JAACAP open最新文献

{"title":"Social Disparity and Treatment-Seeking in Eating Disorders During Childhood and Adolescence: A Nationwide Population-Based Cohort Study","authors":"Ella C. Hesse Krenchel MSc,&nbsp;Andrea Joensen MSc,&nbsp;Else Marie Olsen MD, PhD,&nbsp;Helen Bould BMBCh, DPhil,&nbsp;Amanda M. Hughes PhD,&nbsp;Claus Thorn Ekstrøm PhD,&nbsp;Katrine Strandberg-Larsen PhD","doi":"10.1016/j.jaacop.2026.03.004","DOIUrl":"10.1016/j.jaacop.2026.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>Advantaged socioeconomic circumstances are linked to a higher risk of diagnosed eating disorders (EDs). However, evidence on non-diagnosed cases, that is, individuals reporting ED symptoms without formal diagnosis, remains limited, suggesting detection and treatment-seeking barriers. In this study, we assessed associations between socioeconomic circumstances and clinically diagnosed and non-diagnosed EDs in childhood and adolescence.</div></div><div><h3>Method</h3><div>This study used data from the Danish National Birth Cohort, linking registry-based diagnosed EDs (participant ages 6-18 years) with self-reported ED symptoms at age 18 years. Data included 523,148 individuals born in Denmark between 1996 and 2003, with 44,552 providing information on self-reported ED symptoms used to classify non-diagnosed EDs. Socioeconomic indicators, including parental education and household income at age 6 years, were analyzed using quasi-Poisson and multinomial logistic regression to estimate incidence rate ratios (IRRs) and relative risk ratios (RRRs).</div></div><div><h3>Results</h3><div>Diagnosed EDs were more common among individuals with higher parental education, following a stepwise pattern. Compared to short education (∼12 years), long education (∼17-20 years) was associated with higher risk (IRR = 1.35, 95% CI = 1.21-1.52), whereas basic education (∼10 years) was linked to lower risk (IRR = 0.70, 95% CI = 0.59-0.83). The pattern reversed for non-diagnosed EDs, with individuals whose parents had basic education showing a higher risk (RRR = 2.19, 95% CI = 1.83-2.63) compared to individuals whose parents had short education. No clear pattern was observed for household income.</div></div><div><h3>Conclusion</h3><div>This study highlights socioeconomic disparities in ED diagnosis and treatment. Individuals from educationally advantaged backgrounds were more likely to receive a diagnosis, whereas those from educationally disadvantaged backgrounds had a higher risk of non-diagnosed EDs.</div></div><div><h3>Plain language summary</h3><div>Eating disorders represent serious mental health conditions, but not all young people with symptoms receive a diagnosis. Using data from more than half a million children in Denmark, this study found that adolescents from more advantaged families were more likely to be diagnosed, while those from disadvantaged families often had symptoms without a diagnosis. These results highlight social inequities in recognition of symptoms and access to care, even within a universal health system.</div></div><div><h3>Study registration information</h3><div>Parental Social Disparity and Adolescent Eating Disorders; <span><span>https://osf.io/dm24e/</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 678-690"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633011","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":"Emerging Sciences and Innovation in Child and Adolescent Mental Health","authors":"Manpreet K. Singh MD, MS,&nbsp;Robert L. Findling MD, MBA,&nbsp;Mary K. Billingsley ELS,&nbsp;Kara S. Bagot MD,&nbsp;Joseph Blader PhD,&nbsp;Alice Charach MD, MSc, FRCPC,&nbsp;Timothy E. Wilens MD,&nbsp;John T. Walkup MD","doi":"10.1016/j.jaacop.2026.06.002","DOIUrl":"10.1016/j.jaacop.2026.06.002","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 563-565"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633015","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":"Associations Between Adverse Childhood Experiences and Disordered Eating in US Youth: The PLATE Study","authors":"Sierra L. Martin BA,&nbsp;Leah M. Parsons BSc,&nbsp;Christin M. Ogle PhD,&nbsp;Jackie Shiels PsyD,&nbsp;Jeffrey B. Schwimmer MD","doi":"10.1016/j.jaacop.2026.03.005","DOIUrl":"10.1016/j.jaacop.2026.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations between individual adverse childhood experiences (ACEs) and disordered eating behaviors (DEBs) in US youth. In addition, to test mediation and moderation by psychosocial and contextual factors.