Journal of Child Psychology and Psychiatry最新文献

{"title":"Sex differences and implications in outcome in children and adolescents at clinical high risk for psychosis.","authors":"Jordina Tor, Inmaculada Baeza, Xavier Alvarez-Subiela, Marta Rodriguez-Pascual, Daniel Muñoz-Samons, Anna Sintes-Estevez, Elena de la Serna, Olga Puig, Gisela Sugranyes, Daniel Ilzarbe, Josep Maria Haro, Montserrat Dolz","doi":"10.1111/jcpp.14148","DOIUrl":"https://doi.org/10.1111/jcpp.14148","url":null,"abstract":"<p><strong>Background: </strong>Sex differences have been identified in young adults along the psychosis continuum, but studies in children and adolescents are scarce. This study aimed to evaluate possible sex differences in clinical characteristics and outcomes in children and adolescents with clinical high risk for psychosis (CHR).</p><p><strong>Methods: </strong>A naturalistic longitudinal cohort study assessed sociodemographics, CHR symptoms, functioning, and mood at baseline and at 18 months' follow-up in 221 CHR participants (154 females and 67 males) and 159 controls (93 females and 66 males). Regression analyses were performed to test baseline differences, and multinominal regression was used to test the implication of sex in outcome.</p><p><strong>Results: </strong>Despite initial pairwise differences in attenuated positive symptoms, regression analyses failed to show sex differences in CHR symptoms when control group was added to the analyses. The interaction between sex and group significantly predicted depressive symptoms (B = -2.907, p = .040, 95% CI: [-5.681, -0.133]) and caffeine use lifetime (OR = 0.36, 95% CI: [0.138, 0.924], p = .034). A significant interaction between age and sex showed that the older the age in females, the greater the probability of non-remission of CHR at follow-up, as compared to males (B = 0.338, IC 95%: [0.123, 0.933], p = .036), but no relevant associations with sex were found in psychosis outcome.</p><p><strong>Conclusions: </strong>No sex-related differences in CHR symptoms were observed in a CHR children and adolescent population. Outcomes related to non-remission of CHR state in older females could reflect the greater prevalence of psychosis-like experiences in adolescent females. These results invite us to reconsider the usefulness of the current CHR criteria in young populations, especially if we do not take into account a gender perspective and how age might affect it.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717815","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":"Examining the association between placental malperfusion assessed by histopathological examination and child and adolescent neurodevelopment: a systematic review.","authors":"Noha Ibrahim, Sydni A Weissgold, Lucy Brink, Ibtihal Mahgoub, Ben Carter, Vaheshta Sethna, Hein Odendaal","doi":"10.1111/jcpp.14152","DOIUrl":"https://doi.org/10.1111/jcpp.14152","url":null,"abstract":"<p><strong>Background: </strong>Placental malperfusion, categorised into maternal vascular malperfusion (MVM) and foetal vascular malperfusion (FVM), is a main placental pathology known to affect placental functioning and offspring outcomes. The aim of this review is to evaluate the association between exposure to placental malperfusion and offspring neurodevelopment from birth to 18 years of age.</p><p><strong>Methods: </strong>Following the registered protocol on Prospero, Medline, Cochrane, CINHAL, Embase and PsycINFO databases were searched systematically from inception to 01/11/2023. Included were publications examining exposure to placental malperfusion detected on histopathological examination and clinically measured neurodevelopmental outcomes. Publications on multi-pregnancies or animals, exposure to malformations, surgical or medical interventions, review and opinion articles, or those not translated to English, were excluded. Grey literature search and forward and backward citation chaining were performed. The Joanna Briggs Institute's checklists were used for quality assessment. Three studies were pooled using percentages of adjusted associations.