JAACAP open最新文献

{"title":"Systematic Review: Culturally Tailored Digital Substance Use Prevention Interventions for Black Adolescents","authors":"Kammarauche Aneni MBBS, MHS, Destiny Pegram MD, Jenny Meyer BS, Melissa C. Funaro MS, MLS, Roberta L. Bruhn PhD, Uzochukwu Imo MBBS, Aaron Hogue PhD, José Szapocznik PhD, Ijeoma Opara PhD, LMSW, MPH","doi":"10.1016/j.jaacop.2026.03.007","DOIUrl":"10.1016/j.jaacop.2026.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>Black adolescents differ from adolescents of other racial/ethnic groups in prevalence, patterns, risk and protective factors, and consequences of substance use, underscoring the need for culturally tailored interventions. Black adolescents also experience unique barriers in access to interventions that may be amenable to digital interventions. However, based on available literature, no systematic review has examined the efficacy of culturally tailored digital interventions for substance use prevention among Black adolescents. Here, existing culturally tailored digital interventions for substance use prevention among Black adolescents were systematically reviewed, and their efficacy in preventing substance use was examined.</div></div><div><h3>Method</h3><div>A systematic search of biomedical research databases was conducted. Search terms included controlled vocabulary terms and free text terms for concepts of digital interventions, substance use, and clinical trials. Randomized controlled trials comparing a culturally tailored intervention for Black adolescents with a control intervention were included. The level of cultural tailoring (surface- vs deep-level tailoring) was determined, and the impact of interventions on substance use outcomes was assessed. The quality of studies was evaluated using the National Institutes of Health tool for quality assessment of controlled intervention studies. A narrative synthesis summarizing results by study characteristics, intervention characteristics, and study outcomes/findings was also conducted.</div></div><div><h3>Results</h3><div>Eleven articles comprising 6 studies testing 6 interventions met inclusion criteria. The proportion of Black adolescents varied among studies from 41% to 100% (n = 109-421). Four interventions significantly improved overall substance use outcomes with effect sizes ranging from 0.002 to 1.5 for alcohol use, 0.11 to 1.57 for marijuana use, 0.002 to 0.64 for tobacco use, and 0.009 to 0.35 for other drugs. Five interventions also improved antecedents to substance use (eg, self-efficacy, intentions to use drugs, parental monitoring). Effects persisted at long-term follow-up (≥12 months) among 75% of interventions that examined these outcomes. Cultural tailoring varied widely among interventions, with 4 studies reporting surface-level adaptations, 1 study reporting deep-level adaptations, and 1 study reporting both surface- and deep-level adaptations. Cultural tailoring largely focused on intervention content, with only 2 studies describing additional tailoring at the implementation level. One study assessed the impact of cultural tailoring on intervention outcomes. Interventions were tested in various settings, including community (2 studies), home (1 study), school (1 study), emergency department (1 study), and primary care (1 study); were delivered using a CD-ROM/computer (5 studies) or videotape (1 study); and comprised different types of interventions","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 569-588"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633016","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":"Negative Online Experiences and Reporting Rates in Youth With Mental Health Conditions","authors":"Mirelle Kass BA, Lindsay M. Alexander MPH, Tatum Connell BA, Sara Bagheri Hamaneh BA, Najuma Abdullah BA, Michelle Freund PhD, Michael P. Milham MD, PhD, Aki Nikolaidis PhD","doi":"10.1016/j.jaacop.2026.04.001","DOIUrl":"10.1016/j.jaacop.2026.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>Growing engagement with digital spaces among children and adolescents increases the risk of negative online experiences (NOE). This study examined the prevalence, risk factors, and reporting barriers for NOE among youth with mental health and neurodevelopmental conditions.</div></div><div><h3>Method</h3><div>A cross-sectional, mixed-methods study between January and July 2023 was conducted using a community-based sample from the Child Mind Institute’s Healthy Brain Network. A total of 1,009 youth aged 9 to 15 years (58.4% male; mean age = 11.79 years, SD = 1.71 years) completed a quantitative survey. A subsample (n = 109) participated in a qualitative follow-up involving a 3-day moderated online bulletin board.</div></div><div><h3>Results</h3><div>Of the 1,009 participants, 26.6% experienced NOE in the previous year, with 68.7% reporting multiple incidents; however, 80% did not report them. Factor analyses identified 3 key reporting barriers: reporting process, reporting policy, and emotional barriers. Social aptitude, mental health symptoms, and parenting style predicted youths’ likelihood of encountering NOE and key reporting barriers. Qualitative findings indicated that reporting decisions involved assessing malice, perpetrator intent, and NOE type; ambiguity in these areas contributed to reporting uncertainty.