Clinical child psychology and psychiatry最新文献

Children with congenital heart disease are more likely to receive special educational services in schools and have an increased risk of mental health issues. We explored the lived experiences of parents caring for a child with heart disease and concurrent mental health issues in Denmark. Semi-structured interviews with ten parents (age 39-57 years) to these children (age 5-17 years) were analysed using interpretative phenomenological analysis. Three Group Experiential Themes (GETs) were generated from the analysis: The first GET, Parental roles and caring behaviours, described parental struggles of fulfilling their parenting role ideals and experiences with stigmatization of MHI. GET two, Parental reflections on their illness explanations, portrayed how parents utilize different illness explanations to make sense of their child's MHI. GET three, Differences in access to help and support, captured how the CHD affected overall access to mental health support. The results may inform various topics of importance for health professionals to address in their clinical encounters with these families.

BackgroundIndia faces a substantial mental health treatment gap, particularly regarding the underutilization of psychotherapy among adolescents. This mixed-methods study aimed to identify the barriers and facilitators influencing the uptake of psychotherapy for mental health issues among adolescents attending a tertiary care referral center in India.MethodsA mixed-methods design was employed. Quantitative data were collected from 74 adolescents recruited via purposive sampling using standardized scales assessing attitudes toward seeking professional psychological treatment, self-stigma, perceived barriers to seeking help, and the working alliance. Qualitative data were gathered through focus group discussions to further explore barriers and facilitators of psychotherapy.ResultsMost participants were diagnosed with neurotic spectrum disorders and had no prior psychotherapy experience. Higher self-stigma and perceived barriers were associated with less favorable attitudes toward seeking psychotherapy, while a stronger working alliance was associated with more positive attitudes. Thematic analysis identified key barriers including stigma, apprehension, poor awareness, negative social influences, and reliance on informal support. Facilitators included greater mental health literacy, perceived symptom severity, and encouragement from informal networks. Urban adolescents reported stronger working alliances compared to their rural counterparts.ConclusionFindings highlight the need to address stigma, enhance mental health literacy, and consider contextual factors in service delivery.

IntroductionUniversal screening using measures of mental health symptoms is discounted by UK schools due to stakeholder concerns. This is a preliminary study of the psychometric properties of a new Brief Positive School Experiences (B-PSEs) scale, devised to assess associations between cumulative positive school experiences (PSEs) and adolescent mental health as part of a PhD project that explored PSEs count as a potential proxy measure of adolescent mental health risk.MethodsFive teachers developed a brief 19-item PSEs measure. 460 adolescents (aged 14-16) completed a survey based on these items and items measuring mental health (N = 460). Exploratory factor analysis and measures of internal consistency assessed the scale's preliminary psychometric properties.ResultsThe B-PSEs scale demonstrated a three-factor structure; (1) Coping with school demands; (2) School belonging, safety and support; and (3) Equity and low social adversity. Composite reliability was measured at 0.91.ConclusionThe B-PSEs scale is a reliable measure with a robust factor structure and PSEs scores measured using the scale have demonstrated associations with adolescent mental health outcomes.

BackgroundHematopoietic stem cell transplantation is an aggressive, frequent, and relevant therapy for cancer. Studies on this subject predominantly address parents' and health professionals' experiences, and rarely feature the voices of children and adolescents. The purpose of this study is to enhance the understanding of the experiences of children and adolescents with cancer undergoing hematopoietic stem cell transplantation.MethodUsing symbolic interactionism and a narrative research method, data was collected and analyzed from in-depth interviews with seven children and adolescents (aged 6-18 years, up to 18 months post-transplant and under oncological follow-up), at the hematopoietic stem cell transplant service of a reference institution in Brazil.FindingsThe experiences are challenging because they involve complex and dual interactions that intertwine social processes and signs related to suffering and hope. Two thematic categories were identified: (Re)living Suffering in Transplantation and Signifying Transplantation as Hope for a New Chance of Life.DiscussionThe experiences of the participants were influenced and marked by past diagnosis and treatment that generated overload, exhaustion, suffering, and fragility in the present. Participants revealed the centrality of the symbolism of transplantation as a "new chance of life" and a propeller of hope and coping oriented towards a future beyond the disease and treatment. Health professionals caring for this population must access the child's and youth's voice to understand their needs, expectations, and feelings, aiming to accommodate them and provide unique support in their battle and life intersected by cancer and transplantation, and the symbolic constructions related to these elements present in their experiences.

This study explores how former child soldiers in Colombia narrate identity repair following their experiences of conflict. Twenty-five adolescents and young people (aged 14-19) participated in participatory life-history workshops using a creative auto/biography (CAB) method. A narrative analysis of over 200 first-person multimodal texts identified four recurring plots- the Struggler, Learner, Advocate, and Survivor-each reflecting distinct, non-sequential pathways of self-reconstruction, emotional processing, and social re-engagement. These plots show how young people reimagine self and negotiate belonging amid stigma, rupture, and transition. The study proposes a Narrrative Identity Repair Compass comprising six interrelated domains: narrative coherence, self-concept (self-image and self-worth), self-efficacy (capacity to act on and shape circumstance), temporal orientation, relational positioning, and cognitive processing (narrative work integral to change). This multidimensional model conceptualises identity repair as fluid, non-linear, and relational. Post-traumatic growth (PTG) defined here as positive psychological change emerging from the struggle with major adversity is reframed as a contingent possibility shaped by reflection, relationships, and creativity. This framework offers a developmentally appropriate and context-sensitive approach to understanding how former child soldiers reconstruct meaning, repair identity, and move toward psychosocial integration following experiences of armed violence.

