Journal of the American Academy of Child and Adolescent Psychiatry最新文献

{"title":"Translating Evidence Into Practice: Using the Open-Access Evidence-Based Intervention Database for Attention-Deficit/Hyperactivity Disorder (EBI-ADHD) Platform to Support Shared Decision-Making.","authors":"Corentin J Gosling, Miguel Garcia-Argibay, Marco Solmi, Richard Delorme, Samuele Cortese","doi":"10.1016/j.jaac.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.04.015","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling Up Evidence-Based Treatments: An Analysis of 25,000 Sessions of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in Routine Care.","authors":"Nora Braathu, Marianne Skogbrott Birkeland, Lise Tveter, Ane-Marthe Solheim Skar, Silje Mørup Ormhaug, Tine K Jensen","doi":"10.1016/j.jaac.2026.04.012","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.04.012","url":null,"abstract":"<p><strong>Objective: </strong>Most youth in routine mental health care do not receive evidence-based treatments, and when implemented in real-world settings, their effects are typically smaller than those observed in controlled efficacy trials. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is one of the most efficacious and widely implemented evidence-based treatments for traumatized youth worldwide, yet little is known about how it is delivered and adapted in routine practice. We examined 25,000 treatment sessions to understand 1) how TF-CBT is implemented in routine care, 2) what delivery adaptations are made based on child age and the presence of complex posttraumatic stress disorder (CPTSD) symptoms, and 3) whether adaptations are associated with outcomes.</p><p><strong>Method: </strong>Data came from an observational study of TF-CBT implementation (2018-24) across Norwegian child and adolescent mental health services. Youth (6-18 years) with clinically significant posttraumatic stress symptoms (N=1,373) received treatment from 357 therapists across 74 outpatient clinics representing 82% of such services in Norway.</p><p><strong>Results: </strong>Overall, 66% completed treatment and 59% showed reliable improvement. Clinicians applied TF-CBT flexibly as prescribed by the model. Patients with CPTSD received more trauma processing but had less caregiver involvement than those without CPTSD. Children received more stabilization and caregiver involvement than adolescents. More trauma experiences predicted higher dropout, while more caregiver sessions predicted lower dropout. CPTSD was associated with reliable improvement. Number of potentially traumatic event types were more strongly associated with dropout for children than adolescents, and caregiver sessions more strongly predicted improvement in CPTSD cases.</p><p><strong>Conclusion: </strong>This study provides the first large scale systematic documentation of TF-CBT delivery in routine care, showing that TF-CBT can be scaled-up in community clinics, with high improvement rates comparable to recent meta-analyses. A majority of the therapists received supervision, and future studies need to dismantle the importance of case consultation when scaling up evidence-based treatments.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Trauma-Informed to Healing-Informed Care.","authors":"Javeed Sukhera","doi":"10.1016/j.jaac.2026.04.011","DOIUrl":"10.1016/j.jaac.2026.04.011","url":null,"abstract":"<p><p>I write in response to the Journal's call for work addressing structural discrimination and minoritization in child and adolescent mental health. The concept of trauma-informed care (TIC) has proliferated over the past several years. TIC is a foundational principle across systems and sectors that has the potential to promote safety, trust, and empowerment.¹ The framework developed through research on adverse childhood experiences (ACEs) illustrates how such experiences influence psychiatric etiology, history, and treatment.¹.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Treatment of Adolescents With Suicidal and Self-Harming Behaviors: What are the Knowledge Gaps?","authors":"Lars Mehlum, Iselin S Dibaj","doi":"10.1016/j.jaac.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.04.010","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-Analysis: Psychological Interventions for Posttraumatic Stress Disorder in Internally Displaced and Refugee Youth.","authors":"Bianca Schreyer,Verena Ertl,Rita Rosner","doi":"10.1016/j.jaac.2026.04.009","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.04.009","url":null,"abstract":"OBJECTIVERefugee and internally displaced children and adolescents experience high rates of post-traumatic stress symptoms (PTSS). Yet there is a lack of evidence of the effectiveness of psychological interventions in this population. This systematic review and meta-analysis investigates the effects of psychological interventions on PTSS among refugee and internally displaced children and adolescents (PROSPERO CRD[masked]).METHODA comprehensive literature search up to December 19th, 2025, was conducted in PubMed, PsycINFO, PSYNDEX, Web of Science, Epistemonikos, PTSDpubs and ClinicalTrials.gov. Controlled trials were eligible if they studied psychological interventions aiming to reduce PTSS in refugee and internally displaced children and adolescents. Study quality was assessed using Cochrane's RoB-2 tool. Outcomes were analyzed using a random-effects-model meta-analysis.RESULTSEight studies met the inclusion criteria, providing data on nine active treatment conditions and 448 participants. Analyses showed a small effect of psychological interventions on PTSS reduction, g = -0.35, 95%-CI [-0.61, -0.09], and no significant effects on depression, g = -0.34, 95%-CI [-0.76, 0.09], and dropout, OR = 1.71, 95%-CI [0.35, 8.32]. No significant moderators of PTSS reduction could be identified, but pretest-PTSS, b = -0.30, suggesting potential greater effects for those with higher initial symptoms.CONCLUSIONThe findings support the effectiveness of psychological interventions in treating PTSS in refugee and internally displaced children and adolescents. However, further research is needed to understand, whether and why treatment effects appear smaller than in the general population, and whether this relates to migration-factors or factors associated with service-provision and -use or the need for intervention adaptations.STUDY REGISTRATION INFORMATIONPsychological interventions for post-traumatic stress disorder in internally displaced and refugee children and adolescents - A systematic review and meta-analysis; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024614752.