Child and Adolescent Psychiatry and Mental Health最新文献

Background: Perceived social support is considered a crucial protective factor for mental health, particularly among marginalized populations. This study investigated the association between perceived social support and internalizing symptoms (depression, anxiety) in young refugees and immigrant-origin peers from the Middle East. It further examined whether social support buffers the adverse impact of post-migration stress on internalizing symptoms.

Methods: The sample consisted of 135 male adolescents and young adults living in Germany, including n = 75 young refugees (primarily from Syria and Afghanistan) and n = 60 immigrant-origin peers, all with a Middle Eastern background. Validated self-report instruments were used to assess perceived support from friends, family, and significant others, as well as post-migration stress and internalizing symptoms.

Results: While higher perceived support was consistently associated with fewer internalizing symptoms across both groups, a buffering effect on post-migration stress was found among young immigrants for all support sources, but not for their refugee peers (three-way interaction: β = - 0.46, SE = 0.18, p = 0.012; conditional interaction effect for immigrants: β = - 0.04, SE = 0.01, p = 0.008; for refugees: β = 0.01, SE = 0.01, p = 0.448). Refugees reported significantly higher post-migration stress than immigrant-origin peers (t(131) = 5.11, p < 0.001) and perceived less support from friends (t(132) = - 3.29, p = 0.001) and significant others (t(133) = - 2.41, p = 0.017) but not from family (t(130) = - 1.88, p = 0.063).

Conclusions: These findings suggest that, for young male Middle Eastern refugees, perceived social support alone may be insufficient to buffer post-migration stress, underscoring the importance of expanding structural and instrumental support systems in Germany.

Background: The rising rates in depression and other mental health problems among adolescents in recent years, combined with delayed help-seeking, highlights a clear need for action in key areas of adolescents' lives. The school environment, including teachers, can provide mental-health support for children and adolescents.

Methods: The study used a pre-post-follow-up design to investigate whether a two-hour online training course on depression and mental health in childhood and adolescence leads to knowledge acquisition, confidence in supporting pupils with depression and a decrease in stigmatisation in N = 97 teachers, school social workers and school social pedagogues.

Results: We found a significant increase in knowledge and confidence in supporting pupils with depression at post-assessment, which was maintained at a four-week follow-up. A decrease in stigmatisation was found at post-assessment, which was no longer evident at follow-up.

Conclusion: The results suggest that approaching educational professionals through a concise practical online training course can be a promising strategy for knowledge transfer. Future studies could examine whether such trainings can be adapted to other mental health disorders. Trial registration ClinicalTrials.gov, Identifier: NCT06387108. Registered on 24.04.24.

Background: Suicidality is alarmingly prevalent among adolescents placed in residential child welfare facilities, often as a consequence of early adverse childhood experiences (ACEs) and disrupted attachment relationships. Although these vulnerabilities are well established, the gender-specific mechanisms underlying suicidality in institutionalized youth remain poorly understood. Clarifying how trauma exposure and attachment insecurity interact with mental health symptoms is critical to inform targeted prevention.

Methods: In a cross-sectional study, 98 adolescents aged 12-17 years (54 girls, 44 boys; M = 14.34, SD = 2.08) living in French residential care completed validated self-report instruments assessing ACEs, attachment security, depressive and anxiety symptoms, and suicidality. Descriptive statistics, gender comparisons, and multivariate logistic regressions were used to identify predictors of suicidality, with all predictors standardized prior to entry.

Results: One-third of participants (33%) reported suicidal ideation or at least one suicide attempt. Emotional and physical abuse were the most frequent ACEs. Cumulative ACEs and attachment insecurity were independently associated with suicidality, and both correlated with heightened anxiety and depressive symptoms. Gender-stratified analyses showed that suicidality in girls was primarily linked to maternal alienation and emotional dysregulation, whereas in boys it was more strongly related to cumulative trauma exposure and depressive symptoms.

Conclusions: Findings highlight suicidality as a major concern in residential care and identify two complementary risk pathways: adversity-related and attachment-related. Trauma-informed and attachment-based approaches-supported by systematic screening and the integration of mental health professionals within child welfare systems-may enhance early detection and individualized care. While contextualized in the French system, these mechanisms likely generalize across jurisdictions, underscoring the global need for gender-sensitive, relationally focused suicide prevention.

