Child and Adolescent Psychiatry and Mental Health最新文献

Background: Juvenile inmates often face psychological pressures such as stress, anxiety, and depression while serving their sentences. These conditions can reduce their psychological well-being. Previous research has shown that cognitive approaches such as positive self-talk are effective in helping individuals manage negative thoughts, while journaling can improve self-awareness and emotion regulation. However, there have been few interventions that combine these two approaches in juvenile inmates.

Objective: to determine the effect of positive self-talk journaling intervention on the psychological well-being of juvenile prisoners.

Method: this study used a quasi-experimental design with a control and intervention group. The research sample consisted of 110 juvenile prisoners who were selected purposively according to the inclusion criteria, namely aged 13-18 years and willing to participate in the program. Data collection used the Ryff's Psychological Well-Being Scale at two times, before and after the intervention. The intervention was given for 4 weeks with structured sessions for positive self-talk and journaling. Data analysis was performed using the Wilcoxon test for analysis within groups and the Mann-Whitney test for comparison between groups.

Results: the Wilcoxon test results showed a significant increase in psychological well-being scores after the intervention in the intervention group (p < 0.05). The Mann-Whitney test showed a significant difference between the intervention group and the control group after the intervention (p < 0.05). These findings indicate that the positive self-talk journaling program is effective in improving the psychological well-being of juvenile prisoners. This intervention has a positive impact by helping juvenile prisoners recognize negative thoughts and replace them with positive affirmations.

Conclusion: journaling techniques allow for deep self-reflection, thereby improving their ability to manage emotions. These findings support empirical evidence that cognitive and emotional-based approaches can improve mental health in high-stress situations.

Objective: This study aimed to examine whether mixed features during a current major depressive episode (MDE) are associated with increased risk of non-suicidal self-injury (NSSI) among adolescents and young adults, focusing on both first-onset and recurrent NSSI during a 6-month follow-up period.

Method: A total of 713 individuals aged 13-25 years with current MDE were recruited, including 233 with mixed features. NSSI was assessed at baseline and at 1-, 3-, and 6-month follow-ups. Multiple imputation was used to handle missing data (n = 626). Kaplan-Meier and Nelson-Aalen estimators were applied to visualize time-to-event and cumulative risk curves. Cox regression assessed first-onset NSSI, and Andersen-Gill models estimated the risk of repeated events. Rubin's rules were used to pool estimates across imputed datasets. Sensitivity analyses were performed using complete-case data after multiple imputation, while subgroup analyses were conducted using stratified models.

Results: Participants with mixed features were more likely to be female and to report a shorter illness duration and aggression history. Mixed features were associated with earlier NSSI onset (p = .010) and higher cumulative risk (p < .001). Although no significant association was found with first-onset NSSI, mixed features significantly predicted recurrent NSSI in both imputed (HR = 1.35, p = .045) and complete-case models (HR = 1.58, p < .001). The effect was stronger among first-episode cases and those with illness duration < 6 months.

Conclusion: Mixed features in adolescent and young adult MDE may serve as a predictor of recurrent NSSI. Early identification and tailored monitoring strategies are warranted to reduce self-injury risk.

Background: The prevalence of mental health problems and unmet need in preschool-age children highlight the challenge of identifying emerging difficulties using validated measures. Given the lack of existing brief screening measures for preschool-age children, especially multi-informant measures, this study examined two versions of the Pediatric Symptom Checklist (PSC) as reported by parents and educators, the Preschool Pediatric Symptom Checklist (PPSC) and the PSC-17. In line with Standards for Reporting Diagnostic accuracy studies (STARD) guidelines, this study examined the psychometric properties, scoring thresholds, and acceptability of parent-reported PPSC. It also examined the psychometric properties of educator ratings for both PSC measures and the incremental validity of educator and parent ratings.

Methods: Two studies present validation evidence for two mental health measures for use with preschool-age children. Participants were a nationally representative sample of Australian parents (n = 1,045; study 1) and a paired sample of parents and educators (n = 94 dyads; study 2) of children aged 3-5 years.

Results: Results supported the internal consistency, test-retest reliability, concurrent validity of the PPSC. Parents and educators indicated high levels of acceptability of both PSC measures. Results indicated parent-reported PPSC and PSC-17 significantly improved the prediction of clinician-rated functioning scores over and above educator report suggesting incremental validity for multi-informant report. Normative data for the parent-reported PPSC are presented for the first time.

Conclusions: This research expands the evidence base for the validity, reliability and acceptability of the parent and educator-report PPSC and PSC-17 measures as utilised with young children. Although further research is required, this research contributes new evidence, including incremental validity and normative data, to increase the clinical utility of both PSC measures.

Background: More evidence is needed for understanding how evidence-based psychological interventions work, especially when implemented by briefly trained non-professionals in low- and middle-income settings. The nine-session caregiver support intervention (CSI) is such an evidence-based intervention, aiming to improve parental wellbeing and parenting skills. Specifically, this study aims to assess if and how a set of quality of care indicators explain intervention outcomes amongst participants from refugee settlements in Jordan.

Methods: We conducted a three-path mediational model, wherein levels of facilitators' competency (using the ENhancing Assessment of Common Therapeutic factors tool [ENACT]), facilitators' fidelity of implementing CSI, caregivers' attendance, and caregivers' adoption of the key intervention skills and strategies (i.e. mechanisms of action) are predictive of intervention outcomes. Outcome measures include the Warwick-Edinburgh Mental Wellbeing Scale to assess caregiver wellbeing, Kessler Psychological Distress measure to assess caregivers' psychological distress symptoms, Brief Parenting Questionnaire to assess warm and responsive parenting and harsh parenting and Kid(dy)-KINDL for Parents to assess children's psychosocial wellbeing.

Results: The study, amongst caregivers (n = 588) and facilitators (n = 51), demonstrates that baseline to endline intervention improvements in parenting, caregiver wellbeing, and caregiver-reported child wellbeing are all (fully or partly) mediated by a pathway of higher levels of facilitator competencies leading to higher levels of participants' attendance. Higher attendance in turn leads to higher levels of adoption of key intervention strategies by participants. Higher adoption in turn leads to the bespoke positive outcomes (indirect effects: 0.50 [SE = 0.14]; 0.90 [SE = 0.26]; 0.92 [SE = 0.29], respectively). This pathway does not play out for caregiver distress as an outcome (-0.20 [SE = 0.13]).

Conclusion: Both common factors (foundational therapeutic competencies among the service providers) and specific factors (active ingredients of the intervention) are relevant in predicting outcomes following CSI-albeit through different pathways. This study provides support for using competency assessments, attendance tracking, and monitoring participant's skill adoption as a framework for the evaluation and improvement of quality of care.

Background: Mother-infant bonding begins during pregnancy, and a strong bond is crucial for a child's physical and psychological development. The development of this bond is influenced by various factors, including the mother's psychosocial wellbeing and the support she receives during pregnancy and after childbirth. However, few longitudinal studies have examined this topic, and previous results of cross-sectional studies have been somewhat contradictory. Our objective was to investigate the development of postnatal maternal bonding and to identify the most significant pre- and postnatal psychosocial risk factors that influence maternal bonding at eight months postpartum.

Methods: This longitudinal study examined 1298 mothers. Psychiatric symptoms and social risk factors were assessed using standardized self-report questionnaires. The change in bonding from three months to eight months was analyzed using repeated measures ANOVA. The maternal psychosocial factors associated with bonding at eight months were examined using logistic regression analysis.

Results: We found that maternal bonding improved among all the mothers between three and eight months postpartum. However, mothers who experienced psychiatric symptoms or social problems exhibited weaker bonding at both three and eight months postpartum. The most significant risk factors for bonding issues at eight months were bonding disturbances at three months and a lack of positive expectations regarding the relationship with the unborn baby. Postnatal depression, stress, and anxiety were also linked to an increased risk of bonding disturbances.

