Child and Adolescent Psychiatry and Mental Health最新文献

{"title":"Not all wounds are visible: Peer bullying and psychopathology in child and adolescent psychotherapy outpatients.","authors":"Anna-Luisa Kranhold, Sina Weber, Carolin Köhmstedt, Karen Krause, Dieter Wolke, Silvia Schneider, Babett Voigt","doi":"10.1186/s13034-026-01146-w","DOIUrl":"10.1186/s13034-026-01146-w","url":null,"abstract":"<p><strong>Background: </strong>Bullying poses a major risk for poor mental health. While findings from the general population highlight harmful effects of bullying, data from clinical samples with diverse diagnoses and evidence-based diagnostic methods is rare. This study aimed at exploring the association between psychopathology and active bullying involvement in child and adolescent psychotherapy outpatients.</p><p><strong>Methods: </strong>The preregistered study ( https://aspredicted.org/VYW_9TT ) included data from N = 719 outpatients aged 6-20 years from a German child and adolescent psychotherapy centre. Current experiences as a victim, bully-victim, or bully and distressing bullying-specific intrusions were assessed with a screening instrument. Gold-standard diagnostic assessment of psychopathology provided categorial ICD-10 diagnoses. The Strength and Difficulties Questionnaire depicted a dimensional proxy measure of psychopathology. Analyses included examining the frequencies of the bullying roles (victim, bully-victim, bully) and the occurrence of distressing bullying-specific intrusions, Pearson's chi-square tests for gender-specific differences, binary logistic regression analyses testing the bullying roles as predictors of ICD-10 diagnoses, and multiple one-way ANOVAs examining group differences on the Strength and Difficulties Questionnaire scores between the bullying roles.</p><p><strong>Results: </strong>29% of all outpatients reported to be actively involved in bullying (22% victims, 5% bully-victims, 2% bullies), with 32% frequently experiencing distressing bullying-specific intrusions. While victims were more likely to have mood disorders (ICD-10 F3 disorders), bully-victims were less likely to have internalising and more likely to have externalising disorders and behavioural and emotional disorders with onset usually occurring in childhood and adolescence (ICD-10 F9 disorders). Bullies were more likely to have multiple disorders but less likely to have internalising disorders. Independent from specific diagnoses, victims, bully-victims, and bullies overall reported greater emotional and behavioural difficulties than outpatients without bullying experiences.</p><p><strong>Conclusions: </strong>Among outpatients in child and adolescent psychotherapy, bullying is linked to specific related psychological burden and role-specific psychopathology. Bullying and related psychological burden should be addressed and routinely assessed in mental health care settings. The link between bullying and psychopathology as well as specific intervention methods may be explored further in future research.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a stepped-care approach for school-age children with mild to moderate ADHD (ESCAschool-moderate): an adaptive intervention study including a randomized controlled trial.","authors":"Manfred Döpfner, Christina Dose, Christopher Hautmann, Martin Hellmich, Lea Teresa Kohl, Anne-Katrin Treier, Elena von Wirth, Katja Becker, Daniel Brandeis, Ute Dürrwächter, Julia Geissler, Sarah Hohmann, Martin Holtmann, Michael Huss, Thomas Jans, Anna Kaiser, Johanna Ketter, Tanja Legenbauer, Sabina Millenet, Luise Poustka, Tobias J Renner, Jasmin Wenning, Tobias Banaschewski","doi":"10.1186/s13034-026-01115-3","DOIUrl":"10.1186/s13034-026-01115-3","url":null,"abstract":"<p><strong>Background: </strong>This German multicenter study aimed to analyze the efficacy of telephone-assisted self-help (TASH) and changes during subsequent adaptive treatment in children with mild-to-moderate ADHD.</p><p><strong>Methods: </strong>Participants were children (6;0-11;11 years) with mild-to-moderate ADHD. Study Step 1 comprised a randomized waitlist-controlled trial on the efficacy of three-month, parent-directed TASH. Depending on their response to TASH, in Step 2, children were assigned to booster TASH (full response), behavior therapy (partial response), or pharmacotherapy plus behavior therapy or counseling (non-response) for six months. The primary outcome was the change in blinded-clinician-rated ADHD symptoms; for subsequent changes (Step 2), we considered semi-blinded ratings. The primary analyses were by intention-to-treat.