Journal of Child Psychology and Psychiatry最新文献

{"title":"Identifying cognitive, affective, and developmental mechanisms linking threat and deprivation with adolescent psychopathology.","authors":"Ekaterina Sadikova, David G Weissman, Maya L Rosen, Elise Robinson, Liliana J Lengua, Margaret A Sheridan, Henning Tiemeier, Katie A McLaughlin","doi":"10.1111/jcpp.14067","DOIUrl":"https://doi.org/10.1111/jcpp.14067","url":null,"abstract":"<p><strong>Background: </strong>The mechanisms linking early-life adversity with psychopathology over the life-course are complex. In this prospective study, we collectively examined cognitive, affective, and developmental mediators previously found to individually link childhood threat and deprivation experiences to adolescent psychopathology to identify the most potent mechanisms.</p><p><strong>Methods: </strong>Data came from a community sample of 227 children (mean child age 11.5 ± 0.5 years, 48.5% female) from the Seattle metro area with recruitment designed to reflect diversity in family income. Candidate mechanisms included self-rated pubertal development and task-measured attention bias to threat, emotion regulation, theory of mind, fear learning, inhibitory control, language ability, reasoning, and reward sensitivity. Using a high-dimensional mediation approach, we determined which mediating pathways linking threat and deprivation to psychopathology persisted after controlling for all candidate mechanisms associated with psychopathology. Models additionally controlled for the child's age, sex, early-childhood emotional and behavioral symptoms, poverty, and maternal depression.</p><p><strong>Results: </strong>Blunted reward sensitivity mediated the prospective relationship between threat and internalizing psychopathology, explaining 17.25% (95% CI 1.08%, 69.96%) of this association. Advanced pubertal development was associated with increases in internalizing and externalizing symptoms (standardized associations of 0.16 (95% CI 0.03, 0.29) and 0.17 (95% CI 0.05, 0.29), respectively), but not with adversity. Although deprivation was strongly related to psychopathology, no mechanisms were empirically identified.</p><p><strong>Conclusions: </strong>In a well-characterized community sample, we isolated reward sensitivity as a robust mediator of the prospective association between early-life threat and adolescent internalizing psychopathology. Interventions aimed at bolstering reward sensitivity may mitigate the impact of early-life threat experiences on internalizing problems.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142542365","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":"Food choice and neural reward systems in adolescents with anorexia nervosa and atypical anorexia nervosa.","authors":"E Caitlin Lloyd, Jonathan Posner, Janet Schebendach, Alexandra F Muratore, Susie Hong, Jessica Ojeda, Elizabeth Rafanello, Joanna E Steinglass, Karin Foerde","doi":"10.1111/jcpp.14066","DOIUrl":"10.1111/jcpp.14066","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a critical developmental period for the study of anorexia nervosa (AN), an illness characterized by extreme restriction of food intake. The maturation of the reward system during adolescence combined with recent neurobiological models of AN led to the hypothesis that early on in illness, restrictive food choices would be associated with activity in nucleus accumbens reward regions, rather than caudate regions identified among adults with AN.</p><p><strong>Methods: </strong>Healthy adolescents (HC, n = 41) and adolescents with AN or atypical AN (atypAN, n = 76) completed a Food Choice Task during fMRI scanning. Selection of high-fat foods and choice-related activation in nucleus accumbens and anterior caudate regions-of-interest (ROIs) were compared between individuals with AN/atypAN and HC. Associations were examined between choice-related activation and choice preferences among the AN group. Exploratory analyses examined associations between choice-related activation and psychological assessments among the patient group.</p><p><strong>Results: </strong>Adolescents with AN or atypAN selected fewer high-fat foods than HC (t = -5.92, p < .001). Counter to predictions, there were no significant group differences in choice-related activation in the ROIs. Among individuals with AN or atypAN, choice-related neural activity in the anterior caudate was significantly negatively associated with high-fat food selections in the task (r = -.32, p = .024). In exploratory analyses, choice-related anterior caudate activation was positively associated with psychological measures of illness severity among patients (p's < .05, uncorrected).