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding Our Safe Spaces.","authors":"Justin Schreiber, Misty C Richards","doi":"10.1016/j.jaac.2026.04.008","DOIUrl":"10.1016/j.jaac.2026.04.008","url":null,"abstract":"<p><p>It is important that children and adolescents have safe spaces in their lives. That space can be a physical location, with a person they know, or even a place they can go in their mind. When dealing with the many stressors around them, knowing there is a place that can provide some relief is essential. Research has shown that having access to a physical safe space can decrease the risk of posttraumatic stress disorder, anxiety, and substance use.¹ Having safe spaces, safe people, or even the ability to use skills to take a break from these stressors can be a privilege that is not shared by all, based on income, race, intellectual status, and much more. Feeling like one is constantly being targeted and less likely to have a safe space can cause kids to be more avoidant or to feel more like they need to defend themselves.² As child and adolescent psychiatrists, one of our roles is to help our patients to be able to find these safe spaces wherever they can. Identifying a trusted adult in various settings is a great example of this, especially for youth who have had adults treat them poorly. Knowing safe spaces in your community that youth can go to, both to have a place in which they can relax and a place in which they can open up to others if needed, is essential. It is also important to recognize that not everyone can access the same spaces when identifying these resources. Not everyone can get to a location or can afford a membership, so being aware of this will be essential to ensure access for all your patients. This month's Media Forum highlights an example in which having a safe space was essential for the safety of the main character, and another in which the lack of safe spaces had significant impacts on the family.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Protecting Latino Youth from the Impact of Discrimination.","authors":"Andres J Pumariega","doi":"10.1016/j.jaac.2026.03.035","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.03.035","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"30 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147735172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family vs Individual Treatment for Children With Avoidant/Restrictive Food Intake Disorder: A Randomized Clinical Trial.","authors":"James Lock,Brittany Matheson,Booil Jo,Cara Bohon,Nandini Datta,Aileen Whyte,HaLi Boyce,Hazal Y Gurcan,Ainsley E Cogburn,Bohye Kim","doi":"10.1016/j.jaac.2026.04.007","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.04.007","url":null,"abstract":"OBJECTIVETo examine the comparative efficacy of Family-based Treatment for Avoidant/Restrictive Food Intake Disorder (FBT-ARFID) to individual Psychoeducational Motivational Therapy (PMT) for underweight children with ARFID between the ages of 6 and 12 years of age. The main outcome evaluated was the difference between groups on change in percent estimated body weight (%EBW) from baseline (BL) to end of treatment (EOT).METHODNinety-eight children with ARFID were randomized to 14 sessions over 4 months of telehealth FBT-ARFID or PMT. Assessments of weight/height, eating-related cognitions, and behaviors associated with ARFID were collected online at BL, 1 month, 2 months, and EOT by assessors masked to treatment condition.RESULTSFBT-ARFID was superior to PMT at the EOT in promoting increased %EBW. There were no differences between groups on improvements in overall severity of ARFID symptoms or other related ARFID symptoms; however, BL severity of ARFID symptoms moderated the effect, with children who were most symptomatic improving significantly more in FBT-ARFID than in PMT (exploratory analyses).CONCLUSIONFBT-ARFID is superior to PMT for promoting weight gain in low-weight children with ARFID, especially for those children with greater severity of ARFID symptoms.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"66 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reward-Related Neural Substrates of Irritability: A Task-Based fMRI Study of Early Childhood.","authors":"Ruiyu Yang,Qiongru Yu,Erin O Peterson,Lea R Dougherty,Jillian Lee Wiggins","doi":"10.1016/j.jaac.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.04.005","url":null,"abstract":"OBJECTIVEIrritability, conceptualized as elevated proneness to anger, is a transdiagnostic feature and robust predictor of multiple psychological disorders. Identifying neurophenotypes of irritability in early childhood is critical to inform timely intervention, as irritability persisting into school age is associated with increased psychopathology and impairment. The present study aims to examine the neural substrates of irritability in early childhood in relation to reward processing, which is implicated in multiple disorders.METHODData from 185 children (Mage = 6.16 years, SD = 0.50) were included. A child-friendly version of the Monetary Incentive Delay task during functional MRI acquisition assessed neural activity during reward anticipation (i.e., reward vs. no-reward) and feedback (i.e., hit vs. miss the target with a reward expected vs. not). The Multidimensional Assessment Profiles - Temper Loss Scale assessed irritability. Whole-brain multilevel analysis on neural activation and functional connectivity examined associations between irritability and reward processing.RESULTSGreater irritability was associated with greater differences in response to reward vs. no-reward, reflected in left putamen activation. It was also associated with alterations in amygdala and striatal connectivity with multiple frontotemporal and parietal regions. The directionality of the effects varied depending on task-specific conditions (e.g., hitting a target with reward expected, missing a target with no reward expected).CONCLUSIONOur findings provide insights into the reward-related neural pathways of irritability in early childhood, a critical yet understudied developmental stage, which has the potential to facilitate timely and mechanistically informed interventions in young children.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: When, Where, and for Whom Does Behavioral Activation Work? Optimizing Treatment for Adolescent Depression.","authors":"Elizabeth McCauley,Jessica Jennness","doi":"10.1016/j.jaac.2026.04.006","DOIUrl":"https://doi.org/10.1016/j.jaac.2026.04.006","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"21 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}