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Debate: Standing up for science – how to combat misinformation in child mental health: protecting the integrity of autism research and practice in the United States 辩论:支持科学——如何打击儿童心理健康方面的错误信息:保护美国自闭症研究和实践的完整性。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-12-17 DOI: 10.1111/camh.70058
Helen Tager-Flusberg

In 2025, the Coalition of Autism Scientists was formed to counter the misinformation and pseudoscience that was being advanced at the highest levels of the federal government in the United States. The background and history of how the Coalition was formed and its major activities, which include regular meetings, issuing public statements, and providing information and interviews to the media, are described. The importance of engaging in active advocacy in support of autism science is discussed along with some examples of the Coalition's impact. Given the direction that politics is going, sowing greater dissent between science and the public, continued vigilance in support of the highest quality research is critical if we are to meet the urgent needs of autistic people and their families.

2025年,自闭症科学家联盟成立,以对抗美国联邦政府最高层正在推进的错误信息和伪科学。介绍了联盟成立的背景和历史及其主要活动,包括定期会议、发表公开声明、向媒体提供信息和采访。讨论了积极倡导支持自闭症科学的重要性,并举例说明了该联盟的影响。考虑到政治的发展方向,在科学和公众之间播下更大的分歧,如果我们要满足自闭症患者及其家庭的迫切需求,继续保持警惕,支持最高质量的研究是至关重要的。
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引用次数: 0
Commentary: Bridging the gap between emerging harms and evidence-based care: a commentary on Bucci et al. (2025) 评论:弥合新出现的危害和循证护理之间的差距:对Bucci等人(2025)的评论。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-12-17 DOI: 10.1111/camh.70057
Joshua S. Steinberg, Sean H. Toh, Patrick Mair, John R. Weisz

Bucci et al. (Child and Adolescent Mental Health, 13, 1) report on a thoughtfully designed feasibility trial of i-Minds, a digital intervention for youths who have been exposed to technology-assisted sexual abuse. The study represents an important step toward addressing an emerging and deeply concerning threat to youth mental health. More broadly, it highlights a familiar challenge for intervention scientists: how to make go/no-go decisions about larger clinical trials based on small feasibility studies, and how to balance careful, evidence-based treatment development with the urgent public health need for intervention. This tension is especially salient as new harms associated with the internet emerge faster than intervention evaluation can respond. To address this, we suggest balancing urgency with rigor by employing efficient evaluation strategies, including Bayesian analysis to quantify clinically meaningful effects, target trial emulation to create treatment-versus-control comparisons, and adaptive trial designs that allow for refining interventions mid-trial.

