JAACAP open最新文献

{"title":"Examining Alternative Treatment Settings for Adolescents With Suicidal Thoughts During the COVID-19 Pandemic","authors":"Jennifer Combs LISW, MSSA , Ping-I Lin MD, PhD , Melissa P. DelBello MD, MS , Adam C. Carle PhD, MS , Jeffrey A. Bridge PhD , David A. Axelson MD , Victor Fornari MD, MS , Vera Feuer MD , Graham J. Emslie MD , Betsy D. Kennard PsyD, ABPP , Stephen C. Porter MD, MPH, MSc , Michael T. Sorter MD , Drew Barzman MD","doi":"10.1016/j.jaacop.2024.10.005","DOIUrl":"10.1016/j.jaacop.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>Suicide is a leading cause of death for adolescents in the United States. Alternative settings to treat suicidal ideation (SI) are needed. Study primary objectives include evaluating the safety and effectiveness of telehealth crisis intervention services (CIS) and in-person outpatient crisis intervention clinics (OCIC) relative to the current standard of care of inpatient psychiatric hospitalization. A secondary aim seeks to assess changes in suicidal ideation, and patient and parent treatment satisfaction.</div></div><div><h3>Method</h3><div>The study team, consisting of study staff at 4 sites, conducted an observational longitudinal study of patients (12-18 years of age) who were seen in the Emergency Department (ED) for suicidality and were referred to inpatient treatment, in-person OCIC, or telehealth CIS. Primary outcome data, including recurrent ED visits and hospitalizations because of SI, suicide attempts, and life satisfaction, were collected for 24 weeks. All analyses were adjusted for age, sex, and baseline suicidality severity scores. A total of 249 patients were enrolled.</div></div><div><h3>Results</h3><div>There were no statistically significant differences in suicide attempts, time to first suicide attempt, ED visits, hospitalizations, and life satisfaction among the 3 treatment arms. There was no statistically significant difference in outcomes for treatment satisfaction among the treatment groups.</div></div><div><h3>Conclusion</h3><div>In this observational study, in-person OCIC and telehealth CIS did not have significantly different outcomes from the current standard of care of inpatient psychiatric hospitalization. This broadens the scope of services that appear to be safe and effective for adolescents experiencing moderate suicidal thoughts. Future research using randomized controlled trials to clarify the causal effect of different interventions is warranted.</div></div><div><h3>Clinical trial registration information</h3><div>Observational Study to Compare Outcomes of Different Psychiatric Treatment of Suicidal Adolescents (Pre-START); <span><span>https://clinicaltrials.gov/study/NCT04625686</span><svg><path></path></svg></span>.</div></div><div><h3>Plain language summary</h3><div>The PreSTART study sought to explore treatment outcomes for adolescents experiencing suicidal thoughts. Inpatient treatment, outpatient crisis intervention centers, and telehealth crisis interventions were explored and compared to evaluate safety and effectiveness over a 24-week period. Results found no statistical difference in recurrent suicidal events or treatment satisfaction among the different treatments.</div></div><div><h3>Diversity Inclusion Statement</h3><div>We worked to ensure that the study questionnaires were prepared in an inclusive way. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, ","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 567-575"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913171","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":"Predictors of Anxiety Trajectories in Cohort of First-Year College Students","authors":"Laura S.P. Bloomfield MD, PhD , Mikaela Irene Fudolig PhD , Julia N. Kim BA , Jordan Llorin BS , Juniper Lovato PhD , Ellen W. McGinnis PhD , Ryan S. McGinnis PhD , Matthew Price PhD , Taylor H. Ricketts PhD , Peter Sheridan Dodds PhD , Kathryn Stanton DPT , Christopher M. Danforth PhD","doi":"10.1016/j.jaacop.2024.08.004","DOIUrl":"10.1016/j.jaacop.2024.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>The transition to college is a period of growth and vulnerability for young adult health and well-being and provides a critical window for potential behavioral interventions. In this study, we sought to examine the trajectory of anxiety symptoms and their association with individual characteristics, exposure to stressors, and sleep behaviors during the transition to college.</div></div><div><h3>Method</h3><div>We recruited full-time, incoming undergraduate students at a university in the northeastern United States to participate during the first semester of college between October 21, 2022, and December 12, 2022. In a longitudinal cohort study (N = 556), we collected baseline demographic and health history information and weekly survey assessments with the outcome measure of anxiety. Predictors included weekly stressors and sleep measures during this period. Mixed-effects linear models were used to examine trajectories in anxiety symptoms during the first semester of college.