Child and Adolescent Psychiatry and Mental Health最新文献

{"title":"Integrating neurobiological markers to prospectively predict adolescent non-suicidal self-injury and suicide attempts: a machine learning approach.","authors":"Corinna Reichl, Erik Fink, Luisa von den Driesch, Stefan Lerch, Julian Koenig, Thomas Berger, Michael Kaess","doi":"10.1186/s13034-026-01122-4","DOIUrl":"10.1186/s13034-026-01122-4","url":null,"abstract":"<p><strong>Background: </strong>Suicide attempts (SA) and non-suicidal self-injury (NSSI) are closely related phenomena, both common in adolescent clinical samples. This study examined whether neurobiological markers could enhance the prediction of SA and NSSI over a 2-year period, beyond established clinical predictors and age, in a high-risk sample of female adolescents engaging in NSSI.</p><p><strong>Methods: </strong>A total of n = 63 (age: M = 15.1 years, SD = 1.45) female adolescents with NSSI were recruited from our outpatient clinic for risk-taking and self-harming behaviour (AtR!Sk) at the Clinic for Child and Adolescent Psychiatry, University Hospital of Heidelberg, Germany. Machine learning models (linear and logistic regression; elastic net regression; support vector machines with repeated cross-validation) were applied. We tested whether the inclusion of biomarkers (thyroid-stimulating hormone [TSH]; free triiodothyronine [fT3]; adrenocorticotropic hormone [ACTH]; dehydroepiandrosterone sulfate [DHEA-S]; resting heart rate variability [rHRV]; pain threshold) improved prediction of SA and NSSI remission - defined as the absence of any NSSI episodes - over a two years period, beyond clinical variables (past SA; symptoms of borderline personality disorder [BPD]) and age.</p><p><strong>Results: </strong>Models predicting SA that included biomarkers, clinical variables, and age, showed moderate predictive accuracy (AUC: 0.76-0.82), however not higher than when only including clinical variables and age. The strongest predictors were past SA (OR = 7.28), followed by fT3 (OR = 0.16) and TSH (OR = 0.35). The SA prediction models showed high specificity but low sensitivity, indicating strong performance in identifying negative cases but poor detection of positive cases. Models predicting NSSI, including the same variables, did not consistently outperform chance levels and showed low specificity and sensitivity.</p><p><strong>Conclusions: </strong>These findings support the use of machine learning models to predict SA in high-risk adolescents but show that prediction is driven mainly by established clinical features (past SA; BPD) and age, with no added benefit from neurobiological markers. Moreover, all models were more effective at identifying negative than positive cases. Given the small sample size and class imbalance, findings should be interpreted cautiously and require replication in larger and independent samples.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301275","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":"Problematic gaming, problematic social media use, and psychological well-being in adolescents: exploring networks of symptoms in 10 European countries.","authors":"Andrea Stašek, Dimitri Löchner, Meyran Boniel-Nissim, Natale Canale, Regina van den Eijnden, Jana Furstova, Tommaso Galeotti, Sabina Hulbert, Helena Jeriček Klanšček, Claudia Marino, Lukas Blinka","doi":"10.1186/s13034-026-01123-3","DOIUrl":"10.1186/s13034-026-01123-3","url":null,"abstract":"<p><strong>Background: </strong>Studies that jointly examine the specific symptoms of problematic gaming and problematic social media use with comparable conceptualizations and link them to adolescent psychological well-being remain scarce.</p><p><strong>Methods: </strong>This study addresses this gap with an effective representative sample of n = 33,586 adolescents aged 11-15 years across 10 European countries, collected in the 2021-22 Health Behaviour in School-aged Children (HBSC) survey. A network approach was applied to data about problematic media use (i.e., Internet Gaming Disorder Scale, Social Media Disorder Scale) and psychological well-being (i.e., WHO-5 Well-being Index, Multiple Health Complaints Scale, and Loneliness).</p><p><strong>Results: </strong>In gaming and social media, either separately or together, escapism was both the most common and the key bridge symptom: it was connected to loneliness in both genders and to overall well-being and nervousness in girls. Behavioral symptoms that reflect negative consequences of use (i.e., conflict, deception, and problems with others) were strongly related across gaming and social media, suggesting that they reflect a general condition rather than a behavior linked to a specific media use.