</p><p><strong>Conclusions: </strong>In this large cohort of adolescents with AN/atypAN, there was no evidence of altered reward system engagement during food choice. While there was no group difference in choice-related caudate activation, the associations with choices and psychological measures continue to suggest that this neural region is implicated in illness. Longitudinal analyses will clarify whether neural variability relates to longer-term course.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142542364","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":"Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial","authors":"Robert B. Penfold, Abisola E. Idu, R. Yates Coley, Kara L. Cushing‐Haugen, Deborah King, Ashley Glass, Rebecca C. Phillips, Anne D. Renz, Chester J. Pabiniak, Vina F. Graham, Ella E. Thompson, James D. Ralston, Gregory E. Simon, Erin S. Gonzalez, Kathleen M. Myers, Arne Beck, LeeAnn M. Quintana, Arthur J. Runkle, Megan Rogers, Deirdre M. Foster, Gregory N. Clarke, Stefan Massimino, Phillip M. Crawford, Julie A. Cavese, Anthony R. Cordaro, Laura I. Chavez, Kelly J. Kelleher, Nadine Schwartz, Kristina R. Jiner, Swan Bee Liu, Sara Condrac, Robert J. Hilt","doi":"10.1111/jcpp.14059","DOIUrl":"https://doi.org/10.1111/jcpp.14059","url":null,"abstract":"BackgroundAntipsychotic medications (AP) are inappropriately prescribed to young people. The goal of this pragmatic trial was to test a four‐component approach to improved targeting of antipsychotic prescribing to people aged ≥3 and &lt;18 years.MethodsClinicians in four health systems were cluster randomized by the number of previous AP orders and service line – specialty mental health and all others. Intervention arm clinicians received a best practice alert and child psychiatrist consultation and feedback. Families received system navigation and expedited access to psychotherapy. Primary outcomes were total days' supply of AP medication and proportion of youth with any AP supply at 6 months. We estimated the log‐odds of AP use at 6 months and the relative rate of AP over 6 months. <jats:italic>The Safer and Targeted Use of Antipsychotics in Youth</jats:italic> (SUAY) trial took place between 3/2018 and 12/2020.ResultsThe trial enrolled 733 patients. The odds ratio (OR) comparing use at 6 months was 0.75 (95% CI: 0.52, 1.09). The mean number of days using AP was 118.5 for intervention patients and 128.2 for control patients (relative risk [RR] = 0.92; 95% CI: 0.81–1.04). Exploratory heterogeneity of treatment effects (HTE) was not detected in groups defined by age, gender, provider specialty, and insurance type. HTE by race/ethnicity was present: among youth of color, mean days' supply was 103.2 for intervention arm and 131.2 for the control arm (RR 0.79, 95% CI: 0.67–0.93). Among secondary outcomes, only new psychotherapy referrals differed with 44.3% (<jats:italic>n</jats:italic> = 154) of intervention participants having a new order for psychotherapy compared to 33.5% (<jats:italic>n</jats:italic> = 129) in the control arm (OR 1.47: 95% CI: 1.01–2.14).ConclusionsThis intervention did not result in less AP use at 6 months or a reduction in the days' supply of AP medication, although psychotherapy orders increased. The intervention may be effective for some subgroups.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"53 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541233","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":"Childhood trajectories of emotional and behavioral difficulties are related to polygenic liability for mood and anxiety disorders","authors":"Nora R. Bakken, Nadine Parker, Laurie J. Hannigan, Espen Hagen, Pravesh Parekh, Alexey Shadrin, Piotr Jaholkowski, Evgeniia Frei, Viktoria Birkenæs, Guy Hindley, Laura Hegemann, Elizabeth C. Corfield, Martin Tesli, Alexandra Havdahl, Ole A. Andreassen","doi":"10.1111/jcpp.14063","DOIUrl":"https://doi.org/10.1111/jcpp.14063","url":null,"abstract":"BackgroundSymptoms related to mood and anxiety disorders (emotional disorders) often present in childhood and adolescence. Some of the genetic liability for mental disorders, and emotional and behavioral difficulties seems to be shared. Yet, it is unclear how genetic liability for emotional disorders and related traits influence trajectories of childhood behavioral and emotional difficulties, and if specific developmental patterns are associated with higher genetic liability for these disorders.MethodsThis study uses data from a genotyped sample of children (<jats:italic>n</jats:italic> = 54,839) from the Norwegian Mother, Father, and Child Cohort Study (MoBa). We