Frontiers in child and adolescent psychiatry最新文献

Background: Small pilot studies have indicated that transcranial photobiomodulation (tPBM) may help alleviate symptoms of neurological conditions like depression, traumatic brain injury and Autism Spectrum Disorder (ASD).

Objective: To examine the effect of tPBM on the behavioral symptoms of ASD and brain electrophysiology in children aged 2-7.

Methods: We conducted an open label, one-arm study with 23 participants, aged 2-7, previously diagnosed with ASD. We delivered non-invasively to all participants pulses of near-infrared light (wavelength 850 nm, pulse 40 Hz) to cortical nodes of Default Mode Network, Broca and Wernicke areas, and occipital lobe of the brain, twice weekly for 10 weeks. The tPBM was delivered using an investigational medical device designed for this purpose. Changes in ASD symptoms were measured using pre- and post-intervention scores on the Childhood Autism Rating Scale (CARS-2, 2nd Edition). We collected electroencephalogram (EEG) data after each treatment session from all children who tolerated wearing the EEG cap to monitor changes in brain activity.

Results: The intervention resulted in a significant 7-point reduction in average CARS-2 scores (t = 10.23, p < .0001), along with decreased delta power and increased gamma and beta power in EEG readings. The increase in gamma power was statistically significant [t(14) = 2.30, p = 0.047]. Changes in EEG power were significantly correlated with the number of sessions (delta: r(192) = -0.18, p = .013; gamma: r(192) = .19, p = .007; beta: r(192) = .15, p = .04). Improvements in CARS-2 scores were negatively correlated with changes in delta and beta power (delta: r(15) = -.59, p = .020; beta: r(15) = -.54, p = .037). No moderate or severe side effects were reported.

Conclusion: This study supports the potential of tPBM as a safe and effective treatment for ASD, and it suggests that EEG measurements may serve as a useful biomarker for future research.

Trial registration: https://clinicaltrials.gov/ct2/show/NCT04660552.

Introduction: As health systems struggled to respond to the catastrophic effects of SARS-CoV-2, infection prevention and control measures significantly impacted on the delivery of non-COVID children's and family health services. The prioritisation of public health measures significantly impacted supportive relationships, revealed their importance for both mental and physical health and well-being. Drawing on findings from an expansive national collaboration, and with the well-being of children and young people in mind, we make recommendations here for post-pandemic recovery and re-build.

Methods: This consensus statement is derived from a cross-disciplinary collaboration of experts. Working together discursively, we have synthesised evidence from collaborative research in child and family health during the COVID-19 pandemic. We have identified and agreed priorities areas for both action and learning, which we present as recommendations for research, healthcare practice, and policy.

Results: The synthesis led to immediate recommendations grouped around what to retain and what to remove from "pandemic" provision and what to reinstate from pre-pandemic, healthcare provision in these services. Longer-term recommendations for action were also made. Those relevant to children's well-being concern equity and relational healthcare.

Discussion: The documented evidence-base of the effects of the pandemic on children's and family services is growing, providing foundations for the post-pandemic recovery and re-setting of child and family health services and care provision. Recommendations contribute to services better aligning with the values of equity and relational healthcare, whilst providing wider consideration of care and support for children and families in usual vs. extra-ordinary health system shock circumstances.

Introduction: Neurodevelopmental disorders (NDDs) have high comorbidity rates and shared etiology. Nevertheless, NDD assessment is diagnosis-driven and focuses on symptom profiles of individual disorders, which hinders diagnosis and treatment. There is also no evidence-based, standardized transdiagnostic approach currently available to provide a full clinical picture of individuals with NDDs. The pressing need for transdiagnostic assessment led to the development of the Neurodevelopment Assessment Scale (NAS).

Methods: This paper describes the co-design process used in the development of NAS prototype with stakeholders including individuals with NDDs, parents of children with NDDs, and health professionals.

Results and discussion: Results indicated stakeholder consensus that NAS would be useful for NDD assessment, and included recommendations for fine-tuning the way some questions were asked (e.g., child's diagnoses), question flow (e.g., branching logic), and the language and presentation of the prototype (e.g., readability). Stakeholders also suggested the administration protocol should be flexible using electronic, face-to-face, online formats etc.

Introduction: Therapeutic mentoring, which leverages paraprofessional care, is a potential way to scale access to care to address the youth mental health crisis. This scoping review synthesizes the current state of research on self-designated therapeutic mentoring programs for youth mental health.

Method: A systematic search was conducted across four databases using the term "therapeutic mento*" and related keywords, taking a label-first approach to describe the available literature. Inclusion criteria were peer-reviewed articles about research on therapeutic mentoring in the US, written in English. Data were extracted on study characteristics, intervention details, mentor background, and outcomes.

Results: Eighteen empirical articles were identified, published between 2003 and 2024. Most studies focused on at-risk youth from diverse backgrounds. Therapeutic mentoring programming varied, although most (N = 13) studies examined the Campus Connections program. Mentors were typically trained paraprofessionals or undergraduate students supervised by clinical professionals. Only two randomized controlled trials were found, both of the Campus Connections program.

Discussion: The review revealed a lack of rigorous experimental studies on therapeutic mentoring efficacy, as defined by studies that use the term therapeutic mentoring. While some studies showed promising effects, more research is needed to establish the definition of therapeutic mentoring and whether it is an acceptable and effective intervention for youth mental health.

Conclusion: A clear definition of therapeutic mentoring is needed to advance the field and facilitate systematic evaluation of its effectiveness in supporting youth mental health. Future research should prioritize developing program models that align with diverse youth's cultural values, conducting randomized controlled trials, examining program components, and developing standardized measures for assessing therapeutic mentoring outcomes.

Background: Autism spectrum disorder is a neurodevelopmental condition characterized by persistent challenges in social communication and restricted, repetitive behaviors. Emotion recognition deficits are a core feature of ASD, impairing social functioning and quality of life. This meta-analysis evaluates emotion recognition accuracy and response time in individuals with autism spectrum disorder compared to neurotypical individuals and those with other neurodevelopmental disorders.

Methods: This systematic review with a meta-analysis was conducted following PRISMA guidelines. A comprehensive literature search across PubMed, Scopus, Cochrane Library, and Web of Science identified 13 studies published between 2006 and 2024. Data on emotion recognition accuracy and response times were synthesized using standardized mean differences in random-effects models. Heterogeneity was assessed using the I ² statistic, and sensitivity analyses were performed to ensure robustness.

Results: Individuals with ASD exhibited significantly lower overall emotion recognition accuracy compared to TD individuals (SMD = -1.29, 95% CI: -2.20 to -0.39, p < 0.01) and NDDs (SMD = -0.89, 95% CI: -1.23 to -0.55, p = 0.02). Response times were significantly prolonged in ASD compared to TD individuals (SMD = 0.50, 95% CI: 0.36-0.63, p < 0.01) but not when compared to NDDs. Emotion-specific analyses did not consistently reveal significant differences across emotions (fear, anger, happiness, sadness, disgust, surprise), with substantial heterogeneity observed across studies (I ² > 50%).

Conclusions: This systematic review with a meta-analysis highlights significant impairments in emotion recognition accuracy and processing speed among individuals with autism spectrum disorder, particularly compared to neurotypical individuals. These findings underscore the importance of developing targeted interventions to address these deficits, which are foundational to improving social cognition and quality of life in autism spectrum disorder. Future research should prioritize standardized methodologies and explore cultural and contextual factors influencing emotion recognition abilities.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=627339, PROSPERO (CRD42024627339).

Introduction: Experiencing traumatic events (TEs), especially interpersonal TEs, is related to an increased risk of developing post-traumatic stress disorder (PTSD). Both TEs and PTSD are associated with a higher risk of substance use and problems in emotion regulation. Little is known about the associations between specific types of TEs, problems with general self-regulation (including cognitive and behavioral components) and substance use severity in adolescents. Knowledge on these associations could provide important approaches for prevention and therapy for adolescents with a history of trauma.

Methods: This study investigated associations between different types of TEs and PTSD, self-regulation and substance use severity. Moreover, participants were categorized into three groups according to their trauma status: (I) no history of TEs (noTEs), (II) history of TEs but no PTSD diagnosis (TEs), and (III) history of TEs and PTSD diagnosis (PTSD). Differences between the three groups were analyzed in terms of self-regulation and substance use severity. Our sample consisted of N = 89 adolescents aged 12 to 18 years in a child and adolescent psychiatric outpatient clinic in Germany. Substance use severity was only assessed in a smaller subsample (n = 37). Data were obtained from standardized diagnostic procedures and included information on types of TEs and PTSD diagnosis according to ICD-10, problems in self-regulation assessed with the Child Behavior Checklist (CBCL)/ Youth Self Report (YSR) Dysregulation Profile (DP), and substance use severity measured with the Drug Use Disorders Identification Test (DUDIT).

Results: We found that interpersonal TEs were significantly associated with higher rates of PTSD diagnosis compared to non-interpersonal TEs. We found no significant associations between different types of TEs and both problems in self-regulation and substance use severity. Moreover, our findings do not indicate differences in both self-regulation and substance use severity between trauma statuses (noTEs, TEs, PTSD).

Discussion: Future studies should consider other characteristics of TEs such as timing and duration when investigating associations with self-regulation. Longitudinal studies are needed to investigate developmental pathways, as a better understanding of the role of characteristics of TEs and self-regulation in the development of PTSD and substance use problems would provide opportunities for prevention and therapy for trauma-exposed patients.

Background: Since the onset of the COVID-19 pandemic, the scientific community has been concerned about the high rates of psychological distress among adolescents. The pandemic not only tested adolescents' adaptation, but also disrupted key areas of their development. This demonstrates the need to study their psychological adjustment over time during this critical period to better guide services.

Objective: This study sought to explore the extent to which physical activity and its association with self-esteem in the first months of the pandemic impacted adolescents' psychological distress, six months later.

Methods: Two hundred and ninety-four adolescents (73% girls) between the ages of 12 and 17 participated in a longitudinal study launched at the start of the COVID-19 pandemic. The number of hours spent engaging in physical activity (HPA) in the past week and self-esteem were measured at Time 1 (T1; summer 2020). Psychological distress was measured at T1 and Time 2 (T2; winter 2021).

Results: More HPA in the past week were related to greater self-esteem at T1. Greater self-esteem at T1 was related to lower psychological distress, six months later (T2). Lastly, HPA in the past week was not directly linked to psychological distress at T2, which confirms a fully indirect model.

Conclusion: Results suggest that physical activity is a key factor in promoting better mental health adjustment through its benefits in terms of self-esteem, even during times of turmoil. Findings reinforce the recommendation of promoting the practice of sports and athletic activity in difficult times.