JAACAP open最新文献

{"title":"Research Domain Criteria (RDoC) Constructs of Acute and Potential Threat Differentially Associate With Pediatric Anxiety","authors":"Stefanie R. Russman Block PhD , Hannah C. Becker PhD (Candidate) , Dana E. Díaz PhD , Elizabeth R. Duval PhD , D. Angus Clark PhD , Dareen Al-Qawasmeh PA (Candidate) , Alexis Walker-VanSingel MSW , Kristin A. Mannella BS , K. Luan Phan MD , Christopher S. Monk PhD , Kate D. Fitzgerald MD","doi":"10.1016/j.jaacop.2024.11.006","DOIUrl":"10.1016/j.jaacop.2024.11.006","url":null,"abstract":"<div><h3>Objective</h3><div>To address problems with the current categorical diagnostic classification system for mental health, the National Institute of Mental Health created the Research Domain Criteria (RDoC) initiative, which encourages researchers to link dimensionally assessed psychological constructs with transdiagnostic psychopathology to expedite discovery of biological mechanisms and clinical translation. Two constructs that were theorized by the RDoC to be pertinent to anxiety symptoms across categorical anxiety disorders and the spectrum of severity are acute threat (AT; fear of a present danger) and potential threat (PT; anxiety about a distant or uncertain danger). However, these constructs are often conflated in research and lack valid self-report measures, especially among youth.</div></div><div><h3>Method</h3><div>The present study examined how self-reported AT and PT distinctly associate with the following: (1) dimensional anxiety symptom severity, and (2) neural response to threat, among youth 7 to 17 years of age with clinically significant anxiety (ie, anxiety disorder diagnosis, n = 119) and those with subclinical to no anxiety (ie, no anxiety disorder diagnosis, n = 41). AT and PT scores were derived from 3 self/parent-report measures of youth anxiety; expert consensus was used to designate each item as indexing either AT or PT, followed by a generation of AT and PT general factor scores from bifactor models fit to clinical experts’ ratings. Anxiety severity was assessed with a structured clinical interview using the Pediatric Anxiety Rating Scale. Neural response to threat was measured using the Emotional Faces Shifted Attention Task, performed during functional magnetic resonance imaging. Finally, AT and PT factor scores were tested as predictors of clinical anxiety severity and neural activation to threat.</div></div><div><h3>Results</h3><div>AT factor scores positively associated with clinically assessed anxiety severity and right posterior insula response to threat faces across the whole sample. PT factor scores also associated with greater clinician-measured anxiety severity, but only among participants with subclinical to no anxiety, and did not associate with brain activity.</div></div><div><h3>Conclusion</h3><div>Results support the RDoC theory that AT and PT are distinct and clinically relevant constructs that can be assessed via youth self-report. Understanding how AT and PT uniquely relate to anxiety severity may contribute to the development of targeted anxiety treatment and prevention for youth by elucidating which domains of functioning specifically contribute to disorder heterogeneity or symptom severity.</div></div><div><h3>Plain language summary</h3><div>Acute threat (fear of immediate danger) and potential threat (anxiety about a distant or uncertain danger) are thought to contribute to anxious behavior but are often conflated and lack valid self-report measures in youth. In this study, items from 3 self","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 4","pages":"Pages 984-995"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145594497","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}

{"title":"Estimated Prevalence of Substance Use Disorders Among US Adolescents and Emerging Adults by Substance Class, Severity, and Age, 2022","authors":"Zachary W. Adams PhD ,&nbsp;Trey V. Dellucci PhD, MPH ,&nbsp;Jon Agley PhD ,&nbsp;Kristina Bixler PhD ,&nbsp;Maggie Sullivan BA ,&nbsp;Jesse D. Hinckley MD, PhD ,&nbsp;Leslie A. Hulvershorn MD","doi":"10.1016/j.jaacop.2025.01.002","DOIUrl":"10.1016/j.jaacop.2025.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>Substance use disorders (SUDs) often develop during adolescence, forecasting myriad health problems across the lifespan. Implementing responsive clinical services requires information about the prevalence of SUDs by age, substance class, and severity. However, no reports have summarized those data using <em>DSM-5</em> criteria.</div></div><div><h3>Method</h3><div>Using 2022 National Survey on Drug Use and Health (NSDUH) data from participants 12 to 25 years of age (n = 26,276), the prevalence and severity of <em>DSM-5</em> SUDs was estimated across age cohorts (12-13, 14-15, 16-17, 18-20, and 21-25 years) via χ² tests of independence. The Cramer V (φ_<em>c</em>) was also calculated for each outcome to approximate the effect size between age group and substance use outcome.</div></div><div><h3>Results</h3><div>Although past-year rates for alcohol and cannabis use were higher overall as age cohort increased, the prevalence of disordered use and proportional distribution of SUD severity (mild, moderate, severe) did not differ across age cohorts among those who used alcohol (φ_<em>c</em> = 0.04) and cannabis (φ_<em>c</em> = 0.04) in the past year. Conversely, the prevalence and severity of SUDs generally varied across age groups among those who reported past-year use of less commonly used substances (heroin, methamphetamine).</div></div><div><h3>Conclusion</h3><div>Meeting criteria for an SUD was common among youth with past-year substance use. Allocation of developmentally appropriate prevention and treatment resources should account for the distribution of mild to severe SUDs across adolescence. The field would likely benefit from further study of these issues in diverse samples.</div></div><div><h3>Plain language summary</h3><div>This study analyzed data from the 2022 National Survey on Drug Use and Health. It explored the prevalence and severity of substance use disorders among adolescents and young adults aged 12 to 25. The prevalence and severity of substance use disorders among those who use alcohol and cannabis did not differ across age cohorts. It varied across age groups among those who reported past-year use of less commonly used substances (heroin, methamphetamine). The authors emphasized the importance of early screening to identify problematic substance use, since youth can develop mild to severe substance use disorders even in early adolescence.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 4","pages":"Pages 959-971"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145594496","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}