Clinical child psychology and psychiatry最新文献

Scope: Suicide among adolescents is a serious global health concern. Previous research has highlighted that interpersonal factors are vital determinants of suicidality. However, little is known about the cumulative effects of interpersonal risks and the protective factors that buffer individuals from developing suicidal tendencies. The present study examined whether linear or nonlinear models best account for the relationship between cumulative interpersonal risk and suicidal ideation and attempts among early adolescents and the protective value of self-esteem in these associations.

Methods: A sample of 605 seventh-grade students from in Hunan, China was tracked over a 6 month interval. Measures of interpersonal risk, suicidal ideation, suicide attempts, and self-esteem were obtained from adolescents' self-reports.

Results: The findings indicated both concurrent and longitudinal linear associations between cumulative interpersonal risk and adolescent suicidal ideation. Cumulative interpersonal risk was only associated with concurrent adolescent suicide attempts, showing a nonlinear relationship. Self-esteem moderates the association between cumulative interpersonal risk and subsequent suicidal ideation. The results also showed that identifying interpersonal risk early and simultaneously reducing multiple interpersonal risks would benefit high-suicide-risk youths.

Conclusions: Adolescents who face more than three interpersonal risks are particularly at risk for suicide attempts. Self-esteem is insufficient to counteract the cumulative impact of interpersonal risk completely. Study analyzing whether personal worth plays a moderating role in the suicidal ideation and attempts of early Chinese adolescents. While suicide among adolescents is a serious global health concern, little is known about the cumulative effects of interpersonal risks and the protective factors that buffer individuals from developing suicidal tendencies. As such, we followed 605 seventh graders over six months to investigate the combined influence of various interpersonal stressors such as low teacher support, limited classmates' support, ineffective communication with parents, and experiences of social ostracism on suicidality. In addition, we explored whether a good sense of personal worth (self-esteem) made a difference. Our findings showed that, as interpersonal risks accumulate, the likelihood of an adolescent experiencing suicidal thoughts increases. Although self-esteem offers some protection, it does not fully counteract the detrimental effects of combined interpersonal problems. In particular, when an adolescent faces three or more interpersonal stressors, the risk of suicide attempts increases. Based on our findings, we believe that interventions aimed at reducing these interpersonal risks and bolstering adolescent self-esteem could be pivotal for suicide prevention.

Objective: Our objective was to explore clinicians' views on the MyHEARTSMAP screening report; whether this report has impacted their patient care, and if so, how. MyHEARTSMAP is a psychosocial self-screening tool for youth to identify mental health concerns.

Methods: We conducted a cross-sectional study as a sub-study of the MyHEARTSMAP In-Patient randomized control trial. Eligible clinicians (nurses and physicians who have cared for patients in one of our partnered specialties and have seen a MyHEARTSMAP report in their patients' charts) provided their perceptions of the screening report through a survey.

Results: Sixty-five clinicians were enrolled; 60 (92.3%; 95% CI 85.8-98.8%) believe psychosocial screening is beneficial, with many finding it helpful for building rapport with patients/families and providing additional mental health information. Thirty-seven clinicians (56.9%; 95% CI 44.9-69%) had previously read or used the MyHEARTSMAP report, and 31 (83.8%; 95% CI 71.9-95.7%) of these clinicians found the report helpful. Clinicians specifically found the report helpful for communicating with the patient, and guiding patient-centered care.

Conclusion: Clinicians' perceptions towards the MyHEARTSMAP report were positive amongst those who had previously encountered it. While clinicians believe psychosocial screening is beneficial, exploring options for better accessibility to the screening results is necessary to increase utilization.

This commentary explores the 'cost of poverty' for child development, with particular reference to the current UK context. Specifically, it comments on the adverse impacts of poverty on child mental health, education, and maltreatment.

Raising your child with attention deficit hyperactivity disorder (ADHD) in Jordan is a challenge due to the prevailing behavioral concerns, low availability of specialized care, and generalized feelings of social stigma. This phenomenological study involved twelve Jordanian parents of children aged 4-14 years, all diagnosed with ADHD according to DSM-IV-TR criteria. Participants were recruited through purposive sampling, and semi-structured interviews were conducted. Thematic analysis revealed three key themes: "The Journey through ADHD," in which parents recognized the abnormalities of their children, reported suffering during the diagnosis, and described a wide range of uncertainty regarding the diagnosis and treatments. The second theme was "Disease as part of life," where parents reported the impact on family dynamics and social life. The third theme was "Caregiving burden," reflecting physical and emotional exhaustion and financial burden. Jordanian parents caring for children with ADHD face several challenges, including physical, emotional, economic, and social challenges and limited access to specialized services. Identifying their unique needs and challenges is essential in supporting them, providing appropriate services and resources, and developing policies and guidelines for culturally competent quality services.

Previous research has demonstrated the positive associations with parental support with better mental health outcomes in gender-diverse young people. However, less is known about what happens within a family structure if an unsupportive parent or family member leaves the family unit and sees the child only on the condition that they present in a way that conforms to their birth gender. This paper will focus on the first interviews with nine families within the wider sample of 39 families in the LOGIC-Q (Longitudinal Outcomes of Gender Identity in Children - qualitative) study who reported they had experienced rejection by a parent or family member after the young person had disclosed their gender non-conformity. These families' narratives are examined through two themes: How rejection impacts visitation, and Moving past the loss of rejection. The families all spoke about how they had adapted to the loss of their family members. They described how any negative impact would have been worse had they stayed living together, or were in contact with, the rejecting family member. Here, it becomes important then to understand the context of why a gender-diverse young person may choose to no longer see a parent or family member.