Conclusion: We recommend that healthcare professionals focus on identifying difficulties in mother-infant bonding during the prenatal and perinatal periods. They should also consider psychiatric symptoms when assessing the need for support.

Background: Adolescence is a critical period for the development of mental health problems, with self-regulation playing a crucial role as a protective factor. However, little is known about the self-regulation development in adolescence and how this is influenced by environmental factors such as negative life events (NLEs) and parental mental health problems. This study aimed to examine changes in self-regulation and the predictive effect of NLEs and parental mental health problems on self-regulation.

Methods: We included a sample of N = 2803 adolescents from the ABCD study. We explored changes in self-regulation by comparing variables between the ages of 11-12 and 13-14 (behavioral and cognitive self-regulation) and the ages of 12-13 and 13-14 (emotional self-regulation). We also compared self-regulation changes in adolescents with and without a history of NLEs and with and without parents with clinically significant mental health problems. Using linear regression, we analyzed the predictive effect of NLEs and parental mental health problems on self-regulation two years later.

Results: Adolescents showed a small increase in mean cognitive self-regulation (η²_part = 0.22) and expressive suppression as part of emotional self-regulation (η²_part = 0.07), and a small decrease in behavioral self-regulation (η²_part = 0.09). The results of the regression analysis indicate small, significant effects of NLEs and parental mental health problems on adolescent self-regulation. Self-regulation at the first assessment significantly predicted later self-regulation.

Conclusions: Our results suggest that self-regulation still develops in early adolescence, marked both by improvements in some components of self-regulation and difficulties in others. To better understand developmental trajectories and determinants of self-regulation, prospective longitudinal studies starting earlier in development and covering a longer period are needed.

Background: Suicide poses a significant global health challenge and is a leading cause of death among adolescent girls. Although suicidal ideation and attempts are known to increases sharply during female adolescence, and help-seeking behaviors are especially rare in low-income countries, no studies have been conducted on this population in Ethiopia. This study aimed to assess the magnitude, factors related to suicidal ideation and attempts, and help-seeking behaviors.

Methods: A community-based cross-sectional study was carried out in Illu Abba Bor Zone, involving 847 participants selected through multistage cluster sampling. Data, collected using interviewer-administered WHO Composite International Diagnostic Interview (CIDI) and General Help-Seeking Questionnaires, were analyzed using SPSS Version 26.0. Bivariate and multivariate analyses were performed to identify factors associated with the outcomes.

Results: Of the 847 sampled girls, 810 participated, yielding a response rate of 95.6%. The prevalence of suicidal ideation, suicidal plan and attempts was 25.3%, 19.8%, and 16.1%, respectively. Their help-seeking behaviors for suicidality were 14.6%. Risk factors for suicidal ideation included experiencing gender-based violence (AOR = 3.68, 95% CI: 1.94, 6.46), anxiety (AOR = 2.04, 95% CI: 1.42, 4.21), food insecurity (AOR = 1.93, 95% CI: 1.19, 3.48), and premenstrual dysphoric disorder (AOR = 3.54, 95% CI: 1.78, 6.21). For suicidal attempts, associated factors were depression (AOR = 3.14, 95% CI: 2.01, 6.52), gender-based violence (AOR = 4.56, 95% CI: 2.12, 9.34), social phobia (AOR = 1.84, 95% CI: 1.27, 3.13), and a family history of suicide (AOR = 2.14, 95% CI: 1.41, 3.65).

Conclusions: Findings indicate that one in four adolescent girls experienced suicidal ideation, one in six made attempts, but rates of help-seeking behaviors were low. Immediate intervention is crucial; it is essential to design and implement comprehensive, multi-level strategies targeting suicide prevention. Promoting community mental health, help-seeking behaviors for suicidality, and reducing violence against girls are vital steps needed to tackle mental health issues.