Child and Adolescent Mental Health最新文献

{"title":"Debate: Is ACE screening doing more harm than good? Beyond the ACE score – towards more personalised approaches to risk prediction","authors":"Alan J. Meehan,&nbsp;Stephanie J. Lewis,&nbsp;Andrea Danese","doi":"10.1111/camh.70124","DOIUrl":"10.1111/camh.70124","url":null,"abstract":"<p>Adverse childhood experiences (ACEs) are strongly associated with later mental and physical health problems, prompting growing interest in ACE screening to identify vulnerable children and adults who may benefit from interventions to prevent or mitigate these outcomes. However, evidence supporting routine ACE screening in clinical practice remains limited. Although cumulative ACE scores demonstrate robust population-level associations with health outcomes, their individual predictive accuracy is consistently poor, with substantial false-positive and false-negative classifications and potential for inequitable outcomes across demographic groups. Existing screening approaches also fail to capture important contextual differences among reported ACEs, as well as factors that may promote resilience. Furthermore, positive screening results are not currently linked to clearly established, evidence-based clinical pathways, raising wider concerns around labelling stigma and missed needs. Therefore, widespread implementation of ACE screening in its current form cannot be recommended to prevent poor health. However, future approaches that move beyond cumulative adversity counts towards more nuanced, personalised and proportionate ACE measures, which also consider broader developmental, social and protective factors, have the potential to inform more personalised risk assessment following childhood adversity.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 4","pages":"345-347"},"PeriodicalIF":4.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the acceptability and feasibility of a blended imagery-based digital intervention for self-harm in young people (Imaginator 2.0): a co-produced qualitative study.","authors":"Lindsay H Dewa, Athina Servi, Emily Gardner-Bougaard, Saida Jabril Mohamed, Aaron McDermott, Ben Aveyard, Rachel Rodrigues, Adam Hampshire, Nejra Van Zalk, Martina Di Simplicio","doi":"10.1111/camh.70135","DOIUrl":"https://doi.org/10.1111/camh.70135","url":null,"abstract":"<p><strong>Background: </strong>Around 20% of 12- to 25-year-olds experience self-harm, but interventions deemed both acceptable and effective in reducing self-harm behaviour are rare. Digital interventions can be effective; however, they often lack sustained engagement and co-design. Imaginator 2.0 is a brief, blended intervention with a co-designed app using mental imagery to help young people manage self-harm. This study explores the acceptability and perceived feasibility of Imaginator 2.0 with young people.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted via Microsoft Teams with a purposive sample of young people who had used Imaginator 2.0 in the United Kingdom between April 2022 and December 2023. Open questions covered therapy and app experience, mental imagery and intervention experience overall. Three young people with lived experience of self-harm (co-researchers) informed all research stages from design to dissemination. Thematic analysis was conducted.</p><p><strong>Results: </strong>Ten participants were interviewed (all female). Four themes were generated: Imaginator 2.0 therapy impact, mental imagery efficacy and limitations, app experience and engagement, and Imaginator 2.0 expectations and need for improvement. The app was deemed acceptable as a support tool for self-harm and a useful adjunct to therapy. Most participants described imagery plans, audios, mood tracker and crisis support features as helpful, whereas journal and goal tracker features were less favoured. Mental imagery was considered beneficial in reducing self-harm, though not always sufficient during crises. Overall, participants indicated Imaginator 2.0 helped them manage their emotions and behaviour, and they valued the therapist-patient relationship. However, most felt the app required better therapy integration and greater personalisation.</p><p><strong>Conclusion: </strong>These findings support Imaginator 2.0 as a brief early intervention for young people accessing mental health services to help manage and contain self-harm. The next step is to further improve Imaginator 2.0 based on participant feedback and feasibility testing, followed by a randomised controlled trial comparing Imaginator 2.0 with usual care.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High- versus low-frequency exercise for depression in university students: a single-blind randomized controlled trial.","authors":"Fabien D Legrand, Anna Duberg","doi":"10.1111/camh.70134","DOIUrl":"https://doi.org/10.1111/camh.70134","url":null,"abstract":"<p><strong>Background: </strong>The core affect (CA) hypothesis posits that exercise serves either to increase positive affect or reduce negative affect. One rarely examined implication of the CA hypothesis is that multiple short exercise bouts distributed throughout the week, rather than one long training bout, would lead to better outcomes.