</div></div><div><h3>Conclusion</h3><div>This study highlights the gap between the high prevalence and low reporting rates of NOE among youth with mental health and neurodevelopmental conditions. Identified demographic, clinical, and family factors were associated with increased risk of experiencing NOE and the 3 reporting barriers. Findings underscore the need for targeted, developmentally appropriate strategies involving policymakers, technology developers, clinicians, and educators to support safer online environments for at-risk youth.</div></div><div><h3>Plain language summary</h3><div>Children with mental health conditions often face bullying or harassment online. This cross-sectional study of over 1,000 youths examined negative online experiences and reporting patterns. Despite negative online experiences being common, few youths reported them. Barriers included not knowing how to report, doubting action would be taken, and feeling strong emotions. These findings may guide families, schools, clinicians, and technology companies in creating safer online spaces.</div></div><div><h3>Clinical guidance</h3><div>• Educate children and families about online reporting processes using developmentally appropriate, clear, and accessible language.</div><div>• Encourage parents to adopt consistent, supportive involvement in their children’s online activities, as positive parenting was associated with lower risk and reporting barriers.</div><div>• Address emotional barriers by normalizing help-seeking, validating fears of embarrassment or retaliation, and connecting youth with safe peer or adult support.</div><div>• ","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 701-712"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633022","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":"Increased Activity of the Glymphatic System in First-Episode Psychosis: Relationship With Cortical Thinning","authors":"Emily Alder PhD,&nbsp;Kahiau Among BS,&nbsp;Colton A. Olexa BS,&nbsp;Kristen R. Hoskinson PhD,&nbsp;Whitney I. Mattson PhD,&nbsp;Eric E. Nelson PhD,&nbsp;Musa Yilanli MD","doi":"10.1016/j.jaacop.2026.04.004","DOIUrl":"10.1016/j.jaacop.2026.04.004","url":null,"abstract":"<div><h3>Objective</h3><div>First-episode psychosis (FEP) in pediatric onset is a pivotal window for preventing chronic disability and optimizing long-term outcomes. Improved understanding of psychosis biomarkers is essential to clarify the pathophysiology, guide individualized intervention, and improve prognostication for patients. We evaluated the glymphatic system (GS) as a potential mechanistic biomarker and assessed whether developmental processes influence GS function and cortical thinning in a cohort of FEP adolescents. We also explored the impact of age on GS function and cortical thinning.</div></div><div><h3>Method</h3><div>A total of 21 FEP patient research participants (PRP) were recruited from a Psychiatry and Behavioral Health unit. The experimental battery included clinical and neuropsychological assessments and a magnetic resonance imaging session in which both T1 and diffusion-weighted sequences were acquired. PRP were compared to a normative set of 42 community control participants (CCP) from the same scanner. Across both groups, analysis along the perivascular space (ALPS), an approximation of glymphatic activity, was generated from the diffusion images, and whole-brain cortical thickness was compared between groups using Freesurfer software and statistical models.</div></div><div><h3>Results</h3><div>Consistent with previous findings, significant and widespread reductions in cortical thickness were evident in the FEP population relative to the CCP. However, in contrast to expectations, ALPS was significantly elevated in PRP, suggesting increased GS functioning. Cortical thinning partially explained ALPS.</div></div><div><h3>Conclusion</h3><div>In contrast to the few published studies in adults with schizophrenia, which have found significant reductions in ALPS, these results suggest that pediatric PRP with FEP have increased activation of the GS. Our findings suggest that this may relate to excessive cortical thinning in some brain regions (a hypothesis that we are currently exploring), although the directionality of this relationship is unclear. These findings may further indicate to a differential GS response in early vs late phases of disease or other differential pathologies related to development or disease phase, and to a differential role of GS and cortical thinning across groups.</div></div><div><h3>Plain language summary</h3><div>This study examined the difference in brain waste clearance for adolescents with first-episode psychosis compared to adolescents with no history of psychosis symptoms. The study discusses synaptic pruning as a potential explanation for differences in waste clearance activity.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 691-700"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633073","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":"Post-Pandemic Trends in Pediatric Mental Health Treatment: A Nationwide Study","authors":"Raman Baweja MD, MS,&nbsp;Daniel A. Waschbusch PhD,&nbsp;Felix Matos Padilla MD,&nbsp;Richard E. Mattison MD,&nbsp;James G. Waxmonsky MD","doi":"10.1016/j.jaacop.2026.04.006","DOIUrl":"10.1016/j.jaacop.2026.