Frontiers in child and adolescent psychiatry最新文献

{"title":"Community-based behavioural activation for depression in adolescents: feasibility study, survey and stakeholder consultations.","authors":"Lucy Tindall, Emily Hayward, Jinshuo Li, Philip Kerrigan, Susan Metcalfe, Lina Gega","doi":"10.3389/frcha.2025.1596294","DOIUrl":"10.3389/frcha.2025.1596294","url":null,"abstract":"<p><strong>Background: </strong>Behavioural activation, a brief psychological therapy for depression across the lifespan lends itself well for delivery in community settings (e.g., non-hospital health services, schools, charities). Ahead of a randomised controlled trial, we wanted to \"road-test\" our recruitment and assessment processes, intervention materials and data collection tools, and understand (1): how BA can be delivered in community settings and by whom, (2) whether young people will adopt and complete it, (3) whether there are any observed changes in depression and anxiety and (4) whether usual care would be a feasible comparator.</p><p><strong>Methods: </strong>In three settings-one community-based child and adolescent mental health service, one school, one charity-we offered up to 8 sessions of behavioural activation to 12-18-year-olds with mild-to-moderate depression. Stakeholder consultations helped us develop our research materials and processes. Self-report questionnaires assessing depression, anxiety, quality-of-life and resource use were completed by participants at baseline and 8-weeks. Professionals completed an online questionnaire about usual care for young people with depression in different settings, including types of support and staff delivering it.</p><p><strong>Results: </strong>Twenty young people (average age 15 years, 17 females) consented; of those, 19 attended behavioural activation sessions (<i>M</i> = 7.4, <i>SD</i>: 1.5) and all 20 completed baseline and follow-up measures. For three-quarters of participants there was a \"positive\" change in scores (defined as a drop of ≥1 on the RCADS) from baseline to follow-up across all measures. A Resource Use Questionnaire for Adolescents collecting information about use of hospital and community-based health and social care services was developed and tested during the study. Intervention costs were modest at £207 (<i>SD</i>: £79) per participant for just over 5 h (<i>M</i> = 286 min, <i>SD</i> = 63 min) of contact on average with a professional.</p><p><strong>Conclusions: </strong>Excellent intervention uptake and adherence (implying robust recruitment and assessment processes), retention to follow-up and data completeness, and a positive direction of change across all outcome measures justify the need for a fully powered randomised controlled trial comparing community-based behavioural activation with usual care for adolescents with mild-to-moderate depression. Furthermore, usual care rarely included behavioural activation, which made it a suitable comparator for a future randomised controlled trial.</p><p><strong>Trial registration: </strong>https://doi.org/10.1186/ISRCTN30483950, identifier (ISRCTN, ISRCTN304839502).</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1596294"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cooperative parent mediated therapy for Italian children with autism spectrum disorder: a clinical experimental study in a community healthcare service in Italy.","authors":"Alessandra Carta, Laura Casula, Salvatorica Manca, Mariangela Valentina Puci, Giuseppina Puseddu, Elisa Fucà, Giovanni Sotgiu, Stefano Vicari, Stefano Sotgiu, Giovanni Valeri","doi":"10.3389/frcha.2025.1544344","DOIUrl":"10.3389/frcha.2025.1544344","url":null,"abstract":"<p><strong>Introduction: </strong>This Clinical Experimental Study aimed to evaluate the effectiveness of Cooperative Parent Mediated therapy (CPMT), a targeted parent-coaching program for Autism Spectrum Disorder (ASD), in Community Healthcare Service in Italy.</p><p><strong>Methods: </strong>Forty children with ASD and their parents were randomly assigned to treatment conditions: the Control group received Individual Treatment As Usual (TAU Control group); while CPMT group received weekly parent-child sessions in addition to Individual TAU. Primary blinded outcomes were 6-months post-intervention change in parent-child interaction scores. Secondary outcomes included ASD symptom severity, adaptive functioning and parental stress levels. Baseline and post-treatment evaluations, at 6 months of follow up, were performed by an independent team.</p><p><strong>Results: </strong>CPMT group showed significant add-on benefits on parent-child interactions, severity of autism symptoms, adaptive skills and parental stress level.</p><p><strong>Discussion: </strong>This study provides preliminary evidence for the effectiveness of the CPMT model also in community services, representing a further step forward in research on the implementation of therapy for ASD in community healthcare service.