Bucci等人(儿童与青少年心理健康,13,1)报告了一项精心设计的i-Minds可行性试验,这是一种针对遭受技术辅助性侵犯的青少年的数字干预。这项研究是朝着解决对青少年心理健康的新出现的、令人深感担忧的威胁迈出的重要一步。更广泛地说,它突出了干预科学家面临的一个熟悉的挑战:如何在小型可行性研究的基础上对更大规模的临床试验做出进行/不进行的决定,以及如何在谨慎的、基于证据的治疗发展与干预的紧急公共卫生需求之间取得平衡。当与互联网相关的新危害出现的速度超过干预评估的反应速度时,这种紧张关系尤为突出。为了解决这个问题,我们建议采用有效的评估策略来平衡紧迫性和严谨性,包括贝叶斯分析来量化临床有意义的效果,目标试验模拟来创建治疗与对照的比较,以及适应性试验设计,允许在试验中期改进干预措施。
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引用次数: 0
Clinical research updates 临床研究更新。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-12-16 DOI: 10.1111/camh.70053
Marinos Kyriakopoulos, Anastasia Andreou, Dimitrios Apostolou, Paraskevi Lampropoulou
<p>Anastasia Andreou</p><p>National and Kapodistrian University of Athens</p><p>Most individuals with childhood Attention-Deficit/Hyperactivity Disorder (ADHD) experience remittance of their ADHD diagnosis over time, but impairing symptoms of ADHD may persist, and psychiatric disorders are highly prevalent in these individuals. There is limited understanding about childhood factors that may predict these outcomes.</p><p>van der Plas et al. (2025) conducted a systematic review and meta-analysis aimed at identifying childhood factors that predict psychiatric problems in adults diagnosed with childhood ADHD. The final analysis included 36 longitudinal studies investigating 119 unique predictors, although a majority (66%) were studied only once. Meta-analyses were conducted when at least three studies examined the same predictor (10 predictors) with comparable effect sizes; otherwise, narrative reviews were performed (31 predictors). Study quality was assessed using the Newcastle–Ottawa Scale (NOS), with only 44% of studies rated as fair or good quality. Additionally, 53% of studies did not control for confounding variables. Five predictors of ADHD persistence were meta-analyzed. A childhood history of stimulant treatment was associated with an increased risk for persistent ADHD, although children with more severe symptoms may be more likely to receive these medications. Higher childhood Full Scale IQ was associated with a decreased risk, but this association lost significance when one poor-quality study was excluded. ADHD persistence was linked to an increased risk of substance use disorders (SUDs) and major depressive disorder (MDD) in adulthood but not to adult anxiety disorders. Childhood oppositional defiant disorder/conduct disorder (ODD/CD), male sex, and severity of childhood ADHD-related impairment were not associated with adult ADHD persistence. Childhood ODD/CD and stimulant treatment did not predict adult SUDs. Narratively reviewed predictors from fair/good quality studies showed some evidence that ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunction, and low socioeconomic status increase the risk of ADHD persistence. There was also some narrative evidence linking persistent ADHD to adult antisocial personality disorder (ASPD), late initiation of stimulant treatment to increased risk of SUDs in adulthood, and stimulant treatment generally to decreased risk of adult MDD. This study confirms many findings from previous meta-analyses but highlights discrepancies regarding childhood IQ, ODD/CD, and severity of ADHD impairment. Unlike earlier work, childhood MDD was not found to predict adult ADHD persistence.</p><p>The authors emphasize the need for further investigation into predictors such as ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunction, thought problems, parental psychopathology, and socioeconomic status. They h
大多数患有儿童注意力缺陷/多动障碍(ADHD)的个体随着时间的推移会经历ADHD诊断的转移,但ADHD的损害症状可能持续存在,精神疾病在这些个体中非常普遍。对可能预测这些结果的童年因素的了解有限。van der Plas等人(2025)进行了一项系统回顾和荟萃分析,旨在确定儿童时期的因素,预测被诊断患有儿童多动症的成年人的精神问题。最终的分析包括36项纵向研究,调查119个独特的预测因素,尽管大多数(66%)只研究了一次。当至少有三项研究检验了具有可比效应量的相同预测因子(10个预测因子)时,进行荟萃分析;否则,进行叙述性回顾(31个预测因子)。研究质量使用纽卡斯尔-渥太华量表(NOS)进行评估,只有44%的研究被评为公平或质量良好。此外,53%的研究没有控制混杂变量。对ADHD持续性的五个预测因素进行meta分析。儿童期兴奋剂治疗史与持续性ADHD的风险增加有关,尽管症状更严重的儿童更有可能接受这些药物治疗。较高的儿童全量表智商与风险降低有关,但当排除一项质量较差的研究时,这种联系就失去了意义。ADHD的持续存在与成年后物质使用障碍(sud)和重度抑郁症(MDD)的风险增加有关,但与成年焦虑症无关。儿童对立违抗性障碍/行为障碍(ODD/CD)、男性和儿童ADHD相关损害的严重程度与成人ADHD持续性无关。儿童ODD/CD和兴奋剂治疗不能预测成人sud。从公平/高质量的研究中叙述性地回顾预测因子,一些证据表明ADHD合并型、多动/冲动症状、焦虑障碍、外化问题、社会功能障碍和低社会经济地位增加了ADHD持续存在的风险。还有一些叙述性证据表明,持续性ADHD与成人反社会人格障碍(ASPD)有关,较晚开始兴奋剂治疗会增加成年期sud的风险,而兴奋剂治疗通常会降低成年期MDD的风险。这项研究证实了先前荟萃分析的许多发现,但强调了儿童智商、ODD/CD和ADHD损害严重程度方面的差异。与早期的研究不同,儿童时期的重度抑郁症并不能预测成人多动症的持续存在。