Journal of Child Psychology and Psychiatry最新文献

{"title":"Impact of a Pediatric Mental Health Crisis Service in the emergency department on hospital resource utilization: an interrupted time series analysis.","authors":"Vineet Padmanabhan,Cayla A Bellagarda,Laura Dondzilo,Sarah MacDonald,Alexander Hegarty,Michelle Morris,Zamia Pedro","doi":"10.1111/jcpp.14182","DOIUrl":"https://doi.org/10.1111/jcpp.14182","url":null,"abstract":"BACKGROUNDLengthening waitlists, reduced outpatient care availability, and increased numbers of children experiencing mental health (MH) crises have strained emergency departments (EDs). EDs facilitate access to immediate intervention and triage to acute services but are often underresourced and undertrained to manage the unique needs of mental health crises. The combination of demand, complexity, and resources required encouraged the development of specialized mental health crisis services. In 2021, CAMHS Crisis Connect (CCC) was established at Perth Children's Hospital and aims to improve patient flow, reduce hospital resource utilization, and improve the experience of children experiencing crises.METHODSThe aim of the current study is to examine a pediatric crisis intervention service in a West Australian context. We implement interrupted time series analyses (ITS), a quasi-experimental statistical methodology allowing us to make causal interpretations of CCC impact on hospital resource utilization.RESULTSThe key effect here is the substantial reduction in presentations and re-presentations to ED and inpatient wards that are sustained across the long term and directly attributable to CCC. However, there is an increasing length of stay in ED and the very small and potentially not clinically meaningful reduction in inpatient bed occupancy, which requires further investigation.CONCLUSIONSOur results support specialized, multi-faceted crisis care programs in ED to ensure accessibility of acute, intensive care for those with severe and complex needs, supporting the journey for children who may be more effectively managed in community and outpatient settings.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320202","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":"Predictors of Environmental Sensitivity in Syrian refugee children.","authors":"Andrew K May, Demelza Smeeth, Fiona McEwen, Elie Karam, Michael Pluess","doi":"10.1111/jcpp.14178","DOIUrl":"10.1111/jcpp.14178","url":null,"abstract":"<p><strong>Background: </strong>Although more prone to psychopathology on average, refugee children differ in their response to adversity. Growing evidence attributes some of these individual differences to varying levels of Environmental Sensitivity - the extent to which children perceive and process contextual influences. However, there is limited knowledge of how Environmental Sensitivity is developmentally influenced, particularly in the refugee setting.</p><p><strong>Methods: </strong>Here, we investigated whether individual-, family- and community-level predictors (psychosocial and genetic) were associated with self-reported Environmental Sensitivity and its subscales (measured using the 12-item Highly Sensitive Child Scale). Participants were a subsample (n = 1,409) from a cohort of Syrian refugee children and their biological mothers, recruited from informal tented settlements in Lebanon. Multivariate adaptive regression spline models were fitted to identify the best selection from over 40 available predictors.</p><p><strong>Results: </strong>Twelve predictors of Environmental Sensitivity emerged, with the five most commonly selected being maternal behavioural control, human insecurity, positive home experiences, maternal anxiety and child-reported child abuse, the latter three of which were also suggested to predict changes in sensitivity over a 12-month period. Some predictors such as maternal PTSD, war exposure and bullying showed a non-linear, V-shape relationship with sensitivity. All effect sizes, however, were small.</p><p><strong>Conclusions: </strong>Our findings suggest that both highly supportive and highly adverse contextual factors associate with greater childhood Environmental Sensitivity, in line with current theorising. Despite previous suggestive evidence, we did not find that polygenic scores for autism and attention deficit hyperactivity disorder predicted sensitivity. Further research into predictors of Environmental Sensitivity is encouraged, as this may help with improved assessment of the trait in children.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256922","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":"Predictive and incremental validity of adolescent callous-unemotional traits: longitudinal prediction of antisocial and social outcomes in early adulthood.","authors":"Erin P Vaughan, Paul J Frick, James V Ray, Laura C Thornton, Tina D Wall Myers, Emily L Robertson, Toni M Walker, Laurence Steinberg, Elizabeth Cauffman","doi":"10.1111/jcpp.14181","DOIUrl":"https://doi.org/10.1111/jcpp.14181","url":null,"abstract":"<p><strong>Background: </strong>Callous-unemotional (CU) traits were recently added as a diagnostic specifier for disruptive behavior disorders, largely due to their prognostic utility. However, past longitudinal research has yielded mixed results when investigating associations between CU traits and long-term outcomes, particularly when controlling for the individual's level of antisocial behavior.