</div></div><div><h3>Method</h3><div>The study was based on a cross-sectional analysis of 47,617 children 10 to 17 years of age from the 2022–2023 National Survey of Children’s Health. Survey-weighted logistic regression estimated ACE–DEB links adjusted for demographics; mediation was assessed with structural equation modeling and moderation with interaction terms.</div></div><div><h3>Results</h3><div>Overall, DEBs were reported for 29% of youth. Household mental illness and economic insecurity showed the strongest and most consistent associations, each paired with 4 or more DEBs. For compensatory weight-control behaviors specifically, adjusted odds ratios were 1.82 for household mental illness and 2.05 for economic insecurity. Depression, anxiety, and food insecurity demonstrated robust mediation effects across a variety of DEB-ACE pairings. Family resilience and ≥4 shared meals weekly reduced DEB odds, but protection weakened with mental illness or financial strain. Bullying victimization raised DEB risk, but this association was attenuated among youth facing racial discrimination.</div></div><div><h3>Conclusion</h3><div>Household mental illness and financial hardship confer broad risk for disordered eating in youth, largely through internalizing symptoms and, in the context of poverty, food scarcity. Family strengths and peer experience can buffer or amplify these risks. Together, these findings highlight the value of trauma-informed and developmentally sensitive assessment of DEBs that consider emotional, nutritional, and family context, including exposure to adversity, to support early identification and prevention in youth.</div></div><div><h3>Plain language summary</h3><div>Many teens experience disordered eating, but some are at higher risk than others. This cross-sectional study of over 47,000 youths investigated how childhood hardships related to disordered eating behaviors. Poverty and household mental illness had the strongest links to multiple disordered eating patterns. These patterns were partly explained by depression, anxiety, and food insecurity. These findings may help families and providers identify early risk factors for disordered eating behaviors and offer support and prevention strategies.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 665-677"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632923","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":"Hospital-Based Pediatric Suicide Risk Screening Outcomes Vary by Demographic and Clinical Characteristics","authors":"Lauren Gallanis PhD,&nbsp;Quinn Scallon BS,&nbsp;Rachel Cafferty MD,&nbsp;Shaela Moen BSN/RN, MPH,&nbsp;Anne E. Penner MD,&nbsp;K. Ron-Li Liaw MD,&nbsp;Beau A. Carubia MD,&nbsp;Isabel D. Friesner BS,&nbsp;Pauline Gerard MS,&nbsp;Lisa Horowitz PhD,&nbsp;Joel Stoddard MD","doi":"10.1016/j.jaacop.2026.03.009","DOIUrl":"10.1016/j.jaacop.2026.03.009","url":null,"abstract":"<div><h3>Objective</h3><div>Suicide is a leading cause of death among youth, yet differences in screening outcomes across demographic groups remain poorly understood. This study examines associations between demographic and clinical characteristics and responses to universal suicide risk and depression screening tools in a pediatric hospital setting.</div></div><div><h3>Method</h3><div>We conducted a retrospective cohort study of 66,225 patients 10 to 26 years of age who were screened with the Ask Suicide-Screening Questions (ASQ) and Patient Health Questionnaire—9 (PHQ-9) across emergency, urgent care, and inpatient settings. Demographic and clinical data were extracted from electronic health records. Response categories to the ASQ and PHQ-9 were analyzed against these factors with frequency and association tests.</div></div><div><h3>Results</h3><div>Positive ASQ screens occurred in 8.5% of patients (1.9% acute positive), with elevated rates among older youth and those assigned female at birth. Hispanic/Latino ethnicity and private insurance were associated with lower-than-expected rates of positive screens, whereas having a military insurance payor and higher Area Deprivation Index scores were associated with increased risk. Depression symptoms were more prevalent than suicidal ideation and showed similar demographic patterns.