Clinical child psychology and psychiatry最新文献

Little is known about how parent-child dynamics change when parents engage in parenting intervention programmes. To explore this, the Contextualising and Learning in Mental Health Support (CALMS) app was developed to capture daily parent-reports of these key family dynamics. This small-scale pilot study aimed to test (a) the feasibility of recruiting parents attending parenting programmes to a study of parent-child dynamics throughout a 10-12-week intervention and (b) adherence to reporting parent and child behaviours in CALMS during this period. Nine parents were recruited to complete CALMS from two parenting groups and three participated in feedback interviews. Recruitment was shown to be feasible, and adherence acceptable. Most parents reported that CALMS was easy to use, not burdensome and increased their awareness of their own and their child's behaviours. Feasible and acceptable to parents attending parenting intervention, CALMS may have therapeutic benefits that should be explored in future research.

Child and adolescent obsessive-compulsive disorder (OCD) can be complicated by secondary enuresis. In fact, enuresis appears to be more common in these patients than in the general population. In this brief review, we explore various factors that may explain the intriguing link between OCD and enuresis. This review emphasizes the potential bidirectional link between OCD and enuresis, highlighting the possible role of various causes of enuresis within the specific context of OCD, such as pharmacological side effects or a potential autoimmune etiology. Based on these considerations, we propose an algorithm for managing enuresis in children and adolescents with OCD, developed through collaboration between pediatric urologists and child psychiatrists. The goal of this algorithm was to support clinicians in addressing this specific and often overlooked clinical situation.

Psychiatric hospitalization of a child or adolescent is a highly stressful time for parents, who play a central role in their child's mental illness and recovery. Little is known of evidence-based interventions to support parents during their child's admission. This scoping review aims to examine the evidence for existing parent-focused interventions in the acute inpatient child and adolescent psychiatry setting. A literature search was conducted across six databases. Three authors were involved in screening and data extraction procedures. Results were categorized by (1) intervention format, (2) intervention content and treatment targets, (3) feasibility outcomes, and (4) parent outcomes. Nine studies encompassing 9 interventions were included in the final review. Interventions included parent groups (n = 3), 1:1 peer support (n = 2), individualized family-based assessments and interventions (n = 2), an adolescent milieu curriculum (n = 1), and a website intervention (n = 1). Outcomes were heterogeneous which limited comparison between interventions. All interventions were well-received by parents. We conclude that results of this review do not support any one intervention, though all led to parent satisfaction. Some feasibility challenges were encountered, which should be considered in future implementation. More rigorous studies are needed to provide stronger evidence for any one type of parent-focused intervention in the acute inpatient child and adolescent setting.

This study aims to investigate the specific effects of Flash Technique (FT) on adolescents with test anxiety. This follow-up study consists of 38 adolescents, 14-17 years of age (M = 15.39, SD = 1.13). Pre-post assessments were conducted using the Test Anxiety Inventory (TAI), Scale of Attitudes Negatively Affecting the Performance I/Test (POET), and Beck Anxiety Inventory (BAI) at baseline, at the end of the 4^th and 12^th weeks of therapy. The FT was applied for 12 weeks, with one weekly session as an intervention. As a result of the therapy process, the baseline means of total BAI scores decreased from 25.26 to 2.18; the baseline means of TAI decreased from 149.79 to 39.13, and the baseline mean of POET decreased from 298.47 to 73.84 at the end of the 12th week of therapy. Also, the baseline means of SUD scores decreased from 9.42 to zero at the end of the 12th week of treatment. All the adolescents showed complete improvement after the 12th week of the FT. The study findings showed that the test anxiety symptoms significantly decreased with the treatment of the FT. FT can be an effective intervention for test anxiety in adolescents.

BackgroundCare-experienced young people (CEYP) have far higher rates of mental ill-health than their peers. Less is known about their wellbeing and the overlap between mental health and wellbeing in this population. Drawing on two samples of CEYP, we explored mental health and wellbeing profiles, the overlap between these, and basic predictors of symptom severity.MethodsWe recruited two samples of CEYP: 269 10-13-year-olds and 155 16-17-year-olds, and their primary caregiver. All participants were either in local authority (out-of-home) care or had been adopted from the care system in England and Wales. Participants completed standardised measures of anxiety-, depression-, PTSD-, and externalising symptoms, as well as standardised wellbeing measures.ResultsThe majority of young people in both samples reported clinically-elevated symptomology, with mental health and wellbeing particularly poor in the late adolescents sample. Almost half of the 16-17 year old sample rated their wellbeing as poor. Overall, we found moderate associations between mental health and wellbeing. In early adolescents, these associations were less clear (many with clinically-elevated mental health reported average wellbeing), but for older teens poor mental health was closely related with the poorest reported wellbeing. There was no consistent evidence that age, gender, or ethnicity predicted wellbeing, but mental health was generally the poorest for older teens in residential care placements.ConclusionsWe found high levels of disorder-specific mental health symptomology in CEYP, with 16-17-year-olds having particularly high levels of mental health difficulties and low wellbeing. Results highlight the crucial role of early intervention and prevention in this group, before difficulties become entrenched and affect wider aspects of wellbeing.

