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

{"title":"Perceived Racism, Brain Development, and Internalizing and Externalizing Symptoms: Findings From the ABCD Study.","authors":"Shanting Chen,Catalina Lopez-Quintero,Amanda Elton","doi":"10.1016/j.jaac.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.005","url":null,"abstract":"OBJECTIVERacial discrimination drives health disparities among racial/ethnic minority youth, creating chronic stress that affects brain development and contributes to mental and behavioral health issues. This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study to examine the neurobiological mechanisms linking discrimination to mental and behavioral health outcomes.METHODA sample of 3,321 racial/ethnic minority youth was split into training (80%, n=2,674) and testing (20%, n=647) groups. Propensity-score-weighted machine learning was used to assess the effects of perceived discrimination on two-year changes in resting-state functional connectivity between three subcortical regions (nucleus accumbens, amygdala, hippocampus) and large-scale brain networks. Mediation analyses evaluated whether brain changes mediated sex-specific effects on internalizing or externalizing symptoms.RESULTSPerceived discrimination was significantly associated with two-year changes in connectivity of the nucleus accumbens, amygdala, and hippocampus in both cross-validation and independent testing. Key findings included decreases in nucleus accumbens connectivity with retrosplenial-temporal and sensorimotor (hand) networks, decreases in amygdala connectivity with the sensorimotor (mouth) network, and increases in hippocampal connectivity with the auditory network. These changes suggest accelerated maturation in these connections among youth reporting higher discrimination levels. Moderated mediation analyses revealed sex differences, with discrimination-related changes in nucleus accumbens connectivity linked to poorer internalizing outcomes in female participants.CONCLUSIONSThe results indicate perceived racial discrimination experienced in adolescence impact subcortical-cortical brain development, which affect mental and behavioral health outcomes in a sex-specific manner.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"108 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831618","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":"Managing Screen Time in the Age of AI: Supporting Healthier Habits for Teens from the Inpatient Setting.","authors":"Conrad W Safranek,Charlotte M Schwarz","doi":"10.1016/j.jaac.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.006","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"17 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831614","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":"Incarceration and Subsequent Psychosocial Outcomes: A 16-Year Longitudinal Study of Youth After Detention.","authors":"Sara E Thomas,Karen M Abram,David Aaby,Leah J Welty,Jennifer L Arzu,Joeann M Salvati,Linda A Teplin","doi":"10.1016/j.jaac.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.004","url":null,"abstract":"OBJECTIVETo investigate the dose of incarceration and subsequent psychiatric and psychosocial functioning in justice-involved youth 16 years after detention (median age 32).METHODParticipants were from the Northwestern Juvenile Project, a prospective, longitudinal study of 1,829 youth randomly sampled at intake from the Cook County Juvenile Temporary Detention Center, 1995-1998, stratified by sex, race and ethnicity, age, and legal status (processed as juvenile or adult). The study measured incarceration \"dose\": (1) the depth of involvement, i.e. the type of facility where youth were incarcerated as they aged (juvenile-only, adult jail [but not prison], or prison); and (2) total number of days incarcerated. Psychosocial outcomes were: positive mental health, no problematic substance use, educational attainment, gainful activity, residential independence, interpersonal functioning, parenting responsibility, and desistance from criminal activity. Regression models comparing outcomes by facility type were propensity weighted.RESULTSMale participants in the prison group achieved fewer psychosocial outcomes (3.3; 95% CI 3.1-3.5) vs those in the jail (4.8; 95% CI 4.2-5.4) and juvenile-only (5.2; 95% CI 4.3-6.0) groups. Participants only incarcerated in juvenile detention were more likely to achieve every socioeconomic outcome vs those who had been in prison. More time incarcerated was associated with poorer outcomes for male and female participants; findings varied by facility type. Among male participants in prison, each additional year incarcerated reduced the odds of positive mental health.CONCLUSIONHigher doses of incarceration were adversely associated with psychiatric and psychosocial functioning in adulthood. Black and Hispanic men are disproportionately incarcerated and thus disproportionately affected. Community mental health service providers are in a unique position to collaborate with correctional facilities to provide early interventions and services for successful reentry to the community.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827100","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":"How Technology, Social Media, and Current Events Profoundly Affect Adolescents","authors":"Kirti Veeramachaneni BS","doi":"10.1016/j.jaac.2025.04.001","DOIUrl":"10.1016/j.jaac.2025.04.001","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 7","pages":"Pages 851-853"},"PeriodicalIF":9.