Irzam Hardiansyah, Petra Warreyn, Angelica Ronald, Mark J. Taylor, Terje Falck‐Ytter
{"title":"Parent‐child interaction at age 5 months: genetic and environmental contributions and associations with later socio‐communicative development","authors":"Irzam Hardiansyah, Petra Warreyn, Angelica Ronald, Mark J. Taylor, Terje Falck‐Ytter","doi":"10.1111/jcpp.14055","DOIUrl":"https://doi.org/10.1111/jcpp.14055","url":null,"abstract":"BackgroundCharacteristics of parent‐child interaction (PCI) early in life have been associated with later development in the child. Twin studies can help to disentangle child contributions to parent‐child interaction, for example, by assessing the influence of the child's genetics on his/her social environment, which includes parental behaviour.MethodsInfant twins from a community sample [354 monozygotic (MZ), 268 same‐sex dizygotic (DZ)] were assessed in terms of PCI at age 5 months. We used the classical twin design to map the aetiology of several parent and child PCI scales and their covariation. We investigated the relations between PCI and later parent‐rated child's social communication, language, and autistic traits at ages 2 and 3.ResultsHeritability was below 20% for all the included PCI traits. Unique (nonshared) environmental influences substantially overlapped across several PCI scales, suggesting that idiosyncrasies linked to each session shaped the scoring of several traits in a systematic way. Factor analysis revealed three uncorrelated latent factors, which were conceptualized as ‘child negative affect’, ‘positive affective interaction’, and ‘parent's supportive strategies’. Parents who were rated highly on ‘sensitive responsiveness’ at 5 months tended to rate their offspring higher in terms of socio‐communicative and language development and lower in terms of autistic traits in the second and third years of life.ConclusionsThis study maps the phenotypic and aetiological structure of PCI in early infancy and supports the view that parents' sensitive responsiveness towards their infant is associated with later developmental gains in several domains. We did not find strong evidence of any so‐called evocative genetic effects on parents’ behaviour. We discuss the results considering the general challenge for lab‐based observational PCI measures to capture the richness of parent‐child interaction.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"105 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170455","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}
Myriam Clément, Marilyn N. Ahun, Massimiliano Orri, Tina C. Montreuil, Martin St-André, Catherine M. Herba, Gregory Moullec, Sylvana M Côté
{"title":"The interplay of maternal and paternal postpartum depressive symptoms with children's internalizing and externalizing symptoms from childhood to adolescence: does socioeconomic status matter? A longitudinal cohort study","authors":"Myriam Clément, Marilyn N. Ahun, Massimiliano Orri, Tina C. Montreuil, Martin St-André, Catherine M. Herba, Gregory Moullec, Sylvana M Côté","doi":"10.1111/jcpp.14051","DOIUrl":"10.1111/jcpp.14051","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maternal postpartum depression is an important risk factor for internalizing and externalizing problems in children. The role of concurrent paternal depression remains unclear, especially by socioeconomic status. This study examined independent and interactive associations of postpartum maternal and paternal depression with children's internalizing/externalizing symptoms throughout childhood and adolescence (ages 3.5–17 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the Québec Longitudinal Study of Child Development, a representative birth cohort (1997–1998) in Canada. Data included self-reported maternal and paternal depressive symptoms at 5 months' postpartum using the Center for Epidemiologic Studies Depression Scale. Internalizing and externalizing symptoms in children were reported by parents, teachers and children/adolescents using the Social Behaviour Questionnaire (ages 3.5–13 years) and the Mental Health and Social Inadaptation Assessment for Adolescents (ages 15–17 years). We used three-level mixed effects modelling to test associations after adjusting for confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>With 168 single-parent families excluded, our sample consisted of 1,700 families with useable data. Of these, 275 (16.2%) families reported maternal depression (clinically elevated symptoms), 135 (7.9%) paternal depression and 39 (2.3%) both. In families with high socioeconomic status, maternal depression was associated with greater child internalizing (β = .34; <i>p</i> < .001) and externalizing symptoms (β = .22; <i>p</i> = .002), regardless of the presence/absence of paternal depression. In families with low socioeconomic status, associations with symptoms were stronger with concurrent paternal depression (internalizing, β = .84, <i>p</i> < .001; externalizing, β = .71, <i>p</i> = .003) than without (internalizing, β = .30, <i>p</i> < .001; externalizing, β = .24, <i>p</i> = .002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Maternal depression increases the risk for children's internalizing/externalizing problems in all socioeconomic contexts. In families with low socioeconomic status, risks were exacerbated by concurrent paternal depression. Postpartum depression, especially in low socioeconomic environments, should be a primary focus to optimize mental health across generations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 2","pages":"225-240"},"PeriodicalIF":6.