</div></div><div><h3>Conclusion</h3><div>Demographic and clinical factors are correlated with suicide and depression screening outcomes. These findings highlight opportunities to improve equity in screening practice.</div></div><div><h3>Plain language summary</h3><div>66,225 youths were screened for suicide risk in this study. 8.5% screened positive on the Ask Suicide-Screening Questions instrument. A positive screen was more common among those assigned female at birth, those with military insurance, and those living in disadvantaged areas.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 713-723"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632986","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":"Effortful Control but Not Negative Affectivity Predicts Intensity of Restricted Repetitive Behaviors in Toddlers With Neurodevelopmental Conditions","authors":"Suzanne L. Macari PhD,&nbsp;Grace K. Bell BS,&nbsp;Catherine Bianco BA,&nbsp;Sarah Hamilton BA,&nbsp;Mariana Torres-Viso PsyD, BCBA-D,&nbsp;Kelly K. Powell PhD,&nbsp;Angelina Vernetti PhD,&nbsp;Leah A.L. Wang PhD,&nbsp;Chelsea Morgan PsyD,&nbsp;Megan Lyons MS, CCC-SLP,&nbsp;Julian R. Hinz MSc,&nbsp;Thomas V. Fernandez MD,&nbsp;Katarzyna Chawarska PhD","doi":"10.1016/j.jaacop.2026.03.008","DOIUrl":"10.1016/j.jaacop.2026.03.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Restricted repetitive behaviors (RRBs) are prevalent across neurodevelopmental conditions. It has been hypothesized that greater severity of RRBs reflects elevated distress or diminished regulatory capacity. To test these hypotheses, prospective associations between early negative affectivity (NA) and effortful control (EC) and later RRB severity were examined in a transdiagnostic sample of toddlers with and without autism.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Participants were 238 toddlers with neurodevelopmental conditions (autism: n = 165; non-autism: n = 73). NA and EC were assessed at time 1 (T1) (mean [SD] age =24.4 [5.2] months) using the Toddler Behavior Assessment Questionnaire or Early Childhood Behavior Questionnaire. At time 2 (T2) (mean [SD] age = 42.2 [7.3] months), severity of RRBs was assessed using the Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview–Revised (ADI-R). Multivariate regression models tested whether T1 NA and EC predicted time 2 RRBs, controlling for age, sex, nonverbal developmental quotient, T1 RRBs, and visit year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Higher EC at T1 predicted lower ADI-R RRB scores at T2 (&lt;em&gt;p&lt;/em&gt; &lt; .001) but was not associated with ADOS RRB scores (&lt;em&gt;p&lt;/em&gt; = .621). Higher EC was associated with ADI-R lower intensity of compulsive adherence to nonfunctional routines or rituals (&lt;em&gt;p&lt;/em&gt; = .001), stereotyped repetitive motor mannerisms (&lt;em&gt;p&lt;/em&gt; &lt; .001), and preoccupation with parts of objects or their nonfunctional elements (&lt;em&gt;p&lt;/em&gt; = .002), but not circumscribed interests (&lt;em&gt;p&lt;/em&gt; = .266). T1 NA was not associated with T2 RRBs on either measure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Regulatory and affective traits show differential longitudinal associations with RRBs, highlighting a potential role for EC in their emergence or maintenance. Interpretation of null findings for NA is limited by unmeasured early environmental influences on the development of anxiety.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;Restricted and repetitive behaviors (RRBs) are common in children with autism spectrum disorder and other developmental conditions. This study examined whether distress or difficulty with attention and behavior regulation predicted later repetitive behaviors. Toddlers prone to distress were not more likely to develop more intense repetitive behaviors later on, while toddlers with lower attentional and behavioral regulation skills were more likely to develop intense repetitive behaviors in preschool.&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 sex and gender balance in the recruitment of human participants. 