Clinical child psychology and psychiatry最新文献

Despite high prevalence rates of pediatric mental health challenges, estimates suggest over 50% of youth with mental health conditions have never accessed services. eMental health resources have increased over the past two decades to mitigate barriers to access. Positive attitudes towards eMental health resources have been reported in adults; however, little research has focused on parent perceptions of pediatric eMental health resources. The current study explored parent perceptions of matched eMental health resources for their child using machine learning algorithms. Parents were recruited from a longitudinal mental health study; 49 parents participated in a semi-structured individual virtual interview. Interpretative description analysis generated two primary themes: (1) feelings on AI use to assign matched mental health resources and (2) parent perceptions of eMental health resources for their child. Findings support a general acceptance by parents of the integration of AI in assigning and providing them with mental health resources for their child contingent on clinician oversight. This study fills a distinct gap in the literature on parent perceptions of pediatric eMental health resources and the role of AI, which are integral to consider in the development and dissemination of resources.

Depression and anxiety are prevalent mental health challenges experienced by youth and young adults; however, existing psychosocial interventions are not sufficiently effective. A growing body of research has examined the multiple factors that impact psychosocial treatment participation for youth with anxiety and depression. This scoping review uses the Health Belief Model (HBM) as a guiding framework to synthesize and categorize the factors that limit treatment participation (i.e., barriers) and those that are associated with greater treatment participation (i.e., facilitators) for youth aged 12-25 presenting to outpatient services for mood and anxiety difficulties. Abstracts and titles were reviewed for 5483 studies with 21 studies fitting full inclusion criteria. Most of the extracted factors fell within established HBM domains, with factors related to perceived barriers and severity most frequently reported. Relatively understudied areas included cues to action, perceived susceptibility, and self-efficacy. Also identified were multiple factors that serve as both barriers and facilitators depending on the context. The factors not captured by the HBM were socio-demographic factors and factors related to mental health service structure. Overall, this review aims to inform development of refined assessment and treatment approaches for youth with anxiety and/or depression at risk for early treatment termination.

ObjectiveWe aimed to examine the comorbid mental disorders observed in children and adolescents with school refusal behavior (SRB), as well as the role of these disorders in their emotion regulation difficulties.Method95 healthy controls (HC) and 96 individuals with SRB were included. Revised Child Anxiety and Depression Scale (RCADS), School Refusal Assessment Scale-Revised (SRAS-R), Swanson, Nolan, and Pelham Teacher and Parent Rating Scale (SNAP-4), Difficulties in Emotion Regulation Scale (DERS), Strengths and Difficulties Questionnaire (SDQ), and Clinical Global Impression-severity subscale (CGI) were implemented to assess the comorbid psychopathologies and symptom severities.ResultsHC and individuals with SRB were matched on demographic variables. Total and subscores of all scales and symptom severities were significantly different between the groups. There were significant correlations between impulsivity subscore of DERS and hyperactivity/inattention,-emotional problems,-prosocial behaviour subscores of SDQ. Impulsivity subscore of the DERS was also correlated with SRAS total score.ConclusionOur findings indicated that individuals with SRB had more emotion regulation difficulties, anxiety symptoms and behavioural problems, also, impulsivity plays an important role on attention/hyperactivity, emotional problems, prosocial behaviour, and severity of SR in individuals with SR. Further longitudinal studies investigating the role of impulsivity in SR are needed.

Parenting programs are well-established treatments for children's behavioral problems. However, engaging parents remains challenging, and a deeper understanding of how parents perceive these programs is needed to tailor them better respond to parents' needs. This study introduces a novel individually delivered parenting program, OPPI. We investigate parental perceptions of the program's content and teaching formats included and its preliminary effects on children's behavioral symptoms. The participants were 61 parents with 45 children attending the intervention at the child psychiatric clinic at Helsinki University Hospital, Finland. Parents filled out questionnaires on family background, child's symptoms, and their perceptions of the practices and teaching formats in the intervention. Parental overall opinion about the program was highly positive; especially the guidance given by counselors was considered of high quality. Practical teaching methods were perceived by parents as both the easiest and the most useful. Parents perceived most parenting practices as useful and easy to follow. Parents also reported that children's behavioral symptoms decreased significantly from pre- to post-intervention. Our study provides valuable information on the feasibility of formats and contents in parenting program. This can guide clinicians in focusing treatment more effectively, ultimately enhancing parental engagement and the overall effectiveness of parenting programs.

BackgroundPrepped and Ready is a novel intervention designed to enhance caregiver knowledge of means restriction-a suicide prevention strategy that can be implemented in the home. The objective of the present study was to evaluate the extent to which participation in Prepped and Ready is associated with changes in caregivers' implementation of means restriction.MethodsParticipants independently viewed the single-session digital intervention. Survey data were collected at pre-intervention (T1), post-intervention (T2), and three-week follow-up (T3).ResultsA total of 550 participants (90.9% female, 86.2% White, 68.5% college-educated, and 51.3% from suburban areas) completed the intervention and the T1 and T2 surveys, while 60.7% completed the T3 survey. The proportion of participants locking medications increased from 44.2% at T1 to 82.5% at T3 (OR = 103, 95% CI: 17-637, p < 0.001). Among firearm owners, adoption of the safest storage method increased from 31.3% at T1 to 61.0% at T3 (OR 9.2, 95% CI: 4-19, p < 0.001). Nearly all participants (99.3%) agreed Prepped and Ready provided value.ConclusionsThis study suggests that a brief intervention for caregivers has promise for improving implementation of means restriction practices. Further research is needed to bolster confidence in the generalizability of findings.

