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Scoping review on mental health standards for Black youth: identifying gaps and promoting equity in community, primary care, and educational settings 黑人青年心理健康标准范围审查:确定差距并促进社区、初级保健和教育环境中的平等
IF 5.6 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-09 DOI: 10.1186/s13034-024-00800-5
Ruth Martínez-Vega, Aloysius Nwabugo Maduforo, Andre Renzaho, Dominic A. Alaazi, Dzifa Dordunoo, Modupe Tunde-Byass, Olutoyosi Unachukwu, Victoria Atilola, Alicia Boatswain-Kyte, Geoffrey Maina, Barbara-Ann Hamilton-Hinch, Notisha Massaquoi, Azeez Salami, Oluwabukola Salami
Youth mental health is a growing concern in research, practice, and policy. Practice standards, guidelines, or strategies provide an invisible infrastructure that fosters equity, quality, and safety, potentially addressing inconsistencies and more effectively attending to the mental wellness of Black youth as a particular population of concern. This scoping review aimed to address the following question: What standards exist for the delivery of mental health services to Black youth in community, primary care, and educational settings? Due to a limited initial search yield on publications about standards for the delivery of mental health services for Black youth population, our goal was then to identify and map mental health standards, recommendations, or guidelines for the delivery of mental health services using the same settings to all youth. Searches were conducted in various databases, including PubMed/MEDLINE, PsycINFO, Embase, SocINDEX, CINAHL, Gender Studies Database, Social Services Abstracts, Sociological Abstracts, Scopus, Web of Science, and Google Scholar. Screening was independently conducted by two reviewers, with disagreements resolved by a third. Information extraction was performed by two independent reviewers. Out of the 2,701 screened publications, 54 were included in this scoping review. Among them, 38.9% were published between 2020 and 2023, with 40.7% originating from the United States of America, 20.4% from the United Kingdom, and 13% from Canada. Concerning the settings, 25.9% of the publications focused on primary care, 24.1% on health care services, 20.4% on educational settings, and 3.7% on the community. Additionally, 25.9% were classified as general because recommendations were applicable to various settings. Attention-deficit/hyperactivity disorder (11.1%) was the most frequently considered specific condition, followed by autism spectrum disorder (9.3%) and depression (9.3%). However, 31.5% of the included references addressed mental health in general. Only three references provided specific recommendations for the Black population. Recommendations, guidelines, or standards for Black youth mental health services in community, primary care, or educational settings are scarce and limited to North American countries. This scoping review emphasizes the need to consider ethnicity when developing guidelines or standards to improve racial equity and reduce disparities in access to mental health services.
青少年心理健康在研究、实践和政策方面日益受到关注。实践标准、指南或策略提供了一种无形的基础设施,可促进公平、质量和安全,潜在地解决不一致问题,并更有效地关注黑人青少年这一特殊关注人群的心理健康。本次范围界定审查旨在解决以下问题:在社区、初级保健和教育环境中为黑人青少年提供心理健康服务有哪些标准?由于有关为黑人青少年提供心理健康服务标准的出版物的初步搜索结果有限,因此我们的目标是确定并绘制在相同环境下为所有青少年提供心理健康服务的心理健康标准、建议或指南。我们在多个数据库中进行了搜索,包括 PubMed/MEDLINE、PsycINFO、Embase、SocINDEX、CINAHL、性别研究数据库、社会服务文摘、社会学文摘、Scopus、Web of Science 和 Google Scholar。筛选工作由两名审稿人独立完成,出现分歧时由第三名审稿人解决。信息提取由两名独立审稿人完成。在筛选出的 2,701 篇出版物中,有 54 篇被纳入本次范围界定综述。其中,38.9%发表于2020年至2023年之间,40.7%来自美国,20.4%来自英国,13%来自加拿大。在发表地点方面,25.9%的论文集中在基层医疗机构,24.1%集中在医疗服务机构,20.4%集中在教育机构,3.7%集中在社区。此外,25.9%的出版物被归类为一般性出版物,因为其建议适用于各种环境。注意力缺陷/多动障碍(11.1%)是最常被认为是特定的疾病,其次是自闭症谱系障碍(9.3%)和抑郁症(9.3%)。不过,31.5%的参考文献涉及一般的心理健康问题。只有三篇参考文献提供了针对黑人的具体建议。针对社区、初级保健或教育环境中黑人青少年心理健康服务的建议、指南或标准很少,而且仅限于北美国家。此次范围界定审查强调,在制定指南或标准时需要考虑种族因素,以改善种族公平性并减少心理健康服务获取方面的差异。