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 historically underrepresented racial and/or ethnic groups in science. One o","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 4","pages":"Pages 612-624"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633034","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":"Trajectories of Self-Injurious Thoughts and Behavior: Risk and Resiliency Among Cisgender and Gender Diverse Youth","authors":"Amanda J. Thompson PhD ,&nbsp;Avery N. Abel BS ,&nbsp;Rui Huang PhD ,&nbsp;Katherine Sarkisian PhD ,&nbsp;Mindy Westlund Schreiner PhD ,&nbsp;Franky Rife MA ,&nbsp;Donna A. Ruch PhD ,&nbsp;Jeffrey A. Bridge PhD","doi":"10.1016/j.jaacop.2025.10.006","DOIUrl":"10.1016/j.jaacop.2025.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>Transgender and gender diverse (TGD) youth are at high risk for self-injurious thoughts and behaviors (SITB) including suicidal ideation, nonsuicidal self-injury (NSSI), and suicide attempt. We compared total SITB endorsements during a 4-year period among 3 groups: TGD youth with high gender-related social stress (TGD+High-Stress); TGD youth with low gender-related social stress (TGD+Low-Stress); and non-TGD youth. We further identified risk and resiliency correlates of 3 longitudinal SITB trajectories (NSSI, suicidal ideation, and suicide attempt), accounting for gender-related social stress and other known robust risk factors.</div></div><div><h3>Method</h3><div>This study (N = 11,851) used longitudinal data for youth spanning ages 10 to 14 years from the Adolescent Brain Cognitive Development study (release 5.1), of whom 4% were TGD. Analyses of variance were used to compare mean SITB endorsements across groups. Three mixed-effects logistic regressions identified correlates of SITB trajectories during the study.</div></div><div><h3>Results</h3><div>On average, TGD+High-Stress experienced more SITB events than TGD+Low-Stress and non-TGD youth, respectively. Longitudinal results found that TGD compared to non-TGD youth experienced higher NSSI and suicidal ideation risk regardless of gender-related social stress. TGD+High-Stress but not TGD+Low-Stress youth had greater suicide attempt risk than non-TGD youth. Higher psychopathology symptoms and family conflict were associated with higher NSSI and suicidal ideation risk. Only school involvement was protective against ideation and NSSI risk.</div></div><div><h3>Conclusion</h3><div>TGD youth experience higher SITB risk, particularly when facing higher gender-related social stressors at home or school. We urgently need interventions supporting positive connections between TGD youth and their families and peers.</div></div><div><h3>Plain language summary</h3><div>Using longitudinal data from the Adolescent Brain Cognitive Development℠ (ABCD) Study (N = 11,851), the authors compared total self-injurious thoughts and behaviors (SITB) among transgender and gender diverse (TGD) youth and non-TGD youth from ages 10 to 14 years. This study found that TGD youth experience higher risk for SITB than non-TGD youth. High gender-related social stress, more mental health symptoms, and family conflict were associated with higher risk of SITB, whereas school involvement was protective against SITB. This study highlights the need for developing interventions that support positive connections between TGD youth and their families and peers.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 163-171"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049220","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":"Cross-Cultural Consortium on Irritability (C3I): An International Network for Research on Cultural Similarities and Differences in Irritability","authors":"Wan-Ling Tseng PhD ,&nbsp;Nellia Bellaert MS ,&nbsp;Tami D. Benton MD ,&nbsp;Melissa A. Brotman PhD ,&nbsp;Spencer C. Evans PhD ,&nbsp;John D. Herrington PhD ,&nbsp;Manish Kumar Jha MD ,&nbsp;Jennifer E. Lansford PhD ,&nbsp;Julia O. Linke PhD ,&nbsp;Kalina J. Michalska PhD ,&nbsp;Reut Naim PhD ,&nbsp;Massimiliano Orri PhD ,&nbsp;Jamilah Silver MA ,&nbsp;Argyris Stringaris MD, PhD ,&nbsp;Luisa Shiguemi Sugaya MD, PhD ,&nbsp;Pablo Vidal-Ribas PhD ,&nbsp;Cross-Cultural Consortium on Irritability (C3I),&nbsp;Ellen Leibenluft MD","doi":"10.1016/j.jaacop.2025.09.001","DOIUrl":"10.1016/j.jaacop.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>Irritability is among the top reasons for youth mental health referrals worldwide. Cultural factors may affect how irritability manifests and develops; how it is experienced by youth and responded to by their caregivers; and how it is treated. However, the influences of cultural context on irritability have received little systematic investigation.