Frontiers in child and adolescent psychiatry最新文献

Introduction: Group-based parenting programmes have specific mechanisms of change compared to individual delivery. The Mechanisms of Action in Group-based Interventions framework (MAGI); distinguishes between interpersonal and intrapersonal mechanisms of change. This paper articulates a theory of change for Mellow Babies, a 14-week attachment-based group parenting programme for mothers of infants aged under 18 months, identifying the inter and intrapersonal change processes.

Methods: Thirty-two semi-structured interviews were conducted with mothers and practitioners who participated in Mellow Babies, including twenty post-group interviews and nine telephone fidelity checks. Data were analysed using Deductive Qualitative Analysis based on the components identified within the MAGI framework.

Results: Key interpersonal change mechanisms included: 1. Normalisation through social comparisons; 2. Validation and cognitive reframing through group feedback; 3. Peer support, offering accountability for the implementation of new habits, and providing opportunities to give and receive advice; and 4. Social and experiential learning, including internalisation of group responses leading to increased self-compassion. Intrapersonal change mechanisms were: 1. Developing new self-insight, including parenting self-awareness; 2. Increasing parenting knowledge and understanding of infant development; 3. Having time and space for self; 4. Motivation to implement new habits. Interpersonal change mechanisms had a moderating role on intrapersonal change mechanisms and subsequent programme outcomes.

Discussion: The contribution of group processes and interpersonal mechanisms of change are often overlooked within programme evaluations. Findings from this study implicate their mediating role on intrapersonal change mechanisms and subsequent programme outcomes. It is important for programme deliverers and evaluators to understand the interrelationships between group processes, change mechanisms and programme outcomes to optimise efficacy and ensure cross-contextual replicability.

Introduction: Children with problematic sexual behaviors (PSBs) can benefit, along with their parents or caregivers, from specialized therapeutic services to limit the manifestation of these behaviors. However, for some families, mobilization for therapy represents a significant challenge since a considerable proportion do not complete the therapy intended for them. The present study aims to identify the factors associated with therapy completion, thus allowing a deeper understanding of how to support children and more broadly families to complete their therapeutic process.

Methodology: The sample consists of 67 caregiver-child dyads referred to a specialized Center offering PSBs-focused cognitive behavioral therapy, actively involving the caregiver. Standardized questionnaires were administered to children and their caregiver before and after the therapy.

Results: While non-completers represent 31% of our sample, they present very similar profiles to completers in terms of socio-demographic characteristics, behavior problems and symptoms. However, they appear to differ regarding living situations and coping mechanisms. Results show that children who complete therapy are more likely to live in a placement situation, compared to non-completers. Children who completed therapy also report using more coping strategies that aim toward getting social support and less distancing coping strategies than non-completers. Non completers also reported feeling less maternal support compared to completers.

Discussion: Results underline the importance of implementing mobilization efforts for families with children with PSBs, along with a focus on developing efficient coping mechanisms.

Introduction: Anxiety disorders are common, distressing, and impairing for children and families. Cognitive-behavioral interventions targeting the role of family interactions in child anxiety treatment may be limited by lack of attention to antecedents to parental control; specifically, internal parent factors such as experiential avoidance and cognitive fusion. This pilot study evaluates the preliminary efficacy of a group-delivered caregiver treatment program, ACT for Parents of Anxious Children (ACT-PAC) that targets parental experiential avoidance, cognitive fusion, and child internalizing symptoms.

Methods: Twenty-three youth ages 7-17 years with a primary anxiety disorder diagnosis and their primary caregiver participated in six one-hour, weekly group treatment sessions. Parents and children reported on child symptomatology and parents reported on parent symptomatology and quality of life at two assessment points: within one week before ACT-PAC treatment and within one week after treatment. Parents self-reported on parental internal processes specifically targeted by ACT (e.g., cognitive fusion) weekly during the 6-week treatment.

Results: Results support the feasibility and acceptability of ACT-PAC and indicate reductions in parents' cognitive fusion and child internalizing symptoms.

Objectives: The prevalence of many psychiatric symptoms, including anxiety and depression, is higher in individuals born extremely preterm (EP) than in term-born individuals during childhood and adolescence. In this prospective study of adolescents born EP, we examined associations between early-life risk factors (prenatal maternal health conditions, socioeconomic and social factors) and anxiety and depression at 15 years of age.