</p><p><strong>Methods: </strong>Fifty-four university students with depression were randomly allocated to one of three groups: (1) a control group participating in weekly health education sessions, (2) a low-frequency exercise training (LFET) group running once weekly for 60 min, and (3) a high-frequency exercise training (HFET) group running four times weekly for 15 min. All interventions lasted 3 weeks without interruption. Depressive symptoms were assessed pre- and postintervention using the PHQ-9 questionnaire.</p><p><strong>Results: </strong>Compared with the control group, depressive symptoms were significantly reduced in the HFET group (Hedges's g = -0.89, 95% CI [-1.57, -0.20]), but not in the LFET group (Hedges's g = -0.34, 95% CI [-0.99, 0.32]). Moreover, the proportion of participants achieving clinically significant improvement (CSI) was more than threefold higher in the HFET group (38.9%) than in the control group (11.1%), z = 1.93, p = .027, and almost double that of the LFET group (22.2%). Finally, participants in the HFET group, but not in the LFET group, reported significantly higher remission rates than controls (55.6% vs. 27.8%, z = 1.69, p = .046).</p><p><strong>Conclusion: </strong>Although these findings support the CA hypothesis, they should be interpreted cautiously because of the small sample size and short intervention period.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health hospitalisations of care-experienced and general-population children with chronic conditions: evidence from the Children's Health in Care in Scotland (CHiCS) study, a population-wide longitudinal study using administrative data.","authors":"Edit Gedeon, Alastair H Leyland, Marion Henderson, Mirjam Allik","doi":"10.1111/camh.70132","DOIUrl":"https://doi.org/10.1111/camh.70132","url":null,"abstract":"<p><strong>Background: </strong>Care experience and chronic physical conditions in children are associated with an increased risk of mental health (MH) problems. These issues can compound, leading to poorer prognosis for both MH and chronic conditions. Examining the relationship between care experience and mental ill-health, and exploring how chronic conditions may influence this, is crucial for informing policy and mitigating the burdens on children, families and healthcare systems.</p><p><strong>Methods: </strong>Routine health and social care data were linked for 13,830 care-experienced children (CEC) and 649,771 general-population children (GPC) in Scotland. Hospitalisations were followed from birth (between 1990 and 2004) to 2016. Cox proportional hazards models and negative binomial regression models were used to analyse the associations between care, asthma, diabetes, epilepsy and MH hospitalisations.</p><p><strong>Results: </strong>Care experience was associated with a higher risk for MH hospitalisations compared with GPC. For first MH hospitalisations, hazard ratios were 3.22 (95% CI: 2.82-3.68) for CEC females and 2.64 (95% CI: 2.32-2.99) for CEC males. For repeated MH hospitalisations, incident rate ratios were 4.06 (95% CI: 3.58-4.62) for CEC females and 3.66 (95% CI: 3.25-4.12) for CEC males. In both cohorts, chronic conditions were associated with a higher risk for repeated MH hospitalisations.</p><p><strong>Conclusion: </strong>CEC are at a higher risk of MH hospitalisations compared with GPC. Irrespective of care status, chronic conditions are associated with a higher risk of repeated MH hospitalisations. Interventions aimed at improving MH would benefit from a focus on children with chronic conditions.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology Matters: Using digital mental health tools for children and young people - clinical implications of neurorights.","authors":"Rocío Paricio-Del-Castillo, Inmaculada Palanca Maresca","doi":"10.1111/camh.70133","DOIUrl":"https://doi.org/10.1111/camh.70133","url":null,"abstract":"<p><p>The rapid expansion of digital mental health technologies is transforming child and adolescent mental health services through tools such as wearable devices, behavioural monitoring, predictive algorithms and digital interventions. While these innovations offer opportunities for earlier detection, personalised care and improved continuity of support, they also raise important ethical and developmental challenges. Current neurorights frameworks have emerged to protect mental privacy, autonomy, personal identity and agency in response to advances in neuroscience and neurotechnology. However, these frameworks have largely been developed with adults in mind and may not adequately address the distinctive vulnerabilities of children and adolescents. This article examines the implications of digital mental health technologies in young people from a developmental neurorights perspective. It argues that safeguarding children's rights means keeping open the possibilities for their development, avoiding labelling or categorising them too early and respecting their growing autonomy. Clinical, service and policy recommendations are proposed to support ethically responsible implementation.