</p><p><strong>Results: </strong>Nine observational studies fulfilled the eligibility criteria. The included neurodevelopmental outcomes were assessed from 5 days to 8 years when age of assessment is reported. Four publications showed an association between exposure to MVM and poor neurodevelopment at 10-40 months and 8 years, however, no association was observed when examining preterm infants up to 24 months. Conversely, in the six studies examining exposure to FVM, FVM association with neurodevelopmental disorders was reported in two studies looking at preterm infants assessed at 24 months and 8 years and better neurodevelopmental scores in other two studies at 10-40 months.</p><p><strong>Conclusions: </strong>The pattern of association between MVM and FVM with neurodevelopmental outcomes varied among the included studies. Clinical and methodological heterogeneities and poor reporting of relevant populations' characteristics hindered full understanding of the results. Methodologically rigorous research is required to help utilise histopathological findings of placental malperfusion in predicting offspring's neurodevelopmental outcomes.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707934","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":"Combined effects of prenatal ozone exposure and school/neighborhood environments on youth brain, cognition, and psychotic-like experiences.","authors":"Tianjiao Kong, Yumeng Yang, Feng Ji, Jia Liu, Ran Liu, Liang Luo","doi":"10.1111/jcpp.14167","DOIUrl":"https://doi.org/10.1111/jcpp.14167","url":null,"abstract":"<p><strong>Background: </strong>Humans are inevitably exposed to multiple physical and social environmental risk factors, potentially contributing to psychiatric problems and cognitive deficits; however, the combined effects of prenatal air pollution and psychosocial environments on youth remain unclear. This longitudinal study aimed to examine how prenatal ozone exposure interacts with psychosocial environments at 9-10 years to affect adolescent limbic system development, cognition, and psychotic-like experiences (PLEs) at 11-13 years.</p><p><strong>Methods: </strong>We analyzed data from 6,778 participants in the Adolescent Brain Cognitive Development (ABCD) Study® at two time points (baseline: 9-10 years and 2-year follow-up). Prenatal ozone exposure was calculated as a 9-month average of daily exposure estimates based on birth year and address. Social environmental factors included school environment and neighborhood safety at both time points. Structural MRI measures included bilateral amygdala and hippocampus volumes at both time points. Behavioral data consisted of cognition and PLEs scores at both time points. Moderation and moderated mediation models with cluster-robust standard errors were constructed to examine the effects, controlling for covariates.</p><p><strong>Results: </strong>Children who were prenatally exposed to greater ozone and had a more unfavorable school environment exhibited a smaller increase in left hippocampal volume, leading to poorer cognition and more PLEs. Moreover, children who were prenatally exposed to greater ozone and lived in a more unsafe neighborhood had a larger increase in right amygdala volume.</p><p><strong>Conclusions: </strong>This longitudinal study is the first to demonstrate the combined effects of prenatal ozone pollutant and adverse social environments in childhood on youth psychotic-like experiences and cognition, highlighting the limbic system as an important neural mechanism underlying the effects.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699265","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":"Autistic traits in childhood and post-traumatic stress disorder as young adults: a cohort study.","authors":"Alice M G Quinton, Freya Rumball, Angelica Ronald, Helen L Fisher, Louise Arseneault, Francesca Happé, Andrea Danese","doi":"10.1111/jcpp.14163","DOIUrl":"https://doi.org/10.1111/jcpp.14163","url":null,"abstract":"<p><strong>Background: </strong>Despite the higher prevalence of childhood traumatic experiences and post-traumatic stress disorder (PTSD) in autistic adults, research on trauma-related psychopathology and autistic traits in young people is lacking. This study examined if high autistic traits in childhood predispose individuals to traumatic experiences, the development of PTSD and general psychopathology, and greater functional impairment by age 18, in both the general population and a subsample of trauma-exposed young people.