Methods: We included 682 participants (53.2% White, 57.8% male) who were born <28 weeks gestation. Data on demographic factors, maternal health conditions and socioeconomic status (SES) were collected in the first postnatal month, and data on the outcomes (anxiety and depression) were collected at 15 years by a structured clinical diagnostic interview. At the 15-year visit, the mother reported on her own experiences of childhood trauma. Logistic regression models were used to evaluate associations between maternal health indicators, SES factors and mothers' childhood trauma and adolescent outcome variables of anxiety, depression and both anxiety and/or depression, adjusting for potential confounding factors and expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Results: Maternal pre-pregnancy obesity was associated with anxiety (aOR: 1.84, 95% CI: 1.15, 2.95) and depression (aOR: 1.95, 95% CI: 1.17, 3.23) in adolescents at age 15. Maternal exposure to active or second-hand smoke was associated with depression (aOR: 1.8, 95% CI: 1.08, 3.00) and with anxiety and depression (aOR: 2.83, 95% CI: 1.51, 5.31) at age 15. Other maternal pre-pregnancy health indicators of interest including asthma, hypertension and diabetes mellitus did not demonstrate significant associations with symptoms of anxiety or depression in adolescents at age 15 in univariable and multivariate analyses. Maternal childhood experience of parental upheaval was associated with anxiety and depression (OR: 1.91, 95% CI: 1.01, 3.55) in adolescents, and maternal childhood experience of victim violence was linked with anxiety (OR: 2.4, 95% CI: 1.22, 4.62) and anxiety and depression (OR: 2.49, 95% CI: 1.05, 5.42).

Conclusion: These findings suggest that prenatal maternal health and socioeconomic factors contribute to psychiatric disorders among adolescents born EP. These factors could serve as targets for interventions to improve mental health of individuals born EP.

Introduction: Using clear explicit translatable language, we translated the Welch Emotional Connection Screen into a new universal language instrument, the English uWECS. In this study, we had two aims: Aim 1 was to establish concurrent validity of the uWECS by comparing scores coded by primary Spanish-speaking coders using the Spanish translation of the uWECS to scores coded by bilingual, secondary Spanish-speaking coders using the oWECS. Aim 2 was to establish the criterion-related validity in terms of oWECS and uWECS performance in tracking change in autonomic emotional connection (AEC) during the course of an intervention among preschool aged children.

Methods: We created a library of 52 five-minute Spanish-speaking mother-child videos that were collected during a randomized controlled trial of Mother-Child Emotional Preparation intervention (MCEP). The videos were collected at two time points, at enrollment and at a 6-month follow-up. The subsample of Primary Spanish-Speaking dyads from the MCEP study were coded by two independent teams of coders. We trained primary English-speaking (bilingual Spanish) coders on the oWECS, using the original training program. A different team of primary Spanish-speaking coders coded the same cases using the novel uWECS guide and trained briefly for reliability with the Spanish uWECS translation materials.

Results: We found that the Spanish oWECS and Spanish uWECS ratings from the baseline and 6-month follow-up observations were robustly correlated, with intraclass correlations ranging from .81 to .84 and all p-values<.001, thus demonstrating sound concurrent validity for the uWECS. The oWECS and uWECS scores also achieved parallel results when evaluating the efficacy of the MCEP for primary Spanish-speaking dyads. Both the AEC scores of the oWECS [F(1, 27) = 4.31, p < .05] and the scores of the uWECS [F(1,27) = 4.06, p < .05] similarly demonstrated significant change post intervention, thus demonstrating sound criterion-related validity of the uWECS.

Discussion: These findings demonstrate that the uWECS can be used to measure parent/child AEC in linguistically diverse populations and cultures.

Introduction: Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric condition that affects children. Its magnitude varies by area, ranging from 0.2% to 26.8%. Even though there is debate, culture and geographical location may have little or no influence on the epidemiology of ADHD worldwide. Despite this variation, debate over the national prevalence and location of ADHD is unknown in Ethiopia. Therefore, this study aimed to assess the pooled prevalence of ADHD and its contributing factors among children.

Methods: Electronic databases, including Google Scholar, PubMed, Scopus, EMBASE, Web of Science, ScienceDirect, and institutional repositories, were searched. The studies that covered the prevalence and/or risk factors of ADHD in children were included in the collection. The Joanna Briggs Institute quality rating tool was used to rate the quality of each study. The data were extracted using Microsoft Excel 2019, and the statistical analysis was performed using STATA 17.0. Using a random-effects model, we evaluated the combined prevalence of ADHD and associated factors. The Cochrane Q-test and I ² test statistics were used to quantify the heterogeneity. Furthermore, publication bias was examined using funnel plot graphs and Egger's tests. A Galbraith plot was employed to illustrate outliers. Sensitivity analysis was also applied.

