Caroline M Barry, Ashna Jagtiani, Melvin D Livingston, Sierra Talavera-Brown, Hannah LaBounty, Eugena Atkinson, Juli R Skinner, Kelli A Komro
{"title":"Anxiety and depressive symptoms as predictors of substance use initiation among adolescents living on and near a Tribal reservation in the Great Plains region of the U.S.","authors":"Caroline M Barry, Ashna Jagtiani, Melvin D Livingston, Sierra Talavera-Brown, Hannah LaBounty, Eugena Atkinson, Juli R Skinner, Kelli A Komro","doi":"10.3389/frcha.2024.1390793","DOIUrl":"10.3389/frcha.2024.1390793","url":null,"abstract":"<p><strong>Introduction: </strong>This study examines the impacts of anxiety and depressive symptoms on subsequent initiation of alcohol use, cannabis use, and prescription opioid misuse among diverse adolescents attending high schools on or near a Tribal reservation in a rural Great Plains region of the U.S.</p><p><strong>Methods: </strong>In collaboration with Emory University and a Great Plains Tribal nation's behavioral health organization, a community randomized trial of 20 high schools was conducted to prevent substance misuse. Surveys administered at four time points (fall and spring of 10th and 11th grade) included the GAD-7, PHQ-8, and items assessing lifetime alcohol use, cannabis use, prescription opioid misuse, and covariates (age, gender, race, and food insecurity). The analytic sample included students with data at two or more time points (<i>n</i> = 455) from control schools (<i>k</i> = 10). Approximately half of the sample identified as American Indian only or American Indian/White only, and 36%-39% as White only.</p><p><strong>Results: </strong>Adjusted generalized estimating equations showed that every 5-point increase in anxiety symptoms was associated with 1.28 and 1.29 times the odds of initiating alcohol and cannabis use respectively the following semester. Similarly, every 5-point increase in depressive symptoms was associated with 1.25, 1.34, and 1.38 times the odds of initiating alcohol use, cannabis use, and prescription opioid misuse respectively the following semester.</p><p><strong>Discussion: </strong>Results show a consistent 25%-38% increased odds of certain types of substance use initiation following increases in anxiety and depressive symptoms among adolescents. Findings underscore the need for targeted prevention and intervention to address mental health issues among a historically marginalized population. Addressing mental health concerns earlier may mitigate later substance use risks and sequelae for rural and American Indian youth.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788028","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}
Jo Robinson, Pinar Thorn, Samantha M. McKay, Hannah Richards, Rikki Battersby-Coulter, Michelle Lamblin, Laura Hemming, Louise La Sala
{"title":"The steps that young people and suicide prevention professionals think the social media industry and policymakers should take to improve online safety. A nested cross-sectional study within a Delphi consensus approach","authors":"Jo Robinson, Pinar Thorn, Samantha M. McKay, Hannah Richards, Rikki Battersby-Coulter, Michelle Lamblin, Laura Hemming, Louise La Sala","doi":"10.3389/frcha.2023.1274263","DOIUrl":"https://doi.org/10.3389/frcha.2023.1274263","url":null,"abstract":"Concerns exist about the relationship between social media and youth self-harm and suicide. Study aims were to examine the extent to which young people and suicide prevention professionals agreed on: (1) the utility of actions that social media companies currently take in response to self-harm and suicide-related content; and (2) further steps that the social media industry and policymakers could take to improve online safety.This was a cross-sectional survey study nested within a larger Delphi expert consensus study. A systematic search of peer-reviewed and grey literature and roundtables with social media companies, policymakers, and young people informed the questionnaire development. Two expert panels were developed to participate in the overarching Delphi study, one of young people and one of suicide prevention experts; of them 43 young people and 23 professionals participated in the current study. The proportion of participants “strongly agreeing”, “somewhat agreeing”, “neither agreeing nor disagreeing”, and “somewhat disagreeing” or “strongly disagreeing” for each item were calculated; items that achieved =>80% of agreement from both panels were strongly endorsed.There was limited consensus across the two groups regarding the utility of the safety strategies currently employed by companies. However, both groups largely agreed that self-harm and suicide-related content should be restricted. Both groups also agreed that companies should have clear policies covering content promoting self-harm or suicide, graphic depictions of self-harm or suicide, and games, pacts and hoaxes. There was moderate agreement that companies should use artificial intelligence to send resources to users at risk. Just over half of professionals and just under half of young people agreed that social media companies should be regulated by government. There was strong support for governments to require schools to educate students on safe online communication. There was also strong support for international collaboration to better coordinate efforts.Study findings reflect the complexity associated with trying to minimise the risks of communicating online about self-harm or suicide whilst capitalising on the benefits. However, a clear message was the need for better collaboration between policymakers and the social media industry and between government and its international counterparts","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"90 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138996138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: Low threshold interventions and preventive approaches in child mental health care","authors":"Eva Möhler","doi":"10.3389/frcha.2023.1286421","DOIUrl":"https://doi.org/10.3389/frcha.2023.1286421","url":null,"abstract":"","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139224921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of behavior modification training combined with electroencephalographic biofeedback therapy for attention deficit hyperactivity disorder in children: a randomized controlled trial","authors":"Xiangfen Luo, Ling Zhang, Lei Xia, Xiaoqin Zhou","doi":"10.3389/frcha.2023.1235310","DOIUrl":"https://doi.org/10.3389/frcha.2023.1235310","url":null,"abstract":"Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children. Multiple treatments are currently available with varying effectiveness, and our aim was to investigate the efficacy of behavior modification training combined with Electroencephalography (EEG) biofeedback treatment on ADHD in children.Children with ADHD were randomly divided into a control group (n = 42), an EEG biofeedback group (n = 30) and a behavior modification training combined with EEG biofeedback group (i.e., a combined intervention group) (n = 30) according to the intervention. Swanson, Nolan, and Pelham, Version IV (SNAP-IV) and Conners Parent Symptom Questionnaire (PSQ) were assessed before and after three months of treatment.We found that in the EEG biofeedback group and the combined intervention group, the scores of all factors except “anxiety” and “psychosomatic disorder” were lower than before treatment, and the difference was statistically significant (P < 0.05). After treatment, the scores of the three groups were compared. The scores of “impulsivity-hyperactivity”, “learning problems”, “inattention factor” and “hyperactivity factor” were all lower than before, and the difference was statistically significant (P < 0.05). In the post-treatment comprehensive intervention group and the control group, the efficacy was apparent, and the differences in the scores of each factor were statistically significant (P < 0.05). In the comparison between the EEG biofeedback group and the control group, except for “anxiety”, “psychosomatic disorder” and “conduct problem” the scores of each factor were statistically significant (P < 0.05). For the comparison between the integrated intervention group and the EEG biofeedback group, the scores of all factors before and after treatment were statistically significant (P < 0.05), except for “anxiety”, “impulsivity-hyperactivity” and the scores of all the factors before and after treatment were statistically significant (P < 0.05), except for “anxiety”, “impulsivity-hyperactivity” and “psychosomatic disorder”.The comprehensive efficacy of behavior modification training combined with EEG biofeedback therapy on the improvement of symptoms in children with ADHD is positive, and good compliance is worthy of clinical promotion.https://www.chictr.org.cn/indexEN.html, identifier (ChiCTR2300071511).","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139251417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giovanni Nicoli, Giulia Pavon, Andy Grayson, Anne Emerson, Michele Cortelazzo, Suvobrata Mitra