</div></div><div><h3>Results</h3><div>We had 6 main findings. First, there were significantly higher anxiety symptoms in non-male participants compared to male participants. Second, a previous mental health diagnosis and previous traumatic exposures were significant predictors of anxiety symptoms. Third, the personality traits of extraversion and neuroticism were significant predictors of anxiety symptoms. Fourth, perceived sleep duration, quality, and satisfaction were significant predictors of anxiety symptoms. Fifth, sleep duration estimates collected by a biometric wearable were also a significant predictor of anxiety in covariate-adjusted, corrected models. Sixth, weekly stressors and specifically academic stressors were significant predictors of anxiety symptoms.</div></div><div><h3>Conclusion</h3><div>Programs that support young adults entering college may promote sleep hygiene behaviors and target times of particularly elevated stress such as examination periods.</div></div><div><h3>Plain language summary</h3><div>Starting college is a major life transition for young adults, making it an important period for promoting healthy behaviors. In the Lived Experiences Measured Rings Study (LEMURS), we found that individual characteristics like gender, personality, mental health diagnoses, and past traumatic experiences predicted level of anxiety in a first-year college cohort during their first semester at a public university in the northeastern United States. The study also found that several weekly factors strongly predicted anxiety. Specifically, each additional hour of reported sleep was associated with a 0.589-point decrease in anxiety, while each additional hour of objectively recorded sleep reduced anxiety by 0.491 points. Poor sleep quality and low sleep satisfaction were linked to increases in anxiety by 1.176 and 1.348 points, respectively, and the presence of academic stressors, such as papers or exams, increased anxiety by 1.352 points","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 805-816"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913561","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":"Comparing Youth With Bipolar Disorder to Non-Bipolar Youth Referred for Bipolar Disorder","authors":"Jangho Park MD, PhD , Alysha A. Sultan PhD , Aaron Silverman MD, FRCPC , Eric A. Youngstrom PhD , Vanessa Rajamani MSW , Mikaela K. Dimick PhD , Benjamin I. Goldstein MD, PhD, FRCPC","doi":"10.1016/j.jaacop.2024.09.004","DOIUrl":"10.1016/j.jaacop.2024.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>Bipolar disorder (BD) diagnoses require episodes of hypomania and mania as well as depressive episodes. Given the overlap of BD symptoms with symptoms of other psychiatric conditions among youth, misdiagnosis is common. This topic was examined in a large sample of youth clinically referred for BD.</div></div><div><h3>Method</h3><div>Participants were 394 clinically referred youths ages 13 to 20 years, including 255 with confirmed BD and 139 for whom BD was not confirmed (non-BD). Participants and their parent/guardian completed a semistructured diagnostic interview and dimensional scales. Demographic and clinical variables were compared between BD and non-BD groups. Following correction for multiple comparisons, significant variables associated with BD diagnosis (<em>p</em> < .05) in univariate analyses were evaluated in multivariable analyses.</div></div><div><h3>Results</h3><div>Compared with the BD group (n = 255), the non-BD group (n = 139) had significantly lower current mania symptom severity, family history of hypomania/mania, current lithium treatment, and lifetime bulimia nervosa, whereas most severe past global functioning was higher and current oppositional defiant disorder was more common in the non-BD group compared with the BD group. Use of second-generation antipsychotics was high in both groups. Common reasons for not diagnosing BD in the non-BD group included not meeting duration criteria for a hypomanic/manic episode and manic-like symptoms being better explained by other psychiatric disorders.</div></div><div><h3>Conclusion</h3><div>Youth with and without BD did not differ in the vast majority of clinical variables examined. Frequent use of second-generation antipsychotics in non-BD youth may relate to characterization of overlapping comorbidity symptoms as manic symptoms. Both groups have complex presentations, necessitating psychosocial and pharmacological treatments.</div></div><div><h3>Plain language summary</h3><div>A total of 394 youth, aged 13-20 years, were recruited from a subspecialty adolescent bipolar disorder clinic at a teaching hospital in Toronto, Canada, over a 12-year period. Participants were clinically referred for assessment and/or treatment of bipolar disorder. A bipolar spectrum disorder diagnosis was confirmed for 255 of the 394 youth. The authors examined a broad range of demographic, clinical, and familial characteristics, and over 90% did not yield significant between-group differences. The most common reasons for not confirming a bipolar disorder diagnosis were insufficient and/or fleeting manic symptoms and manic-like symptoms being better explained by other psychiatric disorders. Overall, both groups had complex presentations, emphasizing careful assessment and the need for psychosocial and pharmacological treatments in both groups.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure sex and gender balance in the recruitment of human p","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 782-792"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912063","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":"Maternal Serotonin Levels and Neurodevelopmental Severity in Autistic Children: A Partial Replication and Extension","authors":"Amandeep Jutla MD , Lauren C. Shuffrey PhD , Stephen J. Guter Jr. MA , George M. Anderson PhD , Kally C. O’Reilly PhD , Alicia K. Montgomery BMed/MedSci(Hon), FRACP, MPH , James S. Sutcliffe PhD , Edwin H. Cook MD , Jeremy Veenstra-VanderWeele MD","doi":"10.1016/j.jaacop.2024.09.005","DOIUrl":"10.1016/j.jaacop.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>The serotonin system has long been implicated in autism spectrum disorder. A previous study reported lower whole blood serotonin (WB5-HT) concentrations in the mothers of children with more severe autism. This study attempted to replicate this finding in an independent cohort.</div></div><div><h3>Method</h3><div>A latent profile analysis was conducted in 259 children with autism using indicator variables across autistic traits, cognition, and adaptive function. In a subgroup of 162 participants with maternal WB5-HT data, maternal WB5-HT in children with the highest severity profile was compared with maternal WB5-HT in children with other profiles, both overall and across 5 quantiles of the maternal WB5-HT distribution.</div></div><div><h3>Results</h3><div>A latent profile analysis solution was identified that stratified participants into low-, medium-, and high-severity profiles. Although this solution was broadly similar to the prior work, the high-severity profile showed different scores in restricted and repetitive behavior, nonverbal IQ, and adaptive function. Median WB5-HT in the high-severity profile did not differ significantly from other profiles, but was lower at the 90th percentile of severity (by 59.40 ng/mL, 95% CI 6.42 to 101.51 ng/mL, adjusted <em>p</em> < .01). In exploratory models, maternal WB5-HT was negatively associated with social impairment.</div></div><div><h3>Conclusion</h3><div>In contrast to the previous study, this study did not find lower group levels of maternal WB5-HT in children with highest autism symptom severity. However, children in the high-severity group were less likely to have maternal WB5-HT values in the upper range of the distribution. This comparative absence of values in the upper range of maternal WB5-HT in this high-severity group warrants further investigation.</div></div><div><h3>Plain language summary</h3><div>This study explored the link between serotonin levels in mothers and the severity of autism in their children. Data analyzed from 259 autistic children drawn from the Simons Simplex Collection cohort separated them into three “latent profiles” of low, medium, and high severity.</div><div>The relation between severity profile and maternal serotonin level was assessed in a subset of 162 children for whom these data were available. Although previous work suggested that serotonin levels were overall lower in the mothers of severely affected children, the present study did not find a significant difference in overall serotonin levels. However, the present study found that fewer mothers of severely affected children had high serotonin levels, which warrants further investigation.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex balance in ","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 749-757"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914011","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":"Caregiver Attitudes and Youth Suicidality: Implications for Involving Caregivers in Outpatient Crisis Care for Adolescents","authors":"Sarah Danzo PhD ,&nbsp;Molly C. Adrian PhD ,&nbsp;Eileen Twohy PhD ,&nbsp;Kalina Babeva PhD ,&nbsp;Elizabeth McCauley PhD, ABPP","doi":"10.1016/j.jaacop.2024.09.006","DOIUrl":"10.1016/j.jaacop.2024.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>Suicide is a leading cause of death among young people 10 to 24 years old in the United States. Interventions that include both adolescents and their caregivers demonstrate promise in reducing adolescent suicidal thoughts and behaviors (STB), suggesting that caregiver attitudes may impact treatment outcomes. Better understanding of how caregiver attitudes impact youth STB outcomes may highlight important treatment targets.