use latent growth models (1.5–5 years) and latent profile analyses (1.5–8 years) to quantify childhood trajectories and profiles of emotional and behavioral difficulties and diagnoses. We examine associations between these trajectories and profiles with polygenic scores for bipolar disorder (PGS<jats:sub>BD</jats:sub>), anxiety (PGS<jats:sub>ANX</jats:sub>), depression (PGS<jats:sub>DEP</jats:sub>), and neuroticism (PGS<jats:sub>NEUR</jats:sub>).ResultsAssociations between PGS<jats:sub>DEP</jats:sub>, PGS<jats:sub>ANX</jats:sub>, and PGS<jats:sub>NEUR</jats:sub>, and emotional and behavioral difficulties in childhood were more persistent than age‐specific across early childhood (1.5–5 years). Higher PGS<jats:sub>ANX</jats:sub> and PGS<jats:sub>DEP</jats:sub> were associated with steeper increases in behavioral difficulties across early childhood. Latent profile analyses identified five profiles with different associations with emotional disorder diagnosis. All PGS were associated with the probability of classification into profiles characterized by some form of difficulties (vs. a normative reference profile), but only PGS<jats:sub>BD</jats:sub> was uniquely associated with a single developmental profile.ConclusionsGenetic risk for mood disorders and related traits contribute to both a higher baseline level of, and a more rapid increase in, emotional and behavioral difficulties across early and middle childhood, with some indications for disorder‐specific profiles. Our findings may inform research on developmental pathways to emotional disorders and the improvement of initiatives for early identification and targeted intervention.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"44 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490771","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 systemic inflammation as a pathway linking peer victimization to depressive symptoms in adolescence","authors":"Tamara Lorenz, Nathalie Michels, George M. Slavich, Matteo Giletta","doi":"10.1111/jcpp.14060","DOIUrl":"https://doi.org/10.1111/jcpp.14060","url":null,"abstract":"BackgroundAdolescents exposed to victimization are at an increased risk for a variety of adverse mental health outcomes, including depressive symptoms. Yet, the biological pathways underlying these associations remain poorly understood. Focusing on within‐person processes, we examined whether low‐grade systemic inflammation mediated the longitudinal associations between peer victimization and depressive symptoms in adolescence.Methods207 adolescents (at baseline <jats:italic>M</jats:italic><jats:sub>age</jats:sub> = 12.69 years; <jats:italic>SD</jats:italic> = 0.49; 43.5% female) participated in a multi‐wave longitudinal study, with assessments repeated every 6 months over 1.5 years. At each assessment wave, participants self‐reported their peer victimization experiences and depressive symptoms. Dried blood spots were collected at each wave using a finger prick procedure to assay a key marker of low‐grade systemic inflammation, interkeukin‐6 (IL‐6). Data were analyzed using random‐intercept cross‐lagged panel models.ResultsThe cross‐lagged paths from IL‐6 to depressive symptoms were significant across all models and waves (<jats:italic>β</jats:italic><jats:sub><jats:italic>12</jats:italic></jats:sub> = .13; <jats:italic>β</jats:italic><jats:sub><jats:italic>23</jats:italic></jats:sub> = .12; <jats:italic>β</jats:italic><jats:sub><jats:italic>34</jats:italic></jats:sub> = .08), indicating that when adolescents' levels of low‐grade systemic inflammation were above their person‐specific average, they reported increased levels of depressive symptoms in the subsequent months. However, no significant cross‐lagged within‐person associations emerged between peer victimization and either IL‐6 or depressive symptoms.ConclusionsThe findings provide no evidence for the hypothesized mediating role of inflammation in the within‐person associations between peer victimization and depressive symptoms. Nevertheless, they extend prior research by indicating that elevated levels of low‐grade systemic inflammation predict the development of depressive symptoms in adolescence.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"60 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490598","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: An autism case series, vaccine hesitancy, and death by measles","authors":"Eric Fombonne","doi":"10.1111/jcpp.14058","DOIUrl":"10.1111/jcpp.14058","url":null,"abstract":"&lt;p&gt;Measles are back. Larger and more frequent measles outbreaks have been reported in 2024 in the United Kingdom and the United States, which predated the COVID-19 pandemic. Measles deaths worldwide rose to an estimated 136,000 in 2022, mostly children.