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

{"title":"Does State-Level Structural Racism Impact Risk for Suicide Attempts Among US Adolescents Across Race And Ethnicity?","authors":"Lillian Polanco-Roman,Sharifa Z Williams,Ana Ortin-Peralta","doi":"10.1016/j.jaac.2024.09.012","DOIUrl":"https://doi.org/10.1016/j.jaac.2024.09.012","url":null,"abstract":"OBJECTIVEOur study examined the association between state-level structural racism and past year rates of suicide ideation (SI) and suicide attempts (SA) among non-Hispanic Black, Hispanic, and non-Hispanic White adolescents.METHODThis secondary analysis used state- and individual-level linked data combining multiple years i.e., 2011-2019, of the Youth Risk Behavior Surveys, the 2019 American Community Survey, and the 2019 state-level Structural Racism Index (SRI), a composite measuring state-level Black-White (B-W) and Hispanic-White (H-W) racial inequities across five domains: residential segregation, incarceration rates, educational attainment, economic indicators, and employment status. A series of generalized estimating equations were used to examine the association between structural racism and past-year SI and past-year SA, with race/ethnicity as a moderator, adjusting for state- and individual-level covariates, among U.S. adolescents.RESULTSNegative associations were observed between B-W SRI with SI (Adj. b [95% CI] = -0.011 [-0.017, -0.003], p =.004), and SA (-0.011[-0.018, -0.004], p = .002), as well as between H-W SRI with SI (-0.008 [-0.016, -0.0002], p = .044), and SA (-0.011 [-0.018, -0.004], p = .001). These associations were significantly modified by race and ethnicity for both B-W SRI and H-W SRI. Both Black (SI= -0.011 [-0.02, -0.002]; SA= -0.011 [-0.019, -0.004]) and Hispanic (SI = -0.097 [-0.011,-0.004]; SA = -0.011 [-0.018, -0.004]) adolescents living in states with higher structural racism had lower rates of past-year SI and SA relative to White adolescents. Exploratory analyses identified a negative association between the residential segregation index and past-year SI and SA among Black and Hispanic adolescents. Meanwhile, a positive association emerged between B-W incarceration index and past-year SA, though not past-year SI, among Black adolescents.CONCLUSIONAdolescents in states with higher SRI were at lower risk for past-year SI and SA. Racial inequities across various institutions may differentially influence suicide-related risk among adolescents. Structural racism may play an important role in conferring risk for SI and SA, and its impact may vary across Black, Hispanic, and White adolescents. Attending to institutional level markers of racism may help improve the cultural responsiveness of youth suicide prevention strategies.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887745","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":"Psychedelic Therapeutics for Adolescents: Ethics, Safety, Opportunities, and Equipoise-Authors' Reply.","authors":"Jessica K Jeffrey, Marc J Weintraub, Charles S Grob","doi":"10.1016/j.jaac.2024.12.002","DOIUrl":"10.1016/j.jaac.2024.12.002","url":null,"abstract":"<p><p>We are writing in response to 2 Letters to the Editor, both of which discussed our commentary, entitled \"Clinical Research Trials of Psychedelic-Assisted Therapy in Adolescents Aged 16 to 17 Years: Rationale Balanced With Caution.\"¹ We appreciate the thoughtful responses to our commentary, and we invite further dialogue about this important subject. Both letters emphasized the importance in engaging in thoughtful research approaches to ensure the safety of individuals who are administered psychedelics. To ensure safety, ethical and methodologically rigorous research must be conducted across the field of psychedelic medicine. We maintain that conducting such research among adolescents is sensible and worthwhile, but also acknowledge the potential risks associated with extrapolating efficacy data from adult trials and off-label prescribing practices common in child and adolescent psychiatry.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872429","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: Attention-Deficit/Hyperactivity Disorder Symptoms in Children With Neurofibromatosis Type 1.","authors":"Yang Hou, Liyan Yu, Dan Liu, Emma Wilson-Lemoine, Xian Wu, Julia P Moreira, Benjamin F Mujica, Elora S Mukhopadhyay, Angelena N Novotney, Jonathan M Payne","doi":"10.1016/j.jaac.2024.09.011","DOIUrl":"10.1016/j.jaac.2024.09.011","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aimed to robustly estimate differences in attention-deficit/hyperactivity disorder (ADHD) symptoms between children and adolescents with and without neurofibromatosis type 1 (NF1).