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1544344"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Youth Risk Index: psychometrics, predicting the initiation of early adolescent substance use, and the breadth of liability detected.","authors":"Ty A Ridenour, Nisha O'Shea Gottfredson, Jason Williams, Daniel S Shaw, Maureen D Reynolds, Cheryl A Roberts, Richard Spoth, David R Garnica-Agudelo, Idil Baran, Aysenil Belger, Diana H Fishbein","doi":"10.3389/frcha.2025.1513607","DOIUrl":"10.3389/frcha.2025.1513607","url":null,"abstract":"<p><strong>Introduction: </strong>Over the last two decades, drug use epidemics have occurred across the world, including in countries with well-funded services for treatment and recovery, underscoring the need to bolster primary prevention. Moreover, substance use (SU) and SU disorders (SUDs) contribute to the etiology and exacerbation of many medical and psychiatric illnesses. The first step in providing selective/indicated prevention for SU/SUD is identifying high liability (overall risk). We evaluated the <i>Youth Risk Index</i>© (YRI) screening tool, which measures liability to SU and related behaviors, frequently before they are initiated, at ages 8-14.</p><p><strong>Methods: </strong>Using data from five previously recruited samples of youth, psychometric analyses consisted of (1) confirmatory factor analyses comparing two latent structures, (2) non-invariance tests between sexes and purposes for using the YRI (research or screening), and (3) concurrent and predictive validity. Reports from 4,495 youths aged 8-13 were analyzed, with approximately half of the sample representing each sex, each research purpose, and a Caucasian identity.</p><p><strong>Results: </strong>A latent structure with one second-order factor (Overall Liability) and three first-order factors (Disinhibition, Peer Conduct Problems, and Social Contagion) best fit the observed data and was well-replicated within sexes and purposes. Partial scalar non-invariance between purposes occurred for Overall Liability involving two items. Disinhibition had partial non-invariance between sexes and purposes involving the same item. Greater non-invariance was found for Peer Conduct Problems and Social Contagion. Traditional and non-invariance-adjusted scores correlated highly, with values of 0.96 for Overall Liability, 0.99 for Disinhibition, 0.89 for Peer Conduct Problems, and 0.93 for Social Contagion. Traditional scoring provided a good to excellent area under the receiving operating characteristic curve for concurrent and 1-year SU and conduct problems. Greater YRI scores were associated with greater youth-reported depression, sensation seeking, substance use, conduct disorder behaviors, and parental problems from SU and/or legal problems, as well as less self-management and parent fortification and poorer performances in planning, problem-solving, and low-load working memory tasks. YRI scores correlated less with parent reports on youths than with youth self-reports.</p><p><strong>Discussion: </strong>In sum, YRI scores encapsulate many segments of risk for SU/SUD and related behavior problems, which is critical to accurately identify the need for and provision of selective/indicated prevention because of the manifold risk factors for, and complex etiology of, SU/SUD.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1513607"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Parental perspectives on school attendance problems and the role of municipal support systems.","authors":"Ulla Irene Hansen, Ellen Kathrine Munkhaugen, Kenneth Larsen","doi":"10.3389/frcha.2025.1645221","DOIUrl":"10.3389/frcha.2025.1645221","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frcha.2025.1589988.].</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1645221"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Boikoetliso Ba Boko</i> ('exercising the mind'): protocol for a mixed methods feasibility and acceptability study of a prototype mental health intervention for adolescents and young people with anxiety and depression.","authors":"Claire Hart, Rachana Desai, Lauren Stuart, Shane A Norris","doi":"10.3389/frcha.2025.1569135","DOIUrl":"10.3389/frcha.2025.1569135","url":null,"abstract":"<p><strong>Background: </strong>Approximately one in four adolescents in Sub-Saharan Africa experiences significantly elevated symptoms of anxiety and depression. Those living in resource-constrained communities face heightened risks due to acute distress, trauma, and less responsive health care services. <i>Boikoetliso Ba Boko</i> (meaning 'exercising the mind') is an intervention prototype designed for adolescents and young people experiencing common mental health conditions.</p><p><strong>Methods: </strong>The prototype aims to implement a youth-centred community mental health intervention, through collaboration with existing public health systems and community resources. It seeks to enhance access to mental health support for adolescents and young people in Soweto, South Africa, by creating a dynamic and engaging therapeutic environment for those dealing with anxiety, depression, and suicidal ideation. This protocol outlines how we will evaluate the feasibility, acceptability, and implementation process of the prototype mental health intervention. We will enrol 200 at-risk adolescents and young people, aged 14-24 years, who will serve as their own controls, into the intervention and collect assessment and process evaluation data using mixed methods.</p><p><strong>Discussion: </strong>This study aims to provide a comprehensive understanding of how the <i>Boikoetliso Ba Boko</i> adolescent mental health prototype can be effectively evaluated and scaled up in resource-constrained communities. The findings will inform the development of a Phase II randomized controlled trial protocol to assess the prototype's efficacy.