Clinical child psychology and psychiatry最新文献

ObjectiveThis study aimed to compare neurocognition, social cognition and emotion regulation of adolescents aged 12-18 years with bipolar spectrum disorder (BD) and disruptive mood dysregulation disorder (DMDD) to healthy adolescents.MethodsThe sample included 63 adolescents (21 BD, 21 DMDD, 21 healthy), matched for age and gender. Social cognition was assessed using the Faces, Eyes, and Faux Pas tasks. Neurocognitive performance was evaluated with the Wisconsin Card Sorting Test and Stroop Test, while emotion regulation was measured via the Difficulties in Emotion Regulation Scale and Affective Reactivity Index-Parent Form.ResultsSignificant differences were detected among the groups in all three of the theory of mind tests: faces, eyes and faux pas test, and healthy adolescents received statistically significantly higher scores. Both the cognitive characteristics and emotion regulation skills of healthy adolescents were evaluated as better than those in the BD and DMDD groups.ConclusionsAdolescents with BD and DMDD show impairments in social cognition, executive functioning, and emotion regulation. Integrating interventions targeting these areas into treatment plans may enhance psychosocial functioning and support better clinical outcomes for youth with BD and DMDD.

Psychological trauma and post-traumatic stress disorder (PTSD) are under-researched in autistic individuals. We explored the experience of trauma and PTSD symptoms in a sample of autistic adolescents (n = 30) aged 10-16 years (without a maltreatment history; 47% female), compared to a group of typically-developing (TD; n = 29) and a group of (non-autistic) maltreatment-exposed adolescents (n = 28), matched on key demographics. Caregiver reports indicated that a wide range of events were deemed traumatic to autistic adolescents, including those not meeting DSM-5's Criterion A for trauma for a PTSD diagnosis (e.g., bullying and bereavement). Caregiver- and self-reports converged to show more severe PTSD symptoms, and higher rates of probable PTSD, in autistic adolescents (43-57%) relative to the TD adolescents (7-32%). Symptom severity and rates of probable PTSD were comparable between the autistic and maltreatment-exposed adolescents (50-54%), except that, for autistic adolescents, the index trauma mostly did not match DSM-5 criteria, whereas it did for maltreatment-exposed adolescents. This short report's early findings supports the need for improved assessment of trauma exposure and PTSD symptoms in autistic adolescents. A flexible approach to how trauma is defined in this population may be needed, considering subjective experiences and autism-related processing differences.

BackgroundThe Goal-Based Outcomes (GBO) tool tracks patient goals. Its implementation and effectiveness, especially in child and youth mental healthcare (CYMH) clinics using the Choice and Partnership Approach (CAPA) framework has been understudied.MethodsWe used a Hybrid Type II randomized controlled trial (RCT) and the Reach Evaluation Adoption Implementation Maintenance (RE-AIM) framework; 152 caregiver-patient (aged 5 to 17 years) dyads were randomized to GBO + treatment as usual (TAU) or TAU. Effectiveness outcomes included the Strengths and Difficulties Questionnaire (SDQ) and Children's Global Assessment Scale (CGAS) pre-post treatment scores, which measured effectiveness using bivariate, ANCOVA (intention-to-treat), and Reliable Change Index analyses. Post-treatment Evaluation of Services Questionnaire (ESQ) measured care experience. Implementation outcomes included patient flow assessed using the total number of appointments across partnerships and the core partnership number of appointments, a fully recorded session, and the cost to ensure data collection for what was essentially a measurement-based care paradigm. Content of goals and patient/clinician qualitative reports were subjected to thematic analyses.ResultsReach was high in patient and clinician populations. Effectiveness data did not show a group effect. Goal progress exceeded SDQ changes; goal themes were different from SDQ constructs. Adoption was high, as was implementation. All participants had positive experiences with GBO. Clinic function was not negatively affected by the GBO tool.ConclusionsThe GBO tool was implemented successfully into a CAPA-based CYMH clinic, but group effectiveness was mixed. However, the GBO tool identified unique treatment targets, suggesting potential to enhance tailored, precision CYMH.