</p><p><strong>Methods: </strong>Data were utilised from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative cohort of 2,232 same-sex twins born in 1994-1995 across England and Wales. Participants were a subset of children whose parents completed the Childhood Autism Spectrum Test (CAST), during assessments at ages 8, 9 and/or 12 years (N = 1,504). We tested associations between autistic traits in childhood and age-18 reports of lifetime trauma exposure, lifetime PTSD diagnosis, general psychopathology ('p-factor') and NEET status ('not in employment, education or training'). Analyses were conducted controlling for sex, family socioeconomic status (SES), intelligence quotient (IQ) and accounting for family clustering.</p><p><strong>Results: </strong>Higher autistic traits in childhood were significantly associated with greater reports of lifetime trauma exposure (Odd Ratio [OR] = 1.26, 95% Confidence Intervals [CI] = 1.03; 1.54), lifetime PTSD diagnosis (OR = 1.91, 95% CI = 1.29; 2.82), general psychopathology (beta = 3.22, 95% CI = 1.84; 4.60) and NEET status (OR = 1.48, 95% CI = 1.05; 2.09) at age 18. Only the associations of autistic traits with PTSD and general psychopathology were robust to adjustment for potential confounders. Among trauma-exposed children, autistic traits were also significantly associated with lifetime PTSD diagnosis (OR = 1.75, 95% CI = 1.15; 2.68) and psychopathology (beta = 3.36, 95% CI = 0.68; 6.04) at age 18, but only the association with PTSD held when adjusted for confounders.</p><p><strong>Conclusions: </strong>Our findings suggest a need to develop targeted assessments and evidence-based treatments for PTSD to meet the needs of children with high autistic traits. However, whether our findings extend to diagnosed autistic children requires further investigation.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707931","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 home-visiting to promote early childhood development and prevent violence in Rwanda: a hybrid type-2 effectiveness-implementation trial.","authors":"Candace J Black, Matias Placencio-Castro, Gabriela Phend, Jean Marie Vianney Havugimana, Grace Umulisa, Pacifique Uwamahoro, Marie Gaudence Nyirahabimana, Laura Bond, Kayla Hernandez, Sarah Kg Jensen, Ursula Kajani, Shauna M Murray, Laura B Rawlings, Vincent Sezibera, Theresa S Betancourt","doi":"10.1111/jcpp.14160","DOIUrl":"https://doi.org/10.1111/jcpp.14160","url":null,"abstract":"<p><strong>Background: </strong>Children in impoverished families-especially those affected by violence-face risks to healthy development. In the years of strong economic recovery since the 1994 Genocide Against the Tutsi, the Rwandan Government has invested in early child development, social and child protection and violence prevention, but few strategies for scaling evidence-based interventions (EBIs) in these areas have been studied.</p><p><strong>Methods: </strong>We present a Hybrid Type-2 Implementation-Effectiveness study of the PLAY Collaborative implementation strategy to engage government and other stakeholders in scaling Sugira Muryango (SM, \"Strong Family\") to families eligible for social protection in three rural districts. SM promotes nurturing care of children under three while reducing family violence. We assessed delivery quality (fidelity, competence) and perceptions of the PLAY Collaborative (e.g, feasibility, leadership, organisation, sustainability). An embedded trial of 538 households (778 caregivers, 555 children) tested SM effectiveness when delivered by child protection volunteers.</p><p><strong>Results: </strong>Child protection volunteers delivered SM with high fidelity and competence that improved with time and routine supervision. The PLAY Collaborative was rated moderately to highly across implementation outcomes. The embedded trial revealed improvements in children's stimulation at home (d = 0.20, 95% CI: 0.04-0.36) as caregivers involved them more in daily activities (d = 0.37, 95% CI: 0.18-0.57) and provided more learning materials (d = 0.37, 95% CI: 0.16-0.59). SM families increased stimulating care (e.g. singing, playing; d = 0.26, 95% CI: 0.07-0.46); involved fathers more in caregiving (IRR = 1.18, 95% CI: 1.03-1.37); reduced harsh discipline (OR = 0.34, 95% CI: 0.14-0.82); and increased dietary diversity (d = 0.25, 95% CI: 0.04-0.45). SM caregivers reported improved mental health (d = -0.13, 95% CI: -0.26 to -0.01). SM households increased safe water storage (OR = 3.14, 95% CI: 1.64-6.03) and water treatment (OR = 3.56, 95% CI: 1.80-7.05) practices.