</p><p><strong>Results: </strong>Of the 163 included children (77.9% boys), 80 were randomized to TASH and 83 to the waitlist control group. Following TASH, 12 children (8.8%) were classified as full responders, 40 (29.2%) as partial responders, and 85 (62.0%) as non-responders. An analysis of covariance did not yield an effect of TASH on the primary outcome (mean between-group difference = 0.00 ± 0.07, 95% CI[- 0.14, 0.13]; p = 0.95; d = -0.01, 95% CI[- 0.37, 0.34]). During Step 2, full responders demonstrated a stable symptom level (piecewise mixed-effects model for repeated measures; d = - 0.07, 95% CI[- 0.61, 0.47], p = 0.80), partial responders a small increase in ADHD symptoms (d = 0.29, 95% CI[0.00, 0.59], p = 0.05), and non-responders a large decrease (d = - 1.00, 95% CI[- 1.27, - 0.73], p < 0.001).</p><p><strong>Conclusions: </strong>TASH is not effective in reducing blinded-clinician-rated ADHD symptoms in children with mild-to-moderate ADHD. Based on the changes within the response groups during Step 2, hypotheses are generated for adaptive treatment after TASH. Trial registration German Clinical Trials Register (DRKS): DRKS0000897; URL: https://drks.de/search/de/trial/DRKS00008973/details ; registered on December 18th 2015.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Japi 2.0, a gaming platform to stimulate cognitive and socio-emotional skills in early childhood: results of a pilot randomized controlled trial.","authors":"Jorge Gaete, Natalia Ríos, Cristian A Rojas-Barahona, Gabriel Salgado, Saray Ramírez, Ricardo Araya","doi":"10.1186/s13034-026-01133-1","DOIUrl":"10.1186/s13034-026-01133-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early childhood is a sensitive developmental period for the acquisition of cognitive and socio-emotional skills that are strongly associated with later mental health, academic achievement, and social functioning. Children growing up in socioeconomically disadvantaged contexts are at increased risk for early emotional and behavioral difficulties, highlighting the need for accessible, scalable, and developmentally appropriate preventive interventions. Japi 2.0 is a tablet-based gaming platform designed to stimulate six interrelated cognitive and socio-emotional skills-working memory, inhibitory control, emotion recognition, social competence, empathy, and cognitive planning-through structured play in preschool settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a pilot cluster randomized controlled trial in low-income preschools in Santiago, Chile. Schools were randomized to either the Japi 2.0 intervention or treatment as usual. The intervention consisted of 24 individual sessions delivered over 12 weeks during regular class hours. Primary outcomes were acceptability (perceived by children, early years educators, and parents) and feasibility (recruitment, retention, attendance, intervention delivery, and data completeness). Secondary outcomes explored preliminary changes in cognitive, socio-emotional, and behavioral functioning using standardized assessments and parent- and teacher-reported measures. Exploratory analyses were conducted using multilevel models adjusted for baseline scores and clustering, based on available outcome data from randomized participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Japi 2.0 showed high acceptability across stakeholders. Educators and parents reported that the game and the accompanying web-based dashboard were engaging, age-appropriate, easy to use, and pedagogically relevant. Children reported high levels of enjoyment and positive emotional experiences during gameplay. Feasibility indicators were satisfactory: most planned sessions were delivered as scheduled, attendance was high, and outcome data completeness was adequate. Exploratory analyses indicated improvements over time in both groups across most outcomes. Preliminary exploratory signals favoring the intervention were observed for empathy and parent-reported emotional and behavioral difficulties; however, these findings should be interpreted cautiously given the small number of clusters and exploratory nature of the analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot trial demonstrates that Japi 2.0 is a feasible and highly acceptable digital intervention for preschool children in low-income educational settings. Although efficacy findings are preliminary, results support progression to a fully powered randomized controlled trial to evaluate effectiveness and longer-term impacts on cognitive, socio-emotional, and behavioral development. Trial registration Clinical Trials NCT06420544, May 20th, 2024. https://www.