</p><p><strong>Method: </strong>Systematic literature searches were conducted in Scopus, PsycINFO, Web of Science, PubMed, and ProQuest in September 2022, with a supplemental search conducted in Google Scholar in February 2023. The searches identified 2,153 unique articles. Screening identified 114 academic journal articles that assessed parent/caregiver- or teacher-reported ADHD symptoms for children/adolescents with NF1. Two researchers independently screened articles and extracted data. The primary outcome was group differences in ADHD symptoms between children/adolescents with and without NF1 (Hedges g). Data were analyzed using robust variance estimation and random-effects models.</p><p><strong>Results: </strong>The meta-analysis included 70 studies (138 effect sizes), involving 3,653 children/adolescents with NF1 (46% female; mean age = 9.69 years, SD = 2.60 years) and 4,895 children/adolescents without NF1 (48% female; mean age = 10.03 years, SD = 3.10 years). According to parent/caregiver reports, children/adolescents with NF1 exhibited more severe inattentive symptoms (g = 1.20; 95% CI = 1.06-1.35), hyperactive/impulsive symptoms (g = 0.85; 95% CI = 0. 68-1.03), and combined ADHD symptoms (g = 1.02; 95% CI = 0.87-1.17) than unaffected controls. Inattentive ADHD symptoms were more elevated than hyperactivity/impulsivity for children/adolescents with NF1. Larger effect sizes for inattention and hyperactivity/impulsivity were associated with older age, lower intelligence quotient (IQ), and parent/caregiver vs teacher reports.</p><p><strong>Conclusion: </strong>NF1 is a monogenic condition that has strong associations with elevated ADHD symptoms. Findings highlight the importance of early intervention and targeted support for ADHD-related problems in children with NF1.</p><p><strong>Study preregistration information: </strong>Compare the ADHD problems between NF1 and control groups; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=462063.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872434","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":"Psychedelic Therapeutics for Adolescents: Ethics, Safety, Opportunities, and Equipoise.","authors":"Paul E Croarkin, Isabella Sutherland, Ming-Fen Ho","doi":"10.1016/j.jaac.2024.12.003","DOIUrl":"10.1016/j.jaac.2024.12.003","url":null,"abstract":"<p><p>We read with great interest the commentary by Jeffrey et al. entitled \"Clinical Research Trials of Psychedelic-Assisted Therapy in Adolescents Aged 16 to 17 Years: Rationale Balanced With Caution.\"¹ We appreciate the efforts of the authors, the scholarship of this commentary, and the advocacy for research initiatives with psychedelic therapeutics such as psilocybin, lysergic acid diethylamide, and 3,4-methylenedioxymethamphetamine. We agree that there is a compelling rationale for timely, rigorous studies with adolescents as it is likely that these compounds have been and will be used in adolescents with therapeutic intent. We are writing to catalyze further collegial dialogue and advocacy in our field. We do have some considerations for the authors.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872430","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":"Psychedelic Therapeutics for Adolescents: Ethics, Safety, Opportunities, and Equipoise.","authors":"Samuel Dotson, James Luccarelli","doi":"10.1016/j.jaac.2024.12.001","DOIUrl":"10.1016/j.jaac.2024.12.001","url":null,"abstract":"<p><p>We read with interest the Commentary by Jeffrey et al. encouraging clinical research using psychedelics for adolescents.¹ Throughout their commentary, the authors operate under the general presupposition that psychedelics have demonstrated a favorable safety profile in adults, and that therefore teenagers approaching an adult level of neurodevelopment can likely be safely treated with appropriate safeguards. Although we concur that there is an urgent need for new psychopharmaceuticals for adolescents, we question this assumption of safety, given increasing evidence of risks associated with psychedelics in adult trials.^2,3.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872432","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: Understanding the Nature of Attention Problems in Neurofibromatosis Type 1: Clinical and Research Implications.","authors":"Alecia C Vogel","doi":"10.1016/j.jaac.