</p><p><strong>Conclusions: </strong>The PLAY Collaborative successfully overcame implementation barriers and maintained effectiveness across most outcomes while scaling delivery to N = 8,745 families, highlighting the value of systematically investigating implementation strategies while scaling an EBI as integrated into existing social and child protection systems.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707936","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":"Sexual and gender minority identity, peer victimization, and suicidality in adolescents: A mediation study using the ABCD Study.","authors":"Sen Liu, Devin English, Yunyu Xiao, Yan Li, Li Niu","doi":"10.1111/jcpp.14155","DOIUrl":"https://doi.org/10.1111/jcpp.14155","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minority (SGM) youth are more susceptible to suicidal ideation and attempts compared to their heterosexual and cisgender peers. Yet, it is unclear how interpersonal and online victimization experiences account for the elevated suicide risks in this population. This study investigates the extent of peer and cyber victimization among SGM youth and its contribution to their higher risks of suicidal ideation and attempts longitudinally.</p><p><strong>Methods: </strong>Data were from the first three waves of the Adolescent Brain Cognitive Development (ABCD) Study (5,596 9-10-year-old youth; 2,640 [47.2%] female; 3,107 [55.5%] non-Hispanic White). Youth reported sexual and gender identities and experiences of peer (overt, relational, reputational) and cyber victimization. Suicidal ideation and attempts were assessed using youth reports of Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5. We used mixed-effects logistic regression to quantify the association between SGM identity reported at waves 1-2 (9-11 years) and suicidal ideation and attempts at wave 3 (11-12 years) and longitudinal mediation analysis to determine whether peer and cyber victimization accounted for these associations.</p><p><strong>Results: </strong>SGM youth were at greater risk for lifetime suicidal ideation (odds ratio [OR] 4.75, 95% CI 3.74-6.03), lifetime suicide attempts (OR 5.87, 95% CI 3.72-9.28), and current suicidal ideation or attempts (OR 4.94, 95% CI 3.19-7.68) compared to non-SGM youth. SGM youth experienced elevated peer (overt: β = 0.40, 95% CI 0.31-0.49; relational: β = 0.43, 95% CI 0.34-0.53; reputational: β = 0.51, 95% CI 0.42-0.60) and cyber victimization (OR 2.35, 95% CI 1.77-3.11). Around 22%-28% of the disparities in current suicidal ideation or attempts were mediated by peer or cyber victimization.</p><p><strong>Conclusions: </strong>SGM youth are disproportionately affected by both interpersonal and online victimization, which are subsequently associated with their elevated suicide risks. Our findings underscore the urgent need for targeted interventions to foster safer school and online environments to reduce suicide among SGM youth.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690646","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":"Trajectories of parent criticism across treatment for youth self-harm.","authors":"Madison Aitken, Florence Perquier, Bomi Park, Daniela Carvalho, Alexandra Wright-Hughes, David Cottrell, Peter Szatmari","doi":"10.1111/jcpp.14144","DOIUrl":"https://doi.org/10.1111/jcpp.14144","url":null,"abstract":"<p><strong>Background: </strong>Criticism from parents is a risk factor for poor youth mental health, including self-harm and limited response to psychosocial interventions. We identified trajectories of change in parent criticism across treatment for youth self-harm (suicide attempts and non-suicidal self-injury) and compared these trajectories on treatment outcomes.</p><p><strong>Methods: </strong>This is a preregistered secondary analysis of data from the Self-harm Intervention: Family Therapy trial. Participants (N = 831, 11-17 years; 89% girls, 11% boys; 84% White) were clinically referred for self-harm and randomly assigned to family therapy or usual care. A growth mixture model identified trajectories of parent self-reported criticism across baseline, 3, and 6 months. Trajectories were compared on youth self-harm, suicidal ideation, depression, and hopelessness, and parent mental distress (baseline, and change from baseline to 12 and 12-18 months).