JAACAP openPub Date : 2025-07-09DOI: 10.1016/j.jaacop.2025.07.001
Lynsay Ayer PhD (Guest Editor), Daniel P. Dickstein MD, FAAP (Deputy Editor)
{"title":"Introduction to a Special Series on Youth Suicide","authors":"Lynsay Ayer PhD (Guest Editor), Daniel P. Dickstein MD, FAAP (Deputy Editor)","doi":"10.1016/j.jaacop.2025.07.001","DOIUrl":"10.1016/j.jaacop.2025.07.001","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 345-346"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913176","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}
JAACAP openPub Date : 2025-05-28DOI: 10.1016/j.jaacop.2025.05.003
Carol A. Wygant MSW , Cassandra Hartman MA , Xueting Xia MS , Nichole L. Michaels PhD , Donna A. Ruch PhD
{"title":"Characteristics and Precipitating Circumstances of Preteen and Teen Suicide Decedents Who Died by Firearm in the United States, 2012-2021","authors":"Carol A. Wygant MSW , Cassandra Hartman MA , Xueting Xia MS , Nichole L. Michaels PhD , Donna A. Ruch PhD","doi":"10.1016/j.jaacop.2025.05.003","DOIUrl":"10.1016/j.jaacop.2025.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>Youth suicide is a growing public health concern, and younger preteens have experienced notable increases in suicide rates. Suicide by firearm among preteens have increased more than all other suicide methods combined. The current study examined characteristics and precipitating circumstances associated with firearm suicides among preteens and teens ages 8 to 17 years.</div></div><div><h3>Method</h3><div>This cross-sectional study analyzed data from the National Violent Death Reporting System from 2012 to 2021 on youth firearm suicide decedents (N = 3,768). Comparisons between preteens (8-12 years old) and teens (13-17 years old) were analyzed using linear mixed models that adjusted for sex, race, and ethnicity.</div></div><div><h3>Results</h3><div>The sample included 229 preteen and 3,539 teen firearm suicide decedents (14.7% female; 9.4% Black; 8.1% other race; 82.5% White; 10.7% Hispanic). Preteens were more likely to be female (adjusted odds ratio [AOR] = 1.76; 95% CI, 1.26-2.46) and Black (AOR = 1.72; 95% CI, 1.14-2.58) compared with teens and more likely to experience family (AOR = 1.69; 95% CI, 1.27-2.23) and school (AOR = 2.04; 95% CI, 1.51-2.74) problems. Preteens were less likely than teens to have a current mental health problem (AOR = 0.47; 95% CI, 0.32-0.68), a depressed mood at time of death (AOR = 0.49; 95% CI, 0.33-0.72), and a history of suicidal thoughts (AOR = 0.60; 95% CI, 0.38-0.95) or attempts (AOR = 0.25; 95% CI, 0.08-0.81). Among cases with firearm-related information, most youth had access to a gun that was unlocked or loaded.</div></div><div><h3>Conclusion</h3><div>Findings suggest that universal suicide risk screening and assessment is warranted, especially for younger preteens, and advocating for safe firearm storage practices remains a key component of prevention for this population</div></div><div><h3>Plain language summary</h3><div>This study compared characteristics and precipitating circumstances of preteens (8-12) and teens (13-17) who died by firearm suicide using data from the Centers for Disease Control and Prevention’s National Violent Death Reporting System. Preteen decedents were more likely to have been female or Black compared to teens and were more likely to have a diagnosis of attention deficit with hyperactivity. Preteens were approximately half as likely as their teen counterparts to have an identified mental health problem or a perceived depressed mood at the time of death. Findings suggest that preteens would benefit from intervention and prevention efforts tailored to their specific, age-dependent needs.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 655-662"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912358","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}
JAACAP openPub Date : 2025-05-21DOI: 10.1016/j.jaacop.2025.05.002
Jennifer Kramer MSc , Renée L. Roelofs PhD , Ellen Wingbermühle PhD , Sara Pieters PhD , Jos Egger PhD