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引用次数: 0
Association of parental adverse childhood experiences with offspring sleep problems: the role of psychological distress and harsh discipline 父母的不良童年经历与后代睡眠问题的关系:心理困扰和严厉管教的作用
IF 5.6 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-09 DOI: 10.1186/s13034-024-00796-y
Yantong Zhu, Gengli Zhang, Shuwei Zhan
Sleep problems are common in early childhood and may be affected by parental adverse childhood experiences (ACEs). However, few studies have examined the longitudinal effect of parental ACEs on offspring sleep problems and the underlying mechanism. This study examined parents’ psychological distress and harsh discipline (psychological aggression and corporal punishment) as mediators in the longitudinal pathway from parental ACEs to offspring sleep problems. The participants included 617 3-year-old children (mean age of 43.13 months, SD = 3.82) and their parents (mean age of 33.24 years, SD = 4.01) from Wuhu, China. The participants completed an online questionnaire on ACEs, psychological distress, and demographic characteristics in September 2022 (Time 1). Parents completed another online questionnaire in September 2023 (Time 2) on harsh discipline and offspring sleep problems. A path model was used to examine the associations. Parental ACEs did not directly predict offspring sleep problems. Psychological distress (β = 0.041, 95% CI [0.005, 0.111]) and harsh discipline in the form of psychological aggression (β = 0.019, 95% CI [0.006, 0.056]) separately mediated the relationship between parental ACEs and offspring sleep problems. Psychological distress and psychological aggression also played a serial mediating role in the association of parental ACEs with offspring sleep problems (β = 0.014, 95% CI [0.007, 0.038]). Our findings showed the importance of psychological distress and psychological aggression in the intergenerational effect of trauma on offspring sleep problems. Specific interventions aimed at improving mental health and parenting practices should be provided for parents who were exposed to ACEs.
睡眠问题在儿童早期很常见,并可能受到父母不良童年经历(ACE)的影响。然而,很少有研究探讨父母的ACE对后代睡眠问题的纵向影响及其内在机制。本研究考察了父母的心理困扰和严厉管教(心理攻击和体罚)作为父母ACE对后代睡眠问题纵向影响的中介因素。研究对象包括来自中国芜湖的617名3岁儿童(平均年龄43.13个月,SD=3.82)及其父母(平均年龄33.24岁,SD=4.01)。参与者于2022年9月(时间1)完成了一份关于ACE、心理困扰和人口特征的在线问卷。家长于2023年9月(时间2)完成了另一份关于严厉管教和子女睡眠问题的在线问卷。我们采用路径模型来研究两者之间的关联。父母的 ACE 并不能直接预测子女的睡眠问题。心理困扰(β = 0.041,95% CI [0.005,0.111])和以心理攻击为形式的严厉管教(β = 0.019,95% CI [0.006,0.056])分别介导了父母的ACE与后代睡眠问题之间的关系。心理困扰和心理攻击在父母ACE与后代睡眠问题的关系中也起到了连续的中介作用(β = 0.014, 95% CI [0.007, 0.038])。我们的研究结果表明,心理困扰和心理攻击在创伤对后代睡眠问题的代际影响中具有重要作用。因此,应为曾遭受 ACE 的父母提供旨在改善心理健康和养育方式的具体干预措施。
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引用次数: 0
Identification of treatment elements for adolescents with callous unemotional traits: a systematic narrative review. 为具有冷酷无情特征的青少年确定治疗要素:系统性叙事回顾。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-03 DOI: 10.1186/s13034-024-00792-2
Pamela M Waaler, Josefine Bergseth, Linda Vaskinn, Kristin Espenes, Thale Holtan, John Kjøbli, Gunnar Bjørnebekk