{"title":"Individuals with developmental disabilities make their own stylistic contributions to text written with physical facilitation","authors":"Giovanni Nicoli, Giulia Pavon, Andy Grayson, Anne Emerson, Michele Cortelazzo, Suvobrata Mitra","doi":"10.3389/frcha.2023.1182884","DOIUrl":"https://doi.org/10.3389/frcha.2023.1182884","url":null,"abstract":"Introduction For individuals with developmental disabilities (DD) such as autism, Down syndrome, or cerebral palsy, learning to express with language is a two-fold challenge because atypical cognitive capacity is compounded by sensorimotor coordination deficits. One approach to assisting linguistic expression in these individuals is to physically support them, for example, by touching their torso or arm as they type. The neurophysiological mechanism of such motor assistance for linguistic expression is not known, but recently it has been proposed that light touch may reduce the cognitive load associated with the sensorimotor coordination of typing, thereby releasing shared cognitive resources to the task of generating content. Historically, there has been significant controversy over the extent to which the facilitator and not the user authors texts written with touch assistance. User groups and a few researchers have argued that the user can express their thoughts through such techniques, but the prevailing view among researchers is that these texts are entirely the by-products of the facilitators' ideomotor cueing of users' movements. If the user is not a source of the produced text, the only linguistic style detectable in the text should be the facilitator's. Methods Here, we use quantitative linguistic analysis to investigate whether DD users typing text with touch assistance exhibit their own stylistic signatures alongside those of their facilitators. In Study 1, we investigate whether the stylometric fingerprints of a set of users are detectable when they are all assisted by the same facilitator. In Study 2, we examine whether the users' stylometric characteristics are retained even when they are assisted by multiple facilitators. Results Across both studies, the results show that the users' stylistic signature is detectable alongside that of facilitators. This suggests that the texts generated by DD users withphysical assistance should be viewed as coauthored rather than wholly authored by facilitators via ideomotor processes. Discussion The users' stylometric presence in these texts suggests that touch-assistance may serve as a developmental scaffold and should be re-appraised as a teaching aid even where unassisted linguistic expression is an unlikely end goal.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"2014 31","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martha G. Welch, Robert J. Ludwig, Amie A. Hane, Judy Austin, Elizabeth S. Markowitz, Marc E. Jaffe, Michael M. Myers
{"title":"Preschool-based mother-child emotional preparation program improves emotional connection, behavior regulation in the home and classroom: a randomized controlled trial","authors":"Martha G. Welch, Robert J. Ludwig, Amie A. Hane, Judy Austin, Elizabeth S. Markowitz, Marc E. Jaffe, Michael M. Myers","doi":"10.3389/frcha.2023.1232515","DOIUrl":"https://doi.org/10.3389/frcha.2023.1232515","url":null,"abstract":"Introduction Based on the theory that increasing emotional connection and reducing emotional stress between mother and child at home will reduce dysregulated behavior in the classroom, we tested a novel family-based school intervention aimed at facilitating mother-child emotional connection. This question has gained great importance following the COVID-19 pandemic, as child mental health has been declared a national emergency. Methods Subjects were randomized into two groups; one (Control: n = 32) receiving the standard curriculum in a large community-based preschool education program, and another (MCEP) receiving the standard curriculum plus the Mother Child Emotional Preparation Program (MCEP: n = 30). Two to eight MCEP mother-child pairs participated in eight elective weekly 2-h group sessions over a 16-week period. During the 2-h sessions, the pairs were engaged in face to face calming sessions. At 6 months post-enrollment, we assessed mother-child emotional connection on the Welch Emotional Connection Screen (WECS). In addition, mothers and teachers completed validated questionnaires and instruments. Results We found that the percentage of MCEP mother-child pairs who became emotionally connected at 6 months was five-fold higher than Control pairs (47.4%, vs. 8.3% p = 0.004, effect size = 0.44). Also at six months, MCEP children had fewer behavioral symptoms ( p = 0.024)) (effect size &gt;0.5); fewer autism symptoms ( p = 0.048) (effect size = 0.53); fewer emotional symptoms ( p = 0.01) (effect size &gt;0.76); better personal, social skills ( p = 0.045) (effect size = 0.51); better executive function ( p = 0.032) (effect size = 0.59). Importantly, teachers reported MCEP children showed more improved behavior in the classroom, compared to controls. Discussion This trial was retrospectively registered in the clinicaltrial.gov registry (NCT02970565) on April 9, 2019.