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Heterogeneity in children's reading comprehension difficulties: A latent class approach 儿童阅读理解困难的异质性:一种潜在的课堂方法
Pub Date : 2023-06-05 DOI: 10.1002/jcv2.12177
Emma James, Paul A. Thompson, Lucy Bowes, Kate Nation

Background

Poor comprehenders are traditionally identified as having below-average reading comprehension, average-range word reading, and a discrepancy between the two. While oral language tends to be low in poor comprehenders, reading is a complex trait and heterogeneity may go undetected by group-level comparisons.

Methods

We took a preregistered data-driven approach to identify poor comprehenders and examine whether multiple distinct cognitive profiles underlie their difficulties. Latent mixture modelling identified reading profiles in 6846 children from the Avon Longitudinal Study of Parents and Children, based on reading and listening comprehension assessments at 8–9 years. A second mixture model examined variation in the cognitive profiles of weak comprehenders, using measures of reading, language, working memory, nonverbal ability, and inattention.

Results

A poor comprehender profile was not identified by the preregistered model. However, by additionally controlling for overall ability, a 6-class model emerged that incorporated a profile with relatively weak comprehension (N = 947, 13.83%). Most of these children had weak reading comprehension in the context of good passage reading, accompanied by weaknesses in vocabulary and nonverbal ability. A small subgroup showed more severe comprehension difficulties in the context of additional cognitive impairments.

Conclusions

Isolated impairments in specific components of reading are rare, yet a data-driven approach can be used to identify children with relatively weak comprehension. Vocabulary and nonverbal ability were most consistently weak within this group, with broader cognitive difficulties also apparent for a subset of children. These findings suggest that poor comprehension is best characterised along a continuum, and considered in light of multiple risks that influence severity.

传统上,理解能力差的人被认为是阅读理解能力低于平均水平,文字阅读能力处于平均水平,两者之间存在差异。虽然理解能力差的人往往口语水平较低,但阅读是一种复杂的特质,在群体水平的比较中可能无法发现异质性。方法采用预先注册的数据驱动方法来识别较差的理解者,并检查他们的困难是否有多种不同的认知特征。基于8-9岁时的阅读和听力理解评估,潜在混合模型确定了来自雅芳父母与儿童纵向研究的6846名儿童的阅读概况。第二个混合模型使用阅读、语言、工作记忆、非语言能力和注意力不集中的测量来检查弱理解者认知特征的变化。结果预注册模型没有识别出较差的综合者概况。然而,通过对综合能力的额外控制,出现了一个包含相对较弱理解能力的6类模型(N = 947, 13.83%)。这些儿童在良好的文章阅读背景下的阅读理解能力较弱,并伴有词汇和非语言能力的不足。在附加认知障碍的情况下,一小群人表现出更严重的理解困难。结论:在阅读的特定部分中,孤立的损伤是罕见的,然而数据驱动的方法可以用来识别理解能力相对较弱的儿童。词汇和非语言能力在这一组中一直很弱,还有一部分儿童明显存在更广泛的认知困难。这些发现表明,理解能力差的最佳特征是一个连续体,并考虑到影响严重程度的多重风险。
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引用次数: 0
Epidemiology of ADHD coming of age and a plea for prospective research on causes and consequences of ADHD throughout the lifespan in multidisciplinary team science 成人多动症的流行病学,以及在多学科团队科学中对多动症的终身原因和后果进行前瞻性研究的呼吁。
Pub Date : 2023-06-01 DOI: 10.1002/jcv2.12178
Catharina A. Hartman

Attention deficit/hyperactivity disorder (ADHD) used to be studied at age of diagnosis–the typical time that professional help is sought and children get an ADHD diagnosis was also the time that they typically enrolled in scientific studies. As a consequence, most of our knowledge is about referred children with ADHD in middle childhood in the age range of 6–12 years. One implication of this is that for a long time ADHD research was not bothered so much by studying causes of ADHD after its onset—in other words, within the total of studies aimed at understanding the causes of ADHD, prospective studies in ADHD research have been rare.

The first paper that I will highlight in this editorial is by Miller et al. (2023) who discuss the development of ADHD in the period from conception to age of onset. They stress that for understanding the causes of ADHD prospective research prior to its onset is needed and explain that any differences observed in children with ADHD (i.e., after its onset) compared to children without ADHD may be secondary to personal and environmental alterations that are evoked by the ADHD symptoms themselves. At the same time, they point out that an onset of ADHD is gradual and the distinction between pre-onset and post-onset not clear-cut: precursor behaviors of ADHD may already evoke personal and environmental alterations. Thus, for a causal understanding of ADHD, we need to know these as well. Prospective research from conception to full clinical onset allows us to chart such alterations and their temporal sequence up to a full onset of ADHD.