</div></div><div><h3>Method</h3><div>This study examined data from youth (N = 187) and their caregivers who participated in a 4-session outpatient crisis stabilization intervention (mean [SD] youth age = 14.6 [1.9] years; majority cisgender female [62%], mean [SD] number of sessions attended = 3.7 [1.2]). Paired-samples t tests examined changes in caregiver attitudes over the course of the intervention, and moderation analyses examined how baseline caregiver attitudes regarding youth STB impacted the relationship between intervention attendance and self-reported suicide risk at intervention completion.</div></div><div><h3>Results</h3><div>Caregivers’ confidence that they could keep their child safe and their child would not attempt suicide again and hopefulness/optimism for the future significantly moderated the relationship between number of sessions attended and suicide risk (<em>b</em> = .17, <em>t</em>₁₅₁ = 2.12, <em>p</em> &lt; .05; <em>b</em> = .51, <em>t</em>₆₀ = 2.89, <em>p</em> &lt; .01; <em>b</em> = .24, <em>t</em>₁₅₂ = 2.39, <em>p</em> &lt; .05), and caregiver confidence significantly increased over the intervention.</div></div><div><h3>Conclusion</h3><div>Differences in caregiver confidence and hopefulness for the future at intervention initiation impacted youth suicide risk outcomes at intervention completion. These results highlight the need to assess and address caregiver confidence and hopefulness through involving caregivers directly in adolescent crisis interventions to improve youth STB outcomes.</div></div><div><h3>Plain language summary</h3><div>This study examined data from 187 adolescents with suicidal thoughts and behaviors (STB) and their caregivers who participated in a 4-session outpatient crisis stabilization intervention (mean youth age = 14.6 years, SD = 1.9). Differences in caregivers’ confidence in youth’s safety and hopefulness for the future at intervention initiation impacted youth suicide risk outcomes at intervention completion. In addition, caregivers’ confidence in being able to manage their child’s suicidality and keep youth safe significantly increased over the intervention (<em>p</em> &lt; .05). Results highlight the need to assess and address caregiver confidence and hopefulness by incorporating caregivers directly in adolescent crisis interventions in order to improve youth STB outcomes.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 557-566"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913170","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":"COVID-19 Pandemic–Related Prenatal Distress and Infant Functional Brain Development","authors":"Aliza Jaffer BHSc ,&nbsp;Kathryn Y. Manning PhD ,&nbsp;Gerald F. Giesbrecht PhD, RPsych ,&nbsp;Lianne M. Tomfohr-Madsen PhD ,&nbsp;Catherine Lebel PhD","doi":"10.1016/j.jaacop.2024.09.008","DOIUrl":"10.1016/j.jaacop.2024.09.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Psychological distress (eg, anxiety and depression) during pregnancy can disrupt fetal brain development and negatively affect infant behavior. Prenatal distress rose substantially during the COVID-19 pandemic according to most, but not all, studies, raising concerns about its potential effects on brain connectivity and behavior in infants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We investigated 63 mother–infant pairs as part of the Pregnancy during the COVID-19 Pandemic study. Mothers reported depression and anxiety symptoms prospectively during pregnancy; these were combined into one measure of prenatal maternal distress. Infant brain resting state functional magnetic resonance imaging (rs-fMRI) scans were obtained at 3 months of age, and mothers assessed infant behavior at 6 and 12 months using the Infant Behavior Questionnaire—Revised (IBQ-R) and the Ages and Stages Questionnaire (ASQ-3), respectively. The rs-fMRI was processed to measure functional connectivity within auditory, left frontoparietal, and default mode networks, and connectivity was tested for relationships to prenatal maternal distress. Prenatal distress and brain connectivity were also tested for relationships with infant behavior.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Higher prenatal maternal distress was related to stronger functional connectivity in the infant auditory network (T = 2.5, &lt;em&gt;p&lt;/em&gt; = 0.01, q = 0.04, df = 59) and higher infant ASQ-3 personal–social scores (T = 2.9, &lt;em&gt;p&lt;/em&gt; = 0.006, q = 0.03, df = 48). No significant associations were found between brain connectivity and infant behavior.