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166286","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}
Franjo Ivankovic, Sharon Johnson, James Shen, Jeremiah M. Scharf, Carol A. Mathews
{"title":"Optimization of self- or parent-reported psychiatric phenotypes in longitudinal studies","authors":"Franjo Ivankovic, Sharon Johnson, James Shen, Jeremiah M. Scharf, Carol A. Mathews","doi":"10.1111/jcpp.14054","DOIUrl":"10.1111/jcpp.14054","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Adolescent Brain Cognitive Development (ABCD) study is a longitudinal study of US adolescents with a wide breadth of psychiatric, neuroimaging and genetic data that can be leveraged to better understand psychiatric diseases. The reliability and validity of the psychiatric data collected have not yet been examined. This study aims to explore and optimize the reliability/validity of psychiatric diagnostic constructs in the ABCD study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Parent-and-child-reported psychiatric data for 11,876 children (aged 9.5 ± 0.5 at first assessment) were examined over 4 years to derive specific constructs for psychiatric diagnoses using longitudinal information. Rates of psychiatric disorders were calculated and compared to those reported in the epidemiological literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rates of self-reported psychiatric disorders at any single time point (broad diagnostic construct) were higher than indicated by epidemiological studies. Narrow diagnostic constructs, which required the endorsement of psychiatric disorders at a majority of longitudinal assessments, demonstrated a better rate approximation of literature-reported prevalences for most disorders (e.g. the prevalence of broad obsessive-compulsive disorder (OCD) was 13.3% compared to narrow OCD at 2.6% and a literature-reported prevalence of 2.3%). Analysis of comorbidity, using OCD as a representative example, also showed a better approximation of literature-reported comorbidity rates using the narrow construct, with some exceptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Self- or parent-report-based assessments tend to overestimate prevalences of psychiatric disorders in the ABCD Study, particularly when longitudinal data are summed to create lifetime prevalences. Such assessments should be accompanied by more in-depth assessments or clinician-administered structured interviews if using data where accurate disorder classifications are paramount.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 2","pages":"253-265"},"PeriodicalIF":6.5,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152726","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}
Naomi O. Davis, Reginald Lerebours, Rachel E. Aiello, Kimberly L.H. Carpenter, Scott Compton, Lauren Franz, Scott H. Kollins, Maura Sabatos-DeVito, Marina Spanos, Geraldine Dawson
{"title":"Behavioral characteristics of toddlers later identified with an autism diagnosis, ADHD symptoms, or combined autism and ADHD symptoms","authors":"Naomi O. Davis, Reginald Lerebours, Rachel E. Aiello, Kimberly L.H. Carpenter, Scott Compton, Lauren Franz, Scott H. Kollins, Maura Sabatos-DeVito, Marina Spanos, Geraldine Dawson","doi":"10.1111/jcpp.14050","DOIUrl":"10.1111/jcpp.14050","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autism commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD), but less is known regarding how ADHD symptoms impact the early presentation of autism. This study examined early behavioral characteristics of a community sample of toddlers later identified with autism diagnosis, ADHD symptoms, combined autism and ADHD symptoms, or neither condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 506 toddlers who were part of a longitudinal study of children's behavioral development. Parents completed questionnaires about their children's behavior at two time points. Four groups were identified based on study measures or medical record: autism diagnosis (<i>n</i> = 45), elevated ADHD symptoms (<i>n</i> = 70), autism and ADHD symptoms (<i>n</i> = 30), or neurotypical development (<i>n</i> = 361). Relationships between early parent report of autism- and ADHD-related behaviors, social–emotional and behavioral functioning, and caregiver experience and