Clinical child psychology and psychiatry最新文献

PurposeRates of adolescents with Autism Spectrum Disorder (ASD) and suicidality have increased. Dialectical Behavioral Therapy (DBT) historically has been found to be effective in targeting suicide risk across the lifespan. Adolescents presenting with parent-reported autism traits were compared to those with low traits on DBT outcomes and suicidality in this study. Moreover, therapeutic alliance was also examined.MethodsEighty-seven adolescents attended a 4-week DBT partial hospital program (PHP); parent-report was administered to assess ASD traits. Adolescents completed self-report questionnaires at admission and discharge on four DBT outcomes. Suicidality characteristics were examined through a structured interview.ResultsWe found that adolescents presenting with autism traits did not significantly differ from adolescents presenting with low or no autism traits on suicide ideation, suicide gestures, and self-harm. They did, however, significantly report fewer suicide plans and attempts. Across the sample, DBT was most effective in improving most of adolescents' outcome skills, and this did not significantly differ based on autism traits. We also found that therapeutic alliance ratings were significantly and positively associated with the improvement outcomes observed across this sample.ConclusionOverall, this research supports DBT use for adolescents presenting with autism traits and emotion dysregulation.

Parenting programs are well-established treatments for children's behavioral problems. However, engaging parents remains challenging, and a deeper understanding of how parents perceive these programs is needed to tailor them better respond to parents' needs. This study introduces a novel individually delivered parenting program, OPPI. We investigate parental perceptions of the program's content and teaching formats included and its preliminary effects on children's behavioral symptoms. The participants were 61 parents with 45 children attending the intervention at the child psychiatric clinic at Helsinki University Hospital, Finland. Parents filled out questionnaires on family background, child's symptoms, and their perceptions of the practices and teaching formats in the intervention. Parental overall opinion about the program was highly positive; especially the guidance given by counselors was considered of high quality. Practical teaching methods were perceived by parents as both the easiest and the most useful. Parents perceived most parenting practices as useful and easy to follow. Parents also reported that children's behavioral symptoms decreased significantly from pre- to post-intervention. Our study provides valuable information on the feasibility of formats and contents in parenting program. This can guide clinicians in focusing treatment more effectively, ultimately enhancing parental engagement and the overall effectiveness of parenting programs.

BackgroundAdolescents have increasingly been reported as identifying as transgender or gender-diverse and seeking gender-affirming care. Nonetheless, the proportion receiving gender-affirming medical treatment remains low; in the United States, fewer than 100 out of every 100,000 17-year-old adolescents assigned male at birth receive gender-affirming medical treatment. Attention-deficit hyperactivity disorder (ADHD), the most common childhood neurodevelopmental disorder, is a major public health concern and shows elevated prevalence among transgender and gender-diverse adolescents.Case PresentationThis case presents a 15-year-old adolescent with ADHD and co-morbidities, including gender dysphoria, harmful use of substances, and childhood mood disorders. After antipsychotic and antidepressant pharmacotherapy combined with psychological interventions, the patient demonstrated improved emotional regulation and diminished impulsive behaviors.ConclusionThis case underscores the need for life course-oriented care that addresses transgender-specific stressors and incorporates preventive substance abuse strategies. It also emphasises the urgent need for research into comorbidity-tailored pharmacotherapy to balance ADHD treatment efficacy with gender-affirming hormone safety.

ObjectivesResearch has highlighted poorer experiences of cancer care amongst ethnically minoritised groups. Whilst significant strides have been made in understanding cancer experiences of minoritised adults, there exists a knowledge gap in understanding how cancer impacts on minoritised young people, many of whom are faced with complex developmental challenges. This study aimed to understand the experiences of cancer and cancer care amongst minoritised youths in the UK.MethodNine young people aged between 16 to 24 with diverse types of cancer diagnoses, who self-identified as ethnically minoritised shared their cancer experiences in semi-structured interviews. Participants' stories were analysed using thematic narrative analysis.ResultsFindings identified three core narratives reflecting participants' emotional journey through cancer, their cultural stories and cancer care experiences, encompassing 12 themes. Their journeys shared common themes of: Feeling Dismissed; Shock and Turmoil; Grieving Self and Changes; Isolated and Helpless; Adapting in Adversity; and "Changed for the better". Cultural narratives revealed diverging views towards family support, while cultural influences on treatment options and feelings of being othered also complicated their cancer experiences. Overall, participants shared positive experiences of cancer care. Despite a protracted journey to diagnosis, personalised, accessible care and experiences of feeling seen were valued.ConclusionThe findings shed light on cultural influences towards minoritised young people's experiences of cancer and care. Implications around strengthening cultural sensitivity and visibility were highlighted. Future research may be helpful to hone into minoritised cancer experiences at different stages during one's cancer journey including survivorship across more diverse socio-cultural contexts and how systemic factors may impact on the provision of culturally competