Child Psychiatry & Human Development最新文献

Rumination is thought to be a key mechanism contributing to onset and persistence of depression. We aimed to evaluate the psychometric properties of a measure of rumination, the Children's Response Styles Questionnaire (CRSQ), in a sample of UK adolescents (11-16 years; N = 615) who also completed measures of anxiety and depression symptoms. Confirmatory factor analysis supported the two-factor solution: 'rumination' and 'distraction and problem-solving' (DPS), however the DPS subscale was weaker due to item removal. Full and partial measurement invariance was demonstrated for age and gender respectively. The rumination subscale showed good internal consistency, and it is moderately positively correlated with depression and anxiety symptom measures. Our study suggests that the rumination subscale is both reliable and valid and indicates that the measure could be used in research with UK adolescents, however caution is needed if using the DPS subscale. Future research in clinical populations is warranted.

This study examined how childhood maltreatment, bullying victimization, and weakness in social competition co-occur and are associated with adolescent adjustment through belief in a just world (BJW). Data were collected from 1,302 Chinese adolescents over six months. Latent profile analysis identified three adversity profiles: low-adversity profile (84.2%), moderate-adversity, predominantly family maltreatment profile (11.2%), and high-adversity, predominantly peer-related profile (4.6%). Adolescents in the moderate- and high-adversity profiles reported more depressive and externalizing symptoms than those in the low-adversity profile, with the high-adversity profile showing the highest symptom levels. Multicategorical mediation analyses indicated that both general and personal BJW indirectly linked adversity profiles to depressive symptoms, whereas only general BJW indirectly linked adversity profiles to externalizing symptoms. The findings highlight the importance of co-occurring adversity patterns and suggest that BJW may serve as a partial psychological mechanism linking adversity profiles to adolescent adjustment.

Anxiety disorders are highly prevalent in childhood, and increasing demand for services highlights the need for scalable and accessible interventions. This pilot randomized controlled equivalence trial examined the feasibility and preliminary efficacy of a blended adaptation of the Unified Protocol for Children ("Emotion Detectives In-Out"), integrating face-to-face group sessions with self-guided and therapist-supported online components. The intervention was compared with Coping Cat, a well-established cognitive-behavioral group program for childhood anxiety. Seventy-seven children aged 6-13 years with a primary anxiety disorder were randomized to either condition. Outcomes included clinician-rated severity and improvement, child- and parent-reported anxiety and depressive symptoms, and anxiety-related interference in daily life. Both interventions were associated with significant improvements over time across most outcomes. No significant between-group differences were observed for clinician-rated severity or improvement, and remission and treatment response rates were comparable. Significant group-by-time interaction effects favoring the blended intervention emerged for child-reported generalized anxiety, total anxiety and overall symptom scores. Between-group differences were limited, although Coping Cat was associated with significantly lower parent-reported family interference at post-treatment. Equivalence analyses yielded mixed findings, with some primary outcomes meeting the prespecified equivalence criteria. Findings provide preliminary evidence supporting the potential clinical utility of a blended transdiagnostic group intervention. Although several outcomes demonstrated statistical equivalence with Coping Cat, equivalence findings were mixed and should be interpreted cautiously given the pilot nature of the trial. Larger, adequately powered randomized controlled trials are needed to determine whether the interventions achieve clinically equivalent outcomes. Trial registration number: https://doi.org/10.17605/OSF.IO/62N4X (retrospectively registered at November 18, 2025).

