Child and Adolescent Psychiatry and Mental Health最新文献

Background: The aim of this study was to develop and psychometrically evaluate a parent-rated parenting assessment scale including positive and negative dimensions of parenting. Factorial validity, reliability, measurement invariance, latent mean differences and construct validity of the Assessment Scale of Positive and Negative Parenting Behavior (FPNE) were tested in a pooled sample of five studies of 1,879 school-aged children (6.00 to 12.11 years).

Methods: Exploratory factor analysis (EFA) was performed on a first randomized split-half sample, and confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted in the second half of the sample. Measurement invariance tests were conducted to assess factor structure equivalence across gender and age.

Results: The EFA results supported a two-factor structure and the CFA results revealed a model with two correlated factors (Positive Parenting, Negative Parenting), which included 23 items and showed acceptable model fit and good psychometric properties. ESEM did not yield a model with significantly better model fit. Internal consistencies were acceptable. Adequate concurrent validity was demonstrated by low to moderate correlations between the FPNE and similar constructs. The factor structure was invariant (configural, metric, scalar) across different age groups and gender. Tests of latent mean differences revealed that older children scored significantly higher on negative parenting than younger children, while boys showed lower levels of positive parenting and higher levels of negative parenting compared to girls. All effect sizes were small.

Conclusions: The results suggest that the FPNE is a reliable and valid instrument for the assessment of parenting.

This commentary examines the influence of fathers in early childhood development in Africa and its implications for child and adolescent mental health. Historically overshadowed by maternal influence, research increasingly highlights the multifaceted impact of paternal involvement on children's cognitive, emotional, social, and behavioural development. Fathers contribute uniquely to children's mental growth through stimulating play and rich language interaction. Their emotional engagement fosters children's self-esteem and resilience. Moreover, fathers influence social skills by modelling interactions and encouraging exploration. Paternal involvement is linked to improved behaviour regulation. Beyond direct interaction, factors such as paternal mental health, economic stability, and co-parenting dynamics also shape child outcomes. Despite the impact of engaged fatherhood on children's cognitive, emotional, and social development, many fathers encounter barriers such as economic pressures, cultural norms, and migration. These challenges often hinder their ability to participate actively in their children's lives, resulting in a disconnect that can affect family dynamics and child well-being. Addressing cultural and societal barriers to father involvement is crucial to optimise child development. To address these issues, the paper outlines several key policy implications aimed at promoting paternal involvement. This commentary serves as a foundation for further exploration of fathers' complex and vital role in shaping children's lives.

Background: Little is known about the latent profiles of cognitive emotion regulation strategy (CERS) and its relationship with negative emotions and Non-Suicidal Self-Injury (NSSI) in Chinese junior high school students, although CERS is thought to be strongly associated with emotional-behavioral problems in adolescents.

Methods: A total of 2807 junior high school students in Yunnan Province, China, were selected for the study. They were measured with the Cognitive Emotion Regulation Questionnaire (CERQ), the Non-Suicidal Self-Injury Questionnaire, and the Depression-Anxiety-Stress Scale. Latent profile analysis was used to explore latent profiles of CERS among students, and the one-way ANOVA or c² test was used to explore the relationship between the profiles and depression, anxiety, stress or NSSI.

Results: (1) Latent profile analysis revealed five CERS types: 'Maladaptive group' (32.25%), 'Moderate adaptive-low maladaptive group' (24.68%), 'Rigid group' (19.73%), 'High adaptive-moderate maladaptive group' (14.42%), and 'Sensitive group' (8.82%). (2) The multivariable logistic regression analyses showed that with increasing age (OR = 0.812, 95% CI = 0.66-0.99, p < 0.05), junior high school students were less likely to be in the 'Moderate adaptive-low maladaptive group', and males (OR = 0. 698, 95% CI = 0.52-0.94, p < 0.05) were less likely to be classified as 'Moderate adaptive-low maladaptive group'; (3) ANOVA and c² test results showed that the differences between the different latent profiles of junior high school students on anxiety, depression, stress and NSSI indicators were statistically significant (p < 0.05). The 'Sensitive group' had the highest risk of emotional-behavioral problems and the 'Moderate adaptive-low maladaptive group' had the lowest risk of emotional-behavioral problems.

Conclusion: Negative emotions and NSSI in junior high school students are closely related to their CERS profiles, and it is important to use targeted strategies to prevent and intervene in emotional-behavioral problems for individuals with different CERS subtypes.