&lt;/p&gt;&lt;p&gt;&lt;s","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of multiple services from childhood to early adulthood among violent juvenile offenders: a document-based descriptive study.","authors":"Eeva Huikko, Mauri Marttunen, Aulikki Ahlgrén-Rimpiläinen, Terhi Aalto-Setälä, Riikka Lämsä","doi":"10.1186/s13034-026-01140-2","DOIUrl":"10.1186/s13034-026-01140-2","url":null,"abstract":"<p><strong>Background: </strong>Young violent offenders frequently face significant developmental adversities, including learning difficulties, mental disorders, and substance use during childhood and adolescence. Many also grow up in circumstances requiring child welfare interventions. However, limited information is available regarding the services provided to them.</p><p><strong>Objective: </strong>To describe the timing, duration and components of school support services, child welfare services, as well as mental health services and substance abuse services used by young violent offenders.</p><p><strong>Participants and methods: </strong>Data were derived from the forensic psychiatric examination statements of 42 Finnish violent offenders aged 15-22 years and analyzed using qualitative and quantitative content analyses.</p><p><strong>Results: </strong>Almost all young people (95%) had used at least one service. Service use typically began between ages 7 and 12, with school support services accessed more frequently than other services during this period. The highest rate of single-service use occurred at ages 8-9. Adolescence was characterized by the most extensive multiservice involvement, with the combination of school support, mental health, and child welfare services peaking at age 15. Interruptions longer than one year were more frequent in mental health services than in other services. Evidence-based parent training, multidimensional family therapy, and specialized placements for youth with substance use and mental health problems were used only seldom.</p><p><strong>Conclusions: </strong>Most youth who committed violent offences had received multiple services during childhood and adolescence. Our results highlight the need to develop the timing, suitability and acceptability of services for this specific group of young people in their youth.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of pharmacological, adjunctive, and non-pharmacological interventions across behavioral domains in children and adolescents with autism spectrum disorder: a network meta-analysis.","authors":"Longyan Liu, Xianyang Xin, Zhang Ying","doi":"10.1186/s13034-026-01132-2","DOIUrl":"10.1186/s13034-026-01132-2","url":null,"abstract":"<p><strong>Objective: </strong>To systematically compare the efficacy of pharmacological, adjunctive, and non-pharmacological interventions across multiple behavioral domains in children and adolescents with autism spectrum disorder (ASD), including irritability, hyperactivity, social withdrawal, stereotypic behavior, and inappropriate speech.</p><p><strong>Methods: </strong>Following the 2020 PRISMA guidelines, five databases were searched from inception to March 2026 for randomized controlled trials (RCTs). A frequentist network meta-analysis was conducted to estimate the comparative efficacy and ranking probabilities of different interventions across behavioral domains (PROSPERO: CRD420261368925).</p><p><strong>Results: </strong>Sixty-seven RCTs (N = 4,203) were included. For irritability, structured exercise ranked highest (SUCRA = 88.0%; SMD = - 1.48, 95% CI -2.24 to - 0.73), followed by risperidone plus adjunctive anti-inflammatory agents (SUCRA = 72.9%) and neuromodulatory agents (SUCRA = 67.8%). For hyperactivity, pharmacological interventions were most effective, with other antipsychotic/ADHD medications ranking highest (SUCRA = 95.1%; SMD = - 1.85, 95% CI -2.50 to - 1.20), followed by structured exercise (SUCRA = 76.1%). Similarly, for stereotypic behavior, pharmacological treatments dominated, with other antipsychotic/ADHD medications achieving the best performance (SUCRA = 92.0%; SMD = - 1.10, 95% CI -1.67 to - 0.52). In contrast, for social withdrawal, structured exercise emerged as the most effective intervention (SUCRA = 98.9%; SMD = - 1.28, 95% CI -1.96 to - 0.60), followed by risperidone plus neuromodulatory agents (SUCRA = 75.3%). For inappropriate speech, structured exercise (SUCRA = 80.1%) and probiotics plus oxytocin (SUCRA = 76.4%) demonstrated the highest rankings, with structured exercise showing a significant effect (SMD = - 0.80, 95% CI -1.40 to - 0.19).