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

{"title":"Editorial: Leveraging Understudied Biological Risk Factors to Enhance Prediction of Suicidal Thoughts, Suicide Attempts, and Nonsuicidal Self-Injury in Preadolescents.","authors":"Katherine L Sarkisian, Jennifer L Hughes, Jeffrey A Bridge","doi":"10.1016/j.jaac.2025.03.006","DOIUrl":"10.1016/j.jaac.2025.03.006","url":null,"abstract":"<p><p>Despite the prevailing perception that preadolescent children do not experience suicidal thoughts and behaviors, 13.2% of children aged 9 to 10 years report that they have experienced suicidal thoughts at some point in their life, 9.1% report a history of nonsuicidal self-injury (NSSI), defined as deliberate self-harming behavior without suicidal intent, and 1.3% report making a suicide attempt.¹ In addition, suicide rates for children aged 8 to 12 years have been increasing since 2008, and suicide is now the fifth leading cause of death in this age group.² However, relatively little is known about risk and protective factors for self-injurious thoughts and behaviors (SITBs) among preadolescents. The biological underpinnings of suicidal ideation, suicidal behavior, and NSSI have been studied extensively (see Mann and Currier for a review³). Importantly, these studies focus almost exclusively on adolescent and adult samples, and translation of biologically based findings into clinical practice remains a challenge. Across clinical settings, suicide risk screening is increasingly being implemented with preadolescents, but there is a relative lack of developmentally sensitive screening and intervention tools,⁴ and detecting child suicide risk as completely and efficiently as possible remains a challenge. Thus, finding ways to bridge biological findings and suicide risk screening is a promising, yet underutilized, approach with great potential. With the emergence of more large, longitudinal studies that capture a combination of biological, psychological, and social risk factors for SITBs, it is becoming increasingly possible to examine an array of risk and protective factors simultaneously and evaluate the relative strength of these predictors.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663836","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":"Understanding Motor Stereotypies as a Transdiagnostic Phenotype.","authors":"Nathalia Garrido-Torres, Amy Giguere Carney, Megan Lyons, Suzanne Macari, Chelsea Morgan, Kelly Powell, Mariana Torres-Viso, Angelina Vernetti, Katarzyna Chawarska, Thomas V Fernandez","doi":"10.1016/j.jaac.2025.03.003","DOIUrl":"10.1016/j.jaac.2025.03.003","url":null,"abstract":"<p><p>Motor stereotypies (MS) are repetitive, rhythmic actions varying in complexity and presentation. Parents and teachers often notice these movements in children at home or in the classroom, prompting clinical attention. Concerns typically arise regarding the potential adverse consequences of these movements on the child, their impact on others, and whether they signal chronic neurodevelopmental conditions such as autism spectrum disorder (ASD). This Clinical Perspective emphasizes MS as a common, transdiagnostic phenotype. It is crucial for clinicians and families to understand their characteristics, typical course, and potential co-occurring conditions, and that MS do not always signify a neurodevelopmental disorder nor always require intervention.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639638","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: Where Are the Trials on Adolescent Self-Harm and Suicide?","authors":"Kristina T Kumpf, Michael H Bloch","doi":"10.1016/j.jaac.2025.03.002","DOIUrl":"10.1016/j.jaac.2025.03.002","url":null,"abstract":"<p><p>Self-harm and suicide are a major public health problem, particularly among adolescents. Suicide is the third leading cause of death in adolescents in the United Kingdom and the United States, and nonsuicidal self-injury (NSSI) remains a significant source of morbidity and mortality in this population.^1,2 Despite relative consensus about the acuity of this public health problem, we lack evidence-based treatments for patients struggling with self-harm. This scarcity of effective treatments for self-harm in adolescents is highlighted by an important meta-analysis in this issue of the Journal.