The value of establishing the temporal sequence of personal and environmental alterations leading to a clinical onset of a disease cannot be underestimated. It is one element (albeit by no means a sufficient element) in establishing the causality of a risk factor (the risk factor should occur prior to the onset of the disease), and a very important one in observational research. The accumulation of knowledge as to whether a risk factor is (likely) causal is necessary if we want to target the risk factor for interventions: that is, only causal risk factors can actually influence the outcome. Prospective research charting the sequences of personal and environmental alterations in risk during the gradual unfolding of ADHD over time provides opportunities to identify mediators that are useful as intervention targets in particular developmental periods. Also, prospective research may identify protective factors, by comparing children who have the same risk profile (e.g., at conception, at birth) but one group progressing to a full clinical onset of ADHD yet another not. That is, if we only study those who already have an onset of ADHD like we used to do we can never know if onset of ADHD (particularly the impairments experienced by the children) can be prevented, postponed or reduced in severity and thus if and how a developmental trajectory heading toward onset

注意力缺陷/多动障碍(ADHD)过去是在诊断的年龄进行研究的——孩子们寻求专业帮助和得到ADHD诊断的典型时间,也是他们通常参加科学研究的时间。因此,我们的大部分知识都是关于在6-12岁的儿童中期患有多动症的儿童。这其中的一个含义是,在很长一段时间里,ADHD研究并没有那么多地关注ADHD发病后的病因——换句话说,在所有旨在了解ADHD病因的研究中,对ADHD研究的前瞻性研究很少。我将在这篇社论中强调的第一篇论文是Miller等人(2023)的论文,他们讨论了ADHD从受孕到发病的发展过程。他们强调,为了了解ADHD发病前的原因,需要进行前瞻性研究,并解释在ADHD儿童中观察到的任何差异(即发病后)与非ADHD儿童相比,可能是继发于ADHD症状本身引起的个人和环境改变。同时,他们指出多动症的发病是逐渐的,发病前和发病后的区别并不明确:多动症的前兆行为可能已经引起了个人和环境的改变。因此,为了理解ADHD的因果关系,我们也需要知道这些。从受孕到完全临床发作的前瞻性研究使我们能够绘制出这些变化及其时间序列,直到ADHD完全发作。建立导致疾病临床发作的个人和环境变化的时间序列的价值不容低估。它是确定风险因素因果关系的一个因素(尽管绝不是一个充分的因素)(风险因素应该在疾病发作之前发生),也是观察性研究中非常重要的一个因素。如果我们想要针对风险因素进行干预,那么关于风险因素是否(可能)具有因果关系的知识积累是必要的:也就是说,只有因果风险因素才能真正影响结果。前瞻性研究绘制了随着时间的推移,ADHD逐渐发展过程中个人和环境变化的风险序列,为确定在特定发育时期作为干预目标有用的中介提供了机会。此外,前瞻性研究可以通过比较具有相同风险概况(例如,在受孕时,在出生时)的儿童来确定保护因素,但一组发展为完全临床发病的ADHD,而另一组则没有。也就是说,如果我们只研究那些已经有多动症的人,就像我们过去做的那样,我们永远不知道多动症的发病(特别是儿童经历的损伤)是否可以预防,推迟或减轻严重程度,因此,是否以及如何将发展轨迹转向多动症的发病可以转向更有利的结果。Miller等人在本期《JCPP进展》上发表的论文描述了对ADHD发病前的前瞻性研究的研究议程。作者已经成立了早期多动症联盟,以改善对多动症病因的未来前瞻性研究。在我看来,这里的一个重要因素是样本量。显然,我们需要来自大样本的统计力量来深入了解ADHD的原因:ADHD是一种多因素的疾病,是由多种个人和环境风险因素的共同影响造成的,每个因素只占很小的一部分,但却共同提高了ADHD的易感性。由于没有一个风险因素是必要的或充分的,儿童之间的ADHD发病途径是不同的,当对研究样本中的所有儿童进行平均时,任何风险因素预期的小影响都表现出更小的影响。如果我们要确定风险因素之间的相互作用(相互作用),那么为什么需要大样本的推理就更加有效。此外,Miller等人指出,神经发育改变可能先于显性行为改变出现,我们需要在显性行为水平之外的其他理解水平(例如,代谢或神经水平)上理解因果因素,再次强调需要大样本。扩大样本的联合科学团队被证明是遗传学领域的游戏规则改变者,这也应该有助于提高我们对多动症更广泛(潜在的相互作用)原因的理解。因此,JCPP进展很自豪地发表了早期ADHD联盟的“描绘ADHD的早期发展途径:制定国际研究议程”。我将重点介绍的Li等人的第二篇论文也发表在JCPP Advances(2023)上,重点关注ADHD患者生命历程中的不同阶段。Li等人。 是一组作者,他们来自最近成立的另一个多动症联盟“TIMESPAN”,该联盟专注于心脏代谢疾病,这些疾病在大多数情况下都是在多动症发病后(很长时间)发病的。Li等人的荟萃分析是关于心血管疾病(CVD)的,显示患有ADHD的成年人患CVD的可能性几乎是没有ADHD的成年人的两倍。这篇论文的一个重要优点是,作者将这一发现嵌入到关于神经精神疾病和心血管疾病之间联系的更广泛的现有知识中,表明心血管疾病的双重风险与精神分裂症和物质使用障碍的估计相似,但比情绪、焦虑和压力相关疾病的估计要大。TIMESPAN的这个研究小组刚刚发表了一项类似的关于多动症和2型糖尿病的荟萃分析(Garcia-Argibay等人,2023),一项关于多动症和心血管疾病的强有力的实证研究(Li等人,2022),以及关于多动症与肥胖共病的长期研究传统的证据(Cortese等人,2016;Nigg et al., 2016),我们可以得出结论,ADHD和心脏代谢疾病之间的联系现在已经得到了证实。这些论文,包括Li等人在JCPP Advances上发表的论文,共同讨论了需要采取的步骤,以便从机制上理解ADHD成人共病心脏代谢疾病发病的原因及其后果(特别是TIMESPAN联盟研究的后果)。就像ADHD的病因需要在ADHD发病前确定一样,对导致共病的个人和环境改变顺序的前瞻性研究需要在共病发病前确定。这与多动症的并发症是一样的,共病的发作是逐渐的,不仅包括个人危险因素的明显改变,还包括代谢或神经的改变。组建TIMESPAN联盟的一个重要原因是,就像早期ADHD联盟一样,需要一个大样本来对多因素条件进行前瞻性研究(在这种情况下,ADHD和不同的心脏代谢疾病都是多因素的)。正如所争论的那样,Miller等人提出的观点不仅与ADHD发病前有关,而且与整个生命周期有关。为了进一步说明这一点,我想特别强调两个方面。首先,正如已经指出的,Miller等人强调ADHD早期发展的环境风险因素可能随着时间的推移而改变。作为在发育过程中改变风险因素的一个例子,怀孕期间母亲的免疫激活可能会导致ADHD晚发的风险(He et al., 2022),而父母在随后的幼儿期难以调节自己的情绪,可能会导致ADHD晚发的风险(Claussen et al., 2022)。需要注意的是,这些发现除了需要进一步研究外,从未在同一儿童中进行前瞻性研究,以确定潜在的风险积累。我们可以将风险因素在整个生命周期中的变化从ADHD的起因延伸到ADHD的过程。例如,关于并发肥胖的发展,冲动奖励驱动的高热量,低营养的食物导致超重可能在患有多动症的青少年中特别普遍,而缺乏与多动症的动机和组织困难相关的身体活动可能会导致体重增加,特别是在成年人中(注意,这是一个虚构的例子,在不同的发育时期,ADHD患者与非ADHD患者体重增加的危险因素的变化尚未得到研究)。这些关于在整个生命周期中改变风险因素的例子表明,在ADHD发病前或发病后,仍有大量的前瞻性工作要做。Miller等人提出的关于ADHD病因的观点可以延伸到整个生命周期的第二个例子与ADHD的个人和环境风险因素的特异性或非特异性有关(非特异性意味着它们也在其他疾病的发病中发挥作用,而不仅仅是在ADHD的发病中)。Miller等人解释了对ADHD发病的独家关注和对这种结果的特异性风险的假设如何模糊了跨诊断模式并导致不准确的因果模型。这种非特异性是普遍存在的,在ADHD过程中也是相关的,这是无可争议的。我已经引用了Li等人关于ADHD与CVD的关联的例子,以及精神分裂症、物质使用障碍、情绪、焦虑和压力相关疾病与CVD的类似关联。 同样,最近关于多动症的全基因组关联研究表明
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引用次数: 0
Investigating the impact of the COVID-19 pandemic on older adolescents' psychological wellbeing and self-identified cognitive difficulties 调查新冠肺炎疫情对老年青少年心理健康和自我识别认知困难的影响
Pub Date : 2023-05-29 DOI: 10.1002/jcv2.12164
Meg Attwood, Christopher Jarrold