</p><p><strong>Methods: </strong>The current study investigated the longitudinal predictive utility of CU traits in a sample of 1,216 adolescents involved in the juvenile justice system who were followed for 7 years after their first arrest. Growth models of CU traits throughout adolescence were used to predict a variety of young adult outcomes (e.g., aggression, financially-motivated crime, and social impairment) while controlling for the trajectory of antisocial behavior throughout adolescence.</p><p><strong>Results: </strong>Results indicated that adolescent CU traits predicted a variety of antisocial and social outcomes. While several of these associations were no longer significant after accounting for antisocial behavior, CU traits incrementally predicted several early adulthood outcomes (e.g., more arrests, greater aggression, lower quality relationships with friends and romantic partners) when controlling for both the level and degree of change in antisocial behavior.</p><p><strong>Conclusions: </strong>Results support that CU traits are clinically useful when identifying risk for problematic outcomes and highlight the need for effective intervention for youth with elevated CU traits.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256921","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":"Dynamics of depression symptoms in adolescents during three types of psychotherapy and post-treatment follow-up.","authors":"Madison Aitken, Sharon A S Neufeld, Clement Ma, Ian M Goodyer","doi":"10.1111/jcpp.14175","DOIUrl":"https://doi.org/10.1111/jcpp.14175","url":null,"abstract":"<p><strong>Background: </strong>According to the network theory of mental disorders, psychopathology emerges from symptoms that causally influence one another and create interconnections and feedback loops that maintain atypical mental states. Analysis of symptom networks during and following psychotherapy may provide clues to some of the mechanisms through which change occurs. Youth with depression are an important population in which to better understand psychotherapy mechanisms because current evidence-based interventions for this population show only modest effects.</p><p><strong>Methods: </strong>Participants were adolescents with major depressive disorder (N = 465; ages 11-17; 75% female) in a randomized controlled trial comparing cognitive behavioral therapy, short-term psychoanalytical psychotherapy, and brief psychosocial intervention (IMPACT, ISRCTN83033550). Eleven self-reported depression symptoms were used to compute two longitudinal networks: (1) treatment phase, using baseline, 6 and 12 weeks data; and (2) follow-up phase, using 36, 52, and 86 weeks data.</p><p><strong>Results: </strong>During the treatment phase, all depression symptoms were interconnected. Symptoms of insomnia and fatigue showed the highest outstrength centrality (ability to predict other symptoms over time). In contrast, few symptoms were interconnected during the post-treatment phase except worthlessness, which had the highest outstrength centrality. Allowing network parameters to differ across the three treatment types improved model fit during the treatment phase and revealed that symptoms with the highest outstrength centrality varied by treatment type.</p><p><strong>Conclusions: </strong>Individual symptoms may make key contributions to subsequent depressive psychopathology in adolescents. Longitudinal network analysis reveals that insomnia and fatigue predict other symptoms, allowing for consideration of specific mechanisms associated with depression treatment. The findings further suggest that negative cognitions about the self may emerge as a central putative cognitive vulnerability in those with a history of depression. Our exploratory findings also suggest that the three therapies (cognitive behavioral therapy, short-term psychoanalytical psychotherapy, and brief psychosocial intervention) may have achieved equifinality in part through different mechanisms.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256920","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: Conceptualizing and measuring ‘problem behavior’ in early intervention autism research – a project AIM secondary systematic review","authors":"Kristen Bottema‐Beutel, Ruoxi Guo, Jessica Hinson‐Wiliams, Yueyang Shen, Shannon LaPoint, Tiffany Woynaroski, Micheal Sandbank","doi":"10.1111/jcpp.14177","DOIUrl":"https://doi.org/10.1111/jcpp.14177","url":null,"abstract":"BackgroundSome autistic children exhibit behavior that caregivers, clinicians, and researchers consider problematic. However, there is little consensus about the types of behaviors that should be treated as a problem and reduced via intervention. In autism intervention research, problem behaviors range from inherently harmful behaviors such as aggression and self‐injury to nonnormative but not harmful behaviors associated with autism such as repetitive movements. Likewise, there are a variety of conceptualizations and measurement practices used to assess these behaviors.MethodsIn this secondary systematic review of group‐design, nonpharmacological intervention studies for autistic children up to age eight, we explore researchers' conceptualizations of problem behavior and measurement systems to assess problem behavior. We defined problem behavior as any outcome where behaviors were targeted for reduction or elimination. A coding scheme was applied to 102 studies that met inclusion criteria for the secondary review. All studies were double coded by two independent coders.ResultsSixty‐two percent of studies