</p><p><strong>Ethics: </strong>Ethical approval was granted by the Human Ethics Research Committee of the University of the Witwatersrand (M231045 MED23-09-040). <i>Boikoetliso Ba Boko</i> is registered with the Pan African Clinical Trial Registry (PACTR202409702283764).</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1569135"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality following adolescent substance treatment: 21-year follow-up from a single clinical site.","authors":"Christian Thurstone, Cassandra Etzig, Eileen Chen, Haley D Seely, Ryan Loh","doi":"10.3389/frcha.2025.1600101","DOIUrl":"10.3389/frcha.2025.1600101","url":null,"abstract":"<p><strong>Background: </strong>Despite known risks of substance use, mortality following adolescent substance treatment has not been examined. Knowing which youth have greatest risk and how youth die may inform future interventions.</p><p><strong>Methods: </strong>This retrospective chart review combined records from a single adolescent substance treatment program at an urban, safety-net health system (<i>n</i> = 2,957, ages 10-19 years) with a public health registry of deaths from 2003 to 2024. Records from the child mental health treatment program at the same health system (<i>n</i> = 4,400, ages 10-19 years) were used for comparison. The crude mortality rate per 100 person years was calculated for both samples for all 21 years. The standard mortality rate using death within one year of intake was also calculated. Finally, a logistic regression model was used to test the project hypotheses that self-identification as a person of color, no engagement in care, male sex at birth, and involvement in substance treatment would predict mortality.</p><p><strong>Results: </strong>Overall, 92 (2.1%) adolescents in mental health treatment had a death record compared to 119 (4.0%) of adolescents in substance treatment. The crude mortality rate per 100 person years for adolescents in mental health treatment was 0.19 (CI: 0.18-0.20) compared to 0.37 (CI: 0.36-0.38) for adolescents in substance treatment. The standard mortality rate was 120 (32.7-308) for adolescents in mental health treatment compared to the standardized mortality rate of 944 (CI: 599-1,420) for adolescents in substance treatment. Accidental death, which includes overdose, was the most common cause of death in both groups. Results of the logistic regression showed male sex at birth (<i>p</i> = 0.0434, OR = 2.10, CI 1.06-4.53) and substance treatment (<i>p</i> = 0.0035, OR = 3.02, CI 1.47-6.55) as predictors of death within 5 years of treatment intake.</p><p><strong>Conclusions: </strong>Adolescents in substance treatment compared to those in mental health treatment are more likely to die within 5 years of intake. Males compared to females are also more likely to die. Interventions to prevent overdose and other causes of mortality may be indicated.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1600101"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in children and adolescents with attention-deficit/hyperactivity disorder: a literature review.","authors":"Danilo Dimitri, Giuliana Delia, Francesco Cavallo, Matteo Varini, Franco Fioretto","doi":"10.3389/frcha.2025.1582502","DOIUrl":"10.3389/frcha.2025.1582502","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review aimed to synthesize existing research on the symptomatological and behavioural differences between male and female attention-deficit/hyperactivity disorder (ADHD) in individuals aged 6-18 years. ADHD is a prevalent neurodevelopmental disorder that manifests differently across genders, potentially impacting the diagnosis, treatment, and overall management of the condition.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 (PRISMA guidelines), we conducted a comprehensive literature search and identified 67 records published between 2008 and 2024 that met our inclusion criteria. The review examined both direct sex differences-comparing female ADHD subjects to their male counterparts-and the disorder's sex-specific effects, revealing nuanced patterns of compromission.</p><p><strong>Results: </strong>Findings were organized into seven thematic areas: core symptoms, executive and attention performance, neuropsychomotor aspects, psychopathological aspects, behavioural and social aspects, substance use and academic performance. Differences between males and females with ADHD have been highlighted across several domains, including prevalence and intensity of core symptoms, cognitive functioning, and the nature of externalizing vs internalizing behaviours. Notably, variations were observed in the ways symptoms manifest, such as in aggression and emotional regulation. Furthermore, the review highlighted how ADHD's impact is influenced by the subject's sex, specifically affecting neuropsychomotor development, social interactions, and self-esteem. Age-related differences concerning the evolution of symptoms and cognitive functions were also explored, shedding light on how developmental trajectories may differ between sexes.</p><p><strong>Conclusion: </strong>A comprehensive understanding of sex specificity in relation to ADHD is critical for informing effective diagnosis and treatment strategies. This review underscores the need for further research to elucidate these differences, ultimately contributing to more tailored and sex-sensitive approaches in ADHD management.