Background: Between 1 and 4% of children and adolescents suffer from obsessive-compulsive disorder (OCD) worldwide, but the majority of these young people do not have access to cognitive behavioral therapy (CBT) as a first-line treatment. CBT delivered via online videoconferencing (vCBT) offers a new way to provide young people with therapy, especially in the home environment where symptoms usually occur.

Methods: In this study, we investigated the feasibility of a newly revised vCBT manual, symptom change during treatment, and effects on family life and social functioning. 20 patients with OCD, aged 12-18 years, were treated during 14 weekly sessions while using a multimodal sensor system that assessed their physiological and behavioral responses during therapy. Treatment was delivered in real time via an online videoconferencing platform. Measurements of feasibility, acceptance, and implementation were evaluated descriptively, and clinical measures were assessed with t tests.

Results: The primary results showed that patients and parents perceived the manual-based vCBT as feasible and easy to understand. According to the therapists' ratings, all treatment modules and the content could be carried out in accordance with the manual. As a secondary outcome, OCD symptoms improved significantly during treatment (p <.001, d = 1.87), revealed by an average decrease of more than half in the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score. As the psychotherapy could be implemented directly in the patients' home environment, low barriers to participation were reported, and the majority of participants reported improvements in family life after treatment.

Conclusions: In summary, the results of this feasibility study indicated a successful application of manual-based psychotherapy delivered via videoconferencing for pediatric OCD supported by a sensor system. This method should be further investigated in future randomized controlled trials with larger patient samples.

Clinical trial registration: [ www.

Clinicaltrials: gov ], identifier [NCT05291611], first submission: 2021-12-10.

Background and objectives: Conduct disorders are associated with deficits in interpersonal behaviour. Both, callous-unemotional traits and social anxiety are often elevated in patients with conduct disorder and are associated with aggressive approach or disproportional avoidance. Previous studies have focused mainly on questionnaire reports of interpersonal behaviour, whereas direct explicit and implicit interpersonal behaviour in social contexts has not been considered sufficiently. Therefore, explicit and implicit interpersonal behaviour were investigated in children and adolescents with conduct disorder in the current study.

Methods: Forty male adolescent inpatients with conduct disorder and 30 typically developing controls (M_age = 12.5, SD = 1.39) took part in a virtual reality task in which they approached virtual agemates, displaying different facial expressions under the pretext of a cover story while interpersonal distance and walking speed were assessed (indirect condition). In addition, they were asked to move to a comfortable distance for conversation toward the agent (direct condition). Callous-unemotional traits and social anxiety were assessed via questionnaires.

Results: In the indirect condition, no differences between the groups emerged. In the direct condition, typically developing children adjusted their interpersonal distance to the respective expression that the virtual classmate displayed. They showed significantly greater interpersonal distances to angry classmates than to happy classmates. In contrast, conduct disorder patients' interpersonal distance, did not differ between emotions. Interpersonal distance preferences were also associated with social anxiety and callous-unemotional traits.

Conclusion: The findings suggest that conduct disorder patients fail to adjust their interpersonal behaviour to the facial expression of social interaction partners and that this is associated with social anxiety and callous-unemotional traits. A lack of adjustment to social cues might contribute to and maintain problems with peers in individuals with conduct disorder.

Objective: This study aims to investigate the interrelationship of risk factors for suicidal behaviour and their influence on attempt severity in a sample of adolescents who have recently attempted suicide. For it a network analyse was performed.

Method: Data from a sample of adolescents from 12 to 17 years of age with documented suicide attempts were collected and analysed in the context of a larger study conducted in Spain called SURVIVE. Several factors were examined including age, sex, depression, trauma, impulsivity, and substance abuse. Graph analysis was performed to identify relationships and centrality measures among these factors.

Results: A total of 267 participants were enrolled: 233 females and 34 males with a mean age of 15.00 years (SD = 1.52). The results indicate that age and sex do not have a notable relationship with attempt severity in adolescents. Emotional and behavioural difficulties, measured by the Strengths and Difficulties Questionnaire (SDQ), have the greatest influence on other variables. Depression and childhood trauma show varying degrees of association with suicidal behaviour, as does motor impulsivity. Substance use does not appear to be strongly related to suicide attempt severity. The number of suicide attempts is strongly correlated with emotional and behavioural difficulties, depression, and childhood trauma. Lethality of suicide attempts and intensity of suicidal ideation do not show significant associations with the other variables.

Conclusion: This study identifies significant risk factors for adolescent suicide. Emotional and behavioural symptoms, depression, and childhood trauma are strongly linked to suicidal behaviour. However, age, sex, and substance abuse show minimal correlation. Assessing emotional difficulties and depressive symptoms using specific questionnaires could be crucial in evaluating suicidal behaviour in adolescents.