</p><p><strong>Conclusions: </strong>The findings highlight the central role of escapism in the interplay between adolescent problematic media use and psychological well-being, with some gender-specific differences. Symptom-level focus can guide prevention and intervention strategies. It can also prompt further research to move beyond aggregated symptom scores to better capture the heterogeneity of problematic media use as well as how specifically relevant the symptoms are for the two problematic behaviors in relation to psychological well-being.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293507","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":"Trauma-focused treatments for refugee children and adolescents with PTSD: a three-arm randomized controlled trial comparing the efficacy of EMDR and KIDNET versus a waitlist control group (the KIEM study).","authors":"Merel E Velu, Carlijn de Roos, Niels van der Aa, Ruud Jongedijk, Ramón Lindauer, Trudy Mooren","doi":"10.1186/s13034-026-01118-0","DOIUrl":"10.1186/s13034-026-01118-0","url":null,"abstract":"<p><strong>Background: </strong>Due to trauma and ongoing adversity, refugee minors are at high risk for mental health issues, including PTSD. This study evaluated the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) and Narrative Exposure Therapy for Children (KIDNET), in reducing PTSD symptoms, behavioural and emotional symptoms and improving quality of life in refugee children and adolescents in the Netherlands, compared to a waitlist control group (WL). A secondary objective was to compare the efficacy of EMDR and KIDNET.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted with three arms (N = 96): EMDR (n = 32), KIDNET (n = 32), and WL (n = 32). After 8 weeks, WL participants were re-randomized to EMDR or KIDNET. Follow-ups were conducted at 1- and 3-months post-treatment. Participants were refugee minors aged 8-18 years, accompanied by a caregiver, and meeting criteria for a (partial) PTSD diagnosis. Both treatments included 8 weekly sessions and 1-4 parental guidance sessions.</p><p><strong>Results: </strong>Both EMDR (d = 1.31) and KIDNET (d = 0.94) significantly reduced clinician-rated PTSD symptom severity compared to WL. Similar results were found for child-report, but not for caregiver-report. Regarding secondary outcomes, quality of life and emotional and behavioural symptoms, comparisons of both interventions to the WL revealed small to moderate effect sizes with non-significant effects for KIDNET versus WL, and significant effects for EMDR versus WL. EMDR, compared to KIDNET, showed a significantly greater reduction in clinician-rated PTSD symptom severity (T1-T3) (d=-0.38) with no significant differences on other outcome measures. Results were achieved after an average of 6.61 sessions for EMDR and 9.10 for KIDNET. Dropout rates were 20.8% for EMDR and 10.9% for KIDNET, based on the total sample after the second randomization.</p><p><strong>Conclusions: </strong>These findings suggest that both EMDR and KIDNET are efficacious trauma-focused treatments for refugee children and adolescents. Trial registration The trial was registered in the Overview of Medical Research in the Netherlands on February 2, 2014 (NL-OMON44793), amended on June 16, 2017, and re-registered on June 16, 2021 (NL-OMON22679), where one updated outcome measure and expanded eligibility criteria were documented.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293486","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":"The longitudinal relationships between parent-child alienation and depression in adolescents: insights of network analysis.","authors":"Qin Dai, Ying He, Xiaoxiao Sun, Zongpei Dai, Wenxiang Jian, Xiaomei Ren, Qiaoning Zhou","doi":"10.1186/s13034-026-01120-6","DOIUrl":"10.1186/s13034-026-01120-6","url":null,"abstract":"<p><strong>Background: </strong>Adolescent depression is a major health issue requiring precise interventions. While Network theory guides symptom-targeted interventions, longitudinal studies in community adolescents remain scarce. Ecological Systems Theory indicates parent-child alienation (PA) as a depression disruptor, but how PA influences depressive networks is unknown. This study aims to bridge this gap by examining symptom-level interactions between PA and depression in community adolescents through two-wave network analysis.</p><p><strong>Methods: </strong>1503 Chinese adolescents (mean age = 13.95 ± 2.05 years; 49.63% female) were surveyed at two time points one year apart [baseline (T1), 12-months later (T2)]. Analyses included: T1 cross-sectional depression network (n = 1503), T1/T2 bridge networks (n = 1148 each), and T1 → T2 cross-lagged panel network (CLPN; n = 1148).