This study aimed to compare the oral health profiles of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and healthy controls, focusing on caries experience, periodontal status, and occlusal characteristics. In this cross-sectional study, children aged 10-18 years diagnosed with ADHD (n = 50) and age-matched healthy controls (n = 50) underwent standardized dental examinations. ADHD diagnoses were established by a child and adolescent psychiatry specialist based on DSM-5 criteria and supported by neuropsychological assessments. All dental evaluations were performed by a single blinded examiner under standardized clinical conditions. Assessments included DMFT scoring, clinical gingival evaluation, malocclusion analysis, dental crowding status, and panoramic radiographic evaluation. Children with ADHD had a significantly higher DMFT index than controls (2.82 ± 1.38 vs. 1.10 ± 1.02; p < 0.001). The odds of having a fractured tooth were higher in the ADHD group than in the control group (36% vs. 10%; unadjusted OR = 5.06, 95% CI: 1.70-15.05; p = 0.004). Any gingival abnormality was more frequent in the ADHD group than in the control group (60% vs. 12%; unadjusted OR = 11.00, 95% CI: 3.95-30.61; p < 0.001). Malocclusion (64% vs. 24%; p < 0.001) and dental crowding (70% vs. 44%; p = 0.015) were also more frequent among children with ADHD. Within this selected sample meeting predefined oral-hygiene, dietary, and dental-attendance criteria, ADHD was associated with poorer oral health indicators. These findings provide clinically relevant insights and may support tailored preventive monitoring and clinically indicated dental-mental health collaboration. Further studies involving larger and more diverse cohorts are warranted to validate these associations across the broader ADHD population.

Telehealth plays an increasingly important role in mental healthcare, but empirical evidence regarding real-time, interactive psychotherapy for children and adolescents delivered via videoconferencing is limited. It has been suggested that research becomes more relevant, acceptable, and appropriate for service users when their research priorities are considered and that future studies should involve patients and their representatives in the planning and conduct of a trial. This study therefore aimed to identify patients' research needs and priorities regarding video-based psychotherapy. Youths with experience in outpatient psychotherapy (n = 33) and their parents (n = 34) participated in the survey. Research questions relating to treatment effectiveness, the quality of the therapeutic relationship, side effects, and safety / privacy issues received high importance ratings, suggesting that these topics reflect patients' and parents' research needs. Parents prioritized research on the quality of the therapeutic relationship. Youths did not prioritize any of the proposed questions. However, patterns of research needs differed depending on youths' personal experience with video-based psychotherapy. Several respondents used an open-ended comment box to indicate further research needs. This study adds valuable information on patient-reported research needs and priorities to the emerging field of digital technologies in mental healthcare. Future studies should not only investigate the course of patients' symptoms and impairments during video-based psychotherapy, but also the therapeutic alliance, the frequency and impact of side effects, ways of delivering videoconference-delivered sessions in an engaging and effective way, safety/privacy issues, patient preferences, and whether video-based treatment improves youths' access to healthcare.

Increasing prevalence of neurodevelopmental disorders (NDDs) is a growing public health concern. Identifying early risk markers may facilitate earlier intervention and reduce long-term burden. Although birth weight has been widely studied in relation to NDDs, evidence from clinically ascertained samples with single and overlapping diagnoses remains limited. In this case-control study, we compared birth weight between clinically referred individuals with intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) from the Norwegian BUPgen registry (n = 720) and a population-based sample from the Norwegian Mother, Father and Child Cohort Study (MoBa) (n = 98,716). Perinatal data were obtained through linkage to the Medical Birth Registry of Norway. Associations were examined using logistic regression adjusted for gestational age, sex, and parental age. Additional analyses assessed interactions by sex and parental age, and birth weight categories. For each 100 g decrease in birth weight, odds significantly increased for the groups any NDD (one or more NDD diagnoses; OR = 1.04) and multiple diagnoses (two or more co-occurring NDDs; OR = 1.07). In diagnosis specific analyses, odds significantly increased for ID (OR = 1.15) and ASD (OR = 1.03). No interactions were observed. In categorical analyses, low birth weight was associated with higher odds of ID (OR = 8.27, p < 0.001), multiple diagnoses (OR = 4.96, p < 0.001), and any NDD (OR = 2.11, p = 0.002). No associations were observed for high birth weight. These findings support low birth weight as an early marker of neurodevelopmental vulnerability across NDD outcomes.