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.jaac.2024.12.005","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"42 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887746","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":"Cultivating Behavioral Change in K–12 Students: Team-Based Intervention and Support Strategies","authors":"Isti Farin Oktafia Safitri BEd, Alfyn Abdan Nurahman BEd, Inda Purnama BEd","doi":"10.1016/j.jaac.2024.11.021","DOIUrl":"https://doi.org/10.1016/j.jaac.2024.11.021","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"47 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142825158","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: Identifying the Perfect Predictor of Absence of Disease: A Shift Toward Necessary Condition Analysis in Evidence-Based Medicine?","authors":"Jan Dul","doi":"10.1016/j.jaac.2024.11.020","DOIUrl":"10.1016/j.jaac.2024.11.020","url":null,"abstract":"<p><p>One of the challenges of evidence-based medicine is balancing population-level findings with individualized care. Average treatment effect studies, including cohort studies and randomized controlled trials, offer insights into factors affecting disease likelihood at group level or subgroup level (precision medicine), but are limited in predicting individual outcomes. This limitation arises because average treatment effect studies operate within a probabilistic causal framework, indicating how likely a disease is when a certain individual or contextual factor is present: if X, then probably Y.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770074","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 Future of Safety Signal Learning as a Biomarker of Risk and Treatment Target for Trauma-Related Psychopathology in Youth.","authors":"Lana Ruvolo Grasser","doi":"10.1016/j.jaac.2024.11.019","DOIUrl":"10.1016/j.jaac.2024.11.019","url":null,"abstract":"<p><p>More than two-thirds of youth will experience at least 1 traumatic event.¹ Ongoing conflicts and increasingly pervasive natural disasters attributable to climate change signal that this number is on the rise.^2,3 There is a significant need for trauma-informed interventions to mitigate the severity, chronicity, and cost of the physical and mental health effects of trauma (eg, cardiometabolic diseases, posttraumatic stress, anxiety, and depression). While such evidence-based interventions do exist, a significant proportion of youth do not respond to treatments such as cognitive-behavioral therapy, and globally an even larger proportion are unable to access treatment.⁴ Thus, there is a great need to identify and optimize new and existing trauma-informed treatment strategies through mechanism-focused research. In this issue, Kribakaran et al.⁵ explored safety signal learning and its neural underpinnings in 102 youths (ages 9-19; 46 girls), approximately half (n = 52) of whom were exposed to interpersonal trauma. They identified age- and exposure-related differences in brain regions and circuits related to threat detection (eg, centromedial amygdala), context processing (eg, anterior hippocampus), and regulation (eg, subgenual anterior cingulate cortex), with implications for risk of posttraumatic stress disorder and treatment across developmental stages. The findings push the needle forward regarding our understanding of the neurobiological underpinnings of aberrant learning processes in youth exposed to trauma and generate new questions regarding individual differences attributable to structural factors such as racism, as well as developmental questions requiring longitudinal testing.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770075","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":"School and Psychiatry Collaboration.","authors":"Justin Schreiber, Misty C Richards","doi":"10.1016/j.jaac.2024.11.017","DOIUrl":"10.1016/j.jaac.2024.11.017","url":null,"abstract":"<p><p>As child and adolescent psychiatrists, sometimes we can feel stuck trying to support our patients and their families with a short visit every few weeks or months, when most of the difficulties are happening outside the office, especially at school. Parents come in describing the many phone calls home, suspensions, or failing grades. Although some of this is affected by the need to better support their hyperactivity and impulsivity or depression leading to frustration tolerance, it is also clear that support in school is essential. It is often hard to establish these connections to ensure that there is an appropriate Individualized Education Program (IEP) or more global behavioral support available at the school. Being able to find ways to develop these connections is essential to ensuring success for our patients.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770079","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}