</p><p><strong>Results: </strong>(1) Anhedonia had the highest expected influence (EI = 1.03) within the T1 depression network. (2) Anhedonia showed the highest bridge EI (BEIT1 = 0.19; BEIT2 = 0.13) linking PA and depression. (3) CLPN revealed bidirectional PA-depression prediction, with stronger prediction effect of depression on subsequent PA than vice versa. Compared with alienation towards father, alienation towards mother predicted subsequent depressive symptoms more strongly. Key paths: \"alienation towards mother\" predicting subsequent \"anhedonia\" and \"negative mood\" (both weight = 0.04); \"negative self-esteem\" predicting subsequent \"alienation towards father (weight = 0.57) /mother (weight = 0.42)\". (4) In CLPN, negative self-esteem was the central symptom (out-EI = 1.52), while anhedonia was the most affected depressive symptom (in-EI = 0.39).</p><p><strong>Conclusions: </strong>This study confirms anhedonia as central symptom within depression network and a core bridge linking PA and depressive symptoms cross-sectionally. Longitudinally, PA and depression bidirectionally predict each other, with depression exerting stronger forward prediction. Furthermore, alienation towards mothers shows stronger prediction on subsequent depressive symptoms. Negative self-esteem functions as an activator and anhedonia as maintainer in CLPN. These findings integrate Network Theory and Ecological Systems Theory to elucidate how PA prompts depression network dynamic and depression self-maintenance pathways. This calls for school-based anhedonia screening for alienated youth and family-focused interventions targeting negative self-esteem and anhedonia.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276273","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":"Depression and anxiety symptoms among Kenyan adolescents: psychometric validation, prevalence, network analysis, and psychosocial determinants.","authors":"Tom L Osborn, Rosine Baseke, Faith Kamau, Maureen Ngesa, Rachael Kilonzo, Priscillah Agunda, Kane Vundi, Ray Kongong'a, Christine M Wasanga, Victoria Mutiso, David Ndetei","doi":"10.1186/s13034-026-01117-1","DOIUrl":"10.1186/s13034-026-01117-1","url":null,"abstract":"<p><strong>Background: </strong>Adolescent mental health in Sub-Saharan Africa remains critically understudied despite high burden estimates. We assessed the psychometric properties of Western-derived instruments, prevalence of depression and anxiety symptoms, associations with psychosocial and sociodemographic factors, and symptom network structures in a large multi-year sample of Kenyan adolescents.</p><p><strong>Methods: </strong>We administered depression (PHQ-8), anxiety (GAD-7), social support, perceived control, and wellbeing measures to 7865 Kenyan secondary school students aged 12-20 across three studies (2021-2023).</p><p><strong>Results: </strong>Both PHQ-8 (α = 0.70) and GAD-7 (α = 0.78) demonstrated adequate reliability, and confirmatory factor analyses supported unidimensional structures with acceptable fit (PHQ-8: RMSEA = 0.052, CFI = 0.945; GAD-7: RMSEA = 0.056, CFI = 0.970). Overall, 30.3% (95% CI 29.3-31.3%) and 25.1% (95% CI 24.2-26.1%) of participants met the ≥ 10 cut-off for clinically elevated depression and anxiety symptoms, respectively, with descriptive variation across study years (2021: 42.1% [39.6, 44.6%], 37.5% [35.1, 40.0%]; 2022: 25.3% [23.8, 26.8%], 21.7% [20.3, 23.2%]; 2023: 29.7% [28.1, 31.3%], 22.5% [21.1-24.0%]); direct year-on-year comparison is limited by differences in wave composition. Mixed-effects modelling identified social support (B = - 0.08) and perceived control (B = - 0.29 for depression, B = - 0.24 for anxiety) as robust protective factors. Final-year students showed elevated symptoms (B = 0.93, B = 0.77), as did students in girls' schools relative to mixed schools (B = 1.35, B = 1.27). Perceived academic ability showed a strong inverse gradient with both outcomes (excellent ability: B = - 2.51 for depression, B = - 1.76 for anxiety). Network analysis identified worry-related symptoms as most central, with hopelessness and nervousness serving as the primary bridges between depression and anxiety domains.</p><p><strong>Discussion: </strong>Western-derived measures demonstrated adequate psychometric properties with Kenyan adolescents. Depression and anxiety were highly prevalent and varied by sex, school form, and school type. Social support and perceived control were the strongest protective factors; academic pressure and girls' school attendance were associated with elevated symptoms. Network analyses identify worry, hopelessness, and negative self-evaluation as possible candidate intervention targets warranting empirical evaluation. These findings underscore the urgent need for contextually grounded, school-based mental health provision in Kenya and comparable Sub-Saharan African settings.