作者强调需要进一步研究ADHD合并型、多动/冲动症状、焦虑障碍、外化问题、社会功能障碍、思想问题、父母精神病理和社会经济地位等预测因素。他们强调了由于现有研究的数量以及所研究的预测因素和结果的类型所造成的局限性。未来的研究建议包括更广泛的潜在预测因素,利用先进的方法,如机器学习,并应用个体参与者数据荟萃分析,以更好地了解儿童多动症的综合预测效应和罕见的成人结果。van der Plas, n.e., Noordermeer, s.d.s., Oosterlaan, J.和Luman, M.(2025)。系统回顾和荟萃分析:儿童注意缺陷/多动障碍成人精神结局的预测因素。美国儿童与青少年精神病学学会杂志:S0890-8567(25)00215-1。doi: 10.1016 / j.jaac.2025.04.012。雅典大学的Dimitrios ApostolouNational和Kapodistrian教授:内化问题(如焦虑、抑郁、社交退缩和躯体抱怨)和外化问题(如攻击性、冲动和行为困难)通常出现在儿童早期,并可能持续到青春期和成年期,导致不利的发展结果。虽然传统上研究是分开的途径,但越来越多的研究表明,内化和外化问题不是独立的,而是经常在发展过程中共同发生和相互作用。这种共存与更严重的心理社会失调、更差的学业成绩和更高的后期精神病理风险有关。Bista等人(2025)进行了一项约2000名参与者从出生到青春期后期的大型出生前队列研究。使用潜在阶级增长分析(LCGA),作者根据家长和老师的重复报告,确定了具有内化和外化问题明显共同发生轨迹的儿童亚组。目的是确定这两个领域的精神病理学是否遵循独立或相互关联的发展过程。出现了四个主要的轨迹组。 低稳定组代表了大多数症状水平持续较低的参与者。中度下降组在童年时期表现出较高的困难,随着时间的推移而减少。增长组的内化和外化问题都在逐步上升,而高稳定组在所有发展阶段都保持高水平。大约8-10%的参与者属于两种最具症状的轨迹。一些早期的危险因素将这些群体区分开来。暴露于母亲精神病理和产前压力、较低的社会经济地位、不一致或严厉的父母以及早期气质失调的儿童更有可能遵循增加或高稳定的轨迹。这些发现支持了发育共病的概念,即情绪和行为问题交织在一起,并随着时间的推移相互加强。该研究的优势包括前瞻性设计,多信息重复评估,以及使用先进的统计模型,可以对发育异质性进行细致入微的描述。然而,局限性包括依赖于父母报告,潜在的损耗偏见,以及对介导生物学或上下文机制的有限探索。总之,这项研究提供了令人信服的证据,表明从童年到青春期,内化和外化问题通常以可识别的模式共同发展。早期家庭和个人因素在形成这些轨迹方面发挥关键作用,强调了长期监测和早期以家庭为重点的预防战略在促进儿童和青少年心理健康方面的重要性。Bista, S., Tait, R. J., Straker, L. M., Lin, A., Steinbeck, K., Graham, P. L.,…& Skinner, S. R.(2025)。儿童期中期到青春期后期内化和外化问题的共同发展轨迹和儿童期风险因素:来自前瞻性产前队列的研究结果。中国精神病学杂志,2011(1),344 - 344。doi: 10.1017 / S0954579423001505。兴奋剂是治疗注意力缺陷/多动障碍(ADHD)的一线药物。尽管它们对多动症的核心症状有好处,但它们也有一些副作用。有人认为兴奋剂可能会诱发精神病和躁狂症状,从而导致精神障碍或双相情感障碍。Salazar de Pablo等人(2025)进行了一项系统回顾和荟萃分析,探讨了兴奋剂对接受ADHD药物治疗的个体的精神病症状或躁狂症/双相情感障碍症状的影响。搜索包括PubMed、Web of Science、Ovid/PsycINFO和Cochrane Central Register of Reviews等数据库,涵盖了从开始到2024年10月1日的文献。共纳入16项研究,包括391,043名年龄在8.5至31.1岁之间(平均12.6岁)的个体。参与者根据DSM或ICD被诊断为ADHD,并在服用兴奋剂时报告有双相情感障碍、精神病或这些症状。荟萃分析结果显示,2.76%的ADHD患者服用兴奋剂后出现精神病症状,2.29%出现精神障碍,3.72%出现双相情感障碍。在纳入的研究中,精神病和双相情感障碍症状的异质性具有统计学意义(I2 &gt; 95%)。根据亚组分析,在研究地域和随访时间方面存在差异。服用安非他明的个体比服用哌甲酯的个体表现出更多的精神病症状(高出57%的几率)。较高的女性比例、兴奋剂剂量和较小的样本量导致了发表偏倚。在质量评估中,71.4%的队列研究被评为良好。一项随机对照试验被评估为低偏倚风险,另一项被评估为存在一些问题。引发精神病或双相情感障碍的机制尚不完全清楚。有些人在服用兴奋剂后可能出现这种症状,但这可能不代表因果关系。确定了几个限制。首先,这些研究没有对照组比较(接受非兴奋剂治疗的个体),只有三项研究比较了安非他明和哌醋甲酯。此外,不可能对与兴奋剂使用相关的躁狂症状发展的数据进行荟萃分析。此外,尽管
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引用次数: 0
Commentary: Interpreting diagnostic data on autism and gender dysphoria: clinical and research implications – a commentary on Sanders et al. (2025) 评论:解释自闭症和性别不安的诊断数据:临床和研究意义-对Sanders等人(2025)的评论。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-12-16 DOI: 10.1111/camh.70056
Kai Thomas, Kate Cooper
<p>Sanders et al. (<span>2025</span>) make a valuable contribution to the literature by examining the co-occurrence of autism and gender dysphoria diagnoses in a large, community-based sample of children and adolescents. One of the most notable strengths of this study is its use of electronic health record data, encompassing over 750,000 individuals. Previous research has been limited to smaller samples within more specialist settings, such as academic medical centres. As well as exploring the prevalence of gender dysphoria among autistic and nonautistic participants, they investigated co-occurring rates of depressive disorder, generalised anxiety disorder and suicide attempts. The study found that autistic children and adolescents were more likely to have recorded diagnoses of gender dysphoria than nonautistic children and adolescents. In addition, children and adolescents who were both autistic and had gender dysphoria were more likely to have higher rates of recorded diagnoses of depression, anxiety and suicide attempts compared to those who were not autistic and/or did not have a diagnosis of gender dysphoria.</p><p>The size of the sample allows for a robust comparison across four groups of young people (autistic only, gender dysphoria diagnosis only, autistic with a gender dysphoria diagnosis and nonautistic without a diagnosis of gender dysphoria), enabling insights into the prevalence and co-occurrence of mental health difficulties associated with these intersecting identities. The findings underscore the clinical relevance of the co-occurrence of autism and gender dysphoria. These results reinforce the importance of integrated, developmentally informed approaches to assessment and care.