&lt;/p&gt;&lt;p&gt;Immunizations have been one of the major contributor to the 20th century increased life expectancy alongside better nutrition, hygiene, and lifestyle, way ahead of medical technological prowess that keeps impressing us. Vaccination campaigns and other preventive policies (e.g. car safety belts and anti-tobacco campaigns) have saved and continue to save lives and reduce morbidity (remember tuberculosis or poliomyelitis) much more than da Vinci surgical robots or heart transplants. Vaccines are safe and post-licensure vaccine safety is continuously monitored with different overlapping population-based surveillance systems (Buttery &amp; Clothier, &lt;span&gt;2022&lt;/span&gt;). Vaccines achieved the total eradication of smallpox in the late 1970s. A worldwide campaign to eradicate measles was well under way in the 1990s. Then, a case series published in a prestigious medical journal triggered fears of vaccine-induced autism in the public. Despite rigorous science rapidly dismissing the original claim, the measles-mumps-rubella (MMR) vaccine scare and fear of autism propagated. Years later, it has morphed into what we now refer to as ‘vaccine hesitancy’ (VH), MMR vaccine uptake is still below optimal levels, fueling ongoing measles outbreaks. How did we get there?&lt;/p&gt;&lt;p&gt;The saga started in 1998 with an editorial decision by the &lt;i&gt;Lancet&lt;/i&gt; to publish a case series of 12 children suggesting a new syndrome of autism triggered by MMR vaccination had been discovered (Wakefield et al., &lt;span&gt;1998&lt;/span&gt;). The publication of a case series in the &lt;i&gt;Lancet&lt;/i&gt; almost seems a contradiction in terms. As researchers and editors, we know how cautious we must remain before drawing causal inferences between two variables. There is an established hierarchy of research designs based on their relative strengths for causality assessment. Experimental designs are at the top (e.g. the RCT), followed by controlled observational (cohort and case–control) studies, and by much weaker ecological studies (relying on confounded correlations between group-level data); at the very bottom, lies the case series which, at most, helps generate hypotheses (especially when the knowledge base is quasi-inexistant) but is never sufficient to test causal ones.&lt;/p&gt;&lt;p&gt;While it is fair to assume that those who reviewed the 1998 manuscript and those who made the decision to publish it were unaware at the time of the fraudulent nature of the data (see: Godlee, Smith, and Marcovitch (&lt;span&gt;2011&lt;/span&gt;); Deer &lt;span&gt;2011a&lt;/span&gt;, &lt;span&gt;2011b&lt;/span&gt; and Deer (&lt;span&gt;2020&lt;/span&gt;)), multiple red flags were readily noticeable: its first author had spent previous years trying to prove that adult inflammatory bowel disorders were linked to measles vaccine,","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"65 11","pages":"1403-1406"},"PeriodicalIF":6.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The social skills of autistic boys in preschool: the contributions of their dyadic and triadic interactions with their parents.","authors":"David Oppenheim,Michal Mottes-Peleg,Lior Hamburger,Michal Slonim,Yael Maccabi,Nurit Yirmiya","doi":"10.1111/jcpp.14061","DOIUrl":"https://doi.org/10.1111/jcpp.14061","url":null,"abstract":"BACKGROUNDThe interactions of typically developing (TD) children within the family context are associated with their social skills in preschool, and the question guiding this study, which focused on boys, was whether the same would be true for autistic children. A specific focus was on the importance of the boys' engagement in triadic, mother-father-child interactions over and above their engagement in dyadic, parent-child interactions. The boys' social skills were assessed concurrently with their family interactions and one year later.METHODSSeventy-five autistic preschooler boys (Age in months: M = 49.45, SD = 11.03) and both of their parents were recruited through treatment centers and social media. The boys' dyadic engagement was assessed from observations of their interactions with their mothers and fathers (separately), and their triadic engagement from an observation of mother-father-child interactions. The boys' social skills in preschool were assessed using a Q-sort completed by observers and teachers and by the Social Responsiveness Questionnaire (SRS) completed by teachers.RESULTSControlling for the severity of the boys' symptoms and IQ, their dyadic engagement