Clinical child psychology and psychiatry最新文献

Background: Mentalization is the ability to think about and interpret behaviours of both self and others in terms of thoughts and feelings. Caregiver's capacity to mentalize can enhance the quality of parent-child relationships. The UK Reflective Fostering Programme (RFP) has been developed to enhance foster and kinship carers' self-regulation and self-mentalizing.

Aim: To understand carers' experiences, practical application, and perceived impact of the RFP.

Methods: A qualitative evaluation of the RFP using in depth interviews with twenty-four carers. Interviews were audio-recorded, transcribed verbatim and analysed thematically.

Results: Three key themes were identified: (1) 'Me time' - carer's reflections on the programme and what makes it work, highlights sharing of challenging experiences as important for practising mentalizing. (2) 'Stopping and thinking in the moment' - carer's understanding of programme concepts explores carer's conceptualizations of mentalization, revealing some male carers described challenges regarding sharing personal experiences in a group and the practical application of mentalization. (3) Practical application and perceived impact of the programme suggests successful enactment of learning from the programme, resulting in enhanced capacity to cope with stress, prevention of outbursts and better communication with children in their care.

Conclusions: Our findings suggest the programme can successfully facilitate carer's use of self-mentalizing, leading to greater self-regulation and capacity to support children in their care. Future research should explore experiences of male and kinship carers to inform tailoring.

In 2020 we launched a programme of activity ('The Rainbow Project') across our inner city hospital to make services more accessible and relevant to the needs of LGBTQ + young people and families living with a chronic health condition (detailed in Huckridge et al., 2021). In this article, we celebrate the five year anniversary of the project, and share how it has evolved, with a particular focus on the creation of a quarterly group for young people to meet together to support one another and share experiences. We share some of the dilemmas we have encountered and how we have responded to these, and provide inspiration and ideas for other services who may wish to do the same. Additionally, we talk about setting up a 'Rainbow Advocate' role for young people, who collaborate with us on further developing and delivering the project. Two of our Rainbow Advocates share their experiences of working on the project and their wisdom for practitioners to take forth into their work.

The purpose of this study was to perform a systematic review to describe the empirical support on TF-CBT and therapeutic alliance. Three electronic databases (PsychInfo, Web of Science, and SCOPUS) were searched through October 2023. Quantitative studies containing TF-CBT and measures of alliance were included. A total of 3,036 studies were screened, resulting in 15 quantitative studies being included in the review and charted. The Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields tool was used to check quality. Results suggest the importance of building early alliance, highlight differences in alliance perspectives between raters, and emphasize the strong influence caregivers have on children's perceptions of treatment. The review is limited by moderate-to-weak methodological rigor among studies and a relatively small number of studies available for review indicating the need for future methodologically rigorous research on this topic. This work did not receive funding, and authors have no conflicts of interest to declare.

Adolescents with mental illnesses often struggle with adhering to prescribed medication regimens. This study investigates how patient perceptions influence medication adherence among adolescents with psychiatric disorders. It also examines the role of patient characteristics and medication-related factors on adherence and attitudes. The Pediatric Medication Adherence Scale (PMAS)- 9 questions and the Pediatric Attitude toward Medication Scale (PAMS)- 18 questions, two reliable self-report scales designed for the adolescent population, were used to assess negative adherence behaviors and patients' perceptions of medication. Statistical analysis examined correlations between adherence, attitudes, and patient characteristics. The scales were administered to 288 adolescents with psychiatric disorders, and a significant correlation was found between concern scores and attitudes toward medication (r = 0.886, p < .05). Patients receiving monotherapy demonstrated lower concern scores and more positive attitudes (p < .05). Experiencing side effects was significantly linked to reduced medication adherence and more negative attitudes toward treatment. Patients with eating disorders demonstrated more negative attitudes, while those using antidepressant-antipsychotic combinations demonstrated more negative attitudes than those using stimulants. This study emphasizes the necessity of addressing critical factors that influence medication adherence and attitudes toward psychiatric medication among adolescents with psychiatric disorders. In particular, it highlights the importance of considering concern perception, managing side effects, and evaluating polypharmacy to optimize pharmacotherapy in this population.

Internalizing and externalizing psychiatric disorders among children are common and debilitating, affecting family interactions, learning and peer relations. The aim of the present quasi-randomised pilot-study was to investigate preliminary effects of a mentalization-based time-limited treatment (MBT-C) for children with mixed psychiatric disorders. The trial comprised 17 children, aged 4-11 with mixed disorders, and their parents, admitted to an outpatient psychotherapy clinic. Quasi-randomization allocated patients to 12 sessions MBT-C with parallel parent support, or wait-list control. Compared to wait-list controls, significant improvements were observed in child pathology (d = 1.23, p = .006), therapist-rated global functioning (d = 1.73, p = .002), parent-perceived overall distress and impairment (d = 1.42, p = .017), and child-perceived emotional distress (d = 1.32, p = .024). No significant effects were observed for parent-perceived symptoms (d = 0.41, p = .28). Within-group changes and long-term effects were calculated for all participants including the wait-list after being crossed-over to treatment. Results were either maintained or further improved at 6- and 12-months follow-ups. This trial provides preliminary support for MBT-C in children with mixed disorders.