³ Wright-Hughes and colleagues identified 39 randomized control trials (RCTs) comparing a therapeutic intervention for self-harm to control with 26 studies providing individual patient data (IPD; 3,448 participants) and 7 providing only aggregate data (698 participants). Their 2-stage random-effects meta-analysis of studies with IPD found no significant difference in efficacy between therapeutic interventions and control treatment for preventing self-harm at 12 months. Secondary analyses incorporating aggregate data similarly showed no difference in efficacy and no strong evidence regarding moderators of treatment effect.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634157","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":"Clinical Manual of Youth Addictive Disorders, Second Edition","authors":"Gerald Busch MD","doi":"10.1016/j.jaac.2025.02.013","DOIUrl":"10.1016/j.jaac.2025.02.013","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 6","pages":"Pages 747-749"},"PeriodicalIF":9.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166720","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":"The Rapid Autism Assessment: Reducing Barriers to Behavioral Intervention Services.","authors":"Yumi Kovic, Gabrielle D Dallas, Joanne L Andrade, Lindsay A Lloveras, Kerri P Peters, Takahiro Soda","doi":"10.1016/j.jaac.2025.03.001","DOIUrl":"10.1016/j.jaac.2025.03.001","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615718","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":"If Your Adolescent Has Bipolar Disorder: An Essential Resource for Parents","authors":"Duane Ebesu MPhil","doi":"10.1016/j.jaac.2025.02.012","DOIUrl":"10.1016/j.jaac.2025.02.012","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 6","pages":"Pages 746-747"},"PeriodicalIF":9.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166719","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: Structural Determinants of School Discipline: A Call to Action.","authors":"Brittany E Bryant","doi":"10.1016/j.jaac.2025.02.014","DOIUrl":"10.1016/j.jaac.2025.02.014","url":null,"abstract":"<p><p>Although the classroom is meant to be a space for learning and growth, decades of research has shown it to be a battleground for many Black youth, as disparities in school disciplinary actions continue to fuel cycles of academic failure, impaired development, and psychological distress.¹ Studies have found that Black youth face significantly higher rates of detention and suspension than their White peers, and this disparity is rarely due to individual-level characteristics such as externalizing symptoms (acting out), special education, or familial characteristics.¹ These disparities are deeply rooted in systemic bias and racism, which manifest through inequitable school policies, educator perceptions, and broader structural inequities that disproportionately target Black youth for punitive disciplinary actions.².</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586070","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":"Effect of Esketamine on Depressive Symptoms in Adolescents With Major Depressive Disorder at Imminent Suicide Risk: A Randomized Psychoactive-Controlled Study.","authors":"Colette Kosik-Gonzalez, Dong-Jing Fu, Li Nancy Chen, Rosanne Lane, Michael H Bloch, Melissa DelBello, Carmen Moreno, Wayne C Drevets, Carla M Canuso","doi":"10.1016/j.jaac.2025.02.015","DOIUrl":"10.1016/j.jaac.2025.02.015","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy, safety, and tolerability of esketamine nasal spray vs psychoactive placebo (oral midazolam) in rapidly reducing depressive symptoms in adolescents with major depressive disorder at imminent risk for suicide.</p><p><strong>Method: </strong>This double-blind, double-dummy, phase 2b study randomized (1:1:1:2) 147 adolescents (12 to <18 years old) to esketamine (28, 56, or 84 mg) or midazolam twice weekly for 4 weeks. Participants concomitantly received comprehensive standard of care, including initial hospitalization, oral antidepressant, and evidenced-based psychotherapy. The primary efficacy end point-change in Children's Depression Rating Scale-Revised (CDRS-R) total score from baseline to 24 hours post first dose-was analyzed using analysis of covariance, according to a pooled sequential multiple testing procedure.