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The impact of exposure to maternal prenatal distress on infant brain networks may be more apparent in networks that develop early, such as the auditory network, compared to later-developing networks, the effects of which may emerge later in childhood. The link between prenatal maternal distress and higher infant behavior scores may suggest compensatory changes, although further study is needed to determine how behavior manifests in the longer term.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;During the COVID-19 pandemic, pregnant individuals were especially stressed, but the impacts on infant brain development are still unclear. This study measured anxiety and depression symptoms in 63 mothers during pregnancy and performed resting-state functional brain magnetic resonance imaging scans in their infants at 3 months of age at the Alberta Children’s Hospital. Mothers who experienced higher distress during pregnancy had infants with stronger functional communication within the auditory brain network and more advanced social behaviors. Our findings show the importance of studying a range of brain regions beyond those involved in emotion and suggest the need for continued monitoring of this infant cohort through early childhood.&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 ens","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 758-767"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914012","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":"Association Between Extreme Heat and Externalizing Symptoms in Pre- and Early Adolescence: Findings From the ABCD Study","authors":"Sara Briker MD ,&nbsp;Kate T. Tran MPH ,&nbsp;Elina Visoki MSc ,&nbsp;Joshua H. Gordon MD, PhD ,&nbsp;Kevin W. Hoffman MD, PhD ,&nbsp;Ran Barzilay MD, PhD","doi":"10.1016/j.jaacop.2024.09.009","DOIUrl":"10.1016/j.jaacop.2024.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>Considering the growing threat of climate change and the current youth mental health crisis, data are needed on the relationship between climate and youth mental health. Hot weather contributes to the mental health burden, specifically aggression. We studied associations between extreme heat and externalizing symptoms or suicidal behavior among US preadolescents.</div></div><div><h3>Method</h3><div>We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study. Participants (N = 8,120, mean age 9.89 years at baseline, 48.40% female, 23.81% Black, 18.17% Hispanic) were assessed longitudinally between 2016 and 2020 across 21 sites. We estimated exposure to extreme heat (measured around the study site) as the number of days in the month of study visit with a maximum temperature ≥90°F (32.2°C) based on National Centers for Environmental Information data. We characterized exposure to extreme heat across racial/ethnic groups. We used mixed-effects regression models to test associations of extreme heat with externalizing symptoms (parent-report) and suicide attempts (self-report), assessed in a validated clinical interview. Models adjusted for demographics (age, sex, race, ethnicity, and household income) and neighborhood characteristics (gross residential density, population density, national walkability index, and fraction of grass, forest, and built land use).</div></div><div><h3>Results</h3><div>Exposure to extreme heat was less prevalent among non-Hispanic White participants (5.2 days/mo) compared to non-Hispanic Black and to Hispanic youth (7.2 and 7.4 days/mo, respectively). Extreme heat showed a small but significant association with externalizing symptoms (incidence rate ratio [IRR]=1.06, 95% CI = 1.04-1.08, <em>p</em> &lt; .001). The association did not change when adjusting for demographics, and remained similar when further adjusting for neighborhood characteristics (IRR = 1.05, 95% CI = 1.00-1.12, <em>p</em> = .04). Sensitivity analyses using extreme heat at the participants’ home address level in the 6 days prior to study visit, available only for ABCD baseline assessment, revealed similar findings. Extreme heat was not associated with suicide attempts (odds ratio = 0.94, 95% CI = 0.77-1.14, <em>p</em> = .52).</div></div><div><h3>Conclusion</h3><div>Our findings add to the literature on the association between extreme heat and externalizing symptoms, and suggest that this association already exists in preadolescence. Future studies are warranted to better understand the mechanisms linking hot weather and mental health and its related racial/ethnic disparities.</div></div><div><h3>Plain language summary</h3><div>Using data from the ABCD Study that follows 8,120 children from childhood to adolescence, this study found an association of exposure to extreme heat, defined by days of the month with ≥ 90°F (32.2°C), with behavioral symptoms in preadolescents aged 10-12 years across the US. In addition, t","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 713-724"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913174","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":"Resting-State Functional Connectivity in a Community Sample of Children With a Range of Cognitive Disengagement Syndrome Symptoms","authors":"Stephen P. Becker PhD ,&nbsp;Adebayo Braimah MS ,&nbsp;Jonathan A. Dudley PhD ,&nbsp;Leanne Tamm PhD ,&nbsp;Jeffery N. Epstein PhD","doi":"10.1016/j.jaacop.2024.09.003","DOIUrl":"10.1016/j.jaacop.