Background

The COVID-19 pandemic coincides with growing concern regarding the mental health of young people. Older adolescents have faced a particular set of pandemic-related challenges and demonstrate heightened vulnerability to affective disorders (particularly anxiety). Anxiety symptoms are associated with a range of cognitive difficulties. Older adolescents may therefore be susceptible to pandemic-related declines in wellbeing and associated cognitive difficulties.

Methods

At three timepoints, independent samples of young people aged 16–18 years (N = 607, 242, 618 respectively) completed an online survey. Data collection coincided with periods of lockdown (timepoints 1 and 3) and young people returning to school (timepoint 2). The survey assessed subjective impacts of the pandemic on overall wellbeing, anxiety and cognitive function.

Results

Findings demonstrated the detrimental impact of the COVID-19 pandemic on older adolescents' psychological wellbeing—a finding that was consistent across samples. The majority of young people at each timepoint experienced heightened anxiety. Crucially, pandemic-related anxiety was associated with self-identified cognitive difficulties, a pattern of association that was evident at all three timepoints. The nature and extent of these difficulties were predictive of specific pandemic-related concerns in this age group.

Conclusions

Older adolescents' experiences of the pandemic are characterised by subjective declines in wellbeing and stable patterns of association between anxiety and self-identified cognitive difficulties. Implications are discussed with reference to future research and intervention.

背景新冠肺炎大流行与人们对年轻人心理健康的日益关注不谋而合。年龄较大的青少年面临着一系列与疫情相关的特殊挑战,并表现出更容易受到情感障碍(尤其是焦虑)的影响。焦虑症状与一系列认知困难有关。因此,年龄较大的青少年可能容易受到与疫情相关的幸福感下降和相关认知困难的影响。方法在三个时间点,对16-18岁的年轻人(分别为607242618)进行独立样本在线调查。数据收集恰逢封锁期(时间点1和3)和年轻人返校(时间点2)。该调查评估了疫情对整体幸福感、焦虑和认知功能的主观影响。结果研究结果表明,新冠肺炎大流行对老年青少年心理健康的有害影响——这一发现在样本中是一致的。在每个时间点,大多数年轻人都经历了更高的焦虑。至关重要的是,与疫情相关的焦虑与自我识别的认知困难有关,这种关联模式在所有三个时间点都很明显。这些困难的性质和程度可以预测这一年龄组与疫情相关的具体问题。结论老年青少年的疫情经历的特点是主观幸福感下降,焦虑和自我识别的认知困难之间的联系模式稳定。讨论了对未来研究和干预的影响。(PsycInfo数据库记录(c)2023 APA,保留所有权利)
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引用次数: 0
The genetics of gaming: A longitudinal twin study 博弈的遗传学:一项纵向双胞胎研究
Pub Date : 2023-05-28 DOI: 10.1002/jcv2.12179
Anders Nilsson, Ralf Kuja-Halkola, Paul Lichtenstein, Henrik Larsson, Sebastian Lundström, Helena Fatouros-Bergman, Nitya Jayaram-Lindström, Yasmina Molero

