hartwell, Louisa Thomas, Marcus Grace

Background

Nature sustains lives, enhances well-being and benefits human populations in many ways. In a world dominated by human technology, the task of effectively reconnecting to and caring for nature is both urgent and vital. Evidence shows that many children and young people (CYP) feel increasingly disconnected from nature Schools and other settings could play a crucial role in promoting time spent in nature, potentially fostering nature connectedness (NC) and improving behaviours for learning (BFL).

Method

A systematic literature review was conducted to explore how NC can be developed in CYP through nature-based interventions and investigate their impact on BFL. Studies from settings working with CYP aged 0 to 29 were included, utilising quantitative, qualitative, and mixed-methods approaches.

Results

A total of 22 studies from 2009–2023 were identified from ERIC, PsycINFO, and Web of Science. Most were quantitative studies (n = 13) from the global north (n = 19), involving primary or secondary school-aged CYP. A variety of nature-based interventions were assessed, including hiking, surfing, gardening, and art-in-nature activities.

Conclusions

The review highlights numerous ways to develop NC in CYP, with many associated benefits for BFL. Areas of impact include social skills, self-regulation, attention, motivation, independence, and problem-solving. Effective activities included walking and reflecting in nature, sensory connections, and creative activities. Many of the interventions reviewed were not carried out by schools, nor did they take place on their grounds, perhaps due to limited access to green space and nature on their school site. This highlights a significant gap in the literature. Given the large range of interventions, ages of participants, and quality of the included studies, it is not possible to draw specific conclusions about the type of activities that may work best for specific age groups or types of setting.

背景:大自然以多种方式维持生命、增进福祉并造福人类。在一个由人类技术主导的世界里,有效地重新连接和保护自然的任务既紧迫又至关重要。有证据表明,许多儿童和年轻人(CYP)感到越来越与大自然脱节。学校和其他环境可以在促进与大自然的接触、潜在地培养自然联系(NC)和改善学习行为(BFL)方面发挥关键作用。方法:通过系统的文献综述,探讨如何通过基于自然的干预措施在CYP中发展NC,并研究其对BFL的影响。研究包括来自0至29岁CYP的研究,采用定量、定性和混合方法。结果:从ERIC、PsycINFO和Web of Science检索到2009-2023年共22项研究。大多数是来自全球北部(n = 19)的定量研究(n = 13),涉及小学或中学学龄CYP。评估了各种基于自然的干预措施,包括徒步旅行、冲浪、园艺和自然艺术活动。结论:该综述强调了CYP中发展NC的多种方法,并对BFL有许多相关益处。影响的领域包括社交技能、自我调节、注意力、动机、独立性和解决问题的能力。有效的活动包括在大自然中散步和反思,感官联系和创造性活动。许多被审查的干预措施不是由学校进行的,也不是在学校的场地上进行的,可能是由于学校场地上的绿地和自然资源有限。这突出了文献中一个重要的空白。考虑到干预措施的大范围、参与者的年龄和纳入研究的质量,不可能得出关于哪种活动最适合特定年龄组或环境类型的具体结论。
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引用次数: 0
Technology Matters: Online Support and Intervention (OSI) for child anxiety problems – an example of the journey from research to practice 技术问题:针对儿童焦虑问题的在线支持和干预(OSI)--从研究到实践的一个范例。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-04-03 DOI: 10.1111/camh.12775
Chloe Chessell, Rachel Evans, Cathy Creswell

Childhood anxiety problems are prevalent and impairing, yet many children are unable to access evidence-based treatment (i.e. cognitive behavioural therapy, CBT). Digitally augmented psychological interventions represent one way to help increase access to CBT for children with mental health problems, as these interventions can substantially reduce the amount of therapist time required to deliver the intervention, as well as bringing a range of other potential advantages for therapists and families. Online Support and Intervention (OSI) is an example of a brief digitally augmented, therapist-supported, parent-led CBT intervention for child anxiety problems that is now being commissioned and delivered in child mental health services. This article outlines the journey of OSI from research to implementation into routine clinical practice and highlights key considerations for translating digitally augmented mental health interventions into routine care in child mental health services.

儿童期焦虑问题普遍存在,并造成损害,但许多儿童无法获得循证治疗(即认知行为疗法,CBT)。数字增强心理干预是帮助有心理健康问题的儿童增加获得CBT的途径之一,因为这些干预可以大大减少治疗师提供干预所需的时间,并为治疗师和家庭带来一系列其他潜在优势。在线支持和干预(OSI)是一个简短的数字增强、治疗师支持、家长主导的儿童焦虑问题CBT干预的例子,目前正在儿童心理健康服务中委托和提供。本文概述了OSI从研究到实施到常规临床实践的历程,并强调了将数字增强的心理健康干预措施转化为儿童心理健康服务的常规护理的关键考虑因素。
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引用次数: 0
The protective role of community cohesion across rural and urban contexts: implications for youth mental health 城乡社区凝聚力的保护作用:对青少年心理健康的影响。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-03-28 DOI: 10.1111/camh.12764
Alexis Brieant, Keith B. Burt

Background

Exposure to adversity (e.g., negative life events) and socioeconomic disadvantage can increase the risk for internalizing and externalizing symptoms, but many youth demonstrate resilience. Risk and protective factors may vary depending on geographic contexts (i.e., urban vs. rural areas). We hypothesized that community cohesion would mitigate the effects of adversity and disadvantage on youth mental health symptoms, especially among rural communities.