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>Despite rapid advancements in understanding of cognitive disengagement syndrome (CDS) in children, less is known about the neural correlates of CDS. The aim of this study was to examine associations between CDS symptom severity and connectivity within and between specific brain networks.</div></div><div><h3>Method</h3><div>The study recruited 65 right-handed children (ages 8-13 years; 36 boys) with the full continuum of CDS symptom severity from the community. As part of a cross-sectional descriptive study investigating CDS, children underwent 10-minute resting-state functional magnetic resonance imaging. Connectivity metrics were extracted from the default mode network and ventral and dorsal attention networks. Parents and teachers completed measures of CDS and attention-deficit/hyperactivity disorder inattention symptoms. Multivariate parametric cluster analyses were performed on within- and between-network connections of the specified networks, with age and sex included as covariates. Separate models were conducted with and without controlling for attention-deficit/hyperactivity disorder inattention symptom severity.</div></div><div><h3>Results</h3><div>Parent-rated CDS symptom severity was not significantly associated with any between- or within-network associations of interest. When attention-deficit/hyperactivity disorder inattention symptom severity was included in the model, teacher-rated CDS symptom severity was associated with greater functional connectivity between several regions of the default mode network and ventral attention network.</div></div><div><h3>Conclusion</h3><div>This study builds on theoretical and empirical evidence suggesting atypical connectivity between task-positive and task-negative networks as potentially key for understanding the neural correlates of CDS. These findings are important for building a neuroscience-based understanding of CDS and support emerging theoretical models linking CDS to mind wandering as well as DMN-related dysfunction.</div></div><div><h3>Plain language summary</h3><div>This study used resting-state functional magnetic resonance imaging in a sample of 65 children (ages 8-13 years) to examine whether cognitive disengagement syndrome (CDS, previously known as sluggish cognitive tempo) symptom severity was associated with connectivity within and between three brain networks clearly implicated in attention. This study adds to a limited literature examining the neural correlates of CDS, finding teacher ratings of CDS symptom severity to be associated with greater functional connectivity (ie, less segregation) between regions of the default mode network (DMN) and ventral attention networks. These findings are important for building a neuroscience-based understanding of CDS and support emerging theoretical models linking CDS to mind wandering and the decoupling of attention as well as DMN-related dysfunction.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 725-735"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914069","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":"Relationships Between Adolescent Perception of Family Functioning and Affective Symptomatology","authors":"Tram N.B. Nguyen MS ,&nbsp;Aaron B. Chance MD ,&nbsp;Chloe Roske AB ,&nbsp;Emily Chase MD ,&nbsp;Tamar B. Rubinstein MD, MS ,&nbsp;Amanda Zayde PsyD ,&nbsp;Wenzhu B. Mowrey PhD ,&nbsp;Vilma Gabbay MD, MS","doi":"10.1016/j.jaacop.2024.09.002","DOIUrl":"10.1016/j.jaacop.2024.09.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The bidirectional relationships between family functioning and adolescent depressive and anxiety disorders have been documented. However, categorical diagnostic criteria for these disorders often mask the high variability of symptom severity across individuals sharing the same diagnoses. Accounting for such heterogeneity, this study examined the associations between domains of family functioning and depression, anxiety, and anhedonia symptoms from the adolescent perspective using a dimensional approach.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Semistructured diagnostic interviews and self-reported measures for depression, anxiety, and anticipatory and consummatory anhedonia were used to evaluate adolescents. Participants’ perception of 7 aspects of family life was assessed with the Family Assessment Device. Bivariate assessments of associations between family subscales and symptom severity scores were conducted. Subsequently, regression models were employed to investigate these relationships while adjusting for age, sex, race, ethnicity, and multiple comparisons.