Pub Date : 2025-12-29DOI: 10.1016/j.jaacop.2025.11.001
Stewart L. Adelson MD, Kara S. Bagot MD, Joseph Blader PhD, Alice Charach MD, MSc, FRCPC, Daniel P. Dickstein MD, FAAP, Robert L. Findling MD, MBA, Alastair J.S. McKean MD, Manpreet Kaur Singh MD, MS
{"title":"Editors’ Best of 2025","authors":"Stewart L. Adelson MD, Kara S. Bagot MD, Joseph Blader PhD, Alice Charach MD, MSc, FRCPC, Daniel P. Dickstein MD, FAAP, Robert L. Findling MD, MBA, Alastair J.S. McKean MD, Manpreet Kaur Singh MD, MS","doi":"10.1016/j.jaacop.2025.11.001","DOIUrl":"10.1016/j.jaacop.2025.11.001","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.jaacop.2025.10.007
Peter S. Jensen MD , Tiffany W. Brandt PhD , Christopher J. Kratochvil MD , Lisa Hunter Romanelli PhD , James Jaccard PhD
<div><h3>Objective</h3><div>To determine whether a 6-month continuing medical education (CME) program can increase primary care clinicians’ (PCCs) use of attention-deficit/hyperactivity disorder (ADHD) evidence-based practice (EBP) diagnostics and treatment, and to examine whether randomly assigned care manager support further facilitates practice changes.</div></div><div><h3>Method</h3><div>A total of 47 PCCs attended a 3-day-long CME training, with one-half of PCCs randomly assigned to receive care manager (CM) assistance. All PCCs received continued support via 12 small group teleconference calls over 6 months, After training completion, 9 ADHD EBP variables were abstracted by chart review of 182 newly diagnosed cases seen over a 2-year period (12 months before and after the educational program).</div></div><div><h3>Results</h3><div>Mixed effects regression analyses examined chart-documented practice changes as a function of pre–post effects of the training and effects of CM assistance, and their interaction. Six of 9 PCCs’ chart-abstracted practice behaviors increased significantly after training, including use of parent–teacher ADHD rating scales at initial diagnosis and over 12 months’ follow-up, as well as side effect monitoring. CM assistance demonstrated additive effects to CME training, but only on 3 of the 9 variables. No training or CM effects were found for 3 other practices: 30-day follow-up visits, total yearly visits, or medication adjustments.</div></div><div><h3>Conclusion</h3><div>Sufficiently intensive CME programs can produce objective and sustained changes in PCCs’ practices. Additional CM support facilitated some (but not all) of the same changes. Further research is required to determine which practice behavior changes require intensive educational training, CM resources, both, or other practice change interventions.</div></div><div><h3>Plain language summary</h3><div>This study examined the impact of an intensive continuing medical education (CME) program on the use of evidence-based diagnostic and treatment practices (EBP) for attention-deficit/hyperactivity disorder (ADHD) among primary care clinicians (N = 47). The CME impact was studied by comparing providers’ charts before and after the CME intervention. Overall, results indicated that this intensive CME intervention increased utilization of EBPs over time, while adding the support of a care manager provided a modest additional benefit on practices.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of
{"title":"Can a Continuing Medical Education Intervention Change Pediatricians’ Attention-Deficit/Hyperactivity Disorder Practices?","authors":"Peter S. Jensen MD , Tiffany W. Brandt PhD , Christopher J. Kratochvil MD , Lisa Hunter Romanelli PhD , James Jaccard PhD","doi":"10.1016/j.jaacop.2025.10.007","DOIUrl":"10.1016/j.jaacop.2025.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether a 6-month continuing medical education (CME) program can increase primary care clinicians’ (PCCs) use of attention-deficit/hyperactivity disorder (ADHD) evidence-based practice (EBP) diagnostics and treatment, and to examine whether randomly assigned care manager support further facilitates practice changes.</div></div><div><h3>Method</h3><div>A total of 47 PCCs attended a 3-day-long CME training, with one-half of PCCs randomly assigned to receive care manager (CM) assistance. All PCCs received continued support via 12 small group teleconference calls over 6 months, After training completion, 9 ADHD EBP variables were abstracted by chart review of 182 newly diagnosed cases seen over a 2-year period (12 months before and after the educational program).