PurposeRates of adolescents with Autism Spectrum Disorder (ASD) and suicidality have increased. Dialectical Behavioral Therapy (DBT) historically has been found to be effective in targeting suicide risk across the lifespan. Adolescents presenting with parent-reported autism traits were compared to those with low traits on DBT outcomes and suicidality in this study. Moreover, therapeutic alliance was also examined.MethodsEighty-seven adolescents attended a 4-week DBT partial hospital program (PHP); parent-report was administered to assess ASD traits. Adolescents completed self-report questionnaires at admission and discharge on four DBT outcomes. Suicidality characteristics were examined through a structured interview.ResultsWe found that adolescents presenting with autism traits did not significantly differ from adolescents presenting with low or no autism traits on suicide ideation, suicide gestures, and self-harm. They did, however, significantly report fewer suicide plans and attempts. Across the sample, DBT was most effective in improving most of adolescents' outcome skills, and this did not significantly differ based on autism traits. We also found that therapeutic alliance ratings were significantly and positively associated with the improvement outcomes observed across this sample.ConclusionOverall, this research supports DBT use for adolescents presenting with autism traits and emotion dysregulation.

ObjectivesThe study investigated the feasibility, acceptability, and effectiveness of delivering a modified Mindfulness Based Stress Reduction (MBSR) programme in reducing symptoms and psychological stress associated with Inflammatory Bowel Disease (IBD).Methods58 outpatients aged 15 to 24 with a diagnosis of IBD attending a large teaching hospital tertiary clinic were randomised to 8 weekly sessions of a modified MBSR programme or waiting list control. Well-being and disease severity were assessed at baseline (T0). Outcomes were collected 2 to 4 weeks following completion of the intervention (T1) and 2 to 4 weeks (T2) after controls completed the intervention. A process evaluation explored reasons for participation and perceived impact of MBSR.ResultsThere were no statically significant changes however there was a clinical improvement in disease severity and quality of life (2.96 points reduction (standardised difference (d = .38)) on the HBI, 12.17 points higher on the IMPACT-III (d = .37) and an increase in mindful awareness (0.70 points higher on the MAAS).Young people enjoyed meeting other young people with IBD and reported improvement in quality of life and feeling more connected to their body. One third (17/49) chose not to attend any groups. Difficulties in recruitment and attrition impacted on power to detect long term changes.ConclusionsYoung people that participated found the group acceptable and reported a positive impact on symptoms however limited uptake argues for caution when considering MBSR as a mainstream intervention in busy tertiary services for adolescents with IBD without mitigation of identified barriers.

This service evaluation reviews the first five years of the Adolescent Community Treatment Service (ACTS), an intensive community treatment team developed by Central and North West London (CNWL) NHS Foundation Trust to support children and young people (CYP) aged 13-17 in mental health crisis. Between July 2019 and July 2024, ACTS worked with 163 CYP. The service aimed to prevent psychiatric admissions and facilitate early discharge from inpatient units. ACTS avoided psychiatric inpatient admission for 58.2% of referrals to inpatient hospitals and supported 43 discharges of CYP from inpatient settings. Post-intervention, significant clinical improvements were observed, including reduced symptom severity, improved functioning, and enhanced educational engagement. Although primary diagnosis did not significantly relate to discharge destination, CYP presenting with greater symptom severity tended to require inpatient care. Findings support ACTS as a flexible, least-restrictive model for crisis intervention to inpatient care. This is consistent with NHS Long Term Plan priorities, but also underscores the ongoing need for inpatient services for those whose safety cannot be managed in the community. Further research is needed to explore long-term outcomes, economic impact, and tailored pathways for neurodivergent and minoritised groups.

This response addresses a commentary on our original work that examined United States adolescent suicidal ideation and attempts by weight group and by perceived closeness to others at school. In this response, we clarify key aspects of our work, highlight areas of conceptual agreement with the commentary authors, and discuss future research directions for adolescent suicide prevention. This exchange emphasizes the complexity of adolescent suicide risk and highlights the importance of continued multidisciplinary discussion to advance clinical research and practice.

This commentary reviews Milligan and Kidwell's (2025) analysis of the relationship among adolescent weight status, perceived social closeness, and suicidality. The authors report higher odds of suicide consideration and attempts among adolescents with overweight and obesity compared with their healthy-weight peers, while perceived closeness to others serves as a protective factor. A limitation, however, is the absence of 95% confidence intervals (CIs) in the abstract, which limits quick appraisal of the findings' precision and clinical interpretability. Based on these findings, we argue for a shift from weight-centered narratives to weight-neutral, stigma-aware approaches that emphasize relational connection as a core target for prevention. We also outline opportunities to use digital peer-support infrastructures to enhance closeness, and we call for longitudinal, culturally responsive research to clarify causal pathways and heterogeneous effects. By centering connection and body acceptance, suicide prevention strategies for young people may become more precise and effective.