Clinical child psychology and psychiatry最新文献

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.

BackgroundThis study investigated changes in school and vocational attendance problems (SVAP) among young people receiving treatment as usual (TAU) at Child and Youth Mental Health Services (CYMHS) in Australia. Although CYMHS primarily addresses severe psychiatric disorders, SVAP frequently co-occurs in this population, impacting overall wellbeing.MethodA random sample of 210 patients who completed treatment in the year prior to the COVID-19 pandemic was selected. SVAP was assessed using the Health of the Nations Outcome Scales for Children and Adolescents (HoNOSCA), a routinely collected measure of symptoms and functioning, with ratings recorded at Assessment, 91-day Review, and Discharge.ResultsAt Assessment, 48.6% of patients presented with SVAP. This reduced to 44.8% at Review and significantly dropped to 24.3% by Discharge (p < 0.001). While no significant change was observed from Assessment to Review, a substantial reduction in SVAP was noted from both Assessment to Discharge and Review to Discharge (p < 0.001).ConclusionThese findings suggest that CYMHS TAU, though not specifically focused on attendance issues, can positively impact SVAP in young people with complex psychiatric needs.

Global South countries are typically faced with multiple socioeconomic and resource challenges that predispose rising child mental health needs, which remain largely unmet. Collectivist societies, however, provide protective mechanisms for child mental health and opportunities for interventions through existing informal support systems. We provide an empirically grounded framework for child mental health service transformation, accounting for the complexities of resource burdens and the need for culturally sensitive adaptations. In presenting this framework, we utilise data from projects in South Africa and Pakistan which engaged participants from disadvantaged urban areas. These involved a total of 10 psychosocial interventions, 504 end-users (youth, parents and professionals) and a sub-sample of 76 focus group participants, to describe the design, refinement, cascade training, implementation and process evaluation of the framework. The secondary thematic analysis illustrates four layers of knowledge generation, translation and transfer, transformation through community engagement and mobilisation, and impact through service integration and systemic changes. The framework and supporting findings informed a provisional Theory of Change. This highlights the principles of stigma prevention, co-production with communities, contextualisation of psychosocial interventions, integration with informal and structural support systems, knowledge cascade, and involvement of youth and parents with lived experience.

AimsThis study examines the influence of cultural factors on mental health perceptions and practices in Kuwait, with a specific focus on mental health professionals working with children and adolescents. Employing the ETHICA-4P toolkit, the study aims to evaluate and promote ethical and culturally sensitive approaches in research and clinical interventions.MethodsA qualitative research design was used, involving semi-structured interviews with mental health professionals to explore their experiences and approaches to culturally sensitive practice.ResultsFindings indicate that cultural factors, such as family dynamics, religious beliefs, and societal stigma, strongly influence help-seeking behaviours and therapeutic outcomes. Despite available mental health services, cultural stigma and fear of social repercussions remain significant barriers in Kuwait, including concerns about family reputation, judgment from the community, and potential impacts on marriage prospects or social standing.ConclusionETHICA-4P can act as a model to integrate cultural competence into clinical practice and improve mental health outcomes for children and youth. Findings also highlight the urgent need for education campaigns directed at therapists, parents, educators, and the general public to reduce stigma and increase mental health awareness.

BackgroundUnaccompanied minors (UMs) are a population at risk for mental health problems, including post-traumatic stress disorder (PTSD). Yet, engagement with mental health services remains limited, with low utilization, missed appointments, and high drop-out rates, posing challenges to effective care.PurposeThis study aimed to examine unaccompanied minors' (UMs) mental health, their help-seeking behaviors, and their perceptions of and satisfaction with psychotherapeutic care, while exploring the links between PTSD symptoms and emotion regulation in a French department (Savoie).MethodA total of 64 UMs who met a psychologist at least once completed self-reported questionnaires: help-seeking behaviors and therapeutic care, post-traumatic symptoms (IES-R), and difficulties in emotion regulation (DERS-F).ResultsThirty-four percent of UMs exhibited probable PTSD. Greater PTSD intensity correlates with fewer adaptive emotion regulation strategies and lower emotional acceptance. After arriving in France, UMs significantly increased their reliance on formal medical services and mental health professionals (MHPs), while decreasing family communication and traditional medicine use. Despite few consultations, UMS reported high satisfaction with therapeutic care and the therapeutic relationship, suggesting trust in this new healthcare system.ConclusionFuture research should explore the benefits of emotion regulation interventions for UMs' mental health. Child welfare services (CWS) should prioritize strategies to improve therapy engagement and ensure sufficient MHP sessions, acknowledging cultural factors influencing their help-seeking behaviors.

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.

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.