Adolescents with callous unemotional (CU) traits are at risk for poor quality-of-life outcomes such as incarceration, suicide, and psychopathy. It is currently unknown which treatments are implemented with CU adolescents specifically and which elements make up these interventions. A narrative systematic review was used to identify the treatments and common elements used with CU adolescents (12-18 years). Eligible studies were randomized controlled trials and quasi-experimental studies evaluating psychosocial interventions, delivered within a clinical context, and directed towards the adolescent or their family. Eight studies with 1291 participants were included. Significant decreases in CU traits were demonstrated only in a minority of studies. The most utilized practice elements were set goals for treatment, practice interpersonal/communication skills, prepare for termination, and teach parents skills and strategies; the most utilized process elements were formal therapy, practice exercises, important others, and flexible/adaptive. A majority of the studies did not report an implementation element. While theoretical frameworks for CU children are employed with CU adolescents, there is still uncertainty regarding their suitability for this age group. Given the limited empirical evidence, there is a critical need for further exploration.

具有冷漠无情(CU)特质的青少年面临着生活质量低下的风险,如监禁、自杀和心理变态。目前尚不清楚针对 CU 青少年实施的具体治疗方法以及这些干预措施的构成要素。本研究采用叙述式系统综述的方法,以确定针对 CU 青少年(12-18 岁)的治疗方法和共同要素。符合条件的研究均为随机对照试验和准实验研究,这些研究评估了在临床环境中针对青少年或其家人实施的社会心理干预措施。八项研究共纳入了 1291 名参与者。只有少数研究表明,CU 特征显著下降。使用最多的实践要素是设定治疗目标、练习人际交往/沟通技巧、为终止治疗做准备以及向家长传授技巧和策略;使用最多的过程要素是正规治疗、练习、重要他人以及灵活/适应。大多数研究没有报告实施要素。虽然针对儿童注意力缺失症的理论框架被用于青少年注意力缺失症的治疗,但这些理论框架是否适用于这一年龄段的青少年仍存在不确定性。鉴于经验证据有限,我们亟需进一步探索。
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引用次数: 0
Prevalence of child maltreatment in a nationwide sample of 18 to 31 year-olds in Germany. 德国 18 至 31 岁全国抽样调查中儿童受虐待的普遍程度。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-03 DOI: 10.1186/s13034-024-00795-z
Christoph Kasinger, Robert Schlack, Elmar Brähler, Jörg M Fegert, Vera Clemens

Background: Child maltreatment (CM) can have devastating and potentially lifelong effects for those affected and is a major contributor to mental health problems. To tackle public health problems it is crucial to have reliable data on CM. The aim of this study is to assess the prevalence and predictors of CM in a nationwide sample of the German population of young adults.

Methods: The study population (young adults aged 18 to 31 years) stems from the KiGGS Cohort study, the longitudinal branch of the German Health Interview and Examination Survey for children and adolescents. This sample meets the criteria of the United Nations Sustainable Development Goals (SDG) indicator 16.2.3. The data was collected between 2014 and 2017. CM were assessed with the Childhood Trauma Questionnaire (CTQ) in. In addition, socio-demographic variables and other known risk factors for CM were assessed. A total of 6433 (47.8% female) participants were included in the analyses. Binary logistic regression analyses were used to investigate predictors of maltreatment subtypes. Ordinal regression was used to examine their association with experience of multiple forms of CM.

Results: Overall, 18.4% (f: 20.9%, m: 16.1%) of the participants reported having experienced at least one type of CM; 6.7% (f: 8.8%, m: 4.8%) reported experiences of emotional abuse, 3.7% (f: 3.9%, m: 3.5%) physical abuse, 3.5% (f: 5.3%, m: 1.7%) sexual abuse, 9.0% (f: 9.9%, m: 8.2%) emotional neglect and 8.6% (f: 8.5%, m: 8.7%) physical neglect. Gender, subjective social status, education and household dysfunction (e.g. living with an individual who is using substances) emerged as significant predictors for different types of CM. Additionally, all these factors were significant risk factors for experiencing cumulative CM.

Conclusions: CM is common in the German population, with almost one in five people experiencing at least one type of CM. The results reveal important risk factors for the occurrence of CM. In particular, people with lower social status and those who grew up in dysfunctional households are at higher risk of CM. Greater support for this vulnerable population may reduce the prevalence of CM.