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135569230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risky sexual behaviors among orphaned youth in South Africa: findings of the 2017 population-based household survey","authors":"Noloyiso Vondo, Musawenkosi Mabaso, Vuyelwa Mehlomakulu, Ronel Sewpaul, Adlai Davids, Philisiwe Ndlovu, Derrick Sekgala, Londiwe Shandu, Sizulu Moyo","doi":"10.3389/frcha.2023.1033663","DOIUrl":"https://doi.org/10.3389/frcha.2023.1033663","url":null,"abstract":"Introduction In sub-Saharan Africa, evidence shows that orphaned youth are exposed to more risky sexual behaviors than non-orphaned peers, which increases the chances of contracting HIV and other sexually transmitted infections. The fast rises in the prevalence of orphanhood are a result of the HIV/AIDS epidemic. Methodology The data for this secondary analysis were collected through a cross-sectional, multi-stage, stratified, cluster randomized sampling design. Multivariable backward stepwise logistic regression analysis was fitted to determine the factors associated with risky sexual behaviors among male and female adolescents and youth aged 12–24 years. Results Of 2,556 orphaned participants, 18.3% (95% CI: 14.3–23.0) had two or more sexual partners in the last 12 months, 31.3% (95% CI: 26.3–36.6) reported no condom use at last sex, and 98.3% (95% CI: 96.6–99.2) reported no consistent condom use. The likelihood of reporting multiple sexual partnerships was significantly lower among female adolescents, those residing in rural formal/farm areas, and those who reported sexual debut at age 15 years and was higher among those who reported sexual partners 5 years and older than their age group. The odds of not using a condom at last sex were significantly higher among female adolescents and those who perceived themselves as being at high risk of HIV infection and were significantly lower among those who had sexual debut at age 15 years and older. Discussion The findings suggest that there is a need for sexual risk-reduction strategies targeted at orphans, especially male orphans and those residing in urban areas. Such efforts should include behavior change interventions for delaying the age of sexual debut, changing HIV risk perception, mitigating multiple sexual partnerships, age-disparate sexual relationships, and enhancing condom use.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135569519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eszter Szekely, David P. Laplante, Henning Tiemeier, Jonathan Evans, Rebecca M. Pearson, Mona Bekkhus, Marian Bakermans-Kranenburg, Marinus H. van IJzendoorn, Ashley Wazana
{"title":"The DREAM BIG project as a model for harmonizing early measures of parental care and parent-child interactions across epidemiological cohorts","authors":"Eszter Szekely, David P. Laplante, Henning Tiemeier, Jonathan Evans, Rebecca M. Pearson, Mona Bekkhus, Marian Bakermans-Kranenburg, Marinus H. van IJzendoorn, Ashley Wazana","doi":"10.3389/frcha.2023.1206922","DOIUrl":"https://doi.org/10.3389/frcha.2023.1206922","url":null,"abstract":"Parenting is a key contributor to child development. The effects of parenting, however, also depend on child characteristics, including genetic factors. A more complete appraisal of the role of parenting thus requires a comprehensive developmental model which explores questions about parenting behavior, child susceptibility to parenting, and child psychopathology. Moving forward, we need to not only be concerned about sample sizes that limit testing of comprehensive models but also the need to replicate findings across multiple settings and samples. A consortium which harmonises key measures offers the opportunity to examine these questions. The Developmental Research in Environmental Adversity, Mental health, BIological susceptibility and Gender (DREAM BIG) consortium includes six international longitudinal prospective birth cohorts to explore the early life origins of major psychiatric disorders in childhood. Here, we will provide a brief overview of parental care research, methodological limitations, and two exciting recent attempts (i.e., the DREAM BIG consortium and the CATS-project), that address key methodological challenges.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135569797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. P. Seakamela, R. G. Mashaba, C. B. Ntimana, M. O. Mbombi, J. Tlouyamma, P. Mphekgwana, R. Nemuramba, K. Mothapo, L. Muthelo, L. N. Mabila, I. Dhau, E. Maimela