</p><p><strong>Systematic review registration: </strong>https://doi.org/10.37766/inplasy2025.4.0093, identifier INPLASY202540093.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1582502"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Digital media use in early childhood-contextual factors, developmental outcomes, and pathways.","authors":"Margarete Bolten, Eva Unternaehrer","doi":"10.3389/frcha.2025.1627511","DOIUrl":"10.3389/frcha.2025.1627511","url":null,"abstract":"","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1627511"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental perspectives on school attendance problems and the role of municipal support systems.","authors":"Ulla Irene Hansen, Ellen Kathrine Munkhaugen, Kenneth Larsen","doi":"10.3389/frcha.2025.1589988","DOIUrl":"10.3389/frcha.2025.1589988","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to explore parents' experiences collaborating with support systems in a Norwegian municipality for children who experience school attendance problems (SAP). The heterogeneity of SAP highlights the need for individualized measures tailored to each student's needs and collaboration between schools, municipal support systems, and the Child and Adolescent Psychiatric Outpatient Clinic (BUP). Empowering parents to advocate for their children is crucial in managing challenging situations.</p><p><strong>Method: </strong>In total, 11 parents of students who received support from a school absenteeism team (SAT) participated in the study. This qualitative study uses focus group interviews as a data collection method.</p><p><strong>Results: </strong>The results underscore the complexity of addressing SAP within municipal support systems and the need for a dedicated SAT to support students and empower parents. The parents underline the importance of having collaborative practices, evidence-based knowledge, structures, and procedures to ensure interventions are relevant and predictable. They emphasized the importance of establishing collaborative practices within the municipality.</p><p><strong>Conclusion: </strong>Collaborating with parents as equal partners increased the sense of wellbeing for the parents and enhanced the students' decision-making process.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1589988"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique and shared influences of anxiety and ADHD on the behavioral profile of autism in early childhood.","authors":"Diana K Waters, Grace T Baranek, Elizabeth Glenn, Hannah Riehl, Lauren DeMoss, Geraldine Dawson, Kimberly L H Carpenter","doi":"10.3389/frcha.2025.1585507","DOIUrl":"10.3389/frcha.2025.1585507","url":null,"abstract":"<p><strong>Introduction: </strong>Autism is characterized by a wide range of core and associated behavioral features that can be influenced by co-occurring conditions such as attention-deficit hyperactivity disorder (ADHD) and anxiety disorders. Executive function difficulties are proposed as a common feature of autism and ADHD and are also evident in persons with anxiety disorders. However, little is known about how anxiety disorders or ADHD differentially impact executive functioning or how these difficulties may influence the presentation of core and associated autistic features in young children. In the current study, we explored the unique executive function difficulties associated with co-occurring anxiety and/or ADHD and elucidated how they differentially impact the clinical presentation of autism in young children.</p><p><strong>Methods: </strong>We assessed 69 autistic children, aged 3 to 5 years. Anxiety and ADHD were assessed through parent interview using the Preschool Age Psychiatric Assessment (PAPA). Executive functions were assessed using the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Core autistic features were measured with the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and additional features were measured with the Restricted and Repetitive Behaviors Scale, Revised (RBS-R) and the Sensory Experiences Questionnaire (SEQ). Using an additive main effect general linear model, we examined the unique contributions of an anxiety disorder and/or ADHD on core and associated autistic features as well as executive function. Mediation analyses explored the contribution of the executive function profiles to specific features of autism.</p><p><strong>Results: </strong>Results showed that greater difficulty with attentional shifting was uniquely associated with anxiety, whereas greater difficulty inhibiting behavioral responses was uniquely associated with ADHD. Attentional shifting mediated the relationship between anxiety and ritualistic behaviors, sameness behaviors, sensory hyper-responsivity, and overall autistic features. Conversely, inhibitory control mediated the relationship between ADHD and both irritability and self-injurious behaviors.</p><p><strong>Discussion: </strong>These findings implicate components of executive functioning as important cognitive processes associated with co-occurring psychiatric conditions in autism. Future research should investigate the impact of early intervention for executive function difficulties on psychiatric and neurodevelopmental outcomes in autistic children.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1585507"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}