Family accommodation is a key environmental factor that can maintain and reinforce child anxiety disorders, but research on accommodation specific to childhood selective mutism (SM) is limited and inconsistent. The absence of a supported measure of accommodation specifically in verbal contexts may explain, in part, why research on accommodation in the families of youth with SM has lagged. In a sample of 412 treatment-seeking anxious youth ages 2-18 years (52.7% with SM; 56.7% female; ~50% Hispanic and/or Latinx), the present study examined the psychometric properties of the Survey of Accommodation in Verbal Encounters (SAVE) - a newly developed caregiver-report scale assessing the frequency of parental accommodation specifically in situations in which child verbal communication is expected. Confirmatory factor analysis supported an 18-item, four-factor structure corresponding to four SAVE subscales: Surrogate Speaking, Permitting of Whispered Communication, Permitting of Nonverbal Communication, and Instrumental Accommodation. The SAVE also demonstrated strong reliability, concurrent and divergent validity, incremental utility, and clinical relevance to SM. These findings offer support for the SAVE as the first measure of parental accommodation in contexts in which child speech is expected. Results also provide empirical insight into the frequency, patterns, and correlates of such accommodation among families of anxious children with and without SM. The SAVE appears to offer a useful tool for researchers and clinicians to assess SM-specific accommodation and key family dynamics associated with verbal reticence in youth.

Rising concerns about youth mental health underscore the need to clarify ecological correlates of broad psychological vulnerability. Using a school-based sample of 8,981 Chinese adolescents, this study examined multilevel correlates of a latent general psychopathology factor (p factor) of mental health difficulties. Self-report measures assessed individual, family, school, and social-environmental factors. A sequential feature-selection procedure (univariate screening, LASSO, Boruta) identified 31 candidate variables, which were incorporated into a Bayesian network to estimate conditional associations. Twenty-four variables showed direct conditional associations with the p factor, spanning sleep quality, repetitive negative thinking, impulsivity, childhood trauma, interparental conflict, peer verbal victimization, learning burnout, academic stress, and digital social pressures. Sleep quality demonstrated the strongest association. Findings highlight the interplay of individual and contextual correlates of broad psychopathology and may help inform school- and family-based prevention efforts.

Rating scales are widely used in autism spectrum disorder (ASD) evaluations to provide information about developmental history and behavior across settings. Despite frequent use, limited research has examined the diagnostic utility of the Autism Spectrum Rating Scale (ASRS) in clinical settings. This study evaluated the ability of the ASRS to predict ASD diagnoses in a clinical sample. We conducted a chart review of 2,200 youth ages 8-18 years (M = 10, SD = 3) who completed comprehensive autism evaluations and either received an ASD diagnosis (n = 1101) or did not (n = 1119). We analyzed parent and teacher ASRS forms using t-tests and receiver operating characteristic analyses. The DSM subscale scores were significantly higher in the ASD group, though effect sizes were small. Teacher ratings performed slightly better than parent ratings, but overall diagnostic accuracy was poor (AUC = 0.62). Findings suggest the ASRS may aid screening but has limited diagnostic utility in high base-rate clinical settings.

Harsh parental disciplinary approaches can negatively impact children emotionally and behaviorally, and early childhood mental health difficulties can impact later life functioning. We examined parental disciplinary approaches (i.e., inductive and power assertion approaches) during childhood in relation to internalizing, externalizing, and total behavior problems across 14 countries. We hypothesized that discipline practice indicators would explain both within- and between-group variance based on differential values, socialization goals, and acceptance of varying approaches across cultures. Caregivers (N = 865) across 14 countries (M = 61 families per site) reported child (M_age = 26.88 months, SD_age = 5.65 months; 52% boys) behavioral, social, and emotional functioning as well as parent disciplinary techniques. Utilizing multilevel modeling, the role of within- and between-culture variance in disciplinary techniques in relation to overall problem behaviors, internalizing problems, and externalizing problems was assessed. Total behavior problems and internalizing problems were predicted by shouting, hitting, and taking privileges. Externalizing problems were predicted by shouting and taking privileges. Further, random slope effects were significant in predicting internalizing problems with parental hitting and taking away privileges. Overall hypotheses were supported. Findings suggest evidence of more universal and some culture-specific prediction in the relations between discipline techniques and behavioral outcomes. Prevention/treatment approaches for child behavior problems aimed at reduction of parental coercive discipline practices may be relevant across different cultures.