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined temporal trends in mental health diagnoses and treatment patterns among children and adolescents across the COVID-19 pre-pandemic, pandemic, and post-pandemic periods in the United States.</div></div><div><h3>Method</h3><div>This retrospective cohort study used the TriNetX U.S. Collaborative Network, including 13.3 million children and adolescents aged 3 to 18 years with health care encounters from October 2018 to December 2022. Using 2 complementary approaches—rolling monthly health care–seeking incidence and treatment-engaged cohorts (≥2 encounters per phase)—we assessed psychiatric diagnoses, psychotropic medication initiation, and psychotherapy use across 3 phases: pre-pandemic (October 2018 to February 2020), pandemic (March 2020 to July 2021), and post-pandemic (August 2021 to December 2022). Analyses were stratified by age, sex, race, and ethnicity.</div></div><div><h3>Results</h3><div>Incidence rates declined sharply during early pandemic lockdowns, rebounded by March 2021, and remained elevated post-pandemic. Compared with pre-pandemic levels, psychiatric diagnoses increased 24%, psychotropic medications 35%, and psychotherapy 26%. Antidepressants had the largest increases (58%-94%), with female children and adolescents showing steeper rises (65%-137%) compared with male children and adolescents (41%-57%). Attention-deficit/hyperactivity disorder (ADHD) medication use also increased, with the greatest rise in preschoolers (147%), whereas male adolescents showed minimal change or decreases. Racial and ethnic disparities persisted. Among treatment-engaged youth, adolescents had higher antidepressant use (32%-36%) and hydroxyzine use (7%-10%), with reduced benzodiazepine use (7%-4%).</div></div><div><h3>Conclusion</h3><div>Substantial and sustained increases in pediatric behavioral health treatment persisted beyond the acute pandemic period, concentrated among female individuals and driven primarily by antidepressant prescribing. These patterns warrant monitoring and targeted interventions to address sex disparities and persistent racial and ethnic inequities.</div></div><div><h3>Plain language summary</h3><div>This study examined mental healthcare utilization trends in US children before, during, and after the COVID-19 pandemic. Mental health diagnoses and treatments rose during and after the pandemic, after a drop during the lockdown period of the pandemic. Antidepressant use showed the greatest increase, especially among girls. Attention-deficit/hyperactivity disorder (ADHD) medication utilization also rose, with greatest increase among preschoolers. Racial and ethnic gaps persisted, highlighting the need for targeted support to improve access to care.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 625-637"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632999","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: Adverse Childhood Experiences and Disordered Eating Behaviors: Specific Associations and Individual Implications","authors":"Sarah Smith MD, MSc","doi":"10.1016/j.jaacop.2026.05.003","DOIUrl":"10.1016/j.jaacop.2026.05.003","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 566-568"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633063","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":"Characterizing Early Childhood Disruptive Mood Dysregulation Disorder","authors":"Ji Su Hong MD,&nbsp;Amie F. Bettencourt PhD,&nbsp;Joan Luby MD,&nbsp;Rebecca Tillman MS,&nbsp;Alecia C. Vogel MD, PhD","doi":"10.1016/j.jaacop.2026.04.002","DOIUrl":"10.1016/j.jaacop.2026.04.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;In &lt;em&gt;DSM-5&lt;/em&gt;, disruptive mood dysregulation disorder (DMDD) is defined as chronic irritability with intense temper outbursts in children aged 6 and older. However, these problems often emerge before age 6. This study aimed to characterize early childhood DMDD (EC-DMDD) in a preschool sample enriched for depression and disruptive behaviors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Children 3 to 5 years old (N = 302) received comprehensive assessments, including the Preschool Age Psychiatric Assessment, MacArthur Health and Behavior Questionnaire–Parent Version 1.0, and Preschool and Early Childhood Functional Assessment Scale. Latent class analysis was used to identify classes varying in intensity and frequency of irritability and temper tantrums. Children with EC-DMDD were compared with children with oppositional defiant disorder (ODD) and children with major depressive disorder (MDD). Regression analysis examined independent associations between EC-DMDD and functional impairment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Latent class analysis identified 3 classes: regulated, EC-DMDD, and transient irritability. Compared with the other classes, the EC-DMDD class was characterized by higher frequency of co-occurring mental disorders and symptoms and more functional impairment. Compared with the ODD group, the EC-DMDD group exhibited more frequent irritability and temper tantrums and more impairment. The EC-DMDD group was characterized by more externalizing symptoms, whereas the MDD group was characterized by more internalizing symptoms; the EC-DMDD + MDD group was associated with increased risk of multiple comorbidities