Result: This study included a total of six articles with 4,338 participants. The pooled prevalence estimate of ADHD was 8.81% [95% confidence interval (CI), 4.52-13.11; I ² = 96.95%; P = 0.001]. Age 6-12 [adjusted odds ratio (AOR) = 3.51 (95% CI, 1.38-5.64), I ² = 0%; P = 0.001], being male [AOR = 1.94 (95% CI, 1.09-2.79), I ² = 0%; P = 0.001], and living with a single parent [AOR = 4.92 (95% CI, 1.24-861), I ² = 0%; P = 0.001] were significant variables.

Conclusion and recommendation: One out of every 12 children in Ethiopia suffers from ADHD. Living with a single parent, being male, and being between the ages of 6 and 12 were risk factors for ADHD. A nationwide study with a large sample size may be required to ascertain the true impact of ADHD. It may be crucial to improve school health services to identify ADHD early and lessen its long-term effects.

Introduction: Symptoms of depression in early childhood have been linked to interpersonal difficulties, whereas friendships serve a protective function.

Methods: In the present study, we examined depression symptoms in preschool age (4 years) in relation to social skills (communication and cooperation), and friendships into early school age (Grades 1 and 2) in a large subsample (n = 943) of Norwegian children.

Results: The results indicated that preschool depression symptoms negatively predicted Grade 1 communication skills, which in turn predicted Grade 2 depression symptoms. This pathway suggests that communication skills may be a maintenance factor for depression symptoms in young children. In addition, preschool depression symptoms predicted lower Grade 1 cooperation skills, which in turn predicted lower Grade 2 communication skills, suggesting that preschool depression symptoms may begin a cascade of social skill problems that affect cooperation and communication skills into early school years. Best friendships were negatively related to depression symptoms in preschool and Grade 2.

Discussion: Given that preschool depression symptoms impact the development of social skills and friendships, it is important to attend to depression symptoms in early childhood.

Background: Child maltreatment is a significant social problem impacting both health and society, with severe and enduring consequences. Certain children, such as those with neurodevelopmental conditions like autism, may be more at risk of experiencing maltreatment. However, little research has examined the characteristics of these children. This study aimed to compare child maltreatment and child protection services experienced by autistic children to those of non-autistic children.

Method: Drawing from a representative selection of verified cases of child abuse investigated by child protection services in Quebec, Canada, a sample of 1,805 substantiated child maltreatment cases were analyzed.

Results: Overall, 4.0% (n = 73) of children had child protection services-reported autism diagnoses. Attention-deficit (OR = 2.207) and attachment problems risk (OR = 2.899) were higher among autistic children compared to non-autistic children. They were more likely to be boys (OR = 5.747), and to present with an intellectual disability (OR = 11.987), but less likely to have previously been investigated by child protection services (OR = 0.722).

Conclusion: These findings suggest that autistic children who have been maltreated are facing specific challenges that require protective interventions tailored to their specific needs.

Students' social media use has quickly gained attention given the effect of considerable time spent on and widespread usage of social media on their development and success. The study aimed to examine whether high school students' social media use predicts more school engagement and less burnout for those who were more successful in controlling their social media use in goal-conflict situations. A sample of 107 Chinese high school students (M _age = 19.21, SD _age = 1.85, 68% female) participated in an online survey. The results showed that social media self-control failure moderated the relationship between general social media use (rather than social media use intensity) and school engagement. A simple effect test revealed that more general social media use predicted higher school engagement for students who were more successful in controlling their social media use. However, no moderation effect was observed of social media self-control failure on the relationship between social media use intensity (or general social media use) and burnout. The results partially supported the study demands-resources model and indicated the potential benefits of controllable social media use on high school students' engagement in the face of high academic demands.

Introduction: Although psychotic behaviors can be difficult to assess in children, early identification of children at high risk for the emergence of psychotic symptoms may facilitate the prevention of related disorders. Psychotic-like experiences (PLEs), or subthreshold thought and perceptual disturbances, could be early manifestations of psychosis that may predict a future diagnosis of a psychosis-related disorder or nonspecific correlates of a wide range of psychological problems. Additional research is needed regarding how PLEs map onto dimensions of psychopathology in children.

Methods: In the present study, we examined the association between PLEs and general and specific dimensions of psychological problems in a sample of 10,692 children from the Adolescent Brain Cognitive Development Study (ABCD Study).

Results: The results of this study showed that self-reported PLEs were associated with a general psychopathology factor and an ADHD factor, which were defined in hierarchical models of parent-rated psychological problems.

Discussion: These findings suggest that PLEs are broadly associated with a wide range of psychological problems through the general psychopathology factor even before psychotic disorders typically manifest. This study supports the need for longitudinal analyses of future waves of the ABCD Study to determine if PLEs can detect children at high risk for serious psychological problems in adulthood.