背景:虐待儿童(CM)会对受影响者造成破坏性的、可能是终生的影响,也是造成心理健康问题的主要因素。要解决公共卫生问题,掌握有关虐待儿童的可靠数据至关重要。本研究的目的是在德国全国范围内抽样调查青少年受虐待的情况,并评估受虐待的预测因素:研究人群(18 至 31 岁的年轻人)来自 KiGGS 队列研究,该研究是德国儿童和青少年健康访谈和检查调查的纵向分支。该样本符合联合国可持续发展目标(SDG)指标 16.2.3 的标准。数据收集时间为 2014 年至 2017 年。儿童和青少年创伤问卷(CTQ)对其进行了评估。此外,还对社会人口变量和其他已知的儿童创伤风险因素进行了评估。共有 6433 名参与者(47.8% 为女性)参与了分析。二元逻辑回归分析用于研究虐待亚型的预测因素。结果显示,18.4%的受访者(47.8%为女性)曾遭受多种形式的虐待:总体而言,18.4%(女:20.9%,男:16.1%)的参与者报告至少经历过一种虐待行为;6.7%(女:8.8%,男:4.8%)的参与者报告曾遭受情感虐待,3.7% (女:3.9%,男:3.5%) 曾遭受身体虐待,3.5% (女:5.3%,男:1.7%) 曾遭受性虐待,9.0% (女:9.9%,男:8.2%) 曾遭受情感忽视,8.6% (女:8.5%,男:8.7%) 曾遭受身体忽视。性别、主观社会地位、教育程度和家庭功能失调(如与使用药物的人共同生活)是预测不同类型中枢神经系统疾病的重要因素。此外,所有这些因素都是累积性儿童疾病的重要风险因素:CM在德国人口中很常见,几乎每五个人中就有一人经历过至少一种类型的CM。研究结果揭示了发生中风的重要风险因素。尤其是社会地位较低的人和在功能失调家庭中长大的人,患累积性中风的风险更高。加强对这一弱势群体的支持可能会降低慢性感染的发病率。
{"title":"Prevalence of child maltreatment in a nationwide sample of 18 to 31 year-olds in Germany.","authors":"Christoph Kasinger, Robert Schlack, Elmar Brähler, Jörg M Fegert, Vera Clemens","doi":"10.1186/s13034-024-00795-z","DOIUrl":"10.1186/s13034-024-00795-z","url":null,"abstract":"<p><strong>Background: </strong>Child maltreatment (CM) can have devastating and potentially lifelong effects for those affected and is a major contributor to mental health problems. To tackle public health problems it is crucial to have reliable data on CM. The aim of this study is to assess the prevalence and predictors of CM in a nationwide sample of the German population of young adults.</p><p><strong>Methods: </strong>The study population (young adults aged 18 to 31 years) stems from the KiGGS Cohort study, the longitudinal branch of the German Health Interview and Examination Survey for children and adolescents. This sample meets the criteria of the United Nations Sustainable Development Goals (SDG) indicator 16.2.3. The data was collected between 2014 and 2017. CM were assessed with the Childhood Trauma Questionnaire (CTQ) in. In addition, socio-demographic variables and other known risk factors for CM were assessed. A total of 6433 (47.8% female) participants were included in the analyses. Binary logistic regression analyses were used to investigate predictors of maltreatment subtypes. Ordinal regression was used to examine their association with experience of multiple forms of CM.</p><p><strong>Results: </strong>Overall, 18.4% (f: 20.9%, m: 16.1%) of the participants reported having experienced at least one type of CM; 6.7% (f: 8.8%, m: 4.8%) reported experiences of emotional abuse, 3.7% (f: 3.9%, m: 3.5%) physical abuse, 3.5% (f: 5.3%, m: 1.7%) sexual abuse, 9.0% (f: 9.9%, m: 8.2%) emotional neglect and 8.6% (f: 8.5%, m: 8.7%) physical neglect. Gender, subjective social status, education and household dysfunction (e.g. living with an individual who is using substances) emerged as significant predictors for different types of CM. Additionally, all these factors were significant risk factors for experiencing cumulative CM.</p><p><strong>Conclusions: </strong>CM is common in the German population, with almost one in five people experiencing at least one type of CM. The results reveal important risk factors for the occurrence of CM. In particular, people with lower social status and those who grew up in dysfunctional households are at higher risk of CM. Greater support for this vulnerable population may reduce the prevalence of CM.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"18 1","pages":"111"},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reflective functioning and emotion regulation in adolescents with a history of sexual offending: a comparative study with a non-offending control group. 有性犯罪史青少年的反思功能和情绪调节:与非犯罪对照组的比较研究。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-03 DOI: 10.1186/s13034-024-00802-3
Mahdieh Pazhooyan, Fahimeh Fathali Lavasani, Zohreh Edalati Shateri, Komeil Zahedi Tajrishi

Background: Sexual offenses encompass a diverse array of behaviors across various contexts, affecting numerous individuals. Despite the prevalence of sexual offending among adolescents, there is still a limited understanding of this population. To contribute further to the literature in this field, the present study was conducted to compare a group of male adolescents convicted of sexual offenses with a control group in terms of reflective functioning (RF), emotion regulation (ER) strategies, and emotion dysregulation (ED).

