Clinical child psychology and psychiatry最新文献

The rapid rise in internet access and smartphone use has significantly changed how children and adolescents engage in screen-based activities. To date, no systematic review has examined long-term trends in screen time use among children and adolescents that cover periods before and after the onset of the COVID-19 pandemic. This systematic review examined repeated cross-sectional studies to determine whether screen time use among children and adolescents changed over time. This systematic review was registered with PROSPERO (ID: CRD42021243869). The Web of Science, PubMed, Embase, and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English, included data from at least two time points, and focused on children and adolescents between 0 and 19 years of age. The search was conducted without any restrictions on publication year. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs. A narrative synthesis was conducted following the Synthesis Without Meta-analysis guidelines. This review identified 60 studies covering the period 1991-2022. The findings indicate that traditional TV watching declined while the use of computers and video games grew. Screen time increased significantly over the years, especially after the COVID-19 pandemic started. The studies reviewed varied in how they defined and measured screen time. The review underscores the importance of continued research and evidence-based policies to guide responsible technology use in the lives of young people.

BackgroundSelf-guided Digital Mental Health Interventions (DMHIs) are increasingly used amongst young people as they are scalable and may improve access to support.ObjectiveTo assess the acceptability, feasibility, utility, and immediate effects of Project ABC-UK, a Single-Session Behavioural Activation DMHI for UK youth.MethodsA single group pre-post design was used. Participants (aged 13-18) completed demographics, as well as measures of hope, self-agency, hopelessness, and perceived control before and after the online intervention. It was completed anonymously, and participants gave feedback. T- and chi-square tests compared completers and non-completers; pre-post effects were assessed using paired t-tests with effect sizes (Cohen's d). Thematic analysis explored feedback.ResultsOf 799 participants, 401 (50.1%) completed the intervention, of whom 356 (88%) completed at least one post-intervention measure. Completers were more likely to be younger, have higher pre-intervention hope and self-agency, and to identify as sexual minorities. Significant improvements were found in hope and self-agency (d = -0.41), hopelessness (d = 0.52), and perceived control (d = 0.45). Most found the intervention enjoyable and useful.ConclusionFindings support the feasibility and acceptability of Project ABC-UK, with promising immediate effects on all outcomes. Future studies should assess effects on depression and anxiety at follow-up and compared to other interventions.

IntroductionTrauma-informed care (TIC) has been promoted as a way for services to be aware and respond to the potential impact of trauma. Although professionals are encouraged to adopt it in routine practice, understanding of TIC is often unclear. A TIC training provider sought advice how to improve training for professionals working with children and adolescents.MethodThis qualitative study explored participants' understanding of TIC after being trained, experiences of barriers and facilitators to implementing TIC, and recommendations to improve training. Nine professionals from health, social and education services completed semi-structured interviews. Participants varied in age and experience but lacked ethnic and gender diversity.ResultsA model of behavior change (COM-B: capabilities, opportunities, motivation, behavior) guided analysis. Participants described an understanding of TIC consistent with current guidelines, with some divergence regarding responsibility for using TIC and the conceptualization of trauma. Facilitators and barriers to TIC implementation were shaped by these perceptions. Some barriers could be addressed through training, while others require more systemic change, (e.g. shared TIC language; increased resources). Suggested training improvements included clarifying definitions and roles, increasing hands-on practice, and training of supervisors.DiscussionFindings offer theory-driven contributions to the evidence-base of TIC understanding, facilitators and training improvement.

IntroductionLimited research has examined the circumstances surrounding childhood suicidal thoughts and behaviors. The interpersonal psychological theory of suicide proposes that suicidal desire arises from perceived burdensomeness and thwarted belongingness, and that suicide attempts result from an acquired capability for suicide. No published study, of which we are aware, has tested whether this theory applies to children's suicidal thoughts or behaviors. The present study examined whether components of the interpersonal psychological theory of suicide would be present in the narratives of children who presented for clinical care with suicide ideation or attempts.MethodsThirty-nine children, ages 7-12 years, recruited from two public hospitals and one outpatient clinic, completed semi-structured interviews assessing the circumstances surrounding their recent suicide ideation or attempts. Interviews were analyzed thematically using a hybrid inductive-deductive approach.ResultsFindings indicated that thwarted belongingness stemmed from loneliness, perceived rejection, and a lack of reciprocal care. Themes reflecting perceived burdensomeness included internalized criticism, low self-esteem, and perceived liability. Children described experiences, such as physical punishment, that may contribute to acquired capability for suicide.DiscussionThese findings support the relevance of the interpersonal psychological theory of suicide in childhood and underscore the critical role caregivers play in protecting children from suicide-related risk.

IntroductionResilience in adolescence has been widely studied, yet most instruments used to assess it were created in Anglo-Saxon contexts and often lack cultural resonance in Latin America. This study examined the factor structure and psychometric properties of the VOLANTÍN Resilience Capabilities Scale, a Chilean instrument designed to capture culturally meaningful expressions of resilience in school settings.MethodA total of 3,934 students aged 10-18 from public schools in Chile completed the scale and an established mental health screening measure. The sample was randomly divided to conduct exploratory and confirmatory analyses using methods appropriate for ordinal data and systematic criteria for refining items.ResultsThe analyses supported a coherent 19-item structure with four dimensions (Self-esteem, Prosocial Behavior, Perseverance, and Emotional Regulation) explaining 51.7% of the variance. Items with unstable patterns were removed. The confirmatory analysis showed strong overall fit (CFI = .953; TLI = .946; RMSEA = .058; SRMR = .055) and supported a hierarchical model with an overarching resilience factor.DiscussionThe VOLANTÍN Scale emerges as a culturally grounded, concise, and psychometrically robust measure of adolescent resilience in Chile. Its properties make it suitable for school-based screening, applied research, and interventions that require contextually sensitive assessments.