{"title":"Executive and Social Functioning in Children and Adolescents With Noonan Syndromes: Cognition and Behavior","authors":"Jennifer Kramer MSc , Renée L. Roelofs PhD , Ellen Wingbermühle PhD , Sara Pieters PhD , Jos Egger PhD","doi":"10.1016/j.jaacop.2025.05.002","DOIUrl":"10.1016/j.jaacop.2025.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>The current study aims to examine executive and social functioning in children and adolescents with Noonan syndromes, which contributes to the understanding of the cognitive and behavioral profile of this population and possible treatment options.</div></div><div><h3>Method</h3><div>A total of 26 children and adolescents with Noonan syndromes (including Noonan syndrome, Noonan syndrome with multiple lentigines, and Noonan-like syndrome with loose anagen hair; mean age = 11.92 years, SD = 2.64) and 25 typically developing children and adolescents (mean age = 10.32 years, SD = 2.75) participated in this study. Cognitive and behavioral measures of executive and social functioning of children and adolescents in these groups were compared using multivariate analyses of variance. Moreover, the relationship between executive and social functioning was examined.</div></div><div><h3>Results</h3><div>Results showed significant group differences on working memory and attention, with controls outperforming children and adolescents with Noonan syndromes, even when controlling for crystallized intelligence. At a behavioral level, children and adolescents with Noonan syndromes experienced more executive function problems and more characteristics of attention-deficit/hyperactivity disorder and autism spectrum disorders in daily life than controls, even when controlling for crystallized intelligence. Positive relationships were found between behavioral measures of executive functions and characteristics of autism spectrum disorders.</div></div><div><h3>Conclusion</h3><div>Difficulties in working memory and attention seem to be key cognitive features in children and adolescents with Noonan syndromes. These difficulties occur alongside parental reports of executive function problems, characteristics of attention-deficit/hyperactivity disorder, and autism spectrum disorders.</div></div><div><h3>Plain language summary</h3><div>This Netherlands study examined executive and social functioning in 26 children and adolescents (7-17 years) with Noonan syndromes compared to 25 typically developing peers. Youth with Noonan syndromes showed relatively lower performance on working memory and attention, and in daily functioning. Parents reported more executive function problems, characteristics of attention deficit with hyperactivity, and autism spectrum disorders in the group with Noonan syndromes. These findings contribute new knowledge of cognitive and behavioral features of Noonan syndromes and underline the importance of individualized neuropsychological assessment in this population, especially in the context of functional impairments, such as learning and social problems.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 645-654"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912357","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}
JAACAP openPub Date : 2025-04-16DOI: 10.1016/j.jaacop.2025.04.002
Mica Goulbourne MD , Farah W. Brink MD , Xueting Xia MS , Danielle L. Steelesmith PhD , Donna Ruch PhD , Jeffrey A. Bridge PhD , Charmaine B. Lo PhD, MPH , Cynthia A. Fontanella PhD
{"title":"Deliberate Self-Harm Among Youth in the Child Welfare System","authors":"Mica Goulbourne MD , Farah W. Brink MD , Xueting Xia MS , Danielle L. Steelesmith PhD , Donna Ruch PhD , Jeffrey A. Bridge PhD , Charmaine B. Lo PhD, MPH , Cynthia A. Fontanella PhD","doi":"10.1016/j.jaacop.2025.04.002","DOIUrl":"10.1016/j.jaacop.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>Youth in the child welfare system are at high-risk for self-harm and suicide attempts; yet little is known about factors associated with deliberate self-harm (DSH) following their initial child protective services (CPS) investigation. This study examined factors associated with DSH among youth in the child welfare system.</div></div><div><h3>Method</h3><div>A retrospective longitudinal cohort analysis was performed using merged data from Ohio Medicaid claims and the Statewide Automated Child Welfare Information Systems for youth ages 5 to 17 with their first CPS investigation between 2010 and 2020 (N = 104,700). Cox proportional hazards analyses were used to examine associations between demographic and clinical factors and DSH within 1 year of the first CPS investigation.</div></div><div><h3>Results</h3><div>During follow-up, 236 youths experienced a DSH claim. Adolescents (ages 13-17) were more likely to have DSH (odds ratio = 7.51, 99% CI: 5.10-11.06) than young children, with the greatest risk within 15 days of a CPS investigation. There was an increased hazard of DSH for adolescents (vs young children; hazard ratio [HR] = 7.20, 99% CI: 4.88-10.60); girls (vs boys; HR = 2.09, 99% CI: 1.45-3.02); and youth with prior DSH (HR = 26.37, 99% CI: 16.36-42.51), ADHD (HR = 2.59, 99% CI: 1.18-3.77), anxiety (HR = 3.71, 99% CI: 2.58-5.34), depression (HR = 7.38, 99% CI: 5.09-10.70), substance use disorder (HR = 2.66, 99% CI: 1.62-4.36), and thought disorders (HR = 7.14, 99% CI: 2.80-18.22).</div></div><div><h3>Conclusion</h3><div>Significant risk factors associated with DSH after the first CPS investigation were prior DSH, mental health disorders, female sex, and older youth. Risk of DSH was highest for adolescents in the first 2 weeks of a CPS investigation. Identification of risk factors and high-risk period can inform early intervention to decrease DSH.</div></div><div><h3>Plain language summary</h3><div>This study highlights the risk of deliberate self-harm (DSH) among children aged 5 to 17 years involved in child welfare investigations by using data from Ohio Medicaid claims and the Statewide Automated Child Welfare Information Systems (SACWIS). Adolescents aged 13 to 17 years were 7.5 times more likely to harm themselves compared to younger children, particularly within the first two weeks of a Child Protective Services investigation. These findings emphasize the need for early identification of at-risk youth, prompt mental health screenings, and linkage to support services that can help reduce self-harm behaviors.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 506-515"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914068","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}
JAACAP openPub Date : 2025-03-21DOI: 10.1016/j.jaacop.2025.02.004
Laura Hennefield PhD , Christina Chen BA , Uchechukwu Agali BS , Joan L. Luby MD
{"title":"Preliminary Validity for a Brief Caregiver-Report Screener for Suicidal Thoughts and Behaviors in Children Under Age 8","authors":"Laura Hennefield PhD , Christina Chen BA , Uchechukwu Agali BS , Joan L. Luby MD","doi":"10.1016/j.jaacop.2025.02.004","DOIUrl":"10.1016/j.jaacop.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>Children as young as preschool age can experience suicidal thoughts and behaviors (STBs). Despite calls for increased youth suicide risk screening and assessment, we lack tools for identifying the youngest children experiencing STBs who might be at heightened risk for suicide, self-harm, and related distress. Clinician and caregiver skepticism about children’s ability to self-report STBs and concerns about negative effects of directly asking children about STBs contribute to this gap. A caregiver-report measure for STBs can address these concerns, offering providers a much-needed tool for assessing STBs in young children.</div></div><div><h3>Method</h3><div>A 4-item caregiver-report suicide risk screener was developed and administered by phone to caregivers of 80 children ages 4 to 7 years (mean [SD] age =6.06 [1.12] years) from diverse sociodemographic backgrounds. Approximately 3 weeks later, caregivers and children independently completed in-person age-appropriate clinical diagnostic interviews to assess STBs. Children with a history of STBs were oversampled. Sensitivity and specificity of positive screens (caregiver endorsed at least 1 item), relative to STBs detected in the diagnostic interview, were calculated to assess the psychometric properties of the screen.</div></div><div><h3>Results</h3><div>Of the 80 suicide risk screeners administered, 18 were positive. Relative to diagnostic interviews with caregivers, the caregiver-STBs screener showed 85% sensitivity and 98.3% specificity for detecting STBs risk. Relative to diagnostic interviews with either caregiver or child, the screener showed 68% sensitivity and 98.2% specificity, and relative to child-only interviews, the screener showed 50% sensitivity and 80% specificity.</div></div><div><h3>Conclusion</h3><div>The caregiver-STBs screener for children under age 8 demonstrates favorable psychometric properties compared with a reference standard. If further validated, this screener could offer clinicians a new brief tool to assess suicide risk in young children. Its high specificity suggests that positive screens should be taken seriously as indicators of risk, warranting further follow-up.</div></div><div><h3>Plain language summary</h3><div>Suicidal thoughts and behaviors (STBs) can occur in children as young as preschool age, yet there are few tools to identify those at risk. This study assessed a new 4-item caregiver-report screener for suicide risk in 80 children aged 4 to 7, comparing results to clinical diagnostic interviews. The screener showed high specificity (98%) and good sensitivity (85%), meaning positive screens should be taken seriously as indicators of STB risk. If further validated, this tool could help clinicians identify young children at risk for suicide to ensure they receive appropriate support and intervention.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure sex and gender balance in the recruitment of ","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 485-495"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914066","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}