Adolescence is a critical life period that marks the transition into adulthood. This novel study aims to evaluate the benefits of 4- day intervention, Sudarshan Kriya Yoga (SKY), a breathing technique, on the emotional, mental, and cognitive health of teenagers. Open label trial tests were administered at pre-intervention, immediately after SKY, and after 40 days of SKY practice. Cognitive abilities of 275 adolescents were tested using the Six letter cancellation test. Mental well-being was assessed using the World Health Organization-five Index (WHO-5), and Emotional well-being using the Strength and Difficulty Questionnaire (SDQ) questionnaire. The Results were analyzed using a paired-sample t test. The results showed an improvement in cognitive abilities for 71% of the study population as measured by the six-letter cancellation test, better mental health scores for 86%, and better SDQ scores for 95% of the population after SKY practice.

Despite rising rates of suicidal thoughts and behaviors in children, little is known about best practices for conducting suicide risk assessments in this population. The acquisition of the concept of death occurs during childhood, and thoughts and preoccupation with death can be developmentally normative. This review highlights a critical gap in knowledge about how children with suicide ideation understand death-a foundational issue in assessing suicide risk. First, we provide an overview of studies that examined the concept of death and related constructs (e.g., preoccupation with death) among children who experienced suicidal ideation or attempted suicide, many of which date back to the 1970s and '80s. We describe indirect methods of assessing death cognitions, such as the Death Implicit Association Test, representations of death/suicidal themes in play, and the role of exposure to these themes through screens (e.g., social media, videogames). Given the potential impact of sociocultural changes since the 1970s-1980s on how children understand death, gaining a contemporary perspective on how children think about death and its relationship to suicide risk is warranted. Guided by a developmental approach, we provide recommendations for future areas of research to advance this field and inform the design of developmentally appropriate risk assessments and interventions for children.

Motivation plays an important role in the field of medicine, as it significantly influences behavior change, such as becoming more physically active. This study aimed to investigate the role of motivation in engagement in a physical activity and its impact on quality of life for adolescents suffering from obesity. We assessed the time dedicated to physical activities, the type of motivation, and the relationship between those factors and their quality of life. Seventy-two adolescents aged 12-18 years (51% girls) participated in the study. Fifteen percent of the sample (11/72) were overweight, 56% (n = 40) were affected by obesity and 29% (n = 21) by severe obesity. We found that adolescents were mostly driven to engage in physical activity by self-determined motivation, but those affected by severe obesity were more motivated by external factors. Moreover, there was a disparity in physical activity engagement between genders, with boys being more active than girls. Finally, our data demonstrated that physical exercise contributed to improving quality of life of our population. This study demonstrates that self-determined motivation plays a significant role in promoting physical activity among adolescents with overweight or obesity, with notable differences between genders. Encouraging intrinsic motivation can improve physical functioning and quality of life.

Objective: Anxiety rates amongst autistic youth range from 11% to 84%. While Cognitive Behavioural Therapy (CBT) is an effective treatment of anxiety in neurotypical youth, there are concerns autistic youth lack the cognitive resources necessary to effectively engage with CBT. It is also unclear whether standard or adapted CBT is more effective. This review aims to compare the effects of standard and adapted CBT in the treatment of anxiety in autistic youth.

Methods: Articles were searched across three online databases. 24 articles were selected for final review. All articles were published between 2008 and 2024. Total sample size was 1,140 and participant age ranged from 4-18 years. Various designs, settings, and CBT formats were incorporated.

Results: When treating anxiety in autistic youth, standard CBT is effective although CBT adapted to accommodate the autism-related needs of the youth appears more effective, with gains maintained up to 26 months post-treatment. Statistical analysis was not significant.

Conclusions: Standard and adapted CBT are effective treatments of anxiety in autistic youth. To optimise outcomes, it may be important to consider the common cognitive styles associated with autism and adapt the therapeutic intervention accordingly. However, there is not yet statistical evidence for this hypothesis.

Today, for divorcing parents, the social norms of "good" parenting appear to impose obligations to "fight" for shared custody of their children. However, this may intensify conflicts experienced by their children in the form of cognitive dissonance. Authors conducted a rapid review to explore children's experiences of divorce (ages three to 12 years old) in the context of narrative therapy, in order to uncover the mechanism of cognitive dissonance. Four databases of Scopus, PsychINFO, Family and Societies Studies Worldwide, and PubMed were searched for literature in the last 10 years. Results included 11 study articles, one policy brief, and one book chapter, representing the experiences of 1169 children from seven developed countries/regions. Our findings suggest four themes associated with cognitive dissonance, whereby the first three represent the formation of harmful perceptions of cognitive dissonance resulting from divorce. The fourth represents the children's coping strategies to reduce their cognitive dissonance. We advocate that family mediators consider narrative therapy targeting cognitive dissonance as a means of repairing disruptions to family coherence. In this regard, we recommend that future research explore the consequences of children's confrontation of their cognitive dissonance in narratives found to be prevalent in children's experiences of divorce.