Background

Gaming is a popular past-time activity among children and adolescents, but it there is also a possible link to negative consequences such as psychological distress and lowered academic achievement. However, there are fundamental knowledge gaps remaining regarding central characteristics of gaming such as heritability, stability over time, and sex differences. We examined the genetic and environmental contribution to gaming behavior, including sex differences, continuity and change, in a longitudinal cohort of twins.

Methods

This is the first longitudinal twin study on gaming, involving 32,006 twins in Sweden. Parents were asked about the twins' gaming at ages 9, 15 and 18. We used univariate and multivariate twin analyses to estimate the relative contribution of genetic and environmental influences at each time-point as well as across time. Sex-differences were also explored.

Results

The results showed large sex differences, where genetics explained more of the variance for boys (31.3%–62.5% depending on age) than for girls (19.4%–23.4%). Genetic factors explained an increasing amount of the variance for boys (31.3% at age 9, 62.5% at age 15 and 53.9% at age 18). Shared environmental factors explained a larger proportion of the variance among girls, which remained relatively stable over time (70.5% at age 9, 61.8% at age 15 and 60.5% at age 18). The results also indicated that most of the variance came from genetic and environmental sources specific to each age.

Conclusions

Compared to many other behavioral phenotypes, such as gambling, gaming was relatively unstable with a large degree of genetic innovation. There were large sex differences in the contribution of genetic and environmental factors. This suggests that excessive gaming could be the result of age- and sex-specific genetic and environmental factors, and should be taken into account when mapping gaming behaviors, since these behaviors might be under continual etiological transformation.

游戏在儿童和青少年中是一种流行的消遣活动,但它也可能与心理困扰和学业成绩下降等负面后果有关。然而,关于游戏的核心特征(如遗传性、时间稳定性和性别差异)仍然存在基本的知识缺口。我们研究了遗传和环境因素对游戏行为的影响,包括性别差异、连续性和变化。这是第一个关于游戏的纵向双胞胎研究,涉及瑞典的32006对双胞胎。父母被问及双胞胎在9岁、15岁和18岁时的游戏情况。我们使用单变量和多变量双胞胎分析来估计遗传和环境影响在每个时间点以及跨越时间的相对贡献。性别差异也被探讨。结果结果显示出较大的性别差异,其中遗传解释了男孩(31.3%-62.5%,取决于年龄)比女孩(19.4%-23.4%)更多的差异。遗传因素解释了男孩的差异增加(9岁时为31.3%,15岁时为62.5%,18岁时为53.9%)。在女孩中,共同的环境因素解释了更大比例的差异,随着时间的推移,这种差异保持相对稳定(9岁时为70.5%,15岁时为61.8%,18岁时为60.5%)。结果还表明,大多数差异来自每个年龄段特定的遗传和环境来源。与赌博等其他行为表型相比,游戏具有较大程度的遗传创新,相对不稳定。遗传和环境因素的影响存在较大的性别差异。这表明过度游戏可能是年龄和性别特定的遗传和环境因素的结果,在绘制游戏行为时应该考虑到这些因素,因为这些行为可能处于持续的病因转变中。
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引用次数: 1
Is there evidence of a causal link between childhood maltreatment and attention deficit/hyperactivity disorder? A systematic review of prospective longitudinal studies using the Bradford-Hill criteria 是否有证据表明儿童期虐待与注意力缺陷/多动障碍之间存在因果关系?使用Bradford‐Hill标准的前瞻性纵向研究的系统综述
Pub Date : 2023-05-27 DOI: 10.1002/jcv2.12169
Paraskevi Bali, Edmund Sonuga-Barke, Christina Mohr-Jensen, Ditte Demontis, Helen Minnis

Background

Studies report an elevated risk of maltreatment in children with attention deficit/hyperactivity disorder (ADHD), and elevated levels of ADHD in people who suffered childhood maltreatment (CM). However, the direction(s) of causality between CM and ADHD remain unclear—does ADHD create a context for CM, does CM cause ADHD, or both?

Objective

This study systematically reviews and qualitatively synthesizes the research evidence relating to this question using Bradford-Hill criteria for establishing causality—strength, temporality, dose-response and plausibility.

Methods

We conducted a systematic review, following PRISMA guidelines, of prospective longitudinal studies examining both CM and ADHD. We then used Bradford-Hill criteria to assess the quality of evidence for a causal link between CM and ADHD.

Results

All 11 included studies demonstrated an association between CM and ADHD. Seven included evidence for temporality: five suggesting that CM precedes ADHD in the lifespan; two suggesting ADHD precedes CM. Four studies demonstrated a dose response relationship in which greater CM exposure was associated with elevated risk of ADHD. Studies presented a range of plausible mechanisms, including CM causing ADHD through biological programming, versus ADHD causing CM through parental stress.

Conclusions

The high quality prospective longitudinal studies reviewed confirm the association between ADHD and CM, but present conflicting evidence about the direction of causality and mechanisms underpinning this association. To better understand the complex interplay between CM and ADHD, more studies using new research designs will be required that can partition effects by type of CM and account for bidirectional effects and other complexities.