</p><p>While Sanders et al. (<span>2025</span>) provide valuable evidence of the association between autism and gender dysphoria in a large community sample, several limitations and further opportunities for inclusivity and nuance warrant attention. First, the reliance on formal diagnoses recorded in electronic health records needs to be carefully considered. We note that this is an inevitable consequence of using large health system data, which also contributes to the strength of the large, community sample. Many young people face barriers to accessing timely and accurate diagnoses of autism and gender dysphoria due to systemic inequities, lack of specialist services or stigma (Crane, Batty, Adeyinka, et al., <span>2018</span>; Smith-Young, Pike, Swab, & Chafe, <span>2025</span>; Squires, Laws, Joubert, & Greenhill, <span>2024</span>). It is not possible from the dataset to understand the clinical processes that led to diagnoses of autism, gender dysphoria, depression and anxiety. Diagnostic overshadowing may have occurred and diagnostic accuracy is likely to be dependent on clinician speciality (i.e. primary care, mental health and gender specialist). As such, the study may not accurately represent the prevalence of conditions reported.</p><p>The
Sanders等人(2025)通过在以社区为基础的大量儿童和青少年样本中研究自闭症和性别不安诊断的共现性,对文献做出了有价值的贡献。这项研究最显著的优势之一是它使用了电子健康记录数据,涵盖了超过75万人。以前的研究仅限于更专业的环境下的小样本,比如学术医疗中心。除了探索自闭症和非自闭症参与者中性别焦虑的患病率外,他们还调查了抑郁症、广泛性焦虑症和自杀企图的共同发生率。研究发现,自闭症儿童和青少年比非自闭症儿童和青少年更有可能被诊断为性别焦虑症。此外,与没有自闭症和/或没有性别焦虑症的儿童和青少年相比,患有自闭症和性别焦虑症的儿童和青少年更有可能有更高的抑郁、焦虑和自杀企图的记录。样本的大小允许在四组年轻人之间进行强有力的比较(仅自闭症,仅诊断为性别焦虑症,诊断为性别焦虑症的自闭症和未诊断为性别焦虑症的非自闭症),从而能够深入了解与这些交叉身份相关的心理健康困难的患病率和共发性。该研究结果强调了自闭症和性别焦虑共存的临床相关性。这些结果加强了综合的、了解发展情况的评估和护理方法的重要性。虽然Sanders等人(2025)在一个大的社区样本中提供了自闭症和性别不安之间联系的有价值的证据,但一些限制和进一步的包容性和细微差别的机会值得注意。首先,需要仔细考虑对电子健康记录中记录的正式诊断的依赖。我们注意到,这是使用大型卫生系统数据的必然结果,这也有助于大型社区样本的强度。由于系统不平等、缺乏专业服务或耻耻感,许多年轻人在获得自闭症和性别焦虑症的及时准确诊断方面面临障碍(Crane, Batty, Adeyinka等,2018;Smith-Young, Pike, Swab, Chafe, 2025; Squires, Laws, Joubert, Greenhill, 2024)。从数据集中不可能了解导致自闭症、性别焦虑症、抑郁症和焦虑症诊断的临床过程。诊断掩盖可能已经发生,诊断的准确性可能取决于临床医生的专业(即初级保健、精神卫生和性别专家)。因此,这项研究可能不能准确地代表所报告的疾病的患病率。这项研究只关注抑郁、焦虑和自杀的同时发生。考虑到自闭症青年和性别焦虑症患者的心理健康需求,这是一个值得称赞的目标。然而,不可避免的是,患有性别焦虑症的自闭症患者的样本量很小(n = 59),这意味着我们应该谨慎对待这些发现。该分析忽略了更广泛的心理健康状况,这些状况已知会与自闭症和性别焦虑症同时发生,比如饮食失调。考虑到越来越多的研究强调自闭症和性别多元化青年饮食失调率上升,这一点尤其引人注目(Pham et al., 2021; Strauss et al., 2021)。考虑其他神经发育诊断的交叉点也很重要,例如注意缺陷多动障碍(ADHD),它也被发现与自闭症和性别焦虑症共同发生(Micai等,2023;Warrier, Greenberg, Weir等,2020),并且与儿童和青少年的焦虑和抑郁有关(Zhang, Liao, Rao, Gao, & Yang, 2025)。将这些情况包括在内,可以更全面地了解这一人群的心理健康风险和服务需求。值得注意的是,在Sanders等人(2025)的研究中,抑郁症的患病率在非自闭症青年和自闭症青年中相似(为2%),这令人惊讶,因为大多数患病率研究已经确定自闭症青年比非自闭症青年更容易经历抑郁症(Corbett, Muscatello, & McGonigle, 2024; Hollocks, Leno, Chandler, et al., 2023)。在这一人群中,抑郁症可能被误诊或记录不足,也许在以焦虑状况为主要诊断的情况下。然而,Sanders等人报道了患有性别焦虑症的青少年抑郁率的差异。具体来说,那些患有自闭症的人比那些患有性别焦虑症但没有自闭症的人更容易患抑郁症。 这可能是由于真正的差异,同时发生的自闭症和性别不安增加了心理健康困难的风险(这将得到成人文献的支持,例如George &amp; Stokes, 2018)和/或由于对经历性别相关困扰的青少年的不同诊断过程。桑德斯和他的同事们发现,有性别不安的人的自杀企图率比没有性别不安的人要高。先前的研究调查了性别不安的青少年与接受心理健康服务的青少年的自杀率,发现这两组的自杀企图率相似(Ruuska, Tuisku, Holttinen, & Kaltiala, 2024)。临床医生必须意识到,与一般人群相比,患有性别不安的青少年自杀企图的风险更高,并采取适当措施支持他们及其父母/照顾者。还应向他们保证,他们支持有精神健康问题的青年的风险管理技能很可能是高度可转移的,并支持经历性别不安的青年。这种风险管理干预措施应该是个性化的,考虑到年轻人的社会和环境背景,并在年轻人的生活中纳入值得信赖的成年人,以帮助他们保持安全(Asarnow & Mehlum, 2019)。鉴于这一领域研究的缺乏,我们注意到未来研究的几个机会,以当前的发现为基础。首先,未来需要进行纵向研究,以检验性别焦虑对整个发展过程中心理健康的影响。在过去的十年里,随着诊断的增加,人们对性别焦虑症的认识也在增加,因此跨时间检查这些关联对于解释人群中潜在的队列效应也很重要。承认这一诊断差距对于解释这些发现并考虑其对服务提供的影响至关重要。未来的研究应确保将性别认同和出生时生理性别分开收集并准确区分。将性别和性行为混为一谈的风险歪曲了样本的性别多样性,并强化了二元框架,这些框架可能无法反映跨性别、非二元和性别不固定的儿童和年轻人的生活经历。纵向研究还应允许在整个研究的多个点收集性别认同,以便准确地表示非二元和性别流动认同,并承认性别认同可以随着时间的推移而演变和改变。准确地代表不同的性别身份,超越二元跨性别身份,允许结果按性别身份分类。这一点很重要,因为人们越来越认识到非二元性和性别膨胀青年的心理健康需求(Klinger et al., 2024)。最后,未来使用大型卫生系统数据的研究应旨在提供有关数据库及其服务人群的全面背景信息。有关社会经济地位、保险范围或服务特征/可用性的信息将帮助读者评估调查结果的普遍性。如果没有这一背景,就很难确定观察到的模式是反映了更广泛的趋势,还是受到卫生系统特定特征的影响。总之,Sanders等人(2025)通过在一个以社区为基础的儿童和青少年样本中研究自闭症和性别不安诊断的共发生,为文献提供了有价值的贡献。未来的研究应该旨在通过检查这些在整个发展过程中共同发生的诊断来扩展这些发现,以提供方向性结论,包括与其他精神健康状况和共同发生的ADHD的关联。最后,性别认同的准确测量对于确保基于证据的临床指南细致入微并包含所有性别认同非常重要。作者没有需要披露的利益冲突。T.由威尔士健康和护理研究高级奖学金(2024-2027)资助。这篇辩论文章不需要伦理批准。数据共享不适用于本辩论条款,因为没有创建或分析数据。
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引用次数: 0
Debate: Standing up for science – how to combat misinformation in child mental health? Five recommendations for disentangling fact from fiction 辩论:支持科学——如何打击儿童心理健康方面的错误信息?将事实与虚构区分开来的五条建议。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-12-12 DOI: 10.1111/camh.70055
Nina Higson-Sweeney, Douglas Badenoch, André Tomlin