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820265","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: Fixing Implementation Science's Implementation Problem.","authors":"David S Mandell","doi":"10.1016/j.jaac.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.003","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"66 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822633","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":"Asking Preadolescents About Suicide Is Not Associated With Increased Suicidal Thoughts.","authors":"Laura Hennefield, Katherine R Luking, Rebecca Tillman, Deanna M Barch, Joan L Luby, Renee J Thompson","doi":"10.1016/j.jaac.2025.03.025","DOIUrl":"10.1016/j.jaac.2025.03.025","url":null,"abstract":"<p><strong>Objective: </strong>Rising rates of suicidal thoughts and behaviors (STBs) in preadolescents make suicide-risk screening in this age group critical to reduce harm. Although screening appears generally safe for youth aged 12 years of age and older, effects in preadolescents remain unknown. This study tested iatrogenic effects of repeated suicide-risk screening in 2 groups of preadolescents (8-12 years of age): a lower-risk group with no prior STBs, and a higher-risk group who had experienced STBs.</p><p><strong>Method: </strong>The Ask-Suicide Screening Questions (ASQ) screener, modified to query suicidal thoughts over the prior week, was administered to 194 preteens from the Pediatric Suicidality Study (PED-SI) over 12 months. PED-SI is a study of preschool-onset depression following children recruited at ages 3 to 6 years for depression and nondepressed peers. Lower-risk preadolescents (n = 68) completed monthly screens, whereas higher-risk preadolescents (n = 124) completed weekly screens, administered remotely via text or e-mail. We examined correlations between screen completion rates and positive screens, changes in positive screens over time, and whether previous screen completion predicted a positive future screen. Bayes factors assessed for meaningfulness of null effects.</p><p><strong>Results: </strong>A total of 192 preadolescents (mean age = 10.13 years; 63% boys, 37% girls; 79.2% White, 8.9% Black, 9.9% Multiracial, 2.1% Asian; 7.3%, Hispanic) completed at least one screen. Findings from inferential statistics and supported by Bayes factors indicated no evidence that repeated screening increased suicidal thoughts in either group. In the lower-risk group, positive screens were rare (1.6%), with no significant increases over time. In the higher-risk group, 7% of screens were positive, but this frequent screening did not exacerbate suicidal thoughts.</p><p><strong>Conclusion: </strong>Suicide-risk screening appears to be safe for preadolescents. Clinicians can proceed with screening preadolescents with increased confidence that the benefits outweigh the risks.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795802","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":"Media Representation and Intergenerational Communication in Immigrant Families.","authors":"Seeba Anam, Manal Khan, Afifa Adiba, Deepika Shaligram","doi":"10.1016/j.jaac.2025.03.024","DOIUrl":"10.1016/j.jaac.2025.03.024","url":null,"abstract":"<p><p>This article highlights how accurate media representation centering SAAs allows discourse on salient topics of SAA-specific discrimination and bullying, identity development, gendered norms, social controls, culturally informed clinical concerns, and attitudes toward mental health. Media representation can serve as a conversational starting point for clinicians and can serve to acknowledge the benefits of belief systems and social connectedness that anchor youth in a sense of purpose that is larger than the individual. Finally, media as a clinical tool could foster bicultural identity, which is shown to protect against acculturation stressors and intergenerational conflicts and to promote resilience, cognitive flexibility, and resourcefulness (socio-cognitive capacity).¹¹ Media can thus be used as an innovative tool for clinicians to support minoritized youth, including SAA, through reflecting the complexities of their experiences, increasing engagement, and promoting insightful, culturally sensitive care.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795807","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":"Prenatal Antidepressant Exposure and Risk of Depression and Anxiety Disorders: An Electronic Health Records-Based Cohort Study.","authors":"Ardesheer Talati,Jennifer L Vande Voort,Launia J White,David Hodge,Cynthia J Stoppel,Myrna M Weissman,Jay A Gingrich,William V Bobo","doi":"10.1016/j.jaac.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.03.026","url":null,"abstract":"OBJECTIVETo examine the associations of serotonergic antidepressant exposure during pregnancy with the risk of depression and anxiety disorders in offspring.METHODThe Mayo Clinic Rochester Epidemiology Project medical records-linkage system was used to study offspring born to mothers who were prescribed selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors (S/NRI users, n=837) during pregnancy (1997-2010). Cox regression models were used to calculate hazard ratios (HRs) to examine associations of S/NRIs with diagnosed depression and anxiety, defined based on a review of medical records by two board-certified psychiatrists, using no maternal antidepressant use during pregnancy (non-users, n=863) and maternal antidepressant use in the year prior to pregnancy (former users, n=399) as control groups.RESULTSAfter all adjustments for covariates, children born to S/NRI users during pregnancy did not differ in onset of depression or anxiety than the children of non-users (Adjusted Hazard Ratios, (aHR [95% CI]=1.00 [0.74, 1.85]) or former users (aHR=0.94 [0.69, 1.27]). The above associations were similar when exposure was limited only to SSRIs.CONCLUSIONOur results suggest that the higher rates of childhood and adolescent depression or anxiety conditioned on maternal S/NRI use in pregnancy are more likely to be driven by maternal depression or underlying propensity for depression rather than direct pharmacological effects of in utero S/NRI exposure.