研究报告指出,患有注意缺陷/多动障碍(ADHD)的儿童遭受虐待的风险增加,而遭受儿童虐待(CM)的人的ADHD水平升高。然而,CM和ADHD之间的因果关系方向仍然不清楚——是ADHD为CM创造了一个环境,还是CM导致了ADHD,还是两者兼而有之?目的本研究采用Bradford-Hill标准建立因果关系强度、时间性、剂量反应和合理性,系统回顾并定性综合了与该问题相关的研究证据。方法:我们按照PRISMA指南,对CM和ADHD的前瞻性纵向研究进行了系统回顾。然后我们使用Bradford-Hill标准来评估CM和ADHD之间因果关系的证据质量。结果所有纳入的11项研究均证实CM与ADHD之间存在关联。其中7项包括暂时性证据:5项表明CM在一生中先于ADHD;两个表明ADHD先于CM。四项研究证明了一种剂量反应关系,即更多的CM暴露与ADHD风险升高有关。研究提出了一系列合理的机制,包括CM通过生物编程导致ADHD,而ADHD通过父母压力导致CM。高质量的前瞻性纵向研究证实了ADHD和CM之间的关联,但在因果关系的方向和支持这种关联的机制方面存在矛盾的证据。为了更好地理解CM和ADHD之间复杂的相互作用,将需要更多的研究使用新的研究设计,可以根据CM的类型划分影响,并考虑双向效应和其他复杂性。
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引用次数: 0
Social gradient in use of health services and health-related quality of life of children with attention-deficit/hyperactivity disorder: A systematic review 注意力缺陷/多动障碍儿童健康服务使用的社会梯度和健康相关生活质量:一项系统综述。
Pub Date : 2023-05-25 DOI: 10.1002/jcv2.12170
Abraham Sevastidis, Sithara Wanni Arachchige Dona, Lisa Gold, Emma Sciberra, David Coghill, Ha Nguyet Dao Le

Aims

ADHD (attention-deficit/hyperactivity disorder) affects 5% of children on average. Despite the high need to access services for ADHD treatment, not all children with ADHD utilise healthcare services equally. This study aims to systematically synthesise evidence of equity and equality in health service use/costs and health-related quality of life (HRQoL)/wellbeing of children with ADHD across socioeconomic (SES) classes.

Methods

The literature search was conducted across seven databases (Academic Search complete, MEDLINE Complete, PsycINFO, ERIC, Global Health, CINAHL and EconLit). The search was limited to peer-reviewed articles published to 23rd January 2023 in English and focused on children. Study quality was assessed using the Critical Appraisal Skills Program (CASP), Joanna Briggs Institute (JBI) and Mixed Methods Appraisal Tool (MMAT) checklists.

Results

25 out of 1207 articles were eligible for inclusion. The results showed that SES was associated with different types of healthcare utilisation. Only three studies were found on HRQoL/well-being. Children with ADHD from low SES families had lower HRQoL than children from high SES families.

Conclusion

This study found that a social gradient exists in both healthcare service use and children's HRQoL among those with ADHD.

目的:ADHD(注意力缺陷/多动障碍)平均影响5%的儿童。尽管人们非常需要获得多动症治疗服务,但并非所有患有多动症的儿童都能平等地利用医疗服务。本研究旨在系统地综合社会经济地位(SES)各阶层ADHD儿童在医疗服务使用/成本和健康相关生活质量(HRQoL)/幸福感方面的公平和平等证据。方法:文献检索在七个数据库(Academic search complete、MEDLINE complete、PsycINFO、ERIC、Global Health、CINAHL和EconLit)中进行。搜索仅限于截至2023年1月23日发表的以儿童为主题的同行评审文章。使用关键评估技能计划(CASP)、乔安娜·布里格斯研究所(JBI)和混合方法评估工具(MMAT)检查表评估研究质量。结果:1207篇文章中有25篇符合入选条件。结果表明,SES与不同类型的医疗保健利用有关。只有三项关于HRQoL/幸福感的研究被发现。低社会经济地位家庭的ADHD儿童的HRQoL低于高社会经济地位家族的儿童。结论:本研究发现,ADHD患者在医疗服务使用和儿童HRQoL方面存在社会梯度。
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引用次数: 2
Development, reach, acceptability and associated clinical changes of a group intervention to improve caregiver-adolescent relationships in the context of adolescent depression 青少年抑郁症背景下改善照顾者与青少年关系的群体干预的发展、影响范围、可接受性和相关临床变化
Pub Date : 2023-05-23 DOI: 10.1002/jcv2.12168
Madison Aitken, Ameeta Sagar, Darren Courtney, Peter Szatmari

Background

Adolescents with depression often experience relationship problems with their caregivers, which predict poorer treatment outcomes. Personalising interventions by targeting factors associated with poor treatment outcomes may enhance the effectiveness of interventions. We report the development and initial evaluation of an intervention designed to target caregiver-adolescent relationship problems in the context of adolescent depression.

Methods

Following a literature search to identify established caregiver interventions, we developed a new group intervention for caregivers through an iterative process including six rounds of the group with n = 53 caregivers of adolescents age 13–18 in the context of an integrated care pathway for adolescent depression. Caregivers rated their family functioning at the beginning and end of the program and provided anonymous satisfaction ratings. Enrolment and attendance data were examined. Youth with lived experience of depression and their caregivers provided input that was incorporated in the final version of the intervention.