The rising use of digital technologies and social media means that individuals, including young people, are increasingly searching for and consuming health-related information online. Although there are benefits to this, there has also been an increase in health-related misinformation, with growing concerns about the impact of this in the context of child mental health. This debate article outlines what misinformation is and why it is an issue in child mental health, before considering the impact that misinformation can have in relation to decision-making, help-seeking, medical mistrust, and stigma. Drawing on experiences with science communication, five recommendations are then presented for combating misinformation, focusing on what individuals can do when confronted with misinformation, how to have conversations with others about misinformation, and what can be done to promote digital literacy.

数字技术和社交媒体的日益普及意味着,包括年轻人在内的个人越来越多地在网上搜索和消费与健康有关的信息。虽然这有好处,但与健康有关的错误信息也有所增加,人们越来越担心这对儿童心理健康的影响。这篇辩论文章概述了错误信息是什么以及为什么它是儿童心理健康中的一个问题,然后考虑了错误信息在决策、寻求帮助、医疗不信任和耻辱方面可能产生的影响。然后,根据科学传播的经验,提出了打击错误信息的五项建议,重点是个人在面对错误信息时可以做些什么,如何与他人就错误信息进行对话,以及可以采取哪些措施来促进数字素养。
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引用次数: 0
How do Artificial Intelligence chatbots respond to questions from adolescent personas about their eating, body weight or appearance? 人工智能聊天机器人如何回答青少年角色关于饮食、体重或外貌的问题?
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-12-03 DOI: 10.1111/camh.70047
Florence Sheen, Bethany Mullarkey, Gemma L Witcomb, Marie-Christine Opitz, Ellen Maloney, Saffron M Baldoza, Hannah J White