was associated with the concurrent observer Q-sort and teacher-reported SRS measures, and their triadic engagement did not explain additional variance in these measures. Predicting over one year, dyadic engagement was associated again with the observer Q-sort and teacher SRS measures, while the boys' triadic engagement accounted for additional variance in these measures as well as the teacher Q-sort. Finally, boys' dyadic engagement predicted gains in social skills on the observer Q-sort, and their triadic engagement was predictive of gains in the observer and teacher Q-sort.CONCLUSIONSThe engagement that autistic preschool-age boys displayed in the context of their dyadic and triadic interactions with their parents appears to be transferred to the preschool setting, and triadic interactions are of particular significance.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"92 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448076","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":"Research Review: Pharmacological and non-pharmacological treatments for adolescents with attention deficit/hyperactivity disorder – a systematic review of the literature","authors":"Margaret H. Sibley,&nbsp;Sabrina Flores,&nbsp;Madeline Murphy,&nbsp;Hana Basu,&nbsp;Mark A. Stein,&nbsp;Steven W. Evans,&nbsp;Xin Zhao,&nbsp;Maychelle Manzano,&nbsp;Shauntal van Dreel","doi":"10.1111/jcpp.14056","DOIUrl":"10.1111/jcpp.14056","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Attention Deficit/Hyperactivity Disorder (ADHD) demonstrates unique developmental manifestations in adolescence with implications for optimized, age-appropriate treatment. This 10-year update is the third in a series of systematic reviews examining the efficacy and safety of adolescent ADHD treatments. We broadly examined efficacy on ADHD symptoms, impairments, and other reported outcomes. Acute and long-term efficacy, and treatment moderators, were considered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We performed PubMed, EMBASE, and PsycINFO searches for articles published or in press from 2013 to 2024, integrated with hand search and randomized controlled trials (RCTs) identified in this series' earlier reviews. RCTs examining the safety or efficacy of interventions delivered to adolescents (ages 10.0–19.9) with a diagnosis of ADHD were included. Study characteristics were extracted and reviewed, quality of evidence was assessed using GRADE, and effect sizes were calculated for individual studies and illustrated using forest plots.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three RCTs were identified. Quality of evidence ranged from high (medication; <i>k =</i> 29) to very low (nutrient supplementation, neurofeedback, occupational therapy; <i>k =</i> 1 each). Medications demonstrated consistent strong impact on ADHD symptoms and inconsistent impact on impairment. Diverse cognitive/behavioral treatments (C/BTs) demonstrated inconsistent impact on ADHD symptoms but strong and consistent impact on impairment and executive function skills, plus moderate benefits on internalizing symptoms. No interventions demonstrated significant safety concerns. Long-term maintenance (up to 3 years post-treatment) was demonstrated for C/BTs, though moderate quality of evidence was noted because participants cannot be fully blinded to receipt of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The effects of C/BTs and medication appear complementary, not duplicative. Combining medication and C/BT is advised at treatment outset to maximize engagement, maintenance, and response breadth (i.e. improving both ADHD symptoms/cognitive performance and coping skills/functional impairments). Engagement strategies (e.g. motivational interviewing) may facilitate uptake. Novel treatments do not yet demonstrate effects on ADHD symptoms or impairments in adolescents but remain a promising area for research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 1","pages":"132-149"},"PeriodicalIF":6.5,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379582","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":"Treatments with versus without medication for children with behavioural difficulties in clinical practice: an economic evaluation with observational data.","authors":"Caitlin K Kiernan, Hermien H Dijk, Barbara J van den Hoofdakker, Pieter J Hoekstra, Annabeth P Groenman","doi":"10.1111/jcpp.14057","DOIUrl":"https://doi.org/10.1111/jcpp.14057","url":null,"abstract":"<p><strong>Background: </strong>Economic evaluations of treatments for children with behavioural difficulties (i.e., characteristics of attention-deficit/hyperactivity disorder (ADHD) and/or oppositional defiant disorder (ODD)) usually rely on data of randomised controlled trials or are model-based. Findings of such studies may not be representative of cost-effectiveness and cost-utility in clinical practice. The current longitudinal study aimed to perform an economic evaluation of treatments for children with hyperactivity, impulsive behaviours, inattention, and/or behavioural difficulties using observational data that were obtained in clinical practice.