This retrospective chart review aimed to identify the intersection between young people with Autism Spectrum Disorder (ASD)'s needs and CAMHS inpatient service needs. A retrospective chart review was conducted on all referrals to a CAMHS inpatient unit over three years (n = 352). Referrals which specified a formal diagnosis or suspected diagnosis of ASD were identified (n = 111), and basic demographic data were collected. Young people with either a formal or suspected diagnosis of ASD referred to the unit presented with a wide range of co-occurring conditions. Of these young people, 30 were admitted to the unit and only 6 of them were engaged with an ASD specialist service. Young people with diagnosed or suspected ASD were more likely to be admitted if they presented with suicidality. Males with diagnosed or suspected ASD were more likely to have a diagnosis of OCD while females with diagnosed or suspected ASD were more likely to present with eating and feeding disorders and personality development difficulties. Findings highlight the lack of a clear care pathway for young people with co-occurring autism or suspected autism and complex mental health problems.

The present study examines insecure attachment styles in female adolescents, who are at risk for developing eating disorders. A second goal was to investigate whether attachment styles differentiate between high risk for anorexia and high risk for bulimia. A total of 150 adolescents were divided into four risk groups: High risk for anorexia, high risk for bulimia, medium risk and control group. The attachment styles were assessed using the Experience in Close Relationships Scale and the Relationship Questionnaire. Anxiety Attachment, but not Avoidance Attachment, was found to characterize those adolescents who are at risk for ED (AN + BN), and especially for those at high-risk for BN. The present results do not support the notion of an avoidance of emotional intimacy, characterizing the avoidant attachment style of those presenting with AN. Preoccupied Attachment style was found to characterize high-risk for BN, but not high-risk for AN, while the Insecure, Fearful, and Dismissing Attachment types did not differentiate between these two high-risk groups. This study highlights the dominant attachment style in adolescents at high risk for developing ED: The Anxiety Attachment style for AN and BN, and the Preoccupied Attachment style for BN but not for AN.

Purpose: Increased mental health (MH) needs during the COVID-19 pandemic led to the implementation of a novel pediatric Emergency Department Virtual Care (EDVC) service. Our study aimed to describe the pediatric MH patient population that used EDVC by comparing patient-specific factors of those who obtained services virtually to those seen in-person. Method: This retrospective chart review was conducted at a pediatric hospital in Eastern Ontario. Children and youth (aged 3-17) who received virtual or in-person emergency MH services from May to December 2020 were included. Patient demographics, clinical presentation details and disposition were compared between the virtual and in-person groups. Data was analyzed using descriptive statistics. Results: 1104 youth (96.1%) utilized the in-person ED for MH concerns; 45 (3.9%) used EDVC. In-person youth had a higher level of perceived risk (78.9% vs. 41.9%) and were more likely to present with concerns of depression, suicidal ideation, self-harm, or laceration (46.1% vs. 35.6%). Anxiety/situational crises or behavioural issues were more likely to present virtually. Eight patients (17.8%) were redirected to the ED from EDVC. Conclusions: Several patient-specific factors varied between youth seen in-person or virtually for MH concern. Study results can assist with the design and implementation of virtual MH care platforms.

This study explored the mental health needs and strengths of young people (aged 11-18 years) living on the remote island of Saint Helena (SH). 24 young people and their carers completed standardised inventories assessing mental health and resilience, of whom 15 of the young people and their carers participated in semi-structured interviews enquiring into mental health awareness, contributing factors to young people's mental health and resilience, as well as experience with local mental health services. Descriptive data were reported based on the quantitative measures and thematic analysis was applied to the interview transcripts. A number of young people were found to meet criteria for mental health problems while they showed high levels of resilience. The themes derived from young people's interviews were broadly centred around mental health boosters, including personal successes, social interactions, engagement in pleasurable activities and use of anxiety management strategies; and around limitations of living in SH in terms of limited resources and difficulty in maintaining trust in the community. From the carers, the themes revolved around awareness of mental health needs and strengths in young people, perceived barriers to access support mainly due to apprehensions around stigma and anonymity. Recommendations for improvement of mental health provision are made.

Few studies have examined how the personal characteristics of students, together with factors from their local social environments and communities, affect students living in generally high levels of social disruption. We examined the influence that personal characteristics as well as factors from the local social environments and communities may have on Colombian students' levels of depressive symptoms shortly after the end of the of armed conflict. Data were collected from 710 students attending the fifth grade in a random sample of elementary schools in the province of Sucre in Colombia. Information was gathered on the students' ages and gender as well as characteristics of their parents, school factors, and community factors. A five-level hierarchical regression model was used to determine the extent to which all these variables predicted depression scores, as measured by the Adolescent Depression Rating Scale. While personal, parental, school and community factors were all found to predict depression scores, the category, parental factors had the most impact. That was followed by school factors, community factors and finally personal characteristics. Multiple social and environmental factors were associated with the level of depression experienced by Colombian students.