Method

Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study (n = 10,812), a longitudinal study in the United States. At baseline (9–10 years old), neighborhood socioeconomic disadvantage was measured with the Area Deprivation Index, and youth reported on the total number of negative life events they had experienced. At the 2-year follow-up, caregivers reported on cohesion within their community, and at the 3-year follow-up, they reported on their child's internalizing and externalizing symptomatology. A multiple-group path model was used to compare effects for youth living in urban versus rural areas.

Results

In the urban subsample, results indicated a significant interaction between neighborhood disadvantage and community cohesion (β = −.03, p = .004), such that higher disadvantage was associated with higher externalizing (but not internalizing) symptomatology at low and medium, but not high, levels of cohesion. We identified similar patterns of results in the rural subsample, and the interaction neared conventional significance thresholds (β = −.09, p = .052). There was no significant interaction with adversity.

Conclusions

Community cohesion may serve as a protective factor for youth experiencing neighborhood disadvantage by mitigating effects on externalizing symptoms.

背景:暴露于逆境(如负面生活事件)和社会经济劣势会增加出现内化和外化症状的风险,但许多青少年表现出了适应能力。风险和保护因素可能因地理环境(即城市与农村地区)而异。我们假设,社区凝聚力将减轻逆境和不利条件对青少年心理健康症状的影响,尤其是在农村社区:数据来自美国的一项纵向研究--青少年大脑认知发展(ABCD)研究(n = 10,812)。在基线期(9-10 岁),用地区贫困指数衡量邻里的社会经济劣势,青少年报告了他们经历的负面生活事件的总数。在 2 年的跟踪调查中,照顾者报告了社区内的凝聚力,在 3 年的跟踪调查中,他们报告了孩子的内化和外化症状。我们采用了多组路径模型来比较居住在城市和农村地区的青少年所受的影响:在城市子样本中,结果显示邻里劣势与社区凝聚力之间存在显著的交互作用(β = -.03,p = .004),即在中低凝聚力水平下,劣势越高,外化(而非内化)症状越严重,而在高凝聚力水平下,外化(而非内化)症状越严重。在农村子样本中,我们也发现了类似的结果模式,交互作用接近常规显著性临界值(β = -.09, p = .052)。社区凝聚力与逆境之间没有明显的交互作用:结论:社区凝聚力可作为邻里弱势青少年的保护因素,减轻对外化症状的影响。
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引用次数: 0
Editorial: ‘Like a bee and a flower’ – the symbiotic relationship between physical environment and children and young people's psychosocial outcomes 社论:“就像蜜蜂和花朵”——自然环境与儿童和青少年的社会心理结果之间的共生关系。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-03-26 DOI: 10.1111/camh.12773
Keri Ka-Yee Wong, Efstathios Papachristou, Marta Francesconi, Tycho J. Dekkers

This special issue captures the multifaceted and dynamic human–environment relationship across a critical stage of development and illustrates the importance of the physical environment in understanding child and adolescent mental health. Illustrated through original articles, action research, systematic reviews, debates, editorial perspectives and commentaries, our authors showcase the nuances of this relationship through diverse methodologies, data sources, interdisciplinary teams and international perspectives. Authors evidence the impact of physical environmental characteristics on psychosocial outcomes early in life, for both community and clinical populations. Exposure to adversities early in life or during critical developmental periods, such as early childhood and adolescence, has the potential to shape later life outcomes. We hope this special issue provides helpful examples of good practice and the ways of working together needed to inspire future youth-led context-specific health research. We also hope that this special issue can encourage us to rethink public health and education policies, urban planning and design priorities, and clinical research and practice to have young people in the centre of this work.

本期特刊阐述了人与环境在一个关键发展阶段的多方面和动态关系,并说明了自然环境在理解儿童和青少年心理健康方面的重要性。通过原创文章、行动研究、系统评论、辩论、编辑观点和评论,我们的作者通过不同的方法、数据来源、跨学科团队和国际视角展示了这种关系的细微差别。作者证明了社区和临床人群在生命早期的生理环境特征对社会心理结果的影响。在生命早期或关键期(如儿童早期和青春期)遭遇逆境,有可能影响以后的生活结果。我们希望本期特刊提供有益的范例,说明良好做法和合作的方式,以激励未来由青年主导的具体情况的健康研究。我们还希望这一期特刊能够鼓励我们重新思考公共卫生和教育政策、城市规划和设计优先事项以及临床研究和实践,以使年轻人成为这项工作的中心。
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引用次数: 0
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Child and Adolescent Mental Health
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