</p><p><strong>Results: </strong>All participants were moderately to severely depressed at enrollment; approximately 95% were moderately to extremely suicidal. Pooled esketamine doses (56 and 84 mg) showed superiority over midazolam in reducing CDRS-R total score at 24 hours post first dose (between-group difference of least squares means [95% CI]: -5.8 [-11.19, -0.35], p = .037). The between-group differences for individual esketamine 84 mg and 56 mg doses vs midazolam were -5.7 ([-12.91, 1.55], p = .123) and -5.9 ([-12.25, 0.53], p = .072), respectively. Severity of suicidality, per Clinical Global Impression of Severity of Suicidality-revised (CGI-SS-R), improved in all 4 groups (between-group difference of least squares means [95% CI]: -0.2 [-0.90, 0.41], -0.3 [-0.93, 0.31], 0.0 [-0.69, 0.72] for esketamine 28, 56, and 84 mg, respectively, at 24 hours post first dose). Common adverse events (incidence ≥20%) reported for esketamine were dizziness, nausea, dissociation, headache, dysgeusia, somnolence, vomiting, hypoesthesia, and intentional self-injury.</p><p><strong>Conclusion: </strong>The primary efficacy end point of the study was met for the pooled esketamine doses (56 and 84 mg). Esketamine in conjunction with comprehensive standard of care rapidly improved depressive symptoms among adolescents at imminent risk for suicide.</p><p><strong>Clinical trial registration information: </strong>Study to Evaluate the Efficacy and Safety of 3 Fixed Doses of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Pediatric Participants Assessed to Be at Imminent Risk for Suicide; https://clinicaltrials.gov/study/NCT03185819.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586088","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: The Power of Racial-Ethnic Socialization in Promoting Adolescent Resilience.","authors":"Amanda E Baker","doi":"10.1016/j.jaac.2025.02.016","DOIUrl":"10.1016/j.jaac.2025.02.016","url":null,"abstract":"<p><p>Adolescence marks a critical period of identity formation, as young people navigate questions about who they are and where they belong in a diverse social landscape. For ethnoracially minoritized youth, this process is often complicated by systemic inequities and racialized stressors, which elevate their risk for mental health challenges such as anxiety and depression.¹ Amid these adversities, developing a strong ethnic-racial identity-a sense of pride, belonging, and connection to one's racial or ethnic group-emerges as a crucial foundation for resilience.².</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586087","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: Imputing Response Rates for First-Line Psychological Treatments for Posttraumatic Stress Disorder in Youth.","authors":"Katie Lofthouse, Alana Davies, Joanne Hodgekins, Richard Meiser-Stedman","doi":"10.1016/j.jaac.2024.12.014","DOIUrl":"10.1016/j.jaac.2024.12.014","url":null,"abstract":"<p><strong>Objective: </strong>Meta-analyses assessing psychological therapies for posttraumatic stress disorder (PTSD) in youth have demonstrated their effectiveness using standardized mean differences. Imputation of response rates (ie, 50% or greater reduction in symptoms) may facilitate easier interpretation for clinicians.</p><p><strong>Method: </strong>We searched 4 databases (MEDLINE, PsycINFO, PTSDPubs, and Web of Science) and screened 1,654 records to include 60 randomized controlled trials (52 trauma-focused cognitive-behavioral therapy [TF-CBT], 8 eye movement desensitization [EMDR]) with a total of 5,113 participants, comparing psychological therapies for PTSD against control conditions in youth. Data from randomized controlled trials of EMDR and TF-CBT for PTSD were used to impute response rates, establishing how many patients display 50% reduction, 20% reduction, and reliable improvement and deterioration (using reliable change indices) in PTSD and depression.</p><p><strong>Results: </strong>The proportion of youth exhibiting a 50% reduction in PTSD symptoms was 0.48 (95% CI = 0.41-0.55) for TF-CBT, 0.30 (0.24-0.37) for EMDR, and 0.46 (0.39-0.52) for all psychological therapies, compared to 0.20 (0.16-0.24) for youth in control conditions. Reliable improvement was displayed by 0.53 (0.45-0.61; TF-CBT 0.55 [0.46-0.64], EMDR 0.42[0.30-0.55]) of youth receiving psychological therapies, compared to 0.25 (0.20-0.30) of youth in control conditions. Reliable deterioration was seen in 0.01 (0.01-0.02) of youth receiving psychological therapies, compared to 0.13 (0.08-0.20) of youth in control conditions. There was a high degree of heterogeneity in the included studies.</p><p><strong>Conclusion: </strong>Psychological therapies, in particular TF-CBT, for young people with PTSD are effective and unlikely to cause deterioration, with around half of youth receiving TF-CBT exhibiting 50% symptom reduction.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536840","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}