Background: Depression is a significant health concern among children and adolescents. Previous epidemiological studies on depressive symptoms in this population have yielded inconsistent findings. This study aims to systematically estimate the prevalence of depressive symptoms among Chinese children and adolescents.

Method: A comprehensive literature search was conducted in both English (PubMed, EMBASE) and Chinese (China National Knowledge Infrastructure, WANFANG) databases from their inception until October 15, 2024. This meta-analysis employed a random-effects model to estimate the pooled prevalence of depressive symptoms.

Results: A total of 439 eligible studies, comprising 1,497,524 participants, were included in the analysis. The pooled point prevalence of depressive symptoms among children and adolescents was found to be 26.17% (95% CI 25.00-27.41%), with significant heterogeneity among studies (I² = 100%, p < 0.001). The most commonly used scales were the SDS and CES-D; the SDS reported a higher prevalence (28.80%, 95% CI 26.88-30.85%) compared to the CES-D (24.50%, 95% CI 22.49-26.68%). There was no clear temporal trend in the prevalence of depressive symptoms over time (r = 0.03, P = 0.74). The highest pooled prevalence was observed in high school students (28.23%, 95% CI 25.58-31.15%), followed by undergraduate students (27.72%, 95% CI 25.79-29.79%) and middle school students (24.15%, 95% CI 21.61-27.00%). Among the provinces, Inner Mongolia exhibited the lowest prevalence (18.43%, 95% CI 11.98-28.36%), while Qinghai and Tibet had the highest rates at 54.19% and 47.50%, respectively, although only two and one study were included for these regions.

Conclusions: The detection rate of depressive symptoms in this study aligns closely with global rates for children and adolescents. High school students exhibit a higher prevalence of depressive symptoms compared to other age groups, highlighting the need for effective interventions targeted at this population. There was no clear temporal trend in the prevalence of depressive symptoms. Additionally, the choice of measurement tool is a critical aspect of epidemiological research; standardizing these measurements is essential for enhancing data comparability across studies. Trial Registration International Prospective Register of Systematic Reviews: No. CRD42023455604.

Background: Wearable-generated data yield objective information on physical activity and sleep variables, which, are in turn, related to the phenomenology of depression. There is a dearth of wearable-generated data regarding physical activity and sleep variables among youth with clinical depression.

Methods: Longitudinal (up to 24 months) quarterly collections of wearable-generated variables among adolescents diagnosed with current/past major depression. Latent class analysis was employed to classify participants on the basis of wearable-generated: Activity, Sleep Duration, and Sleep efficiency. The Patient Health Questionnaire adapted for adolescents (PHQ-9-A), and the Ruminative Response Scale (RRS) at study intake were employed to predict class membership.

Results: Seventy-two adolescents (72.5% girls) were recruited over 31 months. Activity, Sleep Duration, and Sleep efficiency were reciprocally correlated, and wearable-generated data were reducible into a finite number (3 to 4) of classes of individuals. A PHQ-A score in the clinical range (14 and above) at study intake predicted a class of low physical activity (Acceleration) and a class of shorter Sleep Duration.

Limitations: Limited power related to the sample size and the interim nature of this study.

Conclusions: This study of wearable-generated variables among adolescents diagnosed with clinical depression shows that a large amount of longitudinal data is amenable to reduction into a finite number of classes of individuals. Interfacing wearable-generated data with clinical measures can yield insights on the relationships between objective psychobiological measures and symptoms of adolescent depression, and may improve clinical management of depression.

Background: Non-suicidal self-injury (NSSI) is a serious public health concern. Emotional insecurity is a crucial predictor of NSSI among adolescents. However, few studies have elucidated the specific mechanisms between emotional insecurity and NSSI.

Methods: This study employed a longitudinal research design, using a sample of 886 Chinese early adolescents (M_age at T1 = 10.62 years, SD = 0.77 years; 47.40% females), and conducted two surveys six months apart to examine the mediating role of peer exclusion between emotional insecurity and NSSI, as well as the moderating effect of school climate.

Results: The results indicated that peer exclusion significantly mediated the connection between emotional insecurity and adolescent NSSI. Moreover, school climate significantly moderated the connection between emotional insecurity and peer exclusion. Specifically, the impact of emotional insecurity on peer exclusion was significant only in adolescents who reported a negative school climate, but non-significant in those who reported a positive school climate.

Conclusions: These findings provide a robust theoretical foundation and practical insights to help inform the prevention of and interventions for NSSI in adolescents.