described reducing behavior as a primary or secondary purpose of the study and/or intervention, 33% gave a rationale for targeting behaviors for reduction, and 28% offered a conceptualization of the behavior(s) they targeted. Only 8% offered a conceptual definition. The most common measures were ‘off‐the‐shelf’ measures that had undergone at least some previous validation beyond interrater reliability and that involved parent reports. For the 10 most common assessment measures, two were validated along six different validation dimensions in autistic populations. All but one full scale or subscale measured behaviors that were nonnormative but not inherently harmful, or a mix of behaviors that were inherently harmful and that were nonnormative but not inherently harmful.ConclusionsIntervention researchers should provide clear definitions and rationales for targeting behaviors for reduction via intervention and should develop refined measurement tools for assessing these behaviors in collaboration with the autistic community.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"13 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192926","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":"Gaze behavior, facial emotion processing, and neural underpinnings: A comparison of adolescents with autism spectrum disorder and conduct disorder.","authors":"Antonia Tkalcec,Alessandro Baldassarri,Alex Junghans,Vithusan Somasundaram,Willeke M Menks,Lynn V Fehlbaum,Réka Borbàs,Nora Raschle,Gudrun Seeger-Schneider,Bettina Jenny,Susanne Walitza,David M Cole,Philipp Sterzer,Francesco Santini,Evelyn Herbrecht,Ana Cubillo,Christina Stadler","doi":"10.1111/jcpp.14172","DOIUrl":"https://doi.org/10.1111/jcpp.14172","url":null,"abstract":"BACKGROUNDFacial emotion processing deficits and atypical eye gaze are often described in individuals with autism spectrum disorder (ASD) and those with conduct disorder (CD) and high callous unemotional (CU) traits. Yet, the underlying neural mechanisms of these deficits are still unclear. The aim of this study was to investigate if eye gaze can partially account for the differences in brain activation in youth with ASD, with CD, and typically developing youth (TD).METHODSIn total, 105 adolescent participants (NCD = 39, NASD = 27, NTD = 39; mean age = 15.59 years) underwent a brain functional imaging session including eye tracking during an implicit emotion processing task while parents/caregivers completed questionnaires. Group differences in gaze behavior (number of fixations to the eye and mouth regions) for different facial expressions (neutral, fearful, angry) presented in the task were investigated using Bayesian analyses. Full-factorial models were used to investigate group differences in brain activation with and without including gaze behavior parameters and focusing on brain regions underlying facial emotion processing (insula, amygdala, and medial prefrontal cortex).RESULTSYouth with ASD showed increased fixations on the mouth compared to TD and CD groups. CD participants with high CU traits tended to show fewer fixations to the eye region compared to TD for all emotions. Brain imaging results show higher right anterior insula activation in the ASD compared with the CD group when angry faces were presented. The inclusion of gaze behavior parameters in the model reduced the size of that cluster.CONCLUSIONSDifferences in insula activation may be partially explained by gaze behavior. This implies an important role of gaze behavior in facial emotion processing, which should be considered for future brain imaging studies. In addition, our results suggest that targeting gaze behavior in interventions might be potentially beneficial for disorders showing impairments associated with the processing of emotional faces. The relation between eye gaze, CU traits, and neural function in different diagnoses needs further clarification in larger samples.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"83 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146039","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":"Large-scale cohort studies in mental health research – strengths and limitations","authors":"Isabel Morales-Muñoz","doi":"10.1111/jcpp.14176","DOIUrl":"10.1111/jcpp.14176","url":null,"abstract":"<p>In recent years, the use of longitudinal studies in mental health research has grown, particularly in the United Kingdom. These studies provide numerous benefits and improvements in mental health research, such as facilitating the early detection of risk factors for mental health problems. Nevertheless, they also come with drawbacks, including their high financial costs and the complexity involved in their implementation. Although significant efforts have been made in the United Kingdom to fund large longitudinal cohorts for mental health research, most existing longitudinal cohort studies tend to cover a broad range of factors across large sample sizes, often providing only limited information on each individual factor. To address this, future longitudinal studies should prioritise more focused and in-depth evaluations of key variables and mechanisms, rather than broad but less detailed assessments. In other words, it is essential that future longitudinal studies are specifically designed to test well-defined hypotheses. Overall, this could play a major role in guiding the design of more precise and effective early interventions for mental health.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 7","pages":"929-931"},"PeriodicalIF":7.