Frontiers in child and adolescent psychiatry最新文献

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.

Introduction: This study aimed to capture experiences and perspectives of parents of children with autism participating in an intervention program based on the Early Start Denver Model (ESDM). Specifically, we wanted their views regarding feasibility, acceptability, and significance of the intervention program, i.e., its social validity.

Methods: Fourteen parents, whose children has been diagnosed with autism, were interviewed.

Results: The results included three themes (1) Comprehensive approach: the participants emphasized the importance of early detection and interventions in their local setting in close cooperation between themselves, health care professionals, and preschool staff. They also highlighted the individual goals based on the child's needs in different developmental areas, as well as the whole family's needs and prioritizations. (2) Hands on-available locally and accessible: focused on different aspects of procedures, including features of the ESDM, parent education, the parent-therapist relationship and nearby location. (3) Sense of empowerment-parents got increased knowledge: the intervention was significant within family daily living and daily activities. The participants expressed that the interventions program contributed to an increased knowledge about autism and the ESDM strategies, positively impacted their child, and improved the collaboration with the preschool.

Conclusion: Parents emphasized the naturalistic, comprehensive, and local setting of the intervention and described that they had gained new knowledge as well a sense of empowerment. The results indicated that the intervention program based on the ESDM was socially valid according to parent descriptions.

Autism spectrum disorder (ASD) is a multifaceted developmental condition characterized by persistent challenges in social communication, restricted interests, and repetitive behaviors. Though there is no cure, early and intensive interventions can significantly improve the quality of life for those affected. The aim of this paper is to examine the complexities of autism spectrum disorder (ASD) from a public health perspective in South East Asian region, highlighting the global rise in prevalence and the compounded challenges posed by the COVID-19 pandemic. The rise in ASD prevalence from 4 to 5 cases per 10,000 children in the 1980s to 11.3 per 1,000 children in 2012 highlights the need for effective interventions. The pandemic exacerbated behavioral issues, anxiety, and screen time-related health problems, underscoring the importance of adjusting strategies for early identification and support. Diagnostic tools like the Modified Checklist for Autism in Toddlers (M-CHAT) and the Social Communication Questionnaire (SCQ) play a critical role in community-based screening. Effective prevention strategies include primary measures such as public awareness campaigns and genetic counseling, secondary measures focusing on early identification and intervention, and tertiary measures involving ongoing support and therapy. Addressing implementation challenges, particularly in low-income countries, requires enhanced public awareness, training of community health workers, and integration of ASD services into primary healthcare systems. Future research should aim to develop and evaluate scalable, culturally relevant interventions and explore the impact of environmental factors on ASD. Comprehensive strategies at the community level, combined with robust public health policies, are crucial for improving outcomes for individuals with ASD and their families.

Accessibility to developmental interventions for children and adolescents could be increased through virtual, at-home delivery of training programs. Virtual childhood training programs and their effects on cognitive outcomes have not been well studied. To that end, this study examined the effects of the at-home Brain Balance® (BB) program on the cognitive task performance of children and adolescents with baseline developmental and attentional difficulties. The study included students with reported diagnosis of ADHD, autism, anxiety, sensory processing disorder, or dyslexia, and students with no reported diagnosis (aged 4-17 years). The at-home BB program is delivered through (1) a computer-based format utilizing multimodal program activities previously studied in-center (multisensory stimulation, gross motor, coordination, balance, and nutritional recommendations); and (2) the BB app (visual motor, auditory and visual processing, and rhythm and timing training) - creating a comprehensive program experience delivered remotely. Cognitive performance was measured by six cognitive tasks from Creyos Health before and after 3 months of participation in the at-home BB program (N = 316) or in-center BB program (N = 4,232), compared to controls. Results showed that overall cognitive assessment scores (including attention, response inhibition, and working memory) improved after participation in either the at-home or the in-center program, compared to controls. Importantly, significant improvements over the controls were observed for two tasks involving attention and inhibitory control, in both programs. Further, two analyses support that the effects on cognitive performance from either delivery format, in-center or at home, are comparable in magnitude. This research: (1) presents new findings demonstrating improved cognitive performance after completing the at-home BB program; (2) replicates previous findings of cognitive improvements after completing the BB program; and (3) suggests that the cognitive effects of virtual at-home BB training are similar to those observed for in-center BB training. Overall, the results demonstrate the effectiveness of the at-home BB program in improving cognitive functioning in pediatric populations with preexisting developmental and attentional difficulties. Virtual delivery and ease of use, provide at-home programs the potential to reduce barriers of access to much-needed developmental and cognitive support, for individuals who may otherwise lack access to high-quality, evidence-based developmental programs.