{"title":"Prevalence and associated factors of probable depression amongst pregnant and parenting young females: a comparison of adolescents and young adults in rural South Africa","authors":"K. P. Seakamela, R. G. Mashaba, C. B. Ntimana, M. O. Mbombi, J. Tlouyamma, P. Mphekgwana, R. Nemuramba, K. Mothapo, L. Muthelo, L. N. Mabila, I. Dhau, E. Maimela","doi":"10.3389/frcha.2023.1200759","DOIUrl":"https://doi.org/10.3389/frcha.2023.1200759","url":null,"abstract":"Background Pregnant teenagers have been reported to have an increased likelihood of experiencing depression than their non-pregnant peers. There is little research on the risk factors for depression in rural Black adolescents and young adults, especially after the Covid-19 pandemic. Therefore, the current study aimed to identify the prevalence of probable depression and associated factors amongst pregnant and parenting young females. Method The study was a cross-sectional design, consisting of 362 pregnant and parenting adolescents and young adults aged 14–22. The study used the Edinburgh Postnatal Depression Scale (EPDS) to measure probable depression. Data were analyzed using Statistical Package for Social Sciences SPSS, version 27.0. Results The study found that the overall prevalence of probable depression was 42.8%. The study also found a relationship between alcohol consumption, lack of financial support, unplanned pregnancy, and probable depression in pregnant and parenting adolescents. The prevalence of unplanned pregnancy in the present study was 81.8%. Conclusion Furthermore, the present study indicated that participants from low socio-economic status families and those who were HIV positive were at a greater risk of depression in both groups. Therefore, we recommend that measures be put in place for early detection and treatment of depression and that social support be given to adolescent mothers.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136114297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Landry Goodgame Huffman, Darian Lawrence-Sidebottom, Jennifer Huberty, Rachael Guerra, Monika Roots, Kurt Roots, Amit Parikh
{"title":"Sleep problems and parental stress among caregivers of children and adolescents enrolled in a digital mental health intervention","authors":"Landry Goodgame Huffman, Darian Lawrence-Sidebottom, Jennifer Huberty, Rachael Guerra, Monika Roots, Kurt Roots, Amit Parikh","doi":"10.3389/frcha.2023.1265095","DOIUrl":"https://doi.org/10.3389/frcha.2023.1265095","url":null,"abstract":"Introduction Caregivers of children with mental health problems such as anxiety, depression, and attention-deficit/hyperactivity disorder often experience heightened sleep problems, largely due to their children's disrupted sleep, and increased parental stress. Evidence suggests that mental and behavioral health care for children and adolescents has the potential to positively affect their caregivers; however, this has not been investigated in the context of pediatric digital mental health interventions (DMHIs). Therefore, the current study used caregivers' self-report measures to determine whether caregivers whose children are involved in a DMHI exhibit improvements in sleep problems and parental stress after initiation of their children's care. Methods Caregivers with a child or adolescent participating in behavioral coaching and/or therapy with Bend Health Inc., a pediatric DMHI that involves both the child and caregiver in care (e.g., coaching and therapy), were included in the study ( n = 662). Caregiver insomnia severity and parental stress were reported approximately every 30 days using the Insomnia Severity Index (ISI) and Parental Stress Scale (PSS). Changes in symptoms were assessed by comparing caregivers' symptom scores from baseline to first assessment after starting care. Results Among caregivers with elevated insomnia severity ( n = 88) and parental stress ( n = 119) at baseline, 77% showed improvements in sleep and 73% showed improvements in parental stress after the initiation of their child's care, with significant decreases in score from baseline to post-care (ISI: t 72 = −4.83, P &lt; .001, d = 0.61; PSS: Z = −4.98, P &lt; .001, d = 0.59). Discussion While extant research suggests ongoing links between child behavioral problems, parent sleep, and parent well-being, this is the first study to demonstrate improvements in caregiver sleep and stress when a child's mental health symptoms are addressed with behavioral care. Our findings offer promising preliminary evidence that caregivers experience significant secondary benefits to their sleep and parental stress when their children participate in a pediatric DMHI. Further research is warranted to investigate additional moderating and mediating factors, such as caregiver demographics and magnitude of child mental health improvement.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}