Results

The final intervention consists of 8 weekly, 1.5 h group sessions, delivered face-to-face, addressing: psychoeducation, the cognitive-behavioural model and caregiving, positive caregiving, listening and validation, expressing emotions effectively, and problem solving. Reach (56%), attendance (M = 63%, SD = 31%), and satisfaction (M = 92%; SD = 7%) supported the feasibility of the program. Caregivers reported significant improvements in family functioning, t(21) = 2.68, p = .014, dz = 0.56 [95% CI 0.11–1.0].

Discussion

A group intervention is acceptable to caregivers of adolescents with depression and may be associated with improved family functioning. Further research is needed, including a randomised controlled trial to test effects of the intervention on various dimensions of the caregiver-youth relationship and on youth depression outcomes.

患有抑郁症的青少年通常会遇到与照顾者的关系问题,这预示着较差的治疗效果。针对与不良治疗结果相关的因素进行个性化干预可能会提高干预的有效性。我们报告的发展和初步评估的干预措施,旨在目标照顾者-青少年的关系问题,在青少年抑郁症的背景下。方法通过文献检索来确定已建立的照顾者干预措施,我们通过迭代过程开发了一种新的照顾者群体干预措施,包括6轮n = 53名13-18岁青少年照顾者,在青少年抑郁症综合护理途径的背景下。护理人员在项目开始和结束时对他们的家庭功能进行评分,并提供匿名满意度评分。检查入学和出勤数据。有过抑郁经历的年轻人和他们的照顾者提供的意见被纳入了干预的最终版本。结果最终干预包括每周8次,每次1.5小时的小组会议,面对面进行,涉及:心理教育,认知行为模型和护理,积极护理,倾听和验证,有效表达情绪和解决问题。达到(56%)、考勤(M = 63%, SD = 31%),和满意度(M = 92%;SD = 7%)支持该方案的可行性。照护者报告家庭功能有显著改善,t(21) = 2.68, p = 0.014, dz = 0.56 [95% CI 0.11-1.0]。小组干预对抑郁症青少年的照顾者来说是可以接受的,并且可能与改善家庭功能有关。需要进一步的研究,包括一项随机对照试验,以测试干预对照顾者-青少年关系的各个方面以及对青少年抑郁结果的影响。
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引用次数: 0
Sub-types of insomnia in adolescents: Insights from a quantitative/molecular twin study 青少年失眠的亚型:一项定量/分子双生子研究的见解。
Pub Date : 2023-05-06 DOI: 10.1002/jcv2.12167
Juan J. Madrid-Valero, Frühling Rijsdijk, Saskia Selzam, Helena M. S. Zavos, Melanie Schneider, Angelica Ronald, Alice M. Gregory

Background

Insomnia with short sleep duration has been postulated as more severe than that accompanied by normal/long sleep length. While the short duration subtype is considered to have greater genetic influence than the other subtype, no studies have addressed this question. This study aimed to compare these subtypes in terms of: (1) the heritability of insomnia symptoms; (2) polygenic scores (PGS) for insomnia symptoms and sleep duration; (3) the associations between insomnia symptoms and a wide variety of traits/disorders.

Methods

The sample comprised 4000 pairs of twins aged 16 from the Twins Early Development Study. Twin models were fitted to estimate the heritability of insomnia in both groups. PGS were calculated for self-reported insomnia and sleep duration and compared among participants with short and normal/long sleep duration.

Results

Heritability was not significantly different in the short sleep duration group (A = 0.13 [95%CI = 0.01, 0.32]) and the normal/long sleep duration group (A = 0.35 [95%CI = 0.29, 0.40]). Shared environmental factors accounted for a substantial proportion of the variance in the short sleep duration group (C = 0.19 [95%CI = 0.05, 0.32]) but not in the normal/long sleep duration group (C = 0.00 [95%CI = 0.00, 0.04]). PGS did not differ significantly between groups although results were in the direction expected by the theory. Our results also showed that insomnia with short (as compared to normal/long) sleep duration had a stronger association with anxiety and depression (p < .05)—although not once adjusting for multiple testing.

Conclusions

We found mixed results in relation to the expected differences between the insomnia subtypes in adolescents. Future research needs to further establish cut-offs for ‘short’ sleep at different developmental stages and employ objective measures of sleep.

背景:睡眠时间短的失眠被认为比正常/长睡眠时间的失眠更严重。虽然短时间亚型被认为比其他亚型具有更大的遗传影响,但没有研究解决这个问题。本研究旨在从以下方面对这些亚型进行比较:(1)失眠症状的遗传性;(2) 失眠症状和睡眠时间的多基因评分;(3) 失眠症状与多种特征/病症之间的关系。方法:该样本包括来自双胞胎早期发育研究的4000对16岁的双胞胎。采用双生子模型来估计两组失眠的遗传力。根据自我报告的失眠和睡眠时间计算PGS,并在睡眠时间短和正常/长的参与者中进行比较。结果:短睡眠时间组(A=0.13[95%CI=0.01,0.32])和正常/长睡眠时间组的遗传力没有显著差异(A=0.35[95%CI=0.29,0.40])。共享环境因素在短睡眠时间段组(C=0.19[95%CI=0.05,0.32]组(C=0.00[95%CI=0.00,0.04])。尽管结果符合理论预期,但各组之间的PGS没有显著差异。我们的研究结果还表明,睡眠时间短(与正常/长相比)的失眠与焦虑和抑郁的关系更强(p结论:我们发现青少年失眠亚型之间的预期差异喜忧参半。未来的研究需要进一步确定不同发育阶段“短暂”睡眠的界限,并采用客观的睡眠测量方法。
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引用次数: 0
Neurodevelopmental dimensional assessment of young children at high genomic risk of neuropsychiatric conditions 神经精神疾病高基因组风险幼儿的神经发育维度评估。
Pub Date : 2023-05-04 DOI: 10.1002/jcv2.12162
Samuel J. R. A. Chawner, Amy L. Paine, Matt J. Dunn, Alice Walsh, Poppy Sloane, Megan Thomas, Alexandra Evans, Lucinda Hopkins-Jones, Siske Struik, IMAGINE-ID consortium, Jeremy Hall, Jonathan T. Erichsen, Susan R. Leekam, Michael J. Owen, Dale Hay, Marianne B. M. van den Bree