</div></div><div><h3>Results</h3><div>Mixed effects regression analyses examined chart-documented practice changes as a function of pre–post effects of the training and effects of CM assistance, and their interaction. Six of 9 PCCs’ chart-abstracted practice behaviors increased significantly after training, including use of parent–teacher ADHD rating scales at initial diagnosis and over 12 months’ follow-up, as well as side effect monitoring. CM assistance demonstrated additive effects to CME training, but only on 3 of the 9 variables. No training or CM effects were found for 3 other practices: 30-day follow-up visits, total yearly visits, or medication adjustments.</div></div><div><h3>Conclusion</h3><div>Sufficiently intensive CME programs can produce objective and sustained changes in PCCs’ practices. Additional CM support facilitated some (but not all) of the same changes. Further research is required to determine which practice behavior changes require intensive educational training, CM resources, both, or other practice change interventions.</div></div><div><h3>Plain language summary</h3><div>This study examined the impact of an intensive continuing medical education (CME) program on the use of evidence-based diagnostic and treatment practices (EBP) for attention-deficit/hyperactivity disorder (ADHD) among primary care clinicians (N = 47). The CME impact was studied by comparing providers’ charts before and after the CME intervention. Overall, results indicated that this intensive CME intervention increased utilization of EBPs over time, while adding the support of a care manager provided a modest additional benefit on practices.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of ","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 172-183"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.jaacop.2025.10.008
Isaac T. Petersen PhD , Zachary Demko MA , Won-Chan Lee PhD , Jacob J. Oleson PhD
Objective
Psychopathology shows changes in behavioral manifestation across development, that is, heterotypic continuity. However, research has paid little attention to how to account for heterotypic continuity when examining the development of psychopathology. This longitudinal study accounted for heterotypic continuity of multiple psychopathology dimensions by using developmental scaling to place multi-informant ratings of children’s behavior problems onto the same scale to chart children’s trajectories.
Method
The study examined children’s (N = 231) development of 3 psychopathology dimensions—externalizing, internalizing, and thought-disordered—using different measures across 7 timepoints from 3 to 7.5 years of age. Psychopathology dimensions were assessed by mother-, father-, and teacher/caregiver-report. We compared 3 assessment approaches: the common items, upward/downward extension, and construct-valid items approaches. We compared 2 scoring approaches: mean scoring and developmental scaling. Developmental scaling aims to place scores from age-differing measures onto the same scale. We compared their accuracy, for externalizing problems, in terms of criterion validity with respect to observations of compliance and attention to task.
Results
Using different measures across ages (ie, construct-valid items approach) was the most accurate assessment approach—modestly more accurate than using the common items or upward/downward extension—in terms of criterion validity with respect to observations of compliance and attention to task (rdiff = 0.07-0.13). Developmental scaling was the most accurate scoring approach, modestly more accurate than average scores (rdiff = 0.03-0.17).
Conclusion
Using (1) age-differing measures to account for heterotypic continuity and (2) developmental scaling to link scores from the different measures onto the same scale may enable studying development of psychopathology across the lifespan.
Plain language summary
Behavioral health problems manifest differently as children age. This study examined manifestations of 3 dimensions of behavioral health problems from ages 3 to 7.5 years (N = 231). The authors found that using different measures and scaling across ages was the most accurate way to assess behavioral health problems as children age.
Diversity & Inclusion Statement
We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way.