AimsYouth receiving mental health care often face challenges related to romantic relationships, sexuality, and sexual orientation and gender identity (SOGI). Although widely recognized as relevant, these topics are infrequently addressed in youth mental health care. This study explored how youth and mental health professionals experience discussions about sexuality and SOGI in clinical practice.MethodsIn-depth interviews were conducted with 21 youth aged 15-22 years receiving psychiatric care, alongside three focus groups with 20 mental health professionals, at a youth mental health center. Data were analyzed using thematic analysis.ResultsYouth described romance, sexuality, and identity as a normal part of life and closely linked to their well-being, while mental health difficulties often complicated relationships and identity processes. Professionals reported hesitation in raising these topics due to practical and personal barriers. Cultural and religious contexts shaped experiences, particularly for LGBTQ+ youth. Both groups emphasized the importance of addressing sexual side effects of psychotropic medication.ConclusionThis study highlights a gap between the recognized relevance of sexuality and SOGI and their discussion in everyday practice. Youth want these topics addressed in mental health care conversations. Bridging this gap requires proactive, youth-centered and culturally sensitive communication, supported by training and institutional attention.

Children's and adolescents' mental health is increasingly affected by anxiety, stress, bullying, and self-harm, often intensified by social media and technological addictions. The lack of sufficient quantitative studies makes it difficult to measure the full extent of these problems, underlining the value of qualitative research to better capture key concerns. This study integrates perspectives from children, adolescents, parents, and professionals to provide a broad analysis, comparing overlaps and discrepancies in their views on mental health challenges, causes, and unmet needs. Twenty-one focus groups (N = 187) were conducted across four autonomous communities in Spain, involving representatives of all groups. Transcripts were coded and analyzed using MAXQDA 24 software to identify main themes. Children showed interest in mental health but noted that seeking psychological help is still taboo. Adolescents recognized the negative impact of excessive technology use and stressed the need for accessible psychological services. Parents highlighted the urgency of more resources and better coordination among institutions. Professionals emphasized the scarcity of preventive interventions and the lack of resources in the public system, which hinders adequate responses. The study concludes that comprehensive strategies are required to foster emotional education, expand school-based support, and improve coordination of resources from early childhood.

Autism Spectrum Condition (ASC) brings distinct experiences for families, especially around social communication and understanding certain behaviours, which may require tailored support and approaches. Best practice guidelines emphasise the need for timely post-diagnostic support for parents. This study explores parents' experiences and perceived impact of a multidisciplinary psychoeducational workshop designed for parents of children with ASC, conducted in a child and young people's mental health service in the east of London, UK. Using a qualitative design with Thematic Analysis, semi-structured interviews were conducted with 29 parents and carers who had attended the workshop within the past year. Findings revealed that parents found the workshop valuable, both for acquiring practical strategies to support their child and for fostering a sense of community. Some participants expressed a desire for earlier intervention and emphasised the need for follow-up support. Overall, parents reported increased understanding of their child's condition, which contributed to greater acceptance and improved family dynamics. The findings suggest that such interventions may enhance parental confidence, reduce household stress, and positively impact both child and parent wellbeing. These insights highlight the importance of accessible, ongoing support for families navigating ASC-related challenges.

ObjectivesResearch has highlighted poorer experiences of cancer care amongst ethnically minoritised groups. Whilst significant strides have been made in understanding cancer experiences of minoritised adults, there exists a knowledge gap in understanding how cancer impacts on minoritised young people, many of whom are faced with complex developmental challenges. This study aimed to understand the experiences of cancer and cancer care amongst minoritised youths in the UK.MethodNine young people aged between 16 to 24 with diverse types of cancer diagnoses, who self-identified as ethnically minoritised shared their cancer experiences in semi-structured interviews. Participants' stories were analysed using thematic narrative analysis.ResultsFindings identified three core narratives reflecting participants' emotional journey through cancer, their cultural stories and cancer care experiences, encompassing 12 themes. Their journeys shared common themes of: Feeling Dismissed; Shock and Turmoil; Grieving Self and Changes; Isolated and Helpless; Adapting in Adversity; and "Changed for the better". Cultural narratives revealed diverging views towards family support, while cultural influences on treatment options and feelings of being othered also complicated their cancer experiences. Overall, participants shared positive experiences of cancer care. Despite a protracted journey to diagnosis, personalised, accessible care and experiences of feeling seen were valued.ConclusionThe findings shed light on cultural influences towards minoritised young people's experiences of cancer and care. Implications around strengthening cultural sensitivity and visibility were highlighted. Future research may be helpful to hone into minoritised cancer experiences at different stages during one's cancer journey including survivorship across more diverse socio-cultural contexts and how systemic factors may impact on the provision of culturally competent care.