Methods: 60 male adolescents aged 12 to 18 years (M = 16.90; SD = 0.97) who had been convicted of at least one serious sexual offense were recruited from male adolescents referred by juvenile courts to the Legal Medicine Organization in Mashhad, Iran, and compared with a control group of non-offending adolescents consisting of 60 male adolescents aged 12 to 18 years (M = 16.97; SD = 0.82) who were attending school. The groups were matched on age and education level.

Results: A comparison between these two groups revealed that adolescents with a history of sexual offending exhibited poorer RF capacity, greater use of suppression as an ER strategy, and higher scores in all ED domains (p's < 0.001) except non-acceptance of emotional responses compared with the control group.

Conclusions: Results suggest that RF, ER strategies, and ED need to be considered as important psychological factors in understanding and treating adolescents with a history of sexual offending.

背景:性犯罪包括在各种环境下的各种行为,影响着无数人。尽管性犯罪在青少年中很普遍,但对这一人群的了解仍然有限。为了对这一领域的文献做出进一步贡献,本研究从反思功能(RF)、情绪调节(ER)策略和情绪失调(ED)等方面,对一组被判定犯有性犯罪的男性青少年与对照组进行了比较。方法:从伊朗马什哈德市法律医学组织的少年法庭转介的男性青少年中招募了 60 名至少因一次严重性犯罪而被定罪的男性青少年(M = 16.90;SD = 0.97),并将其与 60 名年龄在 12 至 18 岁(M = 16.97;SD = 0.82)、正在上学的非犯罪青少年对照组进行比较。两组在年龄和教育程度上相匹配:对这两组青少年进行比较后发现,有性犯罪史的青少年的RF能力较差,更多使用抑制作为ER策略,在所有ED领域的得分都较高(P's):结果表明,在了解和治疗有性犯罪史的青少年时,需要将RF、ER策略和ED视为重要的心理因素。
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引用次数: 0
Scrolling through adolescence: unveiling the relationship of the use of social networks and its addictive behavior with psychosocial health. 滚动浏览青春期:揭示社交网络的使用及其成瘾行为与社会心理健康的关系。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-08-31 DOI: 10.1186/s13034-024-00805-0
Caroline Brand, Camila Felin Fochesatto, Anelise Reis Gaya, Felipe Barreto Schuch, José Francisco López-Gil

Background: Understanding the relationship of social network use and addictive behaviors with adolescent psychosocial health is crucial in today's digital age.

Aim: To verify the associations between social network use, messaging applications, and the addictive behaviors to social network with psychosocial health in Spanish adolescents.

Methods: A cross-sectional study was developed with 632 adolescents, aged 12 to 17 years from the Region of Murcia, Spain. The assessment of social network use (Facebook, Twitter, Instagram, Snapchat, and TikTok) involved evaluating the frequency of use of each social network individually using a single-item scale with five response options. WhatsApp use (i.e., a messaging application) was evaluated in the same manner. The Short Social Networks Addiction Scale-6 Symptoms was employed to assess potential addictive behaviors to social network use. The psychosocial health was assessed using the Strengths and Difficulties Questionnaire. Generalized linear regression models were conducted, and predictive probabilities of having psychosocial health problems were calculated.

Results: The predicted probability of presenting psychosocial health problems in the medium users and high users of social networks was 19.3% (95% confidence interval [CI] 13.0 to 27.7), and 16.2% (95% CI 10.2 to 24.6) higher compared to low users, respectively. High usage of Instagram, TikTok, Snapchat, and Facebook was associated with increased probabilities of psychosocial health problems, with Facebook showing the highest probabilities, at 31.3% (95% CI 14.8 to 54.2) for medium users and 51.9% (95% CI 26.5 to 76.3) for high users. Additionally, adolescents with addictive behaviors to social network use had from 19.0 to 25.2% probabilities of experiencing psychosocial health problems. Finally, the highest probabilities of having psychosocial health problems were identified in adolescents with high addictive behaviors when using social networks (28.9%; 95% CI 19.3 to 40.8%) and the lowest in those with low addictive behaviors (6.8%; 95% CI 3.3 to 13.6%).

Conclusion: Adolescents who use social networks more frequently and exhibit more addictive behaviors related to their use are more likely to experience psychosocial health problems compared to those who do not. Facebook showed the strongest association, followed by Snapchat, Instagram, and TikTok. Our data also revealed that adolescents exhibit various signs of addictive behaviors to social network use.