{"title":"Studying Development of Psychopathology Using Changing Measures to Account for Heterotypic Continuity","authors":"Isaac T. Petersen PhD , Zachary Demko MA , Won-Chan Lee PhD , Jacob J. Oleson PhD","doi":"10.1016/j.jaacop.2025.10.008","DOIUrl":"10.1016/j.jaacop.2025.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>Psychopathology shows changes in behavioral manifestation across development, that is, heterotypic continuity. However, research has paid little attention to how to account for heterotypic continuity when examining the development of psychopathology. This longitudinal study accounted for heterotypic continuity of multiple psychopathology dimensions by using developmental scaling to place multi-informant ratings of children’s behavior problems onto the same scale to chart children’s trajectories.</div></div><div><h3>Method</h3><div>The study examined children’s (N = 231) development of 3 psychopathology dimensions—externalizing, internalizing, and thought-disordered—using different measures across 7 timepoints from 3 to 7.5 years of age. Psychopathology dimensions were assessed by mother-, father-, and teacher/caregiver-report. We compared 3 assessment approaches: the common items, upward/downward extension, and construct-valid items approaches. We compared 2 scoring approaches: mean scoring and developmental scaling. Developmental scaling aims to place scores from age-differing measures onto the same scale. We compared their accuracy, for externalizing problems, in terms of criterion validity with respect to observations of compliance and attention to task.</div></div><div><h3>Results</h3><div>Using different measures across ages (ie, construct-valid items approach) was the most accurate assessment approach—modestly more accurate than using the common items or upward/downward extension—in terms of criterion validity with respect to observations of compliance and attention to task (<em>r</em><sub>diff</sub> = 0.07-0.13). Developmental scaling was the most accurate scoring approach, modestly more accurate than average scores (<em>r</em><sub>diff</sub> = 0.03-0.17).</div></div><div><h3>Conclusion</h3><div>Using (1) age-differing measures to account for heterotypic continuity and (2) developmental scaling to link scores from the different measures onto the same scale may enable studying development of psychopathology across the lifespan.</div></div><div><h3>Plain language summary</h3><div>Behavioral health problems manifest differently as children age. This study examined manifestations of 3 dimensions of behavioral health problems from ages 3 to 7.5 years (N = 231). The authors found that using different measures and scaling across ages was the most accurate way to assess behavioral health problems as children age.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way.</div></div><div><h3>Study registration information</h3><div>School readiness study: <span><span>https://osf.io/jzxb8</span><svg><path></path></svg></span></div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 111-123"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.jaacop.2025.10.006
Amanda J. Thompson PhD , Avery N. Abel BS , Rui Huang PhD , Katherine Sarkisian PhD , Mindy Westlund Schreiner PhD , Franky Rife MA , Donna A. Ruch PhD , Jeffrey A. Bridge PhD
Objective
Transgender and gender diverse (TGD) youth are at high risk for self-injurious thoughts and behaviors (SITB) including suicidal ideation, nonsuicidal self-injury (NSSI), and suicide attempt. We compared total SITB endorsements during a 4-year period among 3 groups: TGD youth with high gender-related social stress (TGD+High-Stress); TGD youth with low gender-related social stress (TGD+Low-Stress); and non-TGD youth. We further identified risk and resiliency correlates of 3 longitudinal SITB trajectories (NSSI, suicidal ideation, and suicide attempt), accounting for gender-related social stress and other known robust risk factors.
Method
This study (N = 11,851) used longitudinal data for youth spanning ages 10 to 14 years from the Adolescent Brain Cognitive Development study (release 5.1), of whom 4% were TGD. Analyses of variance were used to compare mean SITB endorsements across groups. Three mixed-effects logistic regressions identified correlates of SITB trajectories during the study.
Results
On average, TGD+High-Stress experienced more SITB events than TGD+Low-Stress and non-TGD youth, respectively. Longitudinal results found that TGD compared to non-TGD youth experienced higher NSSI and suicidal ideation risk regardless of gender-related social stress. TGD+High-Stress but not TGD+Low-Stress youth had greater suicide attempt risk than non-TGD youth. Higher psychopathology symptoms and family conflict were associated with higher NSSI and suicidal ideation risk. Only school involvement was protective against ideation and NSSI risk.