Background

Individuals with 22q11.2 deletion are at considerably increased risk of neurodevelopmental and psychiatric conditions. There have been very few studies investigating how this risk manifests in early childhood and what factors may underlie developmental variability. Insights into this can elucidate transdiagnostic markers of risk that may underlie later development of neuropsychiatric outcomes.

Methods

Thirty two children with 22q11.2 Deletion Syndrome (22q11.2DS) (mean age = 4.1 [SD = 1.2] years) and 12 sibling controls (mean age = 4.1 [SD = 1.5] years) underwent in-depth dimensional phenotyping across several developmental domains selected as being potential early indicators of neurodevelopmental and psychiatric liability. Comparisons were conducted of the dimensional developmental phenotype of 22q11.2DS and sibling controls. For autistic traits, both parents and children were phenotyped using the Social Responsiveness Scale.

Results

Young children with 22q11.2DS exhibited large impairments (Hedge's g ≥ 0.8) across a range of developmental domains relative to sibling controls, as well as high rates of transdiagnostic neurodevelopmental and psychiatric traits. Cluster analysis revealed a subgroup of children with 22q11.2DS (n = 16; 53%) in whom neurodevelopmental and psychiatric liability was particularly increased and who differed from other children with 22q11.2DS and non-carrier siblings. Exploratory analyses revealed that early motor and sleep impairments indexed liability for neurodevelopmental and psychiatric outcomes. Maternal autism trait scores were predictive of autism traits in children with 22q11.2DS (intraclass correlation coefficients = 0.47, p = 0.046, n = 31).

Conclusions

Although psychiatric conditions typically emerge later in adolescence and adulthood in 22q11.2DS, our exploratory study was able to identify a range of early risk indicators. Furthermore, findings indicate the presence of a subgroup who appeared to have increased neurodevelopmental and psychiatric liability. Our findings highlight the scope for future studies of early risk mechanisms and early intervention within this high genetic risk patient group.

背景:22q11.2缺失的个体患神经发育和精神疾病的风险显著增加。很少有研究调查这种风险在儿童早期是如何表现的,以及哪些因素可能是发育变异性的基础。对此的深入研究可以阐明可能成为神经精神结果后期发展基础的跨诊断风险标志物。方法:32名患有22q11.2缺失综合征(22q11.2DS)的儿童(平均年龄=4.1[SD=1.2]岁)和12名兄弟姐妹对照(平均年龄=4.1[SD=1.5]岁)在几个发育领域进行了深入的维度表型分析,这些发育领域被选为神经发育和精神责任的潜在早期指标。对22q11.2DS和兄弟姐妹对照的维度发育表型进行了比较。对于自闭症特征,父母和孩子都使用社会反应量表进行了表型分析。结果:与兄弟姐妹对照组相比,22q11.2DS的幼儿在一系列发育领域表现出较大的损伤(Hedge's g≥0.8),以及高的神经发育和精神特征转诊断率。聚类分析显示,有一个22q11.2DS儿童亚组(n=16;53%)的神经发育和精神责任特别增加,与其他22q11.2DS儿童和非携带者兄弟姐妹不同。探索性分析显示,早期运动和睡眠障碍会导致神经发育和精神疾病的后果。母亲自闭症特征评分可预测22q11.2DS儿童的自闭症特征(组内相关系数=0.47,p=0.046,n=31)。结论:尽管精神疾病通常在22q11.2DS的青春期和成年后期出现,但我们的探索性研究能够确定一系列早期风险指标。此外,研究结果表明,存在一个亚组,该亚组似乎具有增加的神经发育和精神责任。我们的发现突出了未来对这一高遗传风险患者群体的早期风险机制和早期干预研究的范围。
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引用次数: 1
A systematic review and meta-analysis of nonpharmacological interventions for children and adolescents with selective mutism 儿童和青少年选择性缄默症非药物干预的系统综述和荟萃分析。
Pub Date : 2023-05-03 DOI: 10.1002/jcv2.12166
Gino Hipolito, Emma Pagnamenta, Helen Stacey, Emily Wright, Victoria Joffe, Kou Murayama, Cathy Creswell

Background

Selective mutism (SM) is an anxiety disorder that often starts in early years with serious and lasting consequences. Nonpharmacological interventions are commonly seen as the preferred first treatment. This systematic review identifies outcome measures used and outcomes achieved for nonpharmacological interventions for children and adolescents with SM.

Methods

Systematic searches were conducted using 13 electronic databases and hand searches, including peer-reviewed and grey literature since 1992.