JAACAP openPub Date : 2025-03-21DOI: 10.1016/j.jaacop.2025.02.005
Yi Zhou PhD , Luis F.S. Castro-de-Araujo MD, PhD , Madhurbain Singh MBBS , Michael C. Neale PhD
{"title":"Causal Analyses of Associations Between Brain Structure and Suicide Attempt in Adulthood and Late Childhood","authors":"Yi Zhou PhD , Luis F.S. Castro-de-Araujo MD, PhD , Madhurbain Singh MBBS , Michael C. Neale PhD","doi":"10.1016/j.jaacop.2025.02.005","DOIUrl":"10.1016/j.jaacop.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>Brain markers for suicide risk in adulthood may be detected during childhood and used for earlier detection and initiation of preventive interventions. Genetic instrumental variable analyses were used to determine whether there is evidence of lower brain total cortical surface area and thinner average cortical thickness (ACT) causing increased suicide risk in adults and whether lower measures of similar brain measures can cause increased risk of suicidality and related psychopathology in older children.</div></div><div><h3>Method</h3><div>Two-sample Mendelian randomization (MR) was used with summary statistics from genome-wide association studies for total cortical surface area, ACT, and suicide attempt in adults to test causal hypotheses. In youth ages 9 to 10 years old, a combined MR and twin-based direction-of-causation approach was applied to the European twin sample (199 monozygotic, 257 dizygotic twin pairs), and a hybrid traditional twin direction-of-causation approach was applied to the full twin sample (308 monozygotic, 397 dizygotic twin pairs) from the Adolescent Brain Cognitive Development (ABCD) Study.</div></div><div><h3>Results</h3><div>Two-sample MR analyses found a significant negative causal effect of total cortical surface area on suicide attempt risk in adults. MR–direction-of-causation analyses did not find a significant causal effect of any brain measure on suicidality in older children, but found significant negative causal effects of ACT on depression and internalizing psychopathology, and vice versa.</div></div><div><h3>Conclusion</h3><div>Brain markers of suicide risk may be instantiated differently in adults compared with older children, though lower ACT may be causally related to psychopathology associated with suicidality in these youth.</div></div><div><h3>Plain language summary</h3><div>Using genetic, neuroimaging, and psychiatric measures from adults and older children, we found that lower total brain surface area may be associated with an increased risk of a suicide attempt in adults, but not in older children. Instead, in older children, lower average brain thickness was associated with increased levels of depression and other psychiatric measures known to be associated with suicide risk. These findings suggest that suicide behaviors may be mediated by different brain processes across adults and older children, and thus may require different screening and diagnostic considerations.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 455-466"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914063","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}
JAACAP openPub Date : 2025-03-01DOI: 10.1016/j.jaacop.2024.01.006
Johan Isaksson PhD , Denis G. Sukhodolsky PhD , Roman Koposov MD, PhD , Andrew Stickley PhD , Mia Ramklint MD, PhD , Vladislav Ruchkin MD, PhD
{"title":"Attention-Deficit/Hyperactivity Disorder Symptoms and Anger and Aggression in Russian Adolescents","authors":"Johan Isaksson PhD , Denis G. Sukhodolsky PhD , Roman Koposov MD, PhD , Andrew Stickley PhD , Mia Ramklint MD, PhD , Vladislav Ruchkin MD, PhD","doi":"10.1016/j.jaacop.2024.01.006","DOIUrl":"10.1016/j.jaacop.2024.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>Aggression is a multifaceted behavior that involves cognitive, behavioral, and affective components. Although aggressive behaviors are commonly observed among individuals with attention-deficit/hyperactivity disorder (ADHD), potential sex-specific aspects of the association between ADHD symptoms and different components of aggression need to be evaluated, while also controlling for comorbid problems.</div></div><div><h3>Method</h3><div>In the present cross-sectional study, self-reported data were collected from 2,838 adolescents (mean age = 14.89 years) from Russia on ADHD symptoms and cognitive (anger rumination, aggressive beliefs), behavioral (physical, verbal, social, proactive), and affective (trait anger) aspects of aggression as well as comorbid emotional and conduct problems. Generalized linear model analyses were used to examine the associations between ADHD symptoms and aggression and to explore sex differences, while also adjusting for comorbid problems.