背景:目的:验证西班牙青少年使用社交网络、信息应用以及社交网络成瘾行为与社会心理健康之间的关系:对西班牙穆尔西亚地区 632 名 12 至 17 岁的青少年进行了横断面研究。对社交网络(Facebook、Twitter、Instagram、Snapchat 和 TikTok)使用情况的评估包括使用一个包含五个回答选项的单项量表对每个社交网络的使用频率进行评估。WhatsApp(即一款消息应用软件)的使用情况也以同样的方式进行评估。采用 "社交网络成瘾简易量表-6 症状 "来评估使用社交网络的潜在成瘾行为。社会心理健康采用优势与困难问卷进行评估。研究人员建立了广义线性回归模型,并计算了出现社会心理健康问题的预测概率:结果:与低用户相比,社交网络中等用户和高用户出现社会心理健康问题的预测概率分别高出 19.3%(95% 置信区间 [CI] 13.0 至 27.7)和 16.2%(95% 置信区间 [CI] 10.2 至 24.6)。Instagram、TikTok、Snapchat和Facebook的高使用率与社会心理健康问题发生概率的增加有关,其中Facebook的发生概率最高,中度使用者为31.3%(95% CI 14.8至54.2),高度使用者为51.9%(95% CI 26.5至76.3)。此外,有社交网络成瘾行为的青少年出现社会心理健康问题的概率为 19.0%至 25.2%。最后,使用社交网络成瘾行为高的青少年出现社会心理健康问题的概率最高(28.9%;95% CI 19.3-40.8%),成瘾行为低的青少年出现社会心理健康问题的概率最低(6.8%;95% CI 3.3-13.6%):结论:与不使用社交网络的青少年相比,更频繁使用社交网络并在使用过程中表现出更多成瘾行为的青少年更有可能出现社会心理健康问题。Facebook 显示出最强的关联性,其次是 Snapchat、Instagram 和 TikTok。我们的数据还显示,青少年在使用社交网络时表现出各种成瘾行为。
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引用次数: 0
Effectiveness of a cognitive behavioural therapy (CBT)-based intervention for reducing anxiety among adolescents in the Colombo District, Sri Lanka: cluster randomized controlled trial. 基于认知行为疗法(CBT)的干预措施对减轻斯里兰卡科伦坡地区青少年焦虑症的效果:分组随机对照试验。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-08-31 DOI: 10.1186/s13034-024-00799-9
Sinha De Silva, Renuka Peris, Sudharshi Senaviratne, Dulani Samaranayake

Anxiety disorders are found to be the most prevalent psychological problems among children and adolescents. Cognitive behaviour therapy (CBT) was found to be effective at reducing anxiety. The purpose of this study was to assess the effectiveness of a universal school-based intervention for reducing anxiety among Grade 9 schoolchildren. A randomized controlled cluster trial was conducted by randomly assigning 36 schools in the Colombo district in Sri Lanka into study and control arms, each comprising 18 schools with 360 students. The levels of anxiety, self-esteem and depression status were assessed using the validated Screen for Child Anxiety Related Disorders (SCARED) tool and the Rosenberg self-esteem scale, respectively, and the Depression, Anxiety and Stress Scale 21 (DASS-21) at baseline, after intervention, and after 3 months. A CBT-based universal intervention package was administered weekly by a trained teacher for eight weeks with a one-month self-practice period to a randomly selected Grade 9 class in each school in the study arm. The control arm received routine care. Anxiety and self-esteem scores and depression status were compared between the two arms after the intervention and at 3 months of follow-up using the generalized estimation equation (GEE), controlling for confounding and clustering. The nonresponse and loss to follow-up rates were < 1%. When comparing the study arm with the control arm using GEE, anxiety levels were significantly lower [β = (-0.096), 95% CI = (-0.005) - (-0.186), p = 0.038] at follow-up but not postintervention [β = (-0.024), 95% CI = 0.006 - (-0.055), p = 0.115]. There were no significant differences in depression status after intervention (OR = 0.257, 95% CI =0.052-1.286; p = 0.098) or follow-up (OR = 0.422, 95% CI 0.177-1.008; p = 0.052), and self-esteem significantly increased after intervention (β = 0.811, 95% CI = 0.314-1.309; p = 0.001) but not at follow-up [β=0.435, 95% CI=(-0.276)-1.145, p=0.231]. This study revealed that the universal package based on CBT is effective at reducing anxiety and improving self-esteem among adolescents. The trial registration number and date were SLCTR/2018/018 and 19th of June 2018 respectively.