</p><p><strong>Methods: </strong>Parents of 209 children (aged 5-12) who were referred to 1 of 10 Dutch youth mental healthcare institutions and who received treatment with (n = 108) or without (n = 101) the use of medication, filled out questionnaires at three timepoints (baseline, and ~ 6 and ~12 months later). Propensity score matching was used to make both groups comparable. Outcomes included quality-adjusted life years (QALYs), ADHD and ODD symptom severity, and impairment. Costs were measured from a societal perspective. Incremental cost-effectiveness ratios (ICERs) were estimated, and cost-effectiveness acceptability curves (CEACs) were derived to show uncertainty around the ICER.</p><p><strong>Results: </strong>Results did not show statistically significant differences in costs and effects between children who were treated with medication (alone or in combination with non-medication treatment) and those who were treated without medication. CEAC suggested that medication treatment has a 55% probability of being cost-effective at the €80,000 threshold and 36% at the €20,000 threshold compared with treatment without medication.</p><p><strong>Conclusions: </strong>Using observational data, our study did not provide clear evidence of the cost-effectiveness and cost-utility of treatment with medication compared with treatment without medication in clinical practice.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337872","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":"Nature and nurture in fussy eating from toddlerhood to early adolescence: findings from the Gemini twin cohort.","authors":"Zeynep Nas,Moritz Herle,Alice R Kininmonth,Andrea D Smith,Rachel Bryant-Waugh,Alison Fildes,Clare H Llewellyn","doi":"10.1111/jcpp.14053","DOIUrl":"https://doi.org/10.1111/jcpp.14053","url":null,"abstract":"BACKGROUNDFood fussiness (FF) describes the tendency to eat a small range of foods, due to pickiness and/or reluctance to try new foods. A common behaviour during childhood, and a considerable cause of caregiver concern; its causes are poorly understood. This is the first twin study of genetic and environmental contributions to the developmental trajectory of FF from toddlerhood to early adolescence, and stability and change over time.METHODSParticipants were from Gemini, a population-based British cohort of n = 4,804 twins born in 2007. Parents reported on FF using the Child Eating Behaviour Questionnaire 'FF' scale when children were 16 months (n = 3,854), 3 (n = 2,666), 5 (n = 2,098), 7 (n = 703), and 13 years old (n = 970). A mixed linear model examined the trajectory of FF, and a correlated factors twin model quantified genetic and environmental contributions to variation in and covariation between trajectory parameters. A longitudinal Cholesky twin model examined genetic and environmental influences on FF at each discrete age.RESULTSWe modelled a single FF trajectory for all children, which was characterised by increases from 16 months to 7 years, followed by a slight decline from 7 to 13 years. All trajectory parameters were under strong genetic influence (>70%) that was largely shared, indicated by high genetic correlations. Discrete age analyses showed that genetic influence on FF increased significantly after toddlerhood (16 months: 60%, 95% CI: 53%-67%; 3 years: 83%; 81%-86%), with continuing genetic influence as indicated by significant genetic overlap across every age. Shared environmental influences were only significant during toddlerhood. Unique environmental influences explained 15%-26% of the variance over time, with some enduring influence from 5 years onwards.CONCLUSIONSIndividual differences in FF were largely explained by genetic factors at all ages. Fussy eating also shows a significant proportion of environmental influence, especially in toddlerhood, and may, therefore, benefit from early interventions throughout childhood. Future work needs to refine the FF trajectory and explore specific trajectory classes.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"65 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273529","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}