</p><p><strong>Results: </strong>Four trajectories of parent criticism were identified: High and remaining elevated despite a small decrease (51.6%); sharply decreasing (7.6%); low/stable (37.2%); and increasing (3.6%). Youth with parents in the high with small decrease class had more severe baseline suicidal behavior. Treatment type was not related to criticism trajectory. Parent mental distress increased in the increasing criticism class. Youth with parents in the increasing class showed less improvement in suicidal ideation at 12-month follow-up compared to the high with small decrease and sharply decreasing classes.</p><p><strong>Conclusions: </strong>Current treatments for youth self-harm may not reduce parent criticism to subclinical levels. Increasing parent criticism may forecast poorer response to a range of treatments for youth self-harm and be indicative of increases in parent mental distress.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690705","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":"Psychoneuroendocrine stress response in female and male youth with major depressive disorder","authors":"Anka Bernhard, Nikola Fann, Andreas G. Chiocchetti, Katharina Ackermann, Anne Martinelli, Christine M. Freitag","doi":"10.1111/jcpp.14168","DOIUrl":"https://doi.org/10.1111/jcpp.14168","url":null,"abstract":"BackgroundExposure to psychosocial stress is one of the strongest risk factors for major depressive disorder (MDD) in youth, but underlying neurobiological mechanisms are poorly understood. Previous studies on the neuroendocrine stress response in youth with MDD are scarce, limited to cortisol, and rarely considered sex differences. Due to puberty‐associated neuroendocrine transitions increasing the risk for MDD onset in adolescence, this study aimed to investigate sex‐specific stress responses of stress and sex hormones as well as of neuropeptides.MethodsIn 103 pubertal youths with MDD and 72 healthy controls (HCs; 62% females, 12–18 years), psychological stress as well as salivary cortisol, testosterone, and oxytocin reactivity to a standardized psychosocial stress test (Trier Social Stress Test, TSST) were assessed. Effects of group and sex, and their interactions were analyzed using hierarchical linear models, while controlling for potentially confounding factors (such as age and pubertal status).ResultsFemales and males with MDD showed a stronger psychological stress response than HCs. In contrast, both female and male youth with MDD showed blunted cortisol, testosterone, and oxytocin stress responses compared to HCs. In addition, baseline testosterone was elevated in MDD compared to HCs.ConclusionsResults indicate a discrepant stress reactivity in youth with MDD, with increased psychological, but decreased neuroendocrine responses to psychosocial stress. Blunted neuroendocrine stress responses in youth with MDD were found across different neuroendocrine systems and in both females and males with MDD. These novel findings point to a fundamentally changed stress response in youth with MDD irrespective of sex, which may influence successful stress regulation in the affected adolescents.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"71 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677693","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":"Navigating early risks: Differential outcomes in middle childhood and the compensatory role of kindergarten experiences.","authors":"Katharina Haag, Tyler Watts, Laurie Hannigan, Helga Ask, Nina Alexandersen, Mari Vaage Wang, Ragnhild Eek Brandlistuen","doi":"10.1111/jcpp.14158","DOIUrl":"https://doi.org/10.1111/jcpp.14158","url":null,"abstract":"<p><strong>Background: </strong>It has been proposed that early risk constellations link differentially to later developmental outcomes. However, existing studies often use a limited set of risk indicators, excluding genetic and child-based risks. It is also unclear if the protective effects of potential moderators, such as kindergarten experiences, differ across risk groups.