Conclusion
TGD youth experience higher SITB risk, particularly when facing higher gender-related social stressors at home or school. We urgently need interventions supporting positive connections between TGD youth and their families and peers.
Plain language summary
Using longitudinal data from the Adolescent Brain Cognitive Development℠ (ABCD) Study (N = 11,851), the authors compared total self-injurious thoughts and behaviors (SITB) among transgender and gender diverse (TGD) youth and non-TGD youth from ages 10 to 14 years. This study found that TGD youth experience higher risk for SITB than non-TGD youth. High gender-related social stress, more mental health symptoms, and family conflict were associated with higher risk of SITB, whereas school involvement was protective against SITB. This study highlights the need for developing interventions that support positive connections between TGD youth and their families and peers.
{"title":"Trajectories of Self-Injurious Thoughts and Behavior: Risk and Resiliency Among Cisgender and Gender Diverse Youth","authors":"Amanda J. Thompson PhD , Avery N. Abel BS , Rui Huang PhD , Katherine Sarkisian PhD , Mindy Westlund Schreiner PhD , Franky Rife MA , Donna A. Ruch PhD , Jeffrey A. Bridge PhD","doi":"10.1016/j.jaacop.2025.10.006","DOIUrl":"10.1016/j.jaacop.2025.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>Transgender and gender diverse (TGD) youth are at high risk for self-injurious thoughts and behaviors (SITB) including suicidal ideation, nonsuicidal self-injury (NSSI), and suicide attempt. We compared total SITB endorsements during a 4-year period among 3 groups: TGD youth with high gender-related social stress (TGD+High-Stress); TGD youth with low gender-related social stress (TGD+Low-Stress); and non-TGD youth. We further identified risk and resiliency correlates of 3 longitudinal SITB trajectories (NSSI, suicidal ideation, and suicide attempt), accounting for gender-related social stress and other known robust risk factors.</div></div><div><h3>Method</h3><div>This study (N = 11,851) used longitudinal data for youth spanning ages 10 to 14 years from the Adolescent Brain Cognitive Development study (release 5.1), of whom 4% were TGD. Analyses of variance were used to compare mean SITB endorsements across groups. Three mixed-effects logistic regressions identified correlates of SITB trajectories during the study.</div></div><div><h3>Results</h3><div>On average, TGD+High-Stress experienced more SITB events than TGD+Low-Stress and non-TGD youth, respectively. Longitudinal results found that TGD compared to non-TGD youth experienced higher NSSI and suicidal ideation risk regardless of gender-related social stress. TGD+High-Stress but not TGD+Low-Stress youth had greater suicide attempt risk than non-TGD youth. Higher psychopathology symptoms and family conflict were associated with higher NSSI and suicidal ideation risk. Only school involvement was protective against ideation and NSSI risk.</div></div><div><h3>Conclusion</h3><div>TGD youth experience higher SITB risk, particularly when facing higher gender-related social stressors at home or school. We urgently need interventions supporting positive connections between TGD youth and their families and peers.</div></div><div><h3>Plain language summary</h3><div>Using longitudinal data from the Adolescent Brain Cognitive Development℠ (ABCD) Study (N = 11,851), the authors compared total self-injurious thoughts and behaviors (SITB) among transgender and gender diverse (TGD) youth and non-TGD youth from ages 10 to 14 years. This study found that TGD youth experience higher risk for SITB than non-TGD youth. High gender-related social stress, more mental health symptoms, and family conflict were associated with higher risk of SITB, whereas school involvement was protective against SITB. This study highlights the need for developing interventions that support positive connections between TGD youth and their families and peers.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 163-171"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.jaacop.2025.09.005
Katherine Y. Kim BS , Joel Stoddard MD , Sofia I. Cárdenas MA , Parmis Khosravi PhD , Katharina Kircanski PhD , Matt Jones PhD , Daniel S. Pine MD , Melissa A. Brotman PhD , Simone P. Haller DPhil
Objective
Pediatric anxiety and irritability are common, impairing, co-occurring symptoms. Biases in interpreting ambiguous face-emotions have been linked to both phenotypes. Here, we assessed whether biases represent a shared cognitive and neural profile. In addition, we attempted replication of prior age associations and group behavioral differences in face-emotion labeling.