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Data from 79 adolescents (15.0 ± 1.84 years old; 61.8% biologically female) were analyzed, including 59 participants with psychopathology and 19 control participants. Adolescents with psychiatric symptoms perceived lower levels of family Problem Solving, Communication, and General Functioning relative to control participants. Depression severity was associated with Problem Solving, Communication, Roles, Affective Responsiveness, and General Functioning. Anxiety was associated with Problem Solving, Roles, and General Functioning. These relationships remained significant following adjustments for covariates and multiple comparisons correction. Anhedonia subconstructs and perceived family functioning associations were not as robust, suggesting a different etiological pathway.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;These findings support the intertwined relationships between adolescent mood and anxiety processes and perceived family functioning factors. Future studies should examine larger samples and incorporate parents’ perspectives.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This study examined biobehavioral factors in 79 participants in relation to the trajectory of adolescent depression with a focus on the associations between domains of family functioning and depression, anxiety, and anhedonia symptoms from the adolescent perspective. Adolescent depression and anxiety severity, but not anhedonia, were significantly associated with lower perception of family functioning across various domains. The findings suggest that clinical interventions which enhance each family member’s understanding of others’ perspectives may help strengthen family 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 sex and gender balance in the recruitment of human participants. We worked to ensur","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 793-804"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912064","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":"Electronic Health Record–Integrated Legal Documentation to Measure Involuntary Mental Health Detention of Children","authors":"Juliet Beni Edgcomb MD, PhD,&nbsp;Chi-hong Tseng PhD,&nbsp;Alexandra M. Klomhaus PhD,&nbsp;Ariel Seroussi MD,&nbsp;Jonathan P. Heldt MD,&nbsp;Chrislie G. Ponce BA, BS,&nbsp;Liliana Perez BS,&nbsp;Joshua J. Lee BS,&nbsp;Bonnie T. Zima MD, MPH","doi":"10.1016/j.jaacop.2024.09.001","DOIUrl":"10.1016/j.jaacop.2024.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the prevalence and correlates of child involuntary mental health detentions through evaluation of legal documentation embedded in medical records and children’s electronic health information.</div></div><div><h3>Method</h3><div>Medical records were analyzed from 3,440 children ages 10 to 17 years with MH-related emergency department visits in a large academic health system over 2 years (2017-2019). Bivariate analyses and random forests were deployed to identify child-, neighborhood-, and systems-level correlates of involuntary MH detentions.</div></div><div><h3>Results</h3><div>Nearly 1 in 4 (n = 769, 22.4%) visits involved an involuntary detention. Half of detained children (n = 357, 46.4%) arrived on a detainment that was discontinued after MH provider evaluation. Odds of detention were greater among Black (odds ratio 1.33 [95% CI 1.02-1.73]) and publicly insured (odds ratio 1.63 [95% CI 1.37-1.94]) children. Children detained in prehospital settings resided in census tracts with greater social vulnerability scores (χ² 13.42, <em>p</em> &lt; .001). Machine learning classifiers (area under the curve 0.83, [95% CI 0.81-0.84]) revealed that strongest indicators of detainment included psychiatric chief concern, prior year psychiatric hospitalization, Social Vulnerability Index, and <em>ICD-10-CM</em> code for suicide or self-harm.</div></div><div><h3>Conclusion</h3><div>Medical record–embedded legal documentation supports transparency in the use of detentions, which are common and jointly predicted by children’s clinical need and social vulnerability.</div></div><div><h3>Plain language summary</h3><div>Study finds that clinical need and social vulnerability jointly predict child involuntary mental health detention. Linking electronic-format detainment orders to emergency department (ED) health records within a large urban health system in Los Angeles, the team discovered factors associated with detainment including suicide-related diagnoses, use of antipsychotic medications, history of psychiatric hospitalizations, child’s age, location of the ED visit, and neighborhood social vulnerability. Findings highlight the growing role of informatics in understanding critical emergency care processes in child psychiatry.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 689-700"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912360","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}