Background: Autism spectrum disorder is a neurodevelopmental condition with a rising prevalence and limited effective pharmacological treatments. As non-pharmacological interventions gain traction, gamified digital health interventions have emerged as a promising alternative due to their accessibility and scalability. This systematic review and meta-analysis evaluated the efficacy of gamified digital health interventions in improving key functional domains in children and adolescents with autism spectrum disorder.

Methods: Following PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions, a systematic search was conducted in six electronic databases (PubMed, Web of Science, EMBASE, Cochrane Library, PsycINFO, and Scopus) and reference lists of relevant articles up to November 2024. A total of 21 randomized controlled trials (RCTs) comprising 1,050 participants met the inclusion criteria. Standardized mean differences (SMDs) were pooled using a random-effects model, and subgroup analyses were conducted to explore the effects of different types of interventions.

Results: Meta-analysis revealed significant improvements in emotional skills (SMD = 0.56), social skills (SMD = 0.45), executive functions (SMD = - 0.43), and motor skills (SMD = 1.53). Subgroup analyses indicated that sensor-based games demonstrated superior efficacy. However, no significant effect was observed in reducing behavioral problems (SMD = - 0.14).

Conclusions: Gamified digital health interventions show promise in enhancing emotional, social, executive, and motor skills in children and adolescents with autism spectrum disorder. Future research should focus on optimizing intervention strategies, refining behavioral outcome measures, and conducting high-quality longitudinal studies to evaluate long-term effectiveness.

Background: Bullying, problematic internet gaming, and problematic social media use are concerning phenomena, especially among youth. However, studies including all three of them are scarce. Therefore, this study investigated the associations between bullying victimization and the two internet-related outcomes. Furthermore, differences between problematic internet gaming and problematic social media use regarding the individual and moderating effects of gender, age, educational background and mental health problems were examined.

Methods: Adolescents (N = 6,735; 48.85% females) answered a school-based survey on bullying, problematic internet gaming, problematic social media use and mental health problems. The age ranged from grade 5 with M = 10.77 years (SD = 0.68) to grade 9 with M = 14.75 years (SD = 0.87) and overall M = 12.73 years (SD = 1.60). A-level school students represented higher educational background (39.52%) while B-level school students represented lower educational background (60.48%). Multilevel modelling was used to examine the associations of bullying victimization with problematic internet gaming and problematic social media use as well as the influences of gender, school grade as a correlate of age, school type and mental health problems.

Results: Victims of bullying showed higher odds for problematic internet gaming and problematic social media use. Overall, boys showed higher levels of problematic internet gaming, whereas girls showed higher levels of problematic social media use. Younger adolescents reported higher odds for problematic internet gaming, while no age effect was found for problematic social media use. Students with lower educational background and those with more mental health problems reported more problematic social media use than problematic internet gaming. Mental health problems moderated the association of bullying victimization with problematic internet gaming and problematic social media use, with stronger relations for students with less mental health problems. Furthermore, gender was a significant moderator for problematic social media use but not for problematic internet gaming, with a stronger association for boys.

Conclusions: Bullying victimization is strongly related to different types of problematic internet use. As differences in the impact on problematic internet gaming and problematic social media use can be identified, prevention should also consider gender, age, educational background and mental health problems. Trial registration DRKS00028183.

Globally, the rising burden of suicide among pre-adolescent children is a pressing clinical problem for mental health practitioners. Over 90% of the world's youth live in low- and middle-income countries, where suicide is the second-leading cause of death among children and youth. Literature about completed suicide in Ugandan children below 10 years of age is limited, although there is a growing body of research predominantly from high-income countries. We present the only available literature in Uganda about pre-adolescent suicide as reported in press-media reports. We utilized the multilevel risk framework to discuss the multi-sociocultural perspective regarding child rearing, the role of childhood trauma, the evolving digital environment, and legal and policy frameworks. We discussed challenges to the practice of Child and Adolescent psychiatry in Uganda, where childhood mental health disorders continue to receive limited attention in clinical practice. We recommend future research efforts to develop a robust methodology to better understand pre-adolescent suicide. Implementation of actionable interventions like school-based suicide screening, community gatekeeper trainings, and child helplines are key. Intersectoral collaborations among diverse stakeholders are essential for co-creating actionable and evidence-based preventive interventions that place the community at the centre.

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.