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263474","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":"Mechanisms linking family socioeconomic status to children's depressive symptoms: a longitudinal moderated mediation analysis.","authors":"Haifan Bai, Tingting Wang, Yuting Yang, Haijiang Lin, Xiaoxiao Chen, Yixuan Liu, Jingyi Wang, Chaowei Fu","doi":"10.1186/s13034-026-01116-2","DOIUrl":"10.1186/s13034-026-01116-2","url":null,"abstract":"<p><strong>Background: </strong>Family socioeconomic status (SES) is a well-established determinant of children's mental health, yet the mechanisms linking SES to depressive symptoms in primary school children remain insufficiently understood. This study aimed to investigate whether loneliness, perceived social support, and parent-child relationship mediate the association between family SES and depressive symptoms, and whether these pathways are moderated by sex and household registration.</p><p><strong>Methods: </strong>A three-wave longitudinal survey was conducted among primary school students in Taizhou City, Zhejiang Province, China (2021-2023). Data were collected via online questionnaires completed by students and their parents. Family SES indicators (parents' education, family economic status, and average living space per person) were assessed at baseline (T1), interpersonal experiences (loneliness, perceived social support, and parent-child relationship) at wave 2 (T2), and depressive symptoms at wave 3 (T3). Structural equation modeling was used to examine direct, mediated, and moderated effects, adjusting for relevant covariates.</p><p><strong>Results: </strong>A total of 2,164 students (mean age = 9.3 ± 1.4 years, 46.5% female) who completed all three waves were included in the analysis. Higher parents' education was directly associated with lower depressive symptoms and indirectly associated via reduced loneliness (indirect effect - 0.02, 95% CI -0.03 to -0.001; 13.2% of the total effect) and greater perceived social support (indirect effect - 0.02, 95% CI -0.03 to -0.01; 16.3%). Better family economic status was linked to fewer depressive symptoms both directly and indirectly through greater perceived social support (indirect effect - 0.01, 95% CI -0.02 to -0.001; 11.1%). Larger average living space per person was associated with lower depressive symptoms only indirectly through increased perceived social support (indirect effect - 0.01, 95% CI -0.02 to -0.002; 43.5%). Household registration moderated the indirect pathway via perceived social support: the indirect effect of family economic status was significant among urban children but not among rural children. No significant moderation by sex was observed.</p><p><strong>Conclusions: </strong>Family SES was associated with depressive symptoms in primary school children partly through loneliness and perceived social support, with the latter pathway contingent on household registration. These findings underscore the importance of interpersonal processes and contextual conditions in shaping socioeconomic inequalities in childhood mental health and highlight the need for context-sensitive prevention strategies.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249439","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":"Feasibility and acceptability of a multi-level school-based intervention for adolescent mental health in Nepal: a mixed-methods study.","authors":"Nagendra Prasad Luitel, Indira Pradhan, Bishnu Lamichhane, Nishan Dulal, G J Melendez-Torres, Emily Shi, Malka Dhillon, Kamal Gautam, Sarah Skeen, Mark Tomlinson, Mark J D Jordans","doi":"10.1186/s13034-026-01111-7","DOIUrl":"10.1186/s13034-026-01111-7","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a crucial developmental stage characterized by rapid biological, psychological, and social changes, that increase vulnerability to mental health issues. Nearly half of all mental health conditions have their onset during this period and are influenced by individual, family, and environmental factors. Schools play a key role in promoting mental well-being among adolescents due to their accessibility and reach. While school-based mental health prevention interventions have shown positive outcomes in high-income countries, evidence from low- and middle-income countries (LMICs) is limited. This study aimed to assess the feasibility and acceptability of Health Action in Schools for a Thriving Adolescent Generation (HASHTAG), a comprehensive school-based intervention for adolescents aged 13-16 years in Nepal.