BackgroundThis study examined whether youth transition between different mental health symptom profiles over time, and what factors predict these transitions. Understanding the stability and change in psychopathology helps discern whether certain behaviours are temporary or signs of persistent problems.MethodsData were drawn from a longitudinal study of 263 youth (ages 2-16) with chronic physical illness and their parents, assessed at baseline (T1), six months (T2), 12 months (T3), and 24 months (T4). Parents reported on youth psychopathology using the Emotional Behavioural Scales (EBS). Latent profile analysis identified psychopathology profiles, and latent transition analysis quantified the probability that youth remained or moved between groups over time.ResultsFour profiles were identified: low psychopathology (LP), primarily internalizing (PI), primarily externalizing (PE), and high psychopathology (HP). Homotypic continuity (i.e., remaining in the same profile over time) was lower for the PI, PE, and HP subgroups. Youth in the PI subgroup were more likely to transition to the LP, while those in HP showed greater stability, with many remaining in the high-symptom groups. Child age, parent psychopathology, and parent education significantly predicted profile transitions.ConclusionsMost youth showed changes in their mental health over time, but a small proportion with HP (<5%) had more persistent problems. Results demonstrate the need for early identification and intervention for youth at risk of chronic mental health difficulties.

This study aimed to investigate the prevalence of social anxiety disorder (SAD) among Malaysian secondary school students during the COVID-19 pandemic and to explore its correlations with demographic variables, impulsivity behavior, and internet gaming disorder (IGD). A total of 1574 participants from 12 government secondary schools across five Malaysian states, comprising 569 males and 1005 females, completed an online questionnaire containing validated Malay versions of the Social Interaction Anxiety Scale, Barratt Impulsiveness Scale, and Internet Gaming Disorder Scale - Short Form. The findings revealed a notable SAD prevalence rate of 40.53% among Malaysian adolescents. Logistic regression analysis unveiled significant associations between SAD and factors such as attention impulsiveness (OR = 2.58, p < .001), motor impulsiveness (OR = 1.47, p = .03), female gender (OR = 2, p < .001), Malay ethnicity, and IGD (OR = 1.08, p < .001). In conclusion, this study provides valuable insights into the extent of social anxiety experienced by Malaysian secondary school students during the pandemic, shedding light on the demographic and psychosocial factors linked to its emergence. Furthermore, the research underscores a robust link between IGD and SAD, emphasizing the need for comprehensive interventions addressing both issues concurrently. By recognizing the multifaceted nature of these associations, future interventions can be tailored to provide holistic support for adolescents' mental well-being.

BackgroundParents can be slow to recognise that an adolescent needs help from a mental health professional, yet the factors affecting their help-seeking intentions are not well understood. The aim of this study was to test the application of the Common-Sense Model (CSM) of Illness Representations to parents' perception of adolescent distress and intentions to seek help.MethodThe study employed an experimental design using video vignettes. Parents (N = 1,176; female N = 993) of adolescents (10-19 years) were asked to self-report key demographic information, an illness perceptions questionnaire, and a measure of stigma.ResultsResults demonstrated that the CSM model explained 38% of the variance in help-seeking intentions. Parents were more likely to report intentions to seek help if they believed that treatment could control the adolescent's problem (OR = 1.39), or if they believed the problem would have negative consequences (OR = 1.41). Parents who believed the problem was in the control of the adolescent, had lower help-seeking intentions (OR = .87).ConclusionThe CSM provides a useful model of help-seeking intentions to guide parental education. Perceiving treatment as controlling distress or that distress would have negative consequences for an adolescent, were key predictors of parental help-seeking intentions.

IntroductionBelonging is a powerful predictor of positive outcomes in youth, including greater well-being. There remains a pressing need to integrate influences across layers of organization within youths' developmental contexts to further understand how to enhance belonging amongst this demographic. Here, we investigate: (1) "How do risk and promotive factors converge in relation to belonging among youth?" and (2) "Do risk and promotive factors associate differently with belonging between boys and girls?".MethodsResponses from a community-based questionnaire were analyzed to establish ecological systems networks of the interrelationships between youths' social connections, well-being, belonging, and sociodemographic factors (N_girls = 477, N_boys = 245; M_age = 14.2, SD = 2.2 years).ResultsOur findings demonstrate the salience of ethnicity-based discrimination experiences in diminished mental health outcomes and lower belonging among boys. Additionally, we show the crucial link between emotional support from teachers and family with higher belonging for youth. Conclusions: We discuss the importance of gender-based considerations when targeting belonging promotion and well-being among children and adolescents.