subsequent group designation were evaluated with adjusted linear regression models controlling for sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant group differences were found in measures of autism-related behaviors, ADHD-related behaviors, externalizing and internalizing behaviors, and parent support needs (<i>p</i> < .0001). Pairwise comparisons indicated toddlers later identified with combined autism diagnosis and ADHD symptoms had higher levels of autism-related behaviors, externalizing and internalizing behaviors, and autism-related parent support needs compared to the other groups. Toddlers with subsequent elevated ADHD symptoms or combined autism diagnosis and ADHD symptoms exhibited similar levels of ADHD-related behaviors, while both groups displayed more ADHD-related behaviors than toddlers subsequently identified with autism or those with neither condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this community sample, toddlers for whom combined autism diagnosis and ADHD symptoms were subsequently identified showed a distinct presentation characterized by higher early autism-related behaviors, broader behavioral concerns, and higher parent support needs. Presence of ADHD symptoms (alone or in combination with autism) was associated with higher parent-reported ADHD-related behaviors during toddlerhood. Results indicate that ADHD-related behaviors are manifest by toddlerhood, supporting screening for both autism and ADHD during early childhood.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 2","pages":"214-224"},"PeriodicalIF":6.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124374","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":"Practitioner Review: Treatments for young people who self-harm – challenges and recommendations for research and clinical practice","authors":"Katrina Witt, Anne Stewart, Keith Hawton","doi":"10.1111/jcpp.14052","DOIUrl":"10.1111/jcpp.14052","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Self-harm is very common in young people and is associated with suicide. Rates of both self-harm and suicide have increased in young people, particularly in females. There is a clear need to identify new approaches to prevent repeat self-harm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We significantly update and build on previous reviews with the aim of identifying issues in research relevant to clinical practice. We identify challenges in developing, implementing and evaluating treatments for self-harm in children and adolescents, suggest a way forward for research, and provide clear and practical guidance for clinicians on how to apply current research evidence in the real world.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Currently, there is limited evidence for effective interventions, other than some support for dialectical behaviour therapy for adolescents (DBT-A). To improve research and, by extension, clinical practice, future studies need to address psychosocial factors associated with youth self-harm and suicide, investigate the critical mechanism(s) of action, ensure trials are sufficiently powered and representative, and involve young people more actively in the design, implementation and evaluation of these approaches. Consideration should also be given to alternative research designs, such as pragmatic or adaptive clinical trials, as well as registry-based randomised controlled trials which leverage administrative data collected in routine clinical practice, to help meet these goals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Recommendations for practice include undertaking comprehensive assessment and formulation, and offering DBT-A where indicated. There should be further development and evaluation (with input from young people) of Cognitive Behavioural-based Therapy adapted for young people. Greater attention to the role of the therapeutic relationship and family involvement (where possible) is also an important considerations, irrespective of the specific therapeutic modality. Finally, more consideration should be given to improving staff training to ensure all clinical staff feel equipped to treat young people who self-harm in a person-centred and compassionate manner.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 1","pages":"122-131"},"PeriodicalIF":6.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078632","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":"Editorial: Reciprocity between sleep and mood in early childhood – an under-explored neural marker of depression risk","authors":"Caroline Hoyniak, Joan Luby","doi":"10.1111/jcpp.14044","DOIUrl":"10.1111/jcpp.14044","url":null,"abstract":"<p>We emphasize the potential importance of the role of early alterations in sleep and circadian rhythms as a biological marker of early-onset depression in the preschool period. This builds on findings of the reciprocal relationship between sleep and mood as well as the validity of preschool depression well established in the extant literature. This editorial highlights two recent studies published in <i>JCPP</i> in 2024 defining the duration of clinically impairing depressive symptoms in young children and methods that are now feasible to track daily patterns of sleep and circadian rhythms and show their relation to mood. We propose future studies to investigate these relationships in young children at risk for depression.</p>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"65 9","pages":"1133-1134"},"PeriodicalIF":6.5,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999073","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}