Method
In a cross-sectional functional magnetic resonance imaging study at a research facility at the National Institute of Mental Health, we used a variant of a drift diffusion model to decompose perceptual and cognitive components of binary happy–angry decisions to ambiguous face-emotions. A total of 95 participants (mean age = 14.11, SD = 3.07, range = 8-22, male = 50.9%) contributed to the analyses. In all, 65 participants did not complete the scan or meet data quality thresholds. Participants had a primary diagnosis of disruptive mood dysregulation disorder (DMDD; n = 27), attention-deficit/hyperactivity disorder (n = 23), oppositional defiant disorder (n = 2), anxiety disorder (n = 19), or no current diagnosis (n = 24), resulting in a wide range of anxiety and irritability symptom levels.
Results
No significant associations between the computational modeling parameter indexing bias and dimensionally assessed anxiety or irritability emerged (r[84] < −0.15, p > .05). Parent- and child-rated irritability, but not anxiety, was associated with increased neural responses to overtly angry faces, most notably in the motor cortex (voxel-wise p < .005). We successfully replicated prior age-associated increases in sensitivity and differences in bias between youth with DMDD and controls.
Conclusion
Increased neural engagement of the bilateral motor cortex likely reflects increased vigor in responding to overtly angry faces, possibly indexing approach behavior. Replication of prior findings increases confidence in the robustness of these associations.
Plain language summary
Youth experiencing high levels of anger or anxiety are thought to interpret ambiguous facial expressions as hostile. In this study, 95 youth aged 8 to 22 years completed a task that assessed their interpretations of facial expressions while measuring brain activation. Youth with higher levels of anxiety or anger did not interpret faces as more hostile. However, when responding to angry faces, youth with higher levels of anger showed increased activation in areas of the brain involved in coordinating actions, which may translate to more aggressive responses in daily life.
{"title":"Sensitivity and Bias in Face-Emotion Labeling: Replication and Extension to Youth With Irritability and Anxiety","authors":"Katherine Y. Kim BS , Joel Stoddard MD , Sofia I. Cárdenas MA , Parmis Khosravi PhD , Katharina Kircanski PhD , Matt Jones PhD , Daniel S. Pine MD , Melissa A. Brotman PhD , Simone P. Haller DPhil","doi":"10.1016/j.jaacop.2025.09.005","DOIUrl":"10.1016/j.jaacop.2025.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatric anxiety and irritability are common, impairing, co-occurring symptoms. Biases in interpreting ambiguous face-emotions have been linked to both phenotypes. Here, we assessed whether biases represent a shared cognitive and neural profile. In addition, we attempted replication of prior age associations and group behavioral differences in face-emotion labeling.</div></div><div><h3>Method</h3><div>In a cross-sectional functional magnetic resonance imaging study at a research facility at the National Institute of Mental Health, we used a variant of a drift diffusion model to decompose perceptual and cognitive components of binary happy–angry decisions to ambiguous face-emotions. A total of 95 participants (mean age = 14.11, SD = 3.07, range = 8-22, male = 50.9%) contributed to the analyses. In all, 65 participants did not complete the scan or meet data quality thresholds. Participants had a primary diagnosis of disruptive mood dysregulation disorder (DMDD; n = 27), attention-deficit/hyperactivity disorder (n = 23), oppositional defiant disorder (n = 2), anxiety disorder (n = 19), or no current diagnosis (n = 24), resulting in a wide range of anxiety and irritability symptom levels.</div></div><div><h3>Results</h3><div>No significant associations between the computational modeling parameter indexing bias and dimensionally assessed anxiety or irritability emerged (<em>r</em>[84] < −0.15, <em>p</em> > .05). Parent- and child-rated irritability, but not anxiety, was associated with increased neural responses to overtly angry faces, most notably in the motor cortex (voxel-wise <em>p</em> < .005). We successfully replicated prior age-associated increases in sensitivity and differences in bias between youth with DMDD and controls.