Background: Body image and eating behaviours are common areas of concern for early adolescents. Artificial Intelligence (AI) interactions are becoming commonplace, including with chatbots that provide human-like communication. Adolescents may prefer using chatbots to anonymously ask sensitive questions, rather than approaching trusted adults or peers. It is unclear how chatbots answer such questions. We explored how chatbots would respond to eating, weight or appearance-related queries from adolescents.

Method: Ten fictitious adolescent personas and scripts were created to facilitate conversations with ChatGPT and Claude.AI. Personas asked questions about eating, body weight and/or appearance, presenting as 'curious', 'worried' or 'having a potential eating disorder'. Conversation outputs were analysed using reflexive thematic analysis to explore the content of chatbot responses.

Results: Five themes were identified: (1) Live a 'healthy' adolescent lifestyle; (2) Eat 'healthily'; (3) Promoting regular physical activity; (4) Seek support; (5) Focus on you. Advice was often framed within societal ideals relating to eating, body weight and/or appearance. Chatbots signposted to trusted adults and healthcare professionals for support, but not to regulated resources (e.g., NHS).

Conclusion: Framings around eating, weight and/or appearance may be problematic for adolescents with eating disorder symptomatology. A lack of prompting for further information or signposting to regulated support means vulnerable adolescents may receive unhelpful information or not reach adequate support. Understanding how AI could be supportive and/or unhelpful to adolescent users presenting with eating, body or appearance-related concerns is important. Findings can inform policy regulating AI chatbots' communications with adolescents.