BackgroundThe Assessment Checklist for Adolescents Plus (ACA+) is a 30-item caregiver-report mental health and relational strengths measure, containing items that are the converse of maltreatment-related mental health and relational difficulties measured by the Assessment Checklist for Adolescents (ACA) and its short form (ACA-SF). The present study is the first to investigate the ACA+'s content validity and factor structure.MethodsACA+ and ACA-SF scores were obtained for 220 adolescents (50.9% boys), aged 12-18 years, living in residential out-of-home care (OOHC) in the UK. Item validity was estimated from item score distributions (item means and prevalence), and correlations with ACA+ total and ACA-SF scale scores. Factor structure was investigated using principal components factor analysis.ResultsAs anticipated, all item-rest correlations were positive (r = .20 to .58), while correlations with the ACA-SF total score were all negative. However, items measuring emotion sharing and relational intimacy were positively correlated with several ACA-SF sub-scale scores, suggesting that among some adolescents these items measure maladaptive dysregulated emotion and relational difficulties. To maximise clinical utility, two sets of factor analyses were performed, yielding: a 21-item four-factor solution that can be safely interpreted by children's agencies; and a 29-item six-factor solution that requires skilled interpretation by mental health clinicians. Factor analyses explained 53.9% and 75.1% of the score variance respectively.ConclusionsThe present analyses suggest the ACA+ has strong content and factorial validity for assessment of adolescents in residential OOHC. Further research is needed to establish its validity for use with adolescents in foster and kinship care.

Psychiatric admission for youth can be a highly stressful experience for caregivers. Groups are one form of caregiver support in the inpatient setting, though evidence is limited. We conducted a needs assessment survey of caregivers of psychiatrically hospitalized children and adolescents to better understand caregiver support needs and their interest in participating in groups. Of 78 caregivers, individualized care plan information was the most frequently received and desired support. 51% reported being extremely likely to attend a caregiver group on parenting skills. Groups were also rated the most helpful among other evidence-based forms of caregiver supports (n = 22; 50%). Most frequently reported barriers to group include travel, work, and time. In conclusion, while their child's individualized care plan information remains the priority, many caregivers still identify groups as an important form of inpatient support though may face various logistical barriers.

Background/aimThis study aimed to investigate whether machine learning (ML) algorithms could accurately differentiate adolescents with Major Depressive Disorder (MDD) from healthy controls (HC) based on neurocognitive data.MethodAdolescents diagnosed with MDD and HC were assessed using structured interviews, and neurocognitive functions were measured via tests for verbal and visual memory, working memory, executive functions, processing speed, inhibition, verbal fluency, and social cognition/Theory of Mind skills. Feature selection was performed using a tree-based approach and implemented through multiple ML algorithms. To address class imbalance, ML models were trained with Synthetic Minority Over-sampling Technique, and model performance was optimized using stratified 10-fold cross-validation (CV). Shapley Additive Explanations (SHAP) values were computed to interpret feature contributions.ResultsA total of 117 MDD and 67 HC adolescents were included in the study. The Support Vector Classifier (SVC) achieved the highest performance, with a mean accuracy = 76.0% (range [min-max] = 71.1%-80.9%), and a mean Area Under Curve (AUC) = 79.0%, (range [min-max] = 74.7%-82.4%); followed by Ridge Classifier (accuracy = 71.8% [65.6%-78.0%]), Linear Discriminant Analysis (accuracy = 71.8% [67.2%-76.4%]), Bagging Classifier (accuracy = 71.2% [63.7%-78.7%]), Random Forest (accuracy = 69.6% [61.8%-77.4%]), Gaussian Naive Bayes (accuracy = 69.6% (63.5%-75.7%]), Ridge Classifier CV (accuracy = 69.1% [62.5%-75.7%]) and Multilayer Perceptron (accuracy = 65.3% [57.5%-73.2%]). SHAP value identified symbol coding, categorical fluency and Stroop Test parameters as the most influential features.ConclusionsML techniques showed good performance in distinguishing adolescents with MDD from HC, with SVC achieving the highest accuracy. Cognitive domains related to processing speed and executive functions appear to be clinically relevant, suggesting that future studies should explore their role in first-episode, medication-naive adolescents and assess whether ML-based cognitive profiling can support early recognition.