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of low-intensity mental health interventions for children and young people in England: a presentation and analysis of synthesised outcomes.","authors":"Susanna Payne, Deepa Mavji, Caroline Stokes, Jessica Richardson, Jonathan Parker, Catherine Gallop, Hollie Gay, Katy Snitter, Elizabeth Deacon, Lili Ly, Vicki Curry, Markku Wood, Tyler Lewis, Cara Miller, Nicola Abraham, Elizabeth Turnbull, Melika Janbakhsh, Nicholas Smith, Helen Barker, Sadie Williams, Laura Bowyer, Kellie Jacques, Mike Turnbull, Jessica Collins, Alisa Kurina, Natalie Fabian, Anne Matthews, Barbara Evetts, Jeevan Kang, Alison Wheeler, Peter Fonagy","doi":"10.1111/camh.70130","DOIUrl":"https://doi.org/10.1111/camh.70130","url":null,"abstract":"<p><strong>Background: </strong>Despite rapid national implementation of the new low-intensity (LI) children and young people's (CYP) mental health (MH) workforce, outcomes have not been synthesised at scale.</p><p><strong>Methods: </strong>This paper presents retrospective, uncontrolled routine outcome data collected between July 2017 and May 2025 from LI services across several regions of England, supported by five Higher Education Institutions (HEIs). Data were drawn from CYP aged 5-18 receiving LI interventions delivered by training and newly qualified practitioners. Paired outcome measures included goal-based outcomes (GBOs; n = 26,012), the Revised Children's Anxiety and Depression Scale (RCADS; n = 14,661), the Child Outcome Rating Scale (CORS; n = 3485), the Outcome Rating Scale (ORS; n = 8320) and the Brief Parental Self-Efficacy Scale (BPSES; n = 944).</p><p><strong>Results: </strong>Significant improvement was observed across outcomes, with medium effect sizes on the RCADS, CORS and ORS, and large effect sizes on the GBOs and BPSES. Reliable improvement rates were 47% on the RCADS and 56% on the GBOs, with reliable deterioration rates of 6% and 1%, respectively. Outcomes were broadly comparable in magnitude to published datasets and meta-analytic benchmarks, despite the lower treatment dosage (2-8 sessions).</p><p><strong>Conclusion: </strong>LI MH interventions delivered by this new workforce were associated with meaningful improvements in symptoms and goal attainment across diverse settings. These findings suggest that this workforce may represent a scalable approach to addressing the treatment gap in CYP MH services. Future work should incorporate demographic data and controlled designs.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative Matters: Drawing the diagnosis - shaping the truth in communicating acute lymphoblastic leukaemia in paediatric oncology.","authors":"Mario Giordano, Elena Barisone, Nicoletta Bertorello, Giulia Zucchetti, Franca Fagioli","doi":"10.1111/camh.70128","DOIUrl":"https://doi.org/10.1111/camh.70128","url":null,"abstract":"<p><p>Communicating a diagnosis of acute lymphoblastic leukaemia in paediatric oncology represents a critical and emotionally charged moment, one that shapes the child's and family's relationship with care from the outset. From a psychodynamic and psychoanalytic perspective, this moment cannot be reduced to the transmission of medical information alone, but constitutes the initiation of a caring relationship in which issues of trust, meaning and emotional containment are immediately at stake. This paper describes and reflects upon a clinically grounded communicative practice developed within a paediatric oncology setting, in which a 'shared drawing' is used as a mediating tool when explaining the diagnosis to children. Drawing is conceptualised as a potential space in Winnicott's sense, allowing medical reality to become thinkable, approachable and emotionally tolerable without being denied or trivialised. Through the co-construction of a simple visual narrative, the paediatric oncologist and psychologist help the child engage with the experience of illness while preserving the child's subjective position and emotional agency. A brief clinical vignette illustrates how this approach may support emotional regulation, understanding and the early formation of a therapeutic alliance. The paper proposes that shared drawing is not a standardised technique but a relational device, whose clinical value lies in the quality of presence, containment and attunement offered within the communicative encounter.