</p><p><strong>Conclusion: </strong>This study establishes a domain-specific treatment hierarchy for ASD, demonstrating that intervention effects vary substantially across behavioral domains. Pharmacological approaches are more effective for hyperactivity and stereotypic behaviors, whereas structured exercise shows superior benefits for irritability and social withdrawal. Combination strategies consistently rank highly across multiple domains, supporting the value of multimodal interventions. These findings underscore the importance of individualized, symptom-targeted, and mechanism-informed treatment strategies to optimize clinical outcomes in ASD.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-specific temporal dynamics of depressive symptoms and emotional resilience in adolescents: a cross-lagged network and simulation-based intervention study.","authors":"Qiu Li, Xueying Liu, Fang Zhou, Weiliang Wang","doi":"10.1186/s13034-026-01138-w","DOIUrl":"10.1186/s13034-026-01138-w","url":null,"abstract":"<p><strong>Background: </strong>Adolescent depression involves dynamic interactions between depressive symptoms and emotional resilience, with potential gender differences.</p><p><strong>Methods: </strong>A total of 818 adolescents completed the CDI-S and AERQ at two time points. Cross-lagged panel networks were estimated separately for males and females, and node centrality was assessed using in- and out-expected influence indices. Simulation-based interventions identified nodes with the greatest impact on overall symptom activation.</p><p><strong>Results: </strong>In males, sadness showed the largest autoregressive effect, self-deprecation showed the highest out-expected influence, and feeling upset when misunderstood showed the highest in-expected influence. In females, feeling unloved showed the largest autoregressive effect, sadness showed the highest out-expected influence, and feeling upset after criticism the highest in-expected influence. Simulation results indicated that enhancing positive emotion generation alleviated symptoms, whereas sleep- and interpersonal-related dysregulation increased network activation.</p><p><strong>Conclusions: </strong>Emotional resilience-depression dynamics differed by gender, with males showing cognitive-evaluative propagation and females emotion-driven interpersonal sensitivity. Targeted, gender-sensitive interventions focused on positive emotion generation and interpersonal recovery may help reduce depressive symptoms in adolescents.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More symptoms, less crime: distinguishing clinical severity from violence risk in a national follow-up study of adolescent forensic inpatients.","authors":"Alfred Sarno, Riittakerttu Kaltiala","doi":"10.1186/s13034-026-01135-z","DOIUrl":"10.1186/s13034-026-01135-z","url":null,"abstract":"<p><strong>Background: </strong>The predictive value of symptom severity on post-discharge criminal offending in forensic psychiatric settings remains unknown, potentially leading to prolonged institutionalization of stabilized patients under the rationale of public safety. Furthermore, outcomes of adolescent forensic psychiatric inpatient care are understudied.</p><p><strong>Aims: </strong>To explore if clinical symptom severity predicts subsequent criminal offending, to investigate the role of severe disorders in future offending, and to quantify offence rates among former adolescent forensic inpatients compared to the general population.</p><p><strong>Methods: </strong>This national register-based study followed 289 youths (under 18 years) consecutively admitted to a forensic psychiatric inpatient unit in Finland between 2003 and 2019 for up to 18 years. Offence rates were analyzed using Cox proportional hazards regression, comparing patients against 1,149 matched general population controls. Predictors included the Brief Psychiatric Rating Scale (BPRS; score range 18-126 points) and Structured Assessment of Violence Risk in Youth (SAVRY), both assigned during a two-month evaluation.