AimThis study aimed to examine the efficacy of the Coping Cat program, a CBT intervention, for Indian children (11-13 years) with high anxiety.MethodologyA total of 240 children were screened, and 120 children with high anxiety were randomly assigned to either a treatment group (n = 60) or a control group (n = 60). The Spence Children's Anxiety Scale (SCAS), Strength and Difficulties Questionnaire (SDQ), and Child Anxiety Impact Scale (CAIS) were used to assess anxiety symptoms and related outcomes. Systematic random sampling was employed to select participants.InterventionThe therapeutic process consisted of a modified CBT protocol, comprising 16 sessions of 40-45 minutes each. The Coping Cat program was specifically designed to address anxiety symptoms in children.Data AnalysisA linear mixed-effects model was used to analyze the data, accounting for both fixed effects (e.g., time and intervention) and random effects (e.g., individual differences). This approach was particularly suited for the repeated-measures design. A follow-up study was conducted one year after the intervention to assess its long-term effects.ResultsSignificant differences were observed between the treatment and control groups, indicating the efficacy of the Coping Cat program in reducing anxiety symptoms. Notably, treatment gains were maintained at the one-year follow-up. Conclusion: The findings suggest that the Coping Cat program is an effective CBT-based intervention for reducing anxiety symptoms in highly anxious children.ConclusionThe results indicated the efficacy of Coping Cat CBT in highly anxious young children.

BackgroundTransgender young people are more likely than their cisgender peers to experience trauma. Through talking about trauma, services may be able to support transgender young people to manage the impact of these events. However, research has highlighted that many trans people are concerned that disclosing trauma would be used to discredit their sense of their gender identity.AimTo explore how transgender young people experience having conversations about trauma with services and how they understand these conversations.MethodSix semi-structured interviews were carried out with young transgender people. Interpretative phenomenological analysis was used.ResultsThe study found that all participants were aware of discourses linking experiences of trauma with transgender identities. All participants recognised these conversations as significant. Some experienced conversations to be supportive and transformative. Others found them deeply distressing, reminiscent of trauma experiences. Relationships with professionals seemed to influence these experiences, as did transphobia and relationships with other services.DiscussionA trauma-informed approach should be used and professionals are encouraged to consider the potential for harm that can arise from these conversations, as well as the therapeutic element. Clinical implications and future research directions are discussed, in particular considering the recently published Cass Review (2024).

Background: Intensive community treatment services are emerging as an alternative to admission and/or to support discharge from hospital. This service evaluation aims to assess treatment pathways and factors associated with treatment duration and general functioning. Methods: A service evaluation using routinely collected data from an intensive community treatment service between 2016 and 2023 was performed. Results: 141 adolescents aged 12 to 17 received intensive community treatment over 8 years. The average treatment duration was 29.2 weeks, significantly longer than the initial 12-week pathway proposed. Those treated for significantly longer seemed to present with more complex mental health needs. Lack of education provision, being part of an ethnic minority or having a higher number of services involved were significantly associated with higher treatment duration (p < .05). Conclusion: Results suggest that a longer treatment pathway might be necessary in intensive community care, so a 24-week treatment pathway was proposed. General functioning also improved over the course of treatment, and 89.4% were discharged back to their local community teams. The involvement of multiple specialist services and the presence of specific diagnoses (e.g., autism) deserve consideration. Future evaluations will clarify if more targeted treatment pathways are more effective and efficient.

IntroductionCapgras syndrome (CS) is characterized by the delusional belief that a person, usually a close relative, has been replaced by an imposter. This study focuses on the co-occurrence of CS and Obsessive-Compulsive Disorder (OCD) in children.MethodsWe present two cases of children diagnosed with CS and OCD treated at our inpatient child psychiatric unit.Cases presentationWe describe the cases of an 11-year-old male who believed his parents were demonic entities and a 12-year-old female who believed her parents were robots. Both children exhibited additional psychiatric manifestations such as depression, catatonia, obsessive-compulsive (OC) symptoms, persecutory delusions, reduced food intake, and suicidal ideation. Our treatment approach combines antipsychotic medication, selective serotonin reuptake inhibitors (SSRIs), and gradual exposure therapy accompanied by parent training, has yielded favorable outcomes in managing the patients' psychiatric symptoms.Discussion and ConclusionWe provide insights into CS with comorbid OCD in children and discuss the behavioral treatment approach employed in our cases. We also discuss similar cases of CS comorbid with OCD from the English literature.