背景:身体形象和饮食行为是青少年早期关注的共同领域。人工智能(AI)互动正变得越来越普遍,包括与提供类似人类交流的聊天机器人。青少年可能更喜欢使用聊天机器人匿名询问敏感问题,而不是接近可信任的成年人或同龄人。目前还不清楚聊天机器人是如何回答这些问题的。我们探索了聊天机器人如何回应青少年关于饮食、体重或外貌的问题。方法:创建了十个虚构的青少年角色和脚本,以促进与ChatGPT和Claude.AI的对话。角色被问及有关饮食、体重和/或外貌的问题,表现为“好奇”、“担心”或“有潜在的饮食失调”。使用反身性主题分析来分析会话输出,以探索聊天机器人响应的内容。结果:确定了五个主题:(1)过健康的青少年生活方式;(2)健康饮食;(3)提倡经常进行身体活动;(4)寻求支持;(5)关注自己。建议通常被框定在与饮食、体重和/或外貌有关的社会理想中。聊天机器人会向值得信任的成年人和医疗保健专业人员寻求支持,但不会向受监管的资源(例如NHS)求助。结论:围绕饮食、体重和/或外表的框架可能对有饮食失调症状的青少年有问题。缺乏获得进一步信息的提示或获得规范支持的指示意味着脆弱的青少年可能会得到无益的信息或得不到充分的支持。理解人工智能是如何支持和/或帮助青少年用户呈现与饮食、身体或外貌相关的担忧是很重要的。研究结果可以为监管人工智能聊天机器人与青少年交流的政策提供信息。
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引用次数: 0
Correction to ‘Debate: Social media in children and young people—time for a ban? From polarised debate to precautionary action—a population mental health perspective on social media and youth well-being’ 更正“辩论:儿童和年轻人的社交媒体——是时候禁止了?”从两极分化的辩论到预防性行动——从社会媒体和青年福祉的角度看人口心理健康”。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-12-02 DOI: 10.1111/camh.70052

Welsey-Smith, O., & Fleming, T. (2025). Debate: Social media in children and young people – time for a ban? From polarised debate to precautionary action – a population mental health perspective on social media and youth well-being. Child and Adolescent Mental Health, 30, 416–418. https://doi.org/10.1111/camh.70033

The first author's name was published as Oonagh Welsey-Smith. It should have been Oonagh Wesley-Smith.

韦尔斯-史密斯,O.和弗莱明,T.(2025)。辩论:儿童和年轻人的社交媒体——是时候禁止了?从两极分化的辩论到预防行动——从社会媒体和青年福祉的角度看人口心理健康。儿童和青少年心理健康,30,416-418。https://doi.org/10.1111/camh.70033The第一作者的名字是Oonagh Welsey-Smith。应该是欧娜·韦斯利-史密斯。
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引用次数: 0
Letter to the Editor: Are young people overpathologising their own mental health? We need empirical research. 致编辑的信:年轻人是否把自己的心理健康过度病态化了?我们需要实证研究。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-11-14 DOI: 10.1111/camh.70049
Isaac L Ahuvia

The journal's recent debate series ('are we overpathologising young people's mental health?') featured compelling articles regarding the pathologisation of emotional distress in young people. Much of the concern over overpathologising is that young people are overpathologising their own mental health (i.e. identifying as having mental illnesses when they are actually experiencing normative, non-clinical levels of emotional distress; Foulkes & Andrews, New Ideas Psychol., 69, 2023, 101010). I wish to briefly share a relevant finding from a recent study (on mental illness self-labelling in late adolescence) and highlight ways that new empirical work can move this debate forward.

该杂志最近的一系列辩论(“我们是否过度病态化了年轻人的心理健康?”))刊登了关于年轻人情绪困扰病理化的引人注目的文章。对过度病态化的担忧是,年轻人将自己的心理健康过度病态化(即,当他们实际上正在经历规范的、非临床水平的情绪困扰时,却认为自己患有精神疾病)。生物工程学报,2023,101010)。我想简要地分享一下最近一项研究(关于青春期后期的精神疾病自我标签)的相关发现,并强调新的实证工作可以推动这场辩论的方式。
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引用次数: 0
Technology matters: AI-driven tools in children's mental healthcare: perspectives from young people and parents. 技术问题:儿童心理保健中的人工智能驱动工具:来自年轻人和父母的观点。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-11-12 DOI: 10.1111/camh.70045
Zoë Firth, Christine Aicardi, Stephen Oram, Nicholas Cummins, Alice Wickersham, Helen L Fisher, Johnny Downs

Artificial intelligence may be able to improve the efficiency, accuracy and predictiveness of mental health assessments, and public perspectives are crucial to ensuring these tools are implemented with fairness and accountability. We developed an artificial intelligence-driven tool to automatically analyse parents' speech data, which if successful could be implemented in children and young people's mental health assessments. To engage stakeholders with this project, we worked with a science fiction writer to produce two stories about possible futures of our tool, which we discussed in workshops with young people and parents. Here, we summarise key themes arising from this novel method of engaging the public in mental health research, and highlight considerations for clinicians and researchers creating novel technologies for children and young people's mental healthcare.