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology Matters: From innovation to implementation - Nationwide self-referral for digital mental healthcare is possible.","authors":"Brynjar Halldorsson, Hafrun Kristjansdottir, Anna Sigridur Islind","doi":"10.1111/camh.70120","DOIUrl":"https://doi.org/10.1111/camh.70120","url":null,"abstract":"<p><p>Digital mental health interventions for children are developing rapidly, yet a persistent gap remains between demonstrating that they work and making them available to families in routine care. This article describes Iceland's national rollout of the Online Support and Intervention for Child Anxiety (OSI) programme, a government-funded digital mental health intervention for parents of children aged 5-12 with common anxiety difficulties, adapted for Icelandic primary care. Its broader importance, we argue, rests not only on the intervention content but also on the service model through which it was delivered. We describe three features: a deliberately simple self-referral pathway that retains clinical oversight, delivery embedded within existing primary care services and national rollout achieved through collaboration across seven health institutions. We argue that scaling digital mental healthcare demands substantial organisational, technical and governance infrastructure and is rarely simpler than face-to-face provision. While Iceland's context may not be directly replicable in other countries, the implementation principles it illustrates may be informative for clinicians, service leaders and policymakers internationally. Improving access depends on implementation as much as innovation.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology Matters: Integrating digital treatments for children and young people with anxiety disorders into routine care.","authors":"Per Andrén, Kajsa Dellgran, Matti Cervin","doi":"10.1111/camh.70121","DOIUrl":"https://doi.org/10.1111/camh.70121","url":null,"abstract":"<p><p>Anxiety disorders in children and young people are common and impairing. Cognitive behavioural therapy (CBT) is the recommended first-line treatment and the past two decades have seen numerous digital CBT interventions emerge. Digital CBT has the potential to improve access, reduce waiting times and scale services. However, guidance on how digital CBT should be integrated into routine care pathways remains limited. This article summarises current clinical guidelines for children and young people with anxiety disorders from different parts of the world, with a specific focus on recommendations for digital CBT and its integration into broader care models. Finally, it discusses the role of digital CBT in stepped-care and stratified-care approaches, including ongoing research integrating and sequencing digital CBT differently.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative effect of multiple health and social factors on adolescent mental well-being: a cross-sectional study in Catalonia","authors":"Marina Robles-Muñoz,&nbsp;Marina Bosque-Prous,&nbsp;Cinta Folch,&nbsp;Helena González-Casals,&nbsp;Gemma Drou-Roget,&nbsp;Cristina Torrado-Cortés,&nbsp;Carles Muntaner,&nbsp;Albert Espelt","doi":"10.1111/camh.70070","DOIUrl":"10.1111/camh.70070","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While numerous studies have explored factors contributing to poor mental health, few have examined the combined influence of multiple health and social factors and their cumulative effect. This study specifically aimed to analyze the cumulative effect of multiple health and social factors associated with poor mental well-being in school-aged adolescents (12–18 years old) in Central Catalonia during the 2021–2022 academic year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional study using data from the 2021–2022 DESKcohort project, with a total sample of 9265 high-school aged students in Central Catalonia (49.2% boys and 50.8% girls). To identify factors associated with poor mental well-being (score &lt; 44 on the Warwick-Edinburgh Mental Well-being Scale), Multilevel Poisson regression models with robust variance were estimated, obtaining prevalence ratios (PR) with their respective 95% confidence intervals (95% CI). The cumulative effect score was derived by summing the factors that were associated with poor mental well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observe a gradient where the likelihood of experiencing poor mental well-being increases statistically significantly with exposure to a greater number of multiple health and social factors. In boys, the prevalence ratio increases statistically significantly from PR = 1.59 (<i>p</i> &lt; .040) to PR = 24.52 (<i>p</i> &lt; .001) for 1 and 10 health and social factors combined, and in girls, increases statistically significantly from PR = 2.56 (<i>p</i> &lt; .001) to PR = 16.23 (<i>p</i> &lt; .001) for 1 and 11 health and social factors combined, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study highlight the multifaceted nature of mental health and the co-presence of multiple axes of inequality, where overall health, family and psychosocial factors, and health behaviors form a cumulative association with adolescents' poor mental well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 3","pages":"186-197"},"PeriodicalIF":4.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}