</div></div><div><h3>Results</h3><div>Clinically significant levels of ADHD symptoms were associated with all components of aggression, and the associations remained significant after adjusting for emotional and conduct problems. Overall, females had higher levels of trait anger and anger rumination, whereas males had higher levels of aggressive beliefs, proactive aggression, and physical and verbal aggression. There was also a sex-specific association, where males with ADHD symptoms reported higher levels of social aggression. Conduct problems moderated the association between ADHD and aggression, increasing the likelihood of trait anger and social aggression in adolescents without ADHD symptoms.</div></div><div><h3>Conclusion</h3><div>Clinically significant levels of ADHD symptoms seem to impact all components of aggression independent of comorbidity. It is therefore important to consider aggression when evaluating and treating ADHD.</div></div><div><h3>Plain language summary</h3><div>This study investigated the association between self-rated attention-deficit/hyperactivity disorder (ADHD) symptoms and different components of aggression among Russian adolescents. ADHD was related to cognitive, behavioral, and affective aspects of aggression, even when taking emotional and conduct problems into consideration. The findings stress the importance of considering aggression when evaluating and treating ADHD.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 126-136"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510265","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}
JAACAP openPub Date : 2025-03-01DOI: 10.1016/j.jaacop.2024.01.002
Lauren M. Spring MD, Joseph E. Schwartz PhD, Gabrielle A. Carlson MD
{"title":"Stimulant Medication Shortens the Duration of Impairing Emotional Outbursts","authors":"Lauren M. Spring MD, Joseph E. Schwartz PhD, Gabrielle A. Carlson MD","doi":"10.1016/j.jaacop.2024.01.002","DOIUrl":"10.1016/j.jaacop.2024.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>Emotional dysregulation, often presenting as severe emotional outbursts, is being increasingly recognized as a source of considerable impairment for individuals with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to conduct a secondary analysis of data examining the impact of standing stimulant medication on the duration of emotional outbursts.</div></div><div><h3>Method</h3><div>The as needed (PRN)–medicated outbursts of psychiatrically hospitalized children, 5 to 12 years of age, were tracked by psychiatric nurses using the Behavioral Activity Rating Scale from the time of PRN administration until the child became calm. The impact of extended-release (ER), immediate-release (IR) stimulant and dose, type and reason for outburst/PRN (aggression, agitation, distress), standing concomitant psychotropic medications and time of day, and days since admission were examined.</div></div><div><h3>Results</h3><div>Forty-seven children had a total of 405 outbursts, 96 of which occurred when no stimulant was prescribed and 309 with stimulant medication. Controlling for time of day and standing neuroleptic dose, outbursts that occurred on an ER stimulant medication were statistically significantly shorter than those that occurred on no stimulant by about 20 minutes (52.7 vs 72.4 minutes), or 30 minutes for aggressive outbursts. Results were unchanged when further controlling for stimulant type and dose, α-agonist, days since admission, PRN medication type, or reason for PRN/outburst. Immediate-release stimulants and short-acting stimulants did not shorten outburst duration.</div></div><div><h3>Conclusion</h3><div>In children with ADHD with severe outbursts, ER stimulants were associated with shorter outburst duration than IR stimulants.</div></div><div><h3>Plain language summary</h3><div>This study examined psychiatrically hospitalized children with attention-deficit/hyperactivity disorder who had emotional outbursts requiring as-needed medication. Children who took extended-release stimulant medication (stimulants that are designed to last throughout the day) had shorter outbursts (by about 20 minutes) than children on no stimulant medication or short-acting stimulant medication.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 114-125"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538456","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}