</div></div><div><h3>Method</h3><div>The Cross-Cultural Consortium on Irritability (C3I; <span><span>https://m.yale.edu/c3i</span><svg><path></path></svg></span>) is an international research network created to increase the limited evidence base on cross-cultural similarities and differences in irritability. By bringing together researchers worldwide, C3I provides an innovative and collaborative approach to address unmet needs and to explore novel research questions regarding cultural variation in irritability. In addition, combining resources and data around the globe helps to produce robust, reproducible, and generalizable results using large mega-data. One important initiative involves pooling existing datasets to support manuscript collaborations. The first 3 such projects focus on cross-cultural comparisons of the following irritability-related topics: boundaries of normative behavior; association with suicidality and self-harm; and informant effects. Another ongoing effort involves conceptualization of irritability across cultures. Other efforts include promoting projects of primary data collection using qualitative and quantitative methods, harmonization across measures, and facilitating/supporting community-based participatory research and engagement.</div></div><div><h3>Discussion</h3><div>C3I is an innovative, collaborative research structure to build a robust, reproducible, and generalizable evidence base on irritability and its characteristics, including sociocultural influences. This evidence base will facilitate recognition and assessment of irritability and, ultimately, inform development of effective, culturally informed prevention and intervention to benefit the largest possible number of youth and their families.</div></div><div><h3>Plain language summary</h3><div>This article describes the Cross-Cultural Consortium on Irritability (C3I), an international network aimed at understanding how culture shapes the presentation, experience, response to, and treatment of irritability in youth. By exploring these cultural influences, C3I seeks to improve recognition, assessment, and development of effective, culturally sensitive prevention and intervention strategies to benefit the largest possible number of youth and their families worldwide.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 184-197"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049250","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":"Sensitivity and Bias in Face-Emotion Labeling: Replication and Extension to Youth With Irritability and Anxiety","authors":"Katherine Y. Kim BS ,&nbsp;Joel Stoddard MD ,&nbsp;Sofia I. Cárdenas MA ,&nbsp;Parmis Khosravi PhD ,&nbsp;Katharina Kircanski PhD ,&nbsp;Matt Jones PhD ,&nbsp;Daniel S. Pine MD ,&nbsp;Melissa A. Brotman PhD ,&nbsp;Simone P. Haller DPhil","doi":"10.1016/j.jaacop.2025.09.005","DOIUrl":"10.1016/j.jaacop.2025.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatric anxiety and irritability are common, impairing, co-occurring symptoms. Biases in interpreting ambiguous face-emotions have been linked to both phenotypes. Here, we assessed whether biases represent a shared cognitive and neural profile. In addition, we attempted replication of prior age associations and group behavioral differences in face-emotion labeling.</div></div><div><h3>Method</h3><div>In a cross-sectional functional magnetic resonance imaging study at a research facility at the National Institute of Mental Health, we used a variant of a drift diffusion model to decompose perceptual and cognitive components of binary happy–angry decisions to ambiguous face-emotions. A total of 95 participants (mean age = 14.11, SD = 3.07, range = 8-22, male = 50.9%) contributed to the analyses. In all, 65 participants did not complete the scan or meet data quality thresholds. Participants had a primary diagnosis of disruptive mood dysregulation disorder (DMDD; n = 27), attention-deficit/hyperactivity disorder (n = 23), oppositional defiant disorder (n = 2), anxiety disorder (n = 19), or no current diagnosis (n = 24), resulting in a wide range of anxiety and irritability symptom levels.</div></div><div><h3>Results</h3><div>No significant associations between the computational modeling parameter indexing bias and dimensionally assessed anxiety or irritability emerged (<em>r</em>[84] &lt; −0.15, <em>p</em> &gt; .05). Parent- and child-rated irritability, but not anxiety, was associated with increased neural responses to overtly angry faces, most notably in the motor cortex (voxel-wise <em>p</em> &lt; .005). We successfully replicated prior age-associated increases in sensitivity and differences in bias between youth with DMDD and controls.