焦虑症是儿童和青少年中最普遍的心理问题。研究发现,认知行为疗法(CBT)能有效减轻焦虑。本研究的目的是评估以学校为基础的普遍干预措施对减轻九年级学生焦虑症的效果。研究采用随机对照分组试验的方法,将斯里兰卡科伦坡地区的 36 所学校随机分配到研究组和对照组,每组包括 18 所学校,共 360 名学生。在基线期、干预期和 3 个月后,分别使用经过验证的儿童焦虑相关障碍筛查(SCARED)工具和罗森伯格自尊量表以及抑郁、焦虑和压力量表 21(DASS-21)对学生的焦虑水平、自尊和抑郁状况进行评估。在研究组的每所学校中,随机抽取一个九年级班级,由一名受过培训的教师每周对该班级进行为期八周、为期一个月的CBT通用干预。对照组则接受常规护理。使用广义估计方程(GEE)比较了干预后和随访 3 个月时两组学生的焦虑和自尊评分以及抑郁状况,并对混杂因素和聚类进行了控制。非响应率和随访损失率为
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引用次数: 0
Supporting and understanding non-binary & gender diverse youth: a physician's view. 支持和理解非二元和性别多元化青年:医生的观点。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-08-24 DOI: 10.1186/s13034-024-00798-w
Jamie Agapoff
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引用次数: 0
A semi-structured interview for the dimensional assessment of internalizing and externalizing symptoms in children and adolescents: Interview Version of the Symptoms and Functioning Severity Scale (SFSS-I). 对儿童和青少年的内化和外化症状进行维度评估的半结构化访谈:症状与功能严重程度量表(SFSS-I)访谈版。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-08-24 DOI: 10.1186/s13034-024-00788-y
Jana Rausch, Leonard Bickman, Nina Geldermann, Felix Oswald, Danny Gehlen, Anja Görtz-Dorten, Manfred Döpfner, Christopher Hautmann

Background: This study evaluates the psychometric properties of the newly developed semi-structured interview, Interview Version of the Symptoms and Functioning Severity Scale (SFSS-I), which is designed to provide a dimensional assessment of internalizing and externalizing symptoms.

Methods: Multi-informant baseline data from the OPTIE study was used, involving 358 children and adolescents aged 6 to 17 years (M = 11.54, SD = 3.4, n = 140 [39.1%] were female). Participants were screened for internalizing and externalizing symptoms. For validity analyses, caregiver (Child Behavior Checklist), youth (Youth Self Report), and teacher ratings (Teacher Report Form) were used. We performed Receiver Operating Characteristic (ROC) analyses to evaluate the effectiveness of the SFSS-I subscales in distinguishing between children and adolescents diagnosed with internalizing and externalizing disorders, as determined by clinical judgement in routine care.

Results: Confirmatory factor analyses supported a correlated two-factor model for internalizing and externalizing symptoms. Acceptable to good internal consistencies (α = 0.76 to 0.89; ω = 0.76 to 0.90) and excellent interrater reliability on the scale level (ICC ≥ 0.91) was found. The ROC analyses showed an acceptable accuracy in identifying internalizing diagnoses (AUC = 0.76) and excellent accuracy for externalizing diagnoses (AUC = 0.84).

Conclusion: The SFSS-I demonstrates potential as a clinically-rated instrument for screening and routine outcome monitoring, offering utility in both clinical practice and research settings for the dimensional assessment of broad psychopathological dimensions.

Trial registration: German Clinical Trials Register (DRKS) DRKS00016737 ( https://www.drks.de/DRKS00016737 ). Registered 17 September, 2019.

研究背景本研究评估了新开发的半结构式访谈--症状和功能严重程度量表访谈版(SFSS-I)的心理测量特性,该量表旨在对内化和外化症状进行维度评估:方法:采用 OPTIE 研究中的多信息基线数据,涉及 358 名 6 至 17 岁的儿童和青少年(男 = 11.54,女 = 140 [39.1%])。研究人员对参与者进行了内化和外化症状筛查。在有效性分析中,我们使用了照顾者(儿童行为检查表)、青少年(青少年自我报告)和教师(教师报告表)的评分。我们进行了ROC(Receiver Operating Characteristic)分析,以评估SFSS-I子量表在区分被诊断为内化障碍和外化障碍的儿童和青少年方面的有效性:结果:确认性因子分析支持内化症状和外化症状的相关双因子模型。该量表的内部一致性(α = 0.76 至 0.89;ω = 0.76 至 0.90)可接受至良好,且在量表水平上具有极佳的互测可靠性(ICC ≥ 0.91)。ROC分析表明,内化诊断的识别准确率可接受(AUC = 0.76),外化诊断的识别准确率极高(AUC = 0.84):结论:SFSS-I具有作为筛查和常规结果监测的临床评定工具的潜力,可在临床实践和研究环境中对广泛的精神病理学维度进行维度评估:德国临床试验注册中心(DRKS)DRKS00016737 ( https://www.drks.de/DRKS00016737 )。注册时间:2019 年 9 月 17 日。
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引用次数: 0
Exploring the relationship between media use and depressive symptoms among gender diverse youth: findings of the Mental Health Days Study. 探索不同性别青少年使用媒体与抑郁症状之间的关系:心理健康日研究结果。
IF 3.4 3区 医学 Q1 PEDIATRICS Pub Date : 2024-08-22 DOI: 10.1186/s13034-024-00797-x
Diana Klinger, Paul L Plener, Golli Marboe, Andreas Karwautz, Oswald D Kothgassner, Tobias Dienlin