</p><p><strong>Results: </strong>Former patients had a significantly higher hazard of offending than controls (HR 6.67, 95% CI 5.10-8.72). However, higher clinical symptom severity (BPRS) independently reduced the risk of future offending by 2% per point (HR = 0.98, 95% CI 0.96-1.00, p = .025); e.g., a 20-point difference corresponds to an approximate 34% reduction in risk. High-risk patients (SAVRY) with severe symptoms offended at rates similar to low-risk patients. Personality disorders were associated with subsequent offending (HR = 1.92, 95% CI 1.01-3.66, p = .047), while schizophrenia spectrum disorders and Length of Stay were not.</p><p><strong>Conclusions: </strong>Severe psychopathology predicts reduced subsequent offending after forensic adolescent inpatient care, possibly due to treatment responsiveness, systemic safety nets and functional impairment. Prolonging hospitalization under the rationale of public safety based on symptom severity may be unnecessary for stabilized patients if continuity of care and outpatient supervision are ensured.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life course, value orientation and self-concept in adolescents with delinquent behavior: a comparative study of delinquent, psychiatric, and healthy youths.","authors":"Helena Gampe, Kornelius Winds, Lucas Rainer, Belinda Plattner","doi":"10.1186/s13034-026-01136-y","DOIUrl":"10.1186/s13034-026-01136-y","url":null,"abstract":"<p><strong>Background: </strong>Juvenile delinquency is closely linked to complex psychosocial and value-based developmental trajectories. This study compares life-course narratives (childhood and school experiences, daily life structure), value orientation, self-concept, and standardized self-reports of emotions among adolescents with delinquent behavior, adolescents with psychiatric disorders, and healthy peers.</p><p><strong>Methods: </strong>Using a mixed-methods design, narrative interviews were conducted with all three groups (N = 48). Participants were asked to describe their feelings in relation to these domains in order to assess emotional processing, measured by the Positive and Negative Affect Schedule (PANAS).</p><p><strong>Results: </strong>Compared with their healthy peers, narratives from adolescents with delinquent behavior were characterized by greater strain across their developmental course. These descriptions were marked by housing and caregiving instability, insecure bonding experiences with primary caregivers, difficulties in forming coherent and socially oriented value systems, and a tendency toward self-concepts marked by overcompensation. Regarding emotional experience, PANAS results indicate that both the delinquent and psychiatric groups reported higher levels of negative affect than healthy adolescents. Although adolescents with psychiatric disorders also reported adversity, their narratives tended to reflect greater variability in protective factors and more opportunities to benefit from therapeutic and relational support.</p><p><strong>Conclusion: </strong>The findings suggest that delinquent behavior may arise from the cumulative interplay of early adversity, environmental instability, disrupted relational experiences, and challenges in developing individualized values and stable, non-compensatory self-concepts. These results highlight the importance of interventions that address potential moral injury, strengthen reliable relational contexts, and promote socially integrated value orientations. Qualitative approaches provide important insights into these mechanisms and should complement quantitative assessments when working with high-risk youth.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital media balance and mental health: effects of a school-based program.","authors":"Mona Guath, Sissela B Nutley, Lisa B Thorell","doi":"10.1186/s13034-026-01131-3","DOIUrl":"10.1186/s13034-026-01131-3","url":null,"abstract":"<p><strong>Background: </strong>Adolescent mental health problems are rising globally, with problematic digital media use identified as an important risk factor. Universal school-based interventions that integrate Social and Emotional Learning (SEL) with digital balance strategies may promote resilience and reduce risk. This study evaluated On the Inside, a classroom-based SEL and digital balance program.