</div></div><div><h3>Conclusion</h3><div>Increased neural engagement of the bilateral motor cortex likely reflects increased vigor in responding to overtly angry faces, possibly indexing approach behavior. Replication of prior findings increases confidence in the robustness of these associations.</div></div><div><h3>Plain language summary</h3><div>Youth experiencing high levels of anger or anxiety are thought to interpret ambiguous facial expressions as hostile. In this study, 95 youth aged 8 to 22 years completed a task that assessed their interpretations of facial expressions while measuring brain activation. Youth with higher levels of anxiety or anger did not interpret faces as more hostile. However, when responding to angry faces, youth with higher levels of anger showed increased activation in areas of the brain involved in coordinating actions, which may translate to more aggressive responses in daily life.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 42-52"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049255","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":"Suicide Risk in 8- to 12-Year-Old Children: Retrospective Review of Emergency Department Electronic Health Records","authors":"David Pagliaccio PhD ,&nbsp;Jaclyn S. Kirshenbaum PhD ,&nbsp;Julia Greenblatt BA ,&nbsp;Megan M. Mroczkowski MD ,&nbsp;Lauren S. Chernick MD ,&nbsp;Peter S. Dayan MD ,&nbsp;Randy P. Auerbach PhD, ABPP","doi":"10.1016/j.jaacop.2025.08.002","DOIUrl":"10.1016/j.jaacop.2025.08.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;As of 2021, suicide has increased to the third leading cause of death among children 8 to 12 years of age. Children presenting to the emergency department (ED) for suicide thoughts and behaviors (STB) are at high risk for recurrent behavioral health (BH) concerns. This study leveraged electronic health records (EHR) to identify risk factors for STB and return ED visits.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;EHR for 920 patients 8 to 12 years of age (N = 1,310 visits) who indicated STB or BH concerns or had a psychiatric consultation in the pediatric ED of a metropolitan hospital were reviewed from 2020 to 2023. Structured data (eg, demographics, diagnoses) were combined with clinician free-text notes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;STB were frequently indicated among BH patients (65%). Ingestion was the most common injury cause from acute suicide behavior (71%). Most suicide behavior was linked to family/social triggers (56%); 21% included conflict over social media/technology. Psychosocial factors differentiated STB from other BH cases, including bullying, impulsivity, irritability, sleep, and LGBTQ+ identity (odds ratio = 2.09-6.46). Of the patients, 13% had multiple visits implicating STB. Most subsequent ED returns were within 3 months of discharge (median = 89 days). Prior psychiatric hospitalization was the strongest predictor of ED returns for subsequent STB within 1 year (odds ratio = 3.27).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Suicide risk is common among 8- to 12-year-old children seeking psychiatric emergency services. EHR provide critical data for understanding this public health challenge and can guide enhancement of pediatric screenings for suicide risk, including detailed assessment of symptoms (eg, impulsivity, sleep disruption) and psychosocial context (eg, bullying, LGBTQ+ identity). Helping families increase safety around ingestible lethal means remains a key point of intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;Suicide risk is the third leading cause of death for children aged 8 to 12 years. This study examined electronic health records from emergency department encounters of children with suicidal thoughts or behaviors or with behavioral health concerns (N = 920 youth). Ingestion or overdose attempts were the most common injury type (71%). Most suicidal behavior was linked to family/social triggers (56%); 21% involved conflict over social media/technology. The authors also identified multiple psychosocial factors associated with suicidal thoughts and behaviors. Children with prior psychiatric hospitalizations were most at risk for repeated emergency room visits. Helping families increase safety around ingestible lethal means remains essential.