BackgroundVery few studies have been conducted to explore psychological capital (combined hope, self-efficacy, resilience, and optimism known as PsyCap) and mental health among rural U.S. adolescents.PurposeThe purpose of this study was to explore the relationship between PsyCap and mental health using a health equity lens.MethodsA sample of 59 rural U.S. adolescents completed the survey packet. Descriptive and inferential statistics were conducted on the RStudio platform.FindingsPsyCap was significantly associated with wellbeing and anxiety. Non-binary adolescents reported significantly lower PsyCap. While the overall sample reported perceived rejection above the national norm, non-binary adolescents reported the highest levels.DiscussionPsychological capital theory served as a useful framework for exploring mental health among rural adolescents. More research needs to be conducted with large inclusive samples of rural adolescents who live on the margins. Examination of mental health services in rural settings should be considered.

ObjectivePrevious research has yielded mixed findings regarding the validity of the Child Behavior Checklist (CBCL) DSM-Oriented Scales (DOSs) in identifying DSM diagnoses. The present study evaluates the concurrent validity of the DOSs by comparing scale classifications with a gold-standard clinical interview.MethodsParticipants (N = 11,851) were children in the NIH Adolescent Brain Cognitive Development (ABCD) study whose caregivers completed the CBCL and the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) semi-structured interview at baseline (9.92 years, SD = 0.63), two-year follow-up (12.03 years, SD = 0.67), or both.Results2,321 (19.59%) children at baseline and 1,708 (15.57%) participants at two-year follow-up met criteria for one or more KSADS disorders. Sensitivity of the CBCL relative to KSADS diagnoses was generally low (10.36% - 75.00%), with only two scales above 50%. Specificity was high (92.47% - 97.07%). Positive predictive values were low (0.71% - 48.20%), and negative predictive values were high (89.84% - 99.90%). Area under the curve (AUC) ranged from 0.55 to 0.84.DiscussionIn the present sample, the DOSs showed poor concurrent validity with a gold standard clinical interview. Caution should be exercised when using the CBCL due to the high rates of false negatives.

PurposeThere is evidence that academic pressure has been rising among adolescents in the UK. While this may be a modifiable risk factor for mental health problems, there are few validated measures of academic pressure and all have limitations.MethodsWith secondary-school students, we co-produced a student-reported measure of academic pressure, the 7-item Academic Pressure Questionnaire (APQ). This was included in the baseline survey of students aged 12-13 within the Positive Choices trial, a whole-school intervention to promote sexual health in English secondary schools. We ran factor analyses and assessed internal consistency, associations with sex and depressive symptoms, and variation in academic pressure between schools.ResultsWe extracted one factor (Cronbach's alpha 0.76). Female students had higher APQ scores than males (mean difference = 2.18, 95% CI: 1.88 to 2.49). Higher APQ scores were associated with more depressive symptoms (coefficient = 0.51, 95% CI: 0.48 to 0.55) and associations were larger in female than male students (p value for interaction <0.001). School-level factors explained 2.6% of variation in APQ scores after adjusting for individual-level factors (ICC = 0.026, 95% CI: 0.01 to 0.06).ConclusionThe APQ is a valid and reliable tool to investigate academic pressure in secondary-school adolescents.

This within-child study examined whether a tailored, single-session virtual reality (VR) training can enhance social skills among children enrolled in special education programs for behavior problems. Forty-nine children (ages 7-13; 85.7% boys; 57.1% ASD, 20.4% ADHD) completed one 20-min VR session. For each child, teachers selected one skill for children to practice with: staying calm (anger regulation), asking to join a group (peer entry), or saying no (assertiveness). Relative to baseline, in-VR observations showed substantial immediate improvements of the targeted skill (η²_p = .35), but teacher reports two weeks later showed no comparable improvement in the classroom (η²_p = .07). Teachers also reported no changes in children's aggressive behavior or emotional problems two weeks later. Children reported moderate levels of immersion and perceived efficacy, low-to-moderate emotional engagement, and high appreciation of the training, VR, and trainer-child relationship. Overall, findings suggest that interactive VR is an attractive tool to practice socially skilled behavior, but that transfer to real life may require more sessions, explicit bridging strategies, and/or more emotionally engaging VR.

Early life experiences play a crucial role in shaping children's emotional and psychological development, influencing their self-perception, interpersonal relationships, and ability to regulate stress. Primary school-aged children are particularly vulnerable, as they have limited control over their environment while being increasingly exposed to challenges such as family conflict, peer difficulties, and academic pressure. Without appropriate support, they may adopt maladaptive coping strategies in response to psychological distress. Although mental health issues among children are gaining recognition, access to effective support remains limited due to stigma, financial constraints, and a lack of resources. Therefore, this study examined the effectiveness of a Brief Cognitive Behavioral Therapy (Brief CBT) workshop on psychological distress, coping strategies, and grit among primary school students in Klang Valley, Malaysia. The study adopted a randomized quasi-experimental design with random selection and allocation of 7 schools to either intervention or wait-list groups, and three quantitative measures were used at two time points to assess the outcomes. Analysis indicated significant intervention effects on Anxiety [F (1, 1092) = 4.32, p = .038], Coping Strategies (Active) [F (1, 1092) = 14.87, p < .001], and Grit [F (1, 1092) = 10.20, p = .001].