</p><p><strong>Methods: </strong>A total of 750 students aged 13-15 years from eight schools (two control schools) participated. Surveys were completed at baseline (T1), post-intervention (T2), and, for a subsample, one year later (T3). The program comprised five video-based sessions delivered by teachers. Outcomes included psychological distress (PHQ-4), problematic social media use (GSMQ-9), and adaptive behaviors. Data were analyzed using multilevel mixed models to account for clustering by school.</p><p><strong>Results: </strong>Relative to controls (n = 193), students in the intervention group (n = 557) reported reductions in psychological distress, problematic social media use, multitasking, and avoidance, alongside increased use of adaptive strategies such as distancing phones during study and challenging negative thoughts. Several effects, including reduced distress and avoidance, and sustained strategy use, remained at one-year follow-up. No significant effects were observed for sleep, help-seeking, or breathing strategies.</p><p><strong>Conclusions: </strong>This universal, teacher-delivered program integrating SEL and digital balance was feasible and produced small but clinically meaningful improvements in adolescent distress and related behaviors, with some effects sustained after one year. These findings support the potential of school-based interventions to address digital media-related risks and promote mental health at a population level. Further research should refine program components, particularly for sleep and screen time, and examine cost-effectiveness to inform broader implementation.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up effects of mindfulness-based interventions on anxiety in adolescents: a systematic review and meta-analysis of randomized controlled trials.","authors":"Hongbo Zhao, Hongxin Huang","doi":"10.1186/s13034-026-01134-0","DOIUrl":"10.1186/s13034-026-01134-0","url":null,"abstract":"<p><strong>Background: </strong>Anxiety is one of the most prevalent mental health problems in adolescence, and its onset often coincides with the secondary school years. Mindfulness-based interventions (MBIs) have shown short-term benefits for reducing anxiety in young people, but the durability of these benefits after treatment remains uncertain. To inform clinical and school-based practice, a quantitative synthesis focused specifically on follow-up effects is needed.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating MBIs in adolescents aged 10-19 years and reporting anxiety outcomes at follow-up assessments conducted at least 3 months after the intervention. The review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420251234254). Major databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus and CNKI) were searched from inception to November 2025. Two reviewers independently screened studies, extracted data and assessed risk of bias using the Cochrane RoB 2 tool. Standardized mean differences (SMDs; Hedges' g) with 95% confidence intervals (CIs) were calculated under a random-effects model. Pre-specified subgroup analyses were conducted by age group (10-14 vs. 15-19 years), intervention type (MBSR/MBCT vs. mindfulness-based stress prevention, MBSP), and follow-up interval (3-6 vs. ≥6 months). Univariable meta-regression explored the impact of mean age and total intervention duration on effect sizes. Certainty of evidence for key outcomes was rated using GRADE.</p><p><strong>Results: </strong>Eleven randomized controlled trials (n = 9,856 adolescents) were included. Overall, MBIs were associated with a modest reduction in anxiety symptoms at follow-up assessments ≥ 3 months after treatment (SMD = - 0.30, 95% CI - 0.44 to - 0.16; I² = 79%). Subgroup analyses indicated a moderate effect at 3-6 months (SMD = - 0.40, 95% CI - 0.56 to - 0.25; I² = 52%) but a very small effect at ≥ 6 months (SMD = - 0.09, 95% CI - 0.14 to - 0.05; I² = 0%), with a significant difference between subgroups (p < 0.001).</p><p><strong>Conclusions: </strong>MBIs may confer a modest follow-up benefit on adolescent anxiety, driven mainly by outcomes measured at 3-6 months. Evidence at ≥ 6 months is limited and of low certainty, and does not support a firm conclusion regarding maintenance of effects. Future trials should test whether maintenance-focused components, such as booster sessions or ongoing practice support, improve durability.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}