&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 sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitm","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 90-100"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049258","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":"Addressing Critical Workforce Shortages in Youth Mental Health: Implementation of a Multicomponent Career Development Program","authors":"Jocelyn I. Meza PhD ,&nbsp;Lindsay M. Alexander MPH ,&nbsp;Lisa Barkley MD ,&nbsp;Eraka Bath MD ,&nbsp;Denese Shervington MD, MPH ,&nbsp;Mirelle Kass BA ,&nbsp;Virginia Henson BA ,&nbsp;Daniel Sebbag LCSW, PhD ,&nbsp;Ivette Irene Sanchez LMFT ,&nbsp;Jamelia C. Silver MBA ,&nbsp;Dyala Alameddine MPH ,&nbsp;Ally Herrnson BS ,&nbsp;Jennie X. Liang MA ,&nbsp;Spencer Webb BA ,&nbsp;Tatum Connell BA ,&nbsp;Erin Brown BA ,&nbsp;Spencer Morenko BA ,&nbsp;Robin Samuels MSEd ,&nbsp;Bennett L. Leventhal MD ,&nbsp;Michael P. Milham MD, PhD","doi":"10.1016/j.jaacop.2025.10.005","DOIUrl":"10.1016/j.jaacop.2025.10.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;With rising prevalence of mental disorders, especially among underserved and under-resourced youth, mental health workforce shortages are evident across the United States. This study aimed to assess the feasibility, acceptability, and pilot implementation of a multicomponent career development program, the Youth Mental Health Academy (YMHA), for structurally marginalized youth—including underrepresentation based on race/ethnicity, disability, sexual orientation/gender identities, socioeconomic challenges, parents/caregivers without college degree, geographic isolation, foster care/juvenile legal system involvement, or having a parent/caregiver in the military.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Structurally marginalized high school students interested in mental health careers were encouraged to apply. Students completed baseline and post-program assessments and weekly acceptability ratings. Program feasibility was assessed via attendance, recruitment, and retention rates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 135 students enrolled in the YMHA pilot. Participants were ethnoracially diverse—51.9% Hispanic/Latinx, 30.4% Asian/Asian American, 14.1% Black/African American, 3.7% Middle Eastern, and 3.7% White; 68.9% identified as female. Approximately 40% met criteria for socioeconomic challenges (eg, Federal Free and Reduced Lunch eligibility), 15% had histories of foster care or juvenile legal involvement, and about 7% reported a chronic condition/disability. Of participants, 92% (n = 125) completed the first summer program with high attendance (&gt;75% days attended), and 87.4% (n = 118) completed a second summer internship. High acceptability was maintained throughout. After the 14-month program, 82.9% of students indicated interest in pursuing mental health careers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;High acceptability, retention, and engagement indicate that the YMHA program is a promising approach to diversifying the mental health workforce. A large-scale study is needed to examine the scalability and sustainability of this model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;The Youth Mental Health Academy (YMHA) is a 14-month career development program for high school students from underrepresented backgrounds to explore careers in mental health. This study enrolled 135 students from diverse backgrounds (51.9% Hispanic/Latinx, 30.4% Asian/Asian American, 14.1% Black/African American, 3.7% Middle Eastern, and 3.7% White; 15% with history of foster care or juvenile legal involvement) who were interested in mental health careers to participate in the program. Most students who participated stayed engaged (92%) and found the program helpful, and 82.9% indicated interest in pursuing mental health careers. This type of program may be a promising approach to diversifying the mental health workforce.&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 sex and gender bal","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"4 1","pages":"Pages 124-139"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049138","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}