Background: Over the past decades, media use has become a key aspect of young people's daily lives, significantly shaping their social interactions, learning processes, and recreational pursuits. At the same time, healthcare professionals and researchers are increasingly concerned about the impact of media use on young people's mental health. This concern is particularly relevant for gender diverse youth who may have distinct experiences with media that could impact their mental health uniquely compared to their peers, such as increased exposure to cyberbullying and negative content regarding their gender identity. This study aims to explore the associations between media use and depressive symptoms among youth and examine if gender moderates this association.

Methods: This study utilized a cross-sectional design involving a school-based sample of 8158 participants (Mage = 14.05 years, SD = 2.45, Ndiverse = 144) from Austria. Participants completed a survey assessing their media use and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Media use was measured by asking participants to report their daily usage in hours and minutes across various categories, including smartphone use, streaming services, social networks, and other media types. Multiple regression analyses were conducted to examine relationships between different forms of media use and depressive symptoms. Moderation analyses were performed using the PROCESS macro for SPSS to explore the role of gender.

Results: For gender diverse youth, multiple regression analysis identified streaming services (β = 0.265, p = .005) and social networks (β = 0.189, p = .037) as significant predictors of depressive symptoms in gender diverse youth. Moderation analyses conducted with the entire sample showed that gender moderates the relationship between depressive symptoms and smartphone use (B = - 0.008, p = .014), with the effect being the most negative for gender diverse individuals.

Conclusion: The findings underscore the complex relationship between media use and depressive symptoms among gender diverse youth, emphasizing the moderating role of gender. These results underline the need for gender-sensitive approaches in media literacy and mental health interventions. Stakeholders should be aware of risks and benefits of different media types to foster healthy media engagement.

背景:在过去的几十年里,媒体的使用已成为青少年日常生活的一个重要方面,对他们的社会交往、学习过程和娱乐活动产生了重大影响。与此同时,医疗保健专业人员和研究人员也越来越关注媒体使用对青少年心理健康的影响。与同龄人相比,不同性别的青少年可能会有不同的媒体体验,从而对他们的心理健康产生独特的影响,例如,他们会更多地接触到网络欺凌和有关其性别认同的负面内容。本研究旨在探讨青少年使用媒体与抑郁症状之间的关联,并研究性别是否会调节这种关联:本研究采用横断面设计,涉及来自奥地利的 8158 名学校样本参与者(年龄 = 14.05 岁,SD = 2.45,Ndiverse = 144)。参与者使用患者健康问卷-9(PHQ-9)完成了一项调查,评估他们的媒体使用情况和抑郁症状。在测量媒体使用情况时,要求受试者以小时和分钟为单位报告他们每天使用智能手机、流媒体服务、社交网络和其他媒体类型的情况。我们进行了多元回归分析,以研究不同形式的媒体使用与抑郁症状之间的关系。使用 SPSS 的 PROCESS 宏进行了调节分析,以探讨性别的作用:对于不同性别的青少年,多元回归分析发现流媒体服务(β = 0.265,p = .005)和社交网络(β = 0.189,p = .037)是预测不同性别青少年抑郁症状的重要因素。对整个样本进行的调节分析表明,性别调节了抑郁症状与智能手机使用之间的关系(B = - 0.008,p = .014),对不同性别个体的影响最为负面:研究结果强调了媒体使用与不同性别青少年抑郁症状之间的复杂关系,并强调了性别的调节作用。这些结果凸显了在媒体扫盲和心理健康干预中采取性别敏感方法的必要性。相关人员应了解不同媒体类型的风险和益处,以促进健康的媒体参与。
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Child and Adolescent Psychiatry and Mental Health
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