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"37 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819290","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":"Racial and Ethnic Disparities in Treatment of Youth With Bipolar Disorders.","authors":"Cynthia A Fontanella, Kristy M Nguyen, Elyse N Llamocca, Rui Huang, Danielle L Steelesmith, Taryn L Mayes, Eric A Youngstrom, Susan dosReis","doi":"10.1016/j.jaac.2025.02.018","DOIUrl":"10.1016/j.jaac.2025.02.018","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about racial/ethnic disparities in the treatment of pediatric bipolar disorder. This study examined racial and ethnic differences in prescription fill patterns and receipt of recommended treatment among Medicaid-enrolled youth.</p><p><strong>Method: </strong>A retrospective longitudinal cohort study using Medicaid claims data from 36 states was conducted for youth 10 to 17 years of age with a \"new episode\" of bipolar disorder from January 1, 2017, through December 31, 2018 (N = 16,807). Measures related to receipt of guideline-concordant care included filled prescription of a mood stabilizer or antipsychotic, any antidepressant monotherapy, and any psychotherapy visit within 90 days of the new episode of bipolar disorder. We used generalized linear mixed models to examine differences by race/ethnicity in guideline-concordant treatment patterns.</p><p><strong>Results: </strong>Approximately two-fifths (39.5%) of the cohort filled prescriptions for the recommended treatment of mood stabilizers or antipsychotic medication and about one-half (47.6%) received psychotherapy within 90 days of the first diagnosis during the 365-day follow-up period. Less than one-fifth (17.5%) of youth received antidepressant monotherapy. After controlling for demographic, clinical, and contextual factors, both Hispanic (adjusted odds ratio [AOR] = 0.70, 95% CI = 0.64-0.77) and non-Hispanic Black youth (AOR = 0.58, 95% CI = 0.53-0.63) had lower odds of filling a mood stabilizer or antipsychotic prescription compared to non-Hispanic White youth. Non-Hispanic Black youth also had lower odds of antidepressant monotherapy (AOR = 0.57, 95% CI = 0.50-0.64) or receiving psychotherapy (AOR = 0.89, 95% CI = 0.81-0.97) than non-Hispanic White youth.</p><p><strong>Conclusion: </strong>Racial/ethnic differences in guideline-concordant treatment for youth with bipolar disorder underscore the need to identify barriers to recommended care for minoritized youth.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795823","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":"Study Preregistration: Clinical and Cognitive Mediators Underlying Subsequent Depression in Individuals With Attention-Deficit/Hyperactivity Disorder: A Developmental Approach.","authors":"Eglė Padaigaitė-Gulbinienė, Gemma Hammerton, Jon Heron, Olga Eyre, Giorgia Michelini, Alexandra Wilson-Newman, Clara S Garavini, Thalia C Eley, Anita Thapar, Lucy Riglin","doi":"10.1016/j.jaac.2025.03.023","DOIUrl":"10.1016/j.jaac.2025.03.023","url":null,"abstract":"<p><p>Individuals with attention-deficit/hyperactivity disorder (ADHD) are about 5.5 times more likely to develop depression,¹ and this comorbidity is associated with greater impairment than either disorder alone. Although there is evidence that ADHD may play a causal role in the development of depression,²^,³ the underlying mechanisms remain poorly understood. Several clinical and cognitive mechanisms have been proposed: (1) clinical antecedents of depression, such as irritability and anxiety, often observed in individuals with ⁴^,⁵; (2) cognitive-affective functions (response inhibition, working memory, sustained attention, and emotion recognition) impaired in individuals with ADHD and, to a lesser extent, in depressed individuals⁶^,⁷; or (3) negative thought patterns underlying vulnerability to depression also observed in individuals with ADHD (external locus of control and negative cognitive styles).⁸ Nevertheless, few longitudinal studies have tested these as potential mediators between ADHD and subsequent depression. Existing studies are primarily cross-sectional, limited by small sample sizes, and have not examined developmental stage-specific effects. Therefore, we will explore the mediating role of clinical, cognitive-affective, and negative thought patterns, and whether their role varies by developmental stage and sex. We will examine all mediators simultaneously, the relative contribution of 3 categories of mediators, and the associations between ADHD and each hypothesized mediator/factor. We hypothesize the following: (1) ADHD will be more strongly associated with irritability and emotion recognition in childhood than in adolescence and young adulthood; (2) the association between ADHD and anxiety will be consistent across development; and (3) ADHD will be more strongly associated with response inhibition, working memory, sustained attention, external locus of control, and negative cognitive style in adolescence and young adulthood compared to childhood.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788475","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}