</p><p><strong>Methods: </strong>A feasibility cluster-randomized controlled trial was conducted in four secondary schools in Morang district, Nepal. Adolescents completed surveys at baseline and at a 3-month follow-up to evaluate mental well-being, emotional and behavioral outcomes, social support, school climate, and functioning. The intervention comprised two components: Thriving Environment in Schools (TES), implemented over three months and Thriving Together (TT), delivered through six weekly sessions. Quantitative data were collected electronically and analyzed descriptively. Qualitative data were gathered through focus group discussions and in-depth interviews with adolescents, teachers, and facilitators to explore implementation experiences and were analyzed thematically.</p><p><strong>Results: </strong>Both the TES and TT components were well received, with TT sessions achieving an average attendance rate exceeding 70%, and being delivered as planned by trained facilitators, indicating good acceptability and feasibility. Explanatory analysis suggested a positive trend in anxiety outcomes in the intervention group while, social support showed a modest increase. Other outcomes showed small, non-significant changes. Qualitative findings highlighted perceived benefits such as improvements in school cleanliness, staff-student relationships, bullying and discrimination reduction, and positive social and behavioral changes. Participants found breathing exercises, games, the workbook, and the 'feeling box' particularly helpful. Implementation challenges included limited space, logistical constraints, COVID-19 related disruptions, and session length.</p><p><strong>Conclusion: </strong>HASHTAG demonstrated feasibility and accessibility as a school-based intervention for adolescents in Nepal, with preliminary indications of potential benefits. Addressing identified implementation challenges will be important for optimizing delivery in future studies. A fully powered randomized controlled trial is warranted to evaluate effectiveness.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238993","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":"Persistent sleep disturbances in disaster-exposed children: the longitudinal impact of maternal psychopathology.","authors":"Elif Kocak, Serkan Gunes, Nazmiye Ince, Dilek Altun Varmis, Emine Merve Kalinli, Gupse Inal Ulutas, Kubra Sahin, Tugce Hilda Demirci, Emine Cilogulları, Elif Gozde Yuce Antepuzumu, Cumali Yuksekkaya","doi":"10.1186/s13034-026-01114-4","DOIUrl":"10.1186/s13034-026-01114-4","url":null,"abstract":"<p><strong>Background: </strong>Natural disasters significantly impact children's physiological and psychological health, with sleep disturbances being among the most prevalent consequences. This study aims to investigate the longitudinal relationship between maternal psychopathology and children's sleep disturbances after the 2023 Türkiye earthquakes.</p><p><strong>Methods: </strong>A total of 132 mother-child dyads (children aged 8-12 years) who directly experienced the earthquakes were assessed at 3 months (T1) and 12 months (T2) post-disaster. Children's sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), while maternal depression, anxiety, and posttraumatic stress symptoms were evaluated using the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and PTSD Checklist for DSM-5 (PCL-5), respectively.</p><p><strong>Results: </strong>Children's overall sleep quality improved from T1 to T2, although 65.9% continued to report poor sleep quality at T2. Maternal PTSD symptoms decreased significantly over time, whereas reductions in depression and anxiety were non-significant. Maternal psychopathology variables (BDI, STAI, PCL-5) were significantly correlated with children's PSQI scores at T2. Hierarchical regression analysis revealed that baseline child sleep disturbances, maternal psychopathology, earthquake exposure severity, and maternal education level together explained 38% of the variance in children's sleep quality at T2.</p><p><strong>Conclusions: </strong>Maternal mental health is significantly associated with the persistence of children's sleep disturbances following the earthquakes. Interventions targeting maternal psychopathology and early sleep problems may help improve long-term sleep outcomes in disaster-affected children.