Results

Twenty-five studies were identified. While specific measures varied, all studies reported an outcome measure for speaking behaviour and 18 used a measure of anxiety. Few studies reported measures of SM remission (k = 6), well-being (k = 6), academic impact (k = 2), or quality of life (k = 1). Within subject outcomes for nonpharmacological interventions were variable for improvements in speaking behaviours (very small to large positive effects) and reduction in anxiety symptoms (very small negative to large positive effects). Only five randomised controlled trials (RCTs) were included in the meta-analysis. Three studies compared a combined systems/behavioural approach with waitlist controls indicating a significant and large effect (Hedges g = 1.06, p < .0001, 95% CI: 0.57–1.56) on improved speaking behaviour. Two of these RCTs showed a large effect for SM remission favouring the intervention (Risk Ratio = 4.25, p = .1774, 95% CI: 0.52–34.84) but this did not reach statistical significance. Non-significant outcomes for two RCTs with active controls (Hedges g = 0.55, p < .2885, 95% CI: −0.47 to 1.57) showed considerable heterogeneity in approach and outcomes, one with large and one with negligible effects.

Conclusion

Despite the considerable impairment caused by SM, there has been little systematic evaluation of non-pharmacological interventions. Although combined systems/behavioural interventions are promising, further systematic evaluations are urgently needed to inform treatment approaches. Cross-study measurement harmonisation is required to promote learning from all studies, including wider clinical and economic outcomes.

Clinical Trial Registration

Not applicable.

背景:选择性缄默症(SM)是一种焦虑症,通常始于早年,后果严重而持久。非药物干预通常被视为首选的第一治疗方法。这项系统综述确定了SM儿童和青少年非药物干预所使用的结果指标和取得的结果。方法:使用13个电子数据库和手工搜索进行系统搜索,包括自1992年以来的同行评审和灰色文献。结果:确定了25项研究。虽然具体的衡量标准各不相同,但所有研究都报告了说话行为的结果衡量标准,18项研究使用了焦虑的衡量标准。很少有研究报告SM缓解(k=6)、幸福感(k=6。非药物干预的受试者内部结果在改善说话行为(从很小到很大的积极影响)和减少焦虑症状(从很低到很大的消极影响)方面是可变的。只有五项随机对照试验(RCT)被纳入荟萃分析。三项研究将系统/行为组合方法与等待名单对照进行了比较,表明其具有显著和巨大的影响(Hedges g=1.06,p=.1774,95%CI:0.52-34.84),但这没有达到统计学意义。两项随机对照试验的非显著结果(Hedges g=0.55,p结论:尽管SM造成了相当大的损害,但对非药物干预的系统评估很少。尽管联合系统/行为干预很有希望,但迫切需要进一步的系统评估来为治疗方法提供信息。需要协调跨研究测量,以促进从所有研究中学习死亡,包括更广泛的临床和经济结果。临床试验注册:不适用。
{"title":"A systematic review and meta-analysis of nonpharmacological interventions for children and adolescents with selective mutism","authors":"Gino Hipolito,&nbsp;Emma Pagnamenta,&nbsp;Helen Stacey,&nbsp;Emily Wright,&nbsp;Victoria Joffe,&nbsp;Kou Murayama,&nbsp;Cathy Creswell","doi":"10.1002/jcv2.12166","DOIUrl":"10.1002/jcv2.12166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Selective mutism (SM) is an anxiety disorder that often starts in early years with serious and lasting consequences. Nonpharmacological interventions are commonly seen as the preferred first treatment. This systematic review identifies outcome measures used and outcomes achieved for nonpharmacological interventions for children and adolescents with SM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic searches were conducted using 13 electronic databases and hand searches, including peer-reviewed and grey literature since 1992.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five studies were identified. While specific measures varied, all studies reported an outcome measure for speaking behaviour and 18 used a measure of anxiety. Few studies reported measures of SM remission (<i>k</i> = 6), well-being (<i>k</i> = 6), academic impact (<i>k</i> = 2), or quality of life (<i>k</i> = 1). Within subject outcomes for nonpharmacological interventions were variable for improvements in speaking behaviours (very small to large positive effects) and reduction in anxiety symptoms (very small negative to large positive effects). Only five randomised controlled trials (RCTs) were included in the meta-analysis. Three studies compared a combined systems/behavioural approach with waitlist controls indicating a significant and large effect (Hedges <i>g</i> = 1.06, <i>p</i> &lt; .0001, 95% CI: 0.57–1.56) on improved speaking behaviour. Two of these RCTs showed a large effect for SM remission favouring the intervention (Risk Ratio = 4.25, <i>p</i> = .1774, 95% CI: 0.52–34.84) but this did not reach statistical significance. Non-significant outcomes for two RCTs with active controls (Hedges <i>g</i> = 0.55, <i>p</i> &lt; .2885, 95% CI: −0.47 to 1.57) showed considerable heterogeneity in approach and outcomes, one with large and one with negligible effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the considerable impairment caused by SM, there has been little systematic evaluation of non-pharmacological interventions. Although combined systems/behavioural interventions are promising, further systematic evaluations are urgently needed to inform treatment approaches. Cross-study measurement harmonisation is required to promote learning from all studies, including wider clinical and economic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </se","PeriodicalId":73542,"journal":{"name":"JCPP advances","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acamh.onlinelibrary.wiley.com/doi/epdf/10.1002/jcv2.12166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10635645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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JCPP advances
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