and functional impairments. In regression analysis, EC-DMDD was associated with functional impairment after controlling for covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study systematically investigated the latent class of EC-DMDD and the association between EC-DMDD, ODD, and MDD in preschoolers, demonstrating that EC-DMDD can be detected in preschoolers and may be distinctly related to elevated risk of impairment. Future studies should investigate larger samples with longitudinal follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This study evaluated 302 preschoolers to compare early childhood disruptive mood dysregulation disorder (EC-DMDD) with oppositional defiant disorder (ODD) and major depressive disorder (MDD). EC-DMDD was characterized by more severe behavioral problems and functional problems than ODD or MDD. Children with EC-DMDD had mainly behavioral problems, children with MDD had more internalizing problems, and children with both conditions had more diverse mental health symptoms and problems in functioning.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Diversity &amp; Inclusion Statement&lt;/h3&gt;&lt;div&gt;We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historical","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 649-664"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632952","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":"Scope","authors":"","doi":"10.1016/S2949-7329(26)00061-X","DOIUrl":"10.1016/S2949-7329(26)00061-X","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Page A1"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647653","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":"Recreational Activities and Youth Outcomes: An Explainable Machine Learning Study","authors":"Yihong Zhao PhD,&nbsp;Xuewei Han MS,&nbsp;Sarah W. Feldstein Ewing PhD,&nbsp;Susan F. Tapert PhD,&nbsp;Martin P. Paulus MD","doi":"10.1016/j.jaacop.2026.03.006","DOIUrl":"10.1016/j.jaacop.2026.03.006","url":null,"abstract":"<div><h3>Objective</h3><div>Recreational activities are considered vital for emotional and cognitive health of youth, yet empirical research examining the specific associations between recreational activities and youth behavioral and cognitive outcomes is limited.</div></div><div><h3>Method</h3><div>In this cohort study, interpretable machine learning methods, specifically random forest paired with SHapley Additive exPlanations (SHAP) analysis, were applied to quantify the contribution of each activity to behavioral and cognitive outcomes in the Adolescent Brain Cognitive Development℠ (ABCD) Study baseline data (ages 9-10). Data-driven activity groups were defined by SHAP contribution patterns for behavioral and cognitive outcomes. Engagement in these groups was then tested for association with the corresponding outcomes using linear mixed-effects models in the hold-out sample, both cross-sectionally and longitudinally.</div></div><div><h3>Results</h3><div>Of activities, 14 were identified with more favorable and 8 with less favorable behavioral patterns, and 13 were identified with more favorable and 2 with less favorable cognitive patterns. Activities with more favorable behavioral patterns (eg, skiing/snowboarding) were linked to fewer problems (β = −1.12, <em>p</em> &lt; .001), whereas activities with less favorable patterns (eg, martial arts) were linked to more problems (β = 1.75, <em>p</em> &lt; .001). For cognition, activities with less favorable patterns (eg, football) were associated with lower cognitive scores (β = −1.34, <em>p</em> &lt; .001), whereas activities with more favorable patterns (eg, musical instruments) were associated with higher scores (β = .98, <em>p</em> &lt; .001), and family income moderated this association (<em>p</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Recreational activities exhibit distinct patterns of association with cognitive and mental health outcomes. These data-driven findings highlight the importance of considering individual differences and contextual factors when investigating youth engagement in recreational activities.</div></div><div><h3>Plain language summary</h3><div>This study used machine learning to examine how different kinds of recreational activities in youth were associated with behavior and cognitive function. Some activities, like music and skiing, were linked to better outcomes, while others showed less positive patterns. In general, access to certain recreational activities was associated with healthier developmental outcomes. These findings merit independent replication and further study.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 601-611"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633002","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":"Loneliness and Bullying by Siblings in Gender-Diverse Adolescents: Results From the Population-Based Generation R Study","authors":"Yllza Xerxa PhD,&nbsp;Akhgar Ghassabian MD, PhD,&nbsp;Manon H.J. Hillegers MD, PhD,&nbsp;Luis Martinez Agulleiro MD,&nbsp;Pauline W. Jansen PhD,&nbsp;Samantha Busa PsyD,&nbsp;Francisco Xavier Castellanos MD,&nbsp;Tonya White MD, PhD","doi":"10.1016/j.jaacop.2026.04.003","DOIUrl":"10.1016/j.jaacop.2026.