Oonagh Coleman, Jessie R. Baldwin, Tim Dalgleish, Kelly Rose-Clarke, Cathy Spatz Widom, Andrea Danese
{"title":"Research Review: Why do prospective and retrospective measures of maltreatment differ? A narrative review","authors":"Oonagh Coleman, Jessie R. Baldwin, Tim Dalgleish, Kelly Rose-Clarke, Cathy Spatz Widom, Andrea Danese","doi":"10.1111/jcpp.14048","DOIUrl":"10.1111/jcpp.14048","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Childhood maltreatment contributes to a large mental health burden worldwide. Different measures of childhood maltreatment are not equivalent and may capture meaningful differences. In particular, prospective and retrospective measures of maltreatment identify different groups of individuals and are differentially associated with psychopathology. However, the reasons behind these discrepancies have not yet been comprehensively mapped.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this review, we draw on multi-disciplinary research and present an integrated framework to explain maltreatment measurement disagreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified three interrelated domains. First, methodological issues related to measurement and data collection methods. Second, the role of memory in influencing retrospective reports of maltreatment. Finally, the motivations individuals may have to disclose, withhold, or fabricate information about maltreatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A greater understanding of maltreatment measurement disagreement may point to new ways to conceptualise and assess maltreatment. Furthermore, it may help uncover mechanisms underlying maltreatment-related psychopathology and targets for novel interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"65 12","pages":"1662-1677"},"PeriodicalIF":6.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141986933","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}
Zoe E. Reed, Richard Thomas, Andy Boyd, Gareth J. Griffith, Tim T. Morris, Dheeraj Rai, David Manley, George Davey Smith, Oliver S.P. Davis
{"title":"Mapping associations of polygenic scores with autistic and ADHD traits in a single city region","authors":"Zoe E. Reed, Richard Thomas, Andy Boyd, Gareth J. Griffith, Tim T. Morris, Dheeraj Rai, David Manley, George Davey Smith, Oliver S.P. Davis","doi":"10.1111/jcpp.14047","DOIUrl":"10.1111/jcpp.14047","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The genetic and environmental aetiology of autistic and Attention Deficit Hyperactivity Disorder (ADHD) traits is known to vary spatially, but does this translate into variation in the association of specific common genetic variants?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We mapped associations between polygenic scores for autism and ADHD and their respective traits in the Avon Longitudinal Study of Parents and Children (<i>N</i> = 4,255–6,165) across the area surrounding Bristol, UK, and compared them to maps of environments associated with the prevalence of autism and ADHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our results suggest genetic associations vary spatially, with consistent patterns for autistic traits across polygenic scores constructed at different <i>p</i>-value thresholds. Patterns for ADHD traits were more variable across thresholds. We found that the spatial distributions often correlated with known environmental influences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings shed light on the factors that contribute to the complex interplay between the environment and genetic influences in autistic and ADHD traits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 2","pages":"202-213"},"PeriodicalIF":6.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981343","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}
Geneva E. Mason, Randy P. Auerbach, Jeremy G. Stewart