人工智能或许能够提高精神健康评估的效率、准确性和预见性,而公众观点对于确保公平和问责地实施这些工具至关重要。我们开发了一种人工智能驱动的工具来自动分析父母的语音数据,如果成功的话,可以在儿童和青少年的心理健康评估中实施。为了让利益相关者参与到这个项目中来,我们与一位科幻小说作家合作,创作了两个关于我们工具可能的未来的故事,我们在研讨会上与年轻人和家长们讨论了这些故事。在这里,我们总结了由这种新颖的方法引起的关键主题,使公众参与心理健康研究,并强调临床医生和研究人员为儿童和青少年的心理健康创造新技术的考虑。
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引用次数: 0
Review: Adolescents' perspectives on and experiences with post-primary school-based suicide prevention as end-users, co-creators and peer helpers - a systematic review meta-ethnography. 综述:青少年作为最终使用者、共同创造者和同伴帮助者对小学后自杀预防的看法和经验——一项系统综述元人种学。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-11-06 DOI: 10.1111/camh.70043
Eibhlin H Walsh, Laura Hemming, Matthew P Herring, Jennifer McMahon

Background: Suicide is the fourth leading cause of death in adolescents globally. Post-primary school-based suicide prevention (PSSP) interventions are an evidence-based suicide prevention strategy. However, adolescents' experiences with PSSP interventions are not well understood but are arguably critical to ensuring PSSP interventions have their intended impacts on adolescent mental health. No known review synthesising adolescents' PSSP intervention experiences exists. The objective of the meta-ethnography review is to explore the perspectives and experiences of adolescents engaging with PSSP interventions, as participants/end-users, intervention advisors, facilitators, co-designers and co-researchers.

Method: A peer-reviewed meta-ethnography protocol has been published. The meta-ethnographic approach followed Noblit and Hare's seven-stage process for conducting meta-ethnography and adhered to the eMERGe reporting and the PRISMA statement guidelines. Searches of nine databases identified journal articles and dissertations. Study quality appraisal was undertaken in duplicate using the CASP checklist.

Results: Sixteen journal articles and dissertations were retained for analysis. Adolescents were engaged in PSSP interventions as end-users, co-creators and peer helpers. Reciprocal translations and lines of argument (LOA) synthesis reveal the importance of the following aspects of engaging with PSSP interventions: (1) how adolescents were engaged; (2) trust in facilitators, peers, school personnel and schools; and (3) personal experience sharing for connection and engagement. Our findings demonstrate the intersection between school contexts and adolescents' experiences with PSSP interventions.

Conclusion: To our knowledge, this is the first review to synthesise qualitative findings of adolescents' experiences with engaging with PSSP interventions. Understanding and harnessing adolescents' perspectives is key for enhancing PSSP intervention effectiveness and implementation. Our findings are relevant to broader health-related fields and practice, particularly given the increasing calls for youth voice.

背景:自杀是全球青少年死亡的第四大原因。基于小学后的自杀预防(PSSP)干预是一种基于证据的自杀预防策略。然而,青少年对PSSP干预的经历还没有得到很好的理解,但这对于确保PSSP干预对青少年心理健康产生预期的影响至关重要。目前还没有综合青少年PSSP干预经验的文献。元民族志综述的目的是探讨青少年作为参与者/最终用户、干预顾问、促进者、共同设计者和共同研究者参与PSSP干预的观点和经验。方法:发表了一份同行评议的元人种学协议。元民族志方法遵循Noblit和Hare进行元民族志的七阶段过程,并遵守eMERGe报告和PRISMA声明指南。检索了9个数据库,确定了期刊文章和论文。使用CASP检查表进行研究质量评估,一式两份。结果:保留了16篇期刊文章和学位论文进行分析。青少年作为最终使用者、共同创造者和同伴帮助者参与了PSSP干预。相互翻译和论证线(LOA)综合揭示了参与PSSP干预措施的以下方面的重要性:(1)青少年如何参与;(2)对辅导员、同伴、学校工作人员和学校的信任;(3)个人经验分享,建立联系和参与。我们的研究结果表明,学校环境和青少年的PSSP干预经验之间存在交集。结论:据我们所知,这是第一次对青少年参与PSSP干预的经验进行定性研究。理解和利用青少年的观点是提高PSSP干预效果和实施的关键。我们的研究结果与更广泛的健康相关领域和实践有关,特别是考虑到越来越多的年轻人的声音。
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引用次数: 0
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Child and Adolescent Mental Health
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