</p><p><strong>Methods: </strong>Using data from the Norwegian Mother, Father and Child (MoBa) cohort study (n = 7,478), we established latent early risk classes based on family, child, and genetic risk factors measured up to 3 years of age. The early risk classes were then compared on parent-rated internalizing and externalizing symptoms and academic performance at 8 years, as well as on registry outcomes reflecting child internalizing and externalizing diagnoses and national test scores at ages 11-14 years. Potential moderating effects of kindergarten protective factors (student-teacher closeness, social play behaviors and structured pre-academic activities) were examined.</p><p><strong>Results: </strong>We identified five classes: a \"low risk\" group (41.1%) performed best across most behavioral and academic outcomes. A \"resource risk\" group (32.1%) struggled academically at 8 and 11 years, while a \"family psychological risk\" group (11.7%) showed mental health difficulties at 8 years and the highest levels of internalizing diagnoses at 12-14 years. A \"developmental risk\" group (7.6%) exhibited more pronounced academic and behavioral difficulties at 8 years only, while a \"preterm birth\" (7.5%) group showed moderate risk across most outcomes. Close student-teacher relationships and social play behaviors, but not structured pre-academic activities, predicted improved outcomes at small effect sizes across the whole sample, with limited evidence for differential responses across groups.</p><p><strong>Conclusions: </strong>Our risk groups were differentially linked to later outcomes, suggesting potential diverging developmental pathways. The investigated Kindergarten factors exerted protective effects across groups, indicating that they may universally benefit children independent of their risk backgrounds.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668624","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":"Sudden gains in modular CBT for mental health disorders in children and young people with epilepsy.","authors":"Alvin Richards-Belle, Daniela Linton, J Helen Cross, Isobel Heyman, Emma Dalrymple, Bruce Chorpita, Sophia Varadkar, Mariam Shah, Roz Shafran, Sophie Bennett","doi":"10.1111/jcpp.14164","DOIUrl":"https://doi.org/10.1111/jcpp.14164","url":null,"abstract":"<p><strong>Background: </strong>Sudden gains (rapid, large, stable improvements in symptoms) are common in psychological therapy and are associated with favourable outcomes, but no studies have investigated sudden gains in children and young people (CYP) with a chronic physical condition.</p><p><strong>Methods: </strong>Within-group study nested in the Mental Health Intervention for Children with Epilepsy (MICE) randomised trial of modular cognitive-behavioural therapy for CYP with epilepsy, utilising goal-based outcomes (GBOs) and standardised session-by-session measures (including the brief parental self-efficacy scale and Strengths and Difficulties Questionnaire [SDQ] session-by-session measure). The occurrence and potential predictors of sudden gains, and the association of sudden gains with outcomes at final session and follow-up were investigated using multivariable logistic and linear regression.</p><p><strong>Results: </strong>Among 147 participants (mean age: 10.4 years, 49% female) and across nine measures, 39% experienced between two and four sudden gains, most frequently on the mean GBO (occurrence, 44.9%). Characteristics such as intellectual disability, pretreatment scores and the number of sessions received were associated with significantly greater odds of sudden gains in some measures, whereas nonwhite ethnicity and nonemployment of the primary caregiver were associated with reduced odds. Sudden gains were associated with favourable final-session scores for mean GBO (GBO, adjusted mean difference [aMD]: 0.9, 95% CI: 0.3 to 1.6, p = .004, D = 0.63), parental self-efficacy (aMD: 1.2, 95% CI, 0.1 to 2.4, p = .027, D = 0.37) and the SDQ session-by-session measure (aMD: -1.7, 95% CI, -3.0 to -0.3, p = .014, D = -0.44), but not with 6-month adjusted SDQ total difficulties scores.</p><p><strong>Conclusions: </strong>Sudden gains were common in this population, occurring most frequently on personalised measures, and were associated with favourable final-session scores. Personalised measures taken at each session with a focus on sudden gains may be a useful adjunct to treatment. Future research and clinical practice should investigate how to increase the occurrence of sudden gains in CYP with long-term conditions receiving psychological therapy.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668647","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}