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249424","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":"Motivations and triggers for non-suicidal self-injury among adolescents with alcohol use disorder in China: a qualitative descriptive study.","authors":"Dongyang Wang, Angran Wang, Thitipong Tankumpuan, Hang Yang","doi":"10.1186/s13034-026-01107-3","DOIUrl":"10.1186/s13034-026-01107-3","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol use disorder (AUD) and non-suicidal self-injury (NSSI) frequently co-occur in adolescents. However, the underlying phenomenological mechanisms and the dynamic spatial-temporal evolution of this complex comorbidity remain significantly under-explored in current literature.</p><p><strong>Aim: </strong>This study aims to explore the perceived experiential processes of comorbid AUD and NSSI in adolescents and to dynamically map their disease journey across different physical and medical spaces.</p><p><strong>Methods: </strong>A qualitative descriptive study design was utilized. In-depth semi-structured interviews were conducted with eighteen adolescents formally diagnosed with AUD and comorbid NSSI. The interview transcripts were analyzed using rigorous inductive thematic analysis. A patient-reported disease journey map was subsequently constructed to visualize the phenomenological trajectory without researcher inference.</p><p><strong>Results: </strong>Three highly nested core themes emerged from the data encompassing the illusory pursuit of emotional numbing, the cognitive tunnel effect driven by alcohol disinhibition, and the pathological closed loop reinforced by secondary shame. The constructed disease journey map delineated three critical transitional phases including the covert pre-hospital incubation, the in-hospital emergency exposure with closed withdrawal, and the post-hospital isolated recovery. Participants experienced intense environmental deprivation during medical spatial transitions and highlighted a severe deprivation of continuous professional support during late-night emotional micro-crises upon returning home.</p><p><strong>Conclusion: </strong>The comorbidity of AUD and NSSI functions as a maladaptive survival strategy fueled by emotional avoidance and cognitive tunneling. Clinical psychiatric nursing urgently requires a paradigm shift towards trauma-informed care and is recommended to develop digital continuous networks to provide immediate psychological safety nets at high-risk relapse nodes.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238994","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":"Parent-adolescent psychological distress (in)congruence and adolescent NSSI: a dyadic response surface analysis.","authors":"Guanghui Shen, Yang Zou, Mengting Wang, Wenqian Jian, Hong Pan, Yawen Zheng, Li Chen","doi":"10.1186/s13034-026-01108-2","DOIUrl":"10.1186/s13034-026-01108-2","url":null,"abstract":"<p><strong>Background: </strong>Non-suicidal self-injury (NSSI) represents a significant public health concern among adolescents with mood disorders. While individual psychological distress is established as a risk factor, the impact of parent-adolescent emotional congruence/incongruence on NSSI remains underexplored. This study aimed to examine the associations between adolescent and parental psychological distress and adolescent NSSI, focusing on the effects of dyadic congruence and incongruence.</p><p><strong>Methods: </strong>The study included 147 parent-adolescent dyads (94 girls, 53 boys; mean age = 15.18 years) with adolescents diagnosed with depression or bipolar disorder. Participants completed the Depression Anxiety Stress Scale (DASS-21) and the Self-Injurious Behavior Scale. Polynomial regression analysis and response surface analysis were employed to examine the effects of congruence and incongruence in psychological distress between parents and adolescents on adolescent NSSI.</p><p><strong>Results: </strong>Adolescent psychological distress was positively associated with NSSI frequency (depression: r = 0.38, p < 0.001; anxiety: r = 0.42, p < 0.001; stress: r = 0.31, p < 0.001). Response surface analyses revealed that emotional incongruence between parents and adolescents significantly predicted higher levels of NSSI for all three dimensions of psychological distress. For anxiety specifically, a U-shaped curvilinear relationship emerged (a₄=0.29, p < 0.001), indicating that extreme incongruence in either direction was particularly detrimental.</p><p><strong>Conclusion: </strong>The current study highlights that beyond individual psychological distress, emotional incongruence between parents and adolescents represents a significant risk factor for NSSI in clinically depressed adolescents. This underscores the importance of family-based interventions that promote emotional understanding and co-regulation within parent-adolescent relationships to reduce NSSI risk in clinical populations.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239006","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}