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>Gender-diverse individuals often face a burden of poor mental health. This study examined whether gender-diverse experiences were associated with higher levels of loneliness in adolescents, over and above depression and anxiety, and how family environmental factors, including maladaptive parenting, being bullied by a sibling at home (victimization), and bullying a sibling at home (perpetration), moderate the associations between gender-diverse and loneliness experiences among 4,424 adolescents in a population-based cohort.</div></div><div><h3>Method</h3><div>This cross-sectional study was embedded in Generation R, a multiethnic population-based cohort from fetal life onward. Adolescents with information on self-reported or parent-reported gender diversity and loneliness at ages 13 to 15 years were included.</div></div><div><h3>Results</h3><div>Adolescents who reported gender diversity had higher levels of loneliness compared with youth who did not report gender diversity (assigned female at birth: <em>B</em> = .67, 95% CI 0.49-1.23; assigned male at birth: <em>B</em> = .45, 95% CI 0.32-0.98). The associations remained after taking into account depression and anxiety, indicating a unique association of gender diversity with lonely feelings in adolescence (assigned female at birth: <em>B</em> = .38, 95% CI 0.24-0.51; assigned male at birth: <em>B</em> = .31, 95% CI 0.17-0.46). Being bullied by a sibling at home (victimization) modified the association of gender diversity with loneliness experiences (interaction <em>p</em> = .04). No evidence was found for interaction effects between gender diversity, maladaptive parenting, and any temperamental traits on adolescent loneliness (<em>p</em>s &gt; .10).</div></div><div><h3>Conclusion</h3><div>Gender diversity is associated with higher levels of loneliness in adolescents. Being a target of bullying modified the association of gender diversity with loneliness experiences, suggesting that gender-diverse adolescents who are bullied by siblings experience particularly higher levels of loneliness.</div></div><div><h3>Plain language summary</h3><div>Gender-diverse youth experience substantial mental health disparities when compared to cisgender youth. This cross-sectional study examined how gender diversity related to loneliness in adolescents, finding higher loneliness levels among gender-diverse youth, independent of depression and anxiety. Sibling bullying—not maladaptive parenting or temperamental traits—was associated with higher levels of loneliness. These findings emphasize modifiable risk factors and the need for targeted support in family and social environments.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 589-600"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633013","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":"Identifying the Depressive Profiles Among Latinx Adolescents Who Have Experienced School Discipline and School Policing: Evidence for the School-to-Patient Nexus","authors":"Collin Perryman PhD, MFHD, MEd","doi":"10.1016/j.jaacop.2026.04.005","DOIUrl":"10.1016/j.jaacop.2026.04.005","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the depressive profiles of 15-year-old Latinx adolescents who have been school disciplined and school policed, and to provide empirical evidence for the School-to-Patient Nexus (STPN).</div></div><div><h3>Method</h3><div>Data from 813 Latinx adolescents from the Future of Families and Child Wellbeing Study (FFCWS) were used to conduct a latent class analysis to understand the subgroup differences among Latinx adolescents in terms of their school discipline, school policing, and depressive symptoms. Covariates included prior mental health history, demographics, and school connectedness.</div></div><div><h3>Results</h3><div>Three classes of Latinx adolescents were identified: (1) “less school policing”; (2) “no school discipline/low school policing”; and (3) “more school policing.” Depressive symptom scores incrementally increased with latent classes.</div></div><div><h3>Conclusion</h3><div>School discipline and school policing influence the depressive symptoms of Latinx adolescents. Compared to the other classes, class 3 indicated that Latina adolescent girls had the highest depressive mean scores, and therefore structural and institutional changes and interventions specifically adhering to the needs of these girls are needed. These findings provide empirical support for the School-to-Patient Nexus, demonstrating how carceral school practices become embodied as mental health outcomes.</div></div><div><h3>Plain language summary</h3><div>Although it is known that school discipline and policing can harm the mental health of young people, little is known about how these factors affect Latinx teenagers. Eight hundred thirteen Latinx teenagers were studied to understand how school discipline and policing related to depressive symptoms. Three distinct groups emerged: (1) “less school policing”; (2) “no school discipline/low school policing”; and (3) “more school policing.” Latina girls in the most heavily policed group had the highest depressive scores, raising the question of whether carceral school practices harm the mental health of Latinx youth.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 638-648"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633069","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}