</div></div><div><h3>Conclusion</h3><div>Increased neural engagement of the bilateral motor cortex likely reflects increased vigor in responding to overtly angry faces, possibly indexing approach behavior. Replication of prior findings increases confidence in the robustness of these associations.</div></div><div><h3>Plain language summary</h3><div>Youth experiencing high levels of anger or anxiety are thought to interpret ambiguous facial expressions as hostile. In this study, 95 youth aged 8 to 22 years completed a task that assessed their interpretations of facial expressions while measuring brain activation. Youth with higher levels of anxiety or anger did not interpret faces as more hostile. However, when responding to angry faces, youth with higher levels of anger showed increased activation in areas of the brain involved in coordinating actions, which may translate to more aggressive responses in daily life.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 42-52"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-16DOI: 10.1016/j.jaacop.2025.10.005
Jocelyn I. Meza PhD , Lindsay M. Alexander MPH , Lisa Barkley MD , Eraka Bath MD , Denese Shervington MD, MPH , Mirelle Kass BA , Virginia Henson BA , Daniel Sebbag LCSW, PhD , Ivette Irene Sanchez LMFT , Jamelia C. Silver MBA , Dyala Alameddine MPH , Ally Herrnson BS , Jennie X. Liang MA , Spencer Webb BA , Tatum Connell BA , Erin Brown BA , Spencer Morenko BA , Robin Samuels MSEd , Bennett L. Leventhal MD , Michael P. Milham MD, PhD
<div><h3>Objective</h3><div>With rising prevalence of mental disorders, especially among underserved and under-resourced youth, mental health workforce shortages are evident across the United States. This study aimed to assess the feasibility, acceptability, and pilot implementation of a multicomponent career development program, the Youth Mental Health Academy (YMHA), for structurally marginalized youth—including underrepresentation based on race/ethnicity, disability, sexual orientation/gender identities, socioeconomic challenges, parents/caregivers without college degree, geographic isolation, foster care/juvenile legal system involvement, or having a parent/caregiver in the military.</div></div><div><h3>Method</h3><div>Structurally marginalized high school students interested in mental health careers were encouraged to apply. Students completed baseline and post-program assessments and weekly acceptability ratings. Program feasibility was assessed via attendance, recruitment, and retention rates.</div></div><div><h3>Results</h3><div>A total of 135 students enrolled in the YMHA pilot. Participants were ethnoracially diverse—51.9% Hispanic/Latinx, 30.4% Asian/Asian American, 14.1% Black/African American, 3.7% Middle Eastern, and 3.7% White; 68.9% identified as female. Approximately 40% met criteria for socioeconomic challenges (eg, Federal Free and Reduced Lunch eligibility), 15% had histories of foster care or juvenile legal involvement, and about 7% reported a chronic condition/disability. Of participants, 92% (n = 125) completed the first summer program with high attendance (>75% days attended), and 87.4% (n = 118) completed a second summer internship. High acceptability was maintained throughout. After the 14-month program, 82.9% of students indicated interest in pursuing mental health careers.</div></div><div><h3>Conclusion</h3><div>High acceptability, retention, and engagement indicate that the YMHA program is a promising approach to diversifying the mental health workforce. A large-scale study is needed to examine the scalability and sustainability of this model.</div></div><div><h3>Plain language summary</h3><div>The Youth Mental Health Academy (YMHA) is a 14-month career development program for high school students from underrepresented backgrounds to explore careers in mental health. This study enrolled 135 students from diverse backgrounds (51.9% Hispanic/Latinx, 30.4% Asian/Asian American, 14.1% Black/African American, 3.7% Middle Eastern, and 3.7% White; 15% with history of foster care or juvenile legal involvement) who were interested in mental health careers to participate in the program. Most students who participated stayed engaged (92%) and found the program helpful, and 82.9% indicated interest in pursuing mental health careers. This type of program may be a promising approach to diversifying the mental health workforce.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure sex and gender bal