{"title":"Predicting the trajectory of non-suicidal self-injury among adolescents","authors":"Geneva E. Mason, Randy P. Auerbach, Jeremy G. Stewart","doi":"10.1111/jcpp.14046","DOIUrl":"10.1111/jcpp.14046","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Non-suicidal self-injury (NSSI) is common among adolescents receiving inpatient psychiatric treatment and the months post-discharge is a high-risk period for self-injurious behavior. Thus, identifying predictors that shape the course of post-discharge NSSI may provide insights into ways to improve clinical outcomes. Accordingly, we used machine learning to identify the strongest predictors of NSSI trajectories drawn from a comprehensive clinical assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included adolescents (<i>N</i> = 612; females <i>n</i> = 435; 71.1%) aged 13–19-years-old (<i>M</i> = 15.6, <i>SD</i> = 1.4) undergoing inpatient treatment. Youth were administered clinical interviews and symptom questionnaires at intake (baseline) and before termination. NSSI frequency was assessed at 1-, 3-, and 6-month follow-ups. Latent class growth analyses were used to group adolescents based on their pattern of NSSI across follow-ups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three classes were identified: Low Stable (<i>n</i> = 83), Moderate Fluctuating (<i>n</i> = 260), and High Persistent (<i>n</i> = 269). Important predictors of the High Persistent class in our regularized regression models (LASSO) included baseline psychiatric symptoms and comorbidity, past-week suicidal ideation (SI) severity, lifetime average and worst-point SI intensity, and NSSI in the past 30 days (<i>b</i>s = 0.75–2.33). Only worst-point lifetime suicide ideation intensity was identified as a predictor of the Low Stable class (<i>b</i> = −8.82); no predictors of the Moderate Fluctuating class emerged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found a set of intake clinical variables that indicate which adolescents may experience persistent NSSI post-discharge. Accordingly, this may help identify youth that may benefit from additional monitoring and support post-hospitalization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 2","pages":"189-201"},"PeriodicalIF":6.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970173","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":"Advancing the treatment of anxiety disorders in transition-age youth: a review of the therapeutic effects of unconscious exposure","authors":"Paul Siegel, Bradley S. Peterson","doi":"10.1111/jcpp.14037","DOIUrl":"10.1111/jcpp.14037","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The real-world effectiveness of exposure-based therapies for youth depends on the willingness and ability of young people to tolerate confronting their fears, which can be experienced as highly aversive and create problems with treatment engagement and acceptance. Recently, neuroscientific research on the nonconscious basis of fear has been translated into novel exposure interventions that bypass conscious processing of feared stimuli and that thus do not cause phobic youth to experience distress. We present a review of these unconscious exposure interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A PRISMA-based search yielded 20 controlled experiments based on three paradigms that tested if fear-related responses could be reduced without conscious awareness in highly phobic, transition-age youth: 14 randomized controlled trials (RCTs), 5 fMRI studies (1 was also an RCT), 4 psychophysiological studies (3 were also RCTs), and 1 ERP study. We conducted meta-analyses of outcomes where feasible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Unconscious exposure interventions significantly (1) reduced avoidance behavior (range of Cohen's <i>d</i> = 0.51–0.95) and self-reported fear (<i>d</i> = 0.45–1.25) during in vivo exposure to the feared situation; (2) reduced neurobiological indicators of fear (<i>d</i> = 0.54–0.62) and concomitant physiological arousal (<i>d</i> = 0.55–0.64); (3) activated neural systems supporting fear regulation more strongly than visible exposure to the same stimuli (<i>d</i> = 1.2–1.5); (4) activated regions supporting fear regulation that mediated the reduction of avoidance behavior (<i>d</i> = 0.70); (5) evoked ERPs suggesting encoding of extinction memories (<i>d</i> = 2.13); and (6) had these effects without inducing autonomic arousal or subjective fear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unconscious exposure interventions significantly reduce a variety of symptomatic behaviors with mostly moderate effect sizes in transition-age youth with specific phobias. fMRI and physiological findings establish a neurophysiological basis for this efficacy, and suggest it occurs through extinction learning. Unconscious exposure was well tolerated, entirely unassociated with drop out, and is highly scalable for clinical practice. However, a number of limitations must be addressed to assess potential clinical impacts, including combining unconscious exposure with exposure therapy to boost treatment acceptance and efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 1","pages":"98-121"},"PeriodicalIF":6.5,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915607","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}