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097752","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":"Each unhappy family is unhappy in its own way† – a call for clearer conceptualization of adverse family factors in biosocial research on child and adolescent mental health problems","authors":"Lucres M.C. Jansen,&nbsp;Patty Leijten","doi":"10.1111/jcpp.14174","DOIUrl":"10.1111/jcpp.14174","url":null,"abstract":"<p>Child and adolescent mental health problems stem from an interaction between biological and environmental factors. In the past decades, conceptualizations of genetic and neurobiological factors have become increasingly detailed. Development of our conceptualizations of environmental factors, in contrast, is lacking behind. Environmental adversity is usually conceptualized as one rather global factor, including, for example, both structural factors (e.g. poverty and racism) and psychosocial factors (e.g. parental violence or neglect). Or, as Chow et al. (2025) in this issue put it ‘There is not yet a consensus on the best way to conceptualise adverse childhood experience’. In this Editorial, we call for clearer, more specific conceptualizations of family adversity in biosocial research. This development is essential for unravelling the mechanisms that shape child and adolescent mental health problems.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 6","pages":"771-774"},"PeriodicalIF":7.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925844","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":"Childhood trauma, adolescent risk behaviours and cardiovascular health indices in the 2004 Pelotas Birth Cohort.","authors":"Megan Bailey,Graeme Fairchild,Gemma Hammerton,Ina S Santos,Luciana Tovo-Rodrigues,Joseph Murray,Alicia Matijasevich,Sarah L Halligan","doi":"10.1111/jcpp.14173","DOIUrl":"https://doi.org/10.1111/jcpp.14173","url":null,"abstract":"BACKGROUNDChildhood trauma has been associated with increased risk of substance use and poor sleep, with these factors linked to subsequent poor cardiovascular health. However, there has been little longitudinal research exploring these associations in adolescence, especially in low- and middle-income countries (LMICs). To address this, we investigated longitudinal pathways from trauma to risk behaviours and cardiovascular health indices among adolescents in the 2004 Pelotas Birth Cohort, Brazil.METHODSLifetime cumulative trauma was assessed via caregiver reports up to age 11, and combined adolescent/caregiver reports at ages 15 and 18. At age 18, current problematic alcohol use, smoking, illicit drug use and sleep duration were measured via self-report and resting heart rate (HR) and blood pressure (BP) were assessed. We tested for trauma risk behaviour-HR/BP associations using multivariable regression, population attributable fractions and counterfactual mediation.RESULTSOf 4,229 adolescents (51.9% boys), 81.9% were trauma-exposed by age 18. Cumulative trauma up to ages 15 and 18 increased the odds of age 18 alcohol, smoking and drug use (adjusted ORs: 1.25-1.44). Sleep duration was unrelated to childhood trauma. Population attributable fractions indicated that childhood trauma explained ≥28% of age 18 substance use. Unexpectedly, greater trauma exposure was associated with lower resting HR and BP. Substance use partially mediated the effect of trauma on cardiovascular health indices.CONCLUSIONSTrauma is associated with substance use in LMIC adolescents. Prevention and intervention strategies targeting trauma are critical given this significant burden. Our finding that trauma predicts lower HR/BP warrants further exploration given well-established associations between trauma and poorer cardiovascular health in adulthood.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"55 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893090","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: Beyond the usual suspects – broadening the scope of environmental influences in child and adolescent mental health research","authors":"Jasmin Wertz,&nbsp;Angelica Ronald","doi":"10.1111/jcpp.14165","DOIUrl":"10.1111/jcpp.14165","url":null,"abstract":"<p>When we think about which environmental influences affect children and young people's mental health, answers that are ‘close to home’ tend to come to mind, such as relationships, screen time, bullying, stressful life events and poverty. These same factors are also often prioritised in child and adolescent mental health research. More distal factors receive less attention, such as the air we breathe, the materials in our built environment, and the cultural and social norms of the societies in which we live. These factors are embedded in the very structure of our built and social environments, but may be harder to ‘imagine’ as being important, perhaps because they feel less tangible. Findings in this issue of the journal highlight the relevance of these factors for child and adolescent mental health. This editorial will reflect on the importance of these findings and then turn to consider how physical and sociocultural factors can be better integrated in research on child and adolescent mental health, by incorporating novel data sources, diversifying samples and by capturing multiple levels of analysis.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 5","pages":"609-611"},"PeriodicalIF":7.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865965","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}