{"title":"Addressing Critical Workforce Shortages in Youth Mental Health: Implementation of a Multicomponent Career Development Program","authors":"Jocelyn I. Meza PhD , Lindsay M. Alexander MPH , Lisa Barkley MD , Eraka Bath MD , Denese Shervington MD, MPH , Mirelle Kass BA , Virginia Henson BA , Daniel Sebbag LCSW, PhD , Ivette Irene Sanchez LMFT , Jamelia C. Silver MBA , Dyala Alameddine MPH , Ally Herrnson BS , Jennie X. Liang MA , Spencer Webb BA , Tatum Connell BA , Erin Brown BA , Spencer Morenko BA , Robin Samuels MSEd , Bennett L. Leventhal MD , Michael P. Milham MD, PhD","doi":"10.1016/j.jaacop.2025.10.005","DOIUrl":"10.1016/j.jaacop.2025.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>With rising prevalence of mental disorders, especially among underserved and under-resourced youth, mental health workforce shortages are evident across the United States. This study aimed to assess the feasibility, acceptability, and pilot implementation of a multicomponent career development program, the Youth Mental Health Academy (YMHA), for structurally marginalized youth—including underrepresentation based on race/ethnicity, disability, sexual orientation/gender identities, socioeconomic challenges, parents/caregivers without college degree, geographic isolation, foster care/juvenile legal system involvement, or having a parent/caregiver in the military.</div></div><div><h3>Method</h3><div>Structurally marginalized high school students interested in mental health careers were encouraged to apply. Students completed baseline and post-program assessments and weekly acceptability ratings. Program feasibility was assessed via attendance, recruitment, and retention rates.</div></div><div><h3>Results</h3><div>A total of 135 students enrolled in the YMHA pilot. Participants were ethnoracially diverse—51.9% Hispanic/Latinx, 30.4% Asian/Asian American, 14.1% Black/African American, 3.7% Middle Eastern, and 3.7% White; 68.9% identified as female. Approximately 40% met criteria for socioeconomic challenges (eg, Federal Free and Reduced Lunch eligibility), 15% had histories of foster care or juvenile legal involvement, and about 7% reported a chronic condition/disability. Of participants, 92% (n = 125) completed the first summer program with high attendance (>75% days attended), and 87.4% (n = 118) completed a second summer internship. High acceptability was maintained throughout. After the 14-month program, 82.9% of students indicated interest in pursuing mental health careers.</div></div><div><h3>Conclusion</h3><div>High acceptability, retention, and engagement indicate that the YMHA program is a promising approach to diversifying the mental health workforce. A large-scale study is needed to examine the scalability and sustainability of this model.</div></div><div><h3>Plain language summary</h3><div>The Youth Mental Health Academy (YMHA) is a 14-month career development program for high school students from underrepresented backgrounds to explore careers in mental health. This study enrolled 135 students from diverse backgrounds (51.9% Hispanic/Latinx, 30.4% Asian/Asian American, 14.1% Black/African American, 3.7% Middle Eastern, and 3.7% White; 15% with history of foster care or juvenile legal involvement) who were interested in mental health careers to participate in the program. Most students who participated stayed engaged (92%) and found the program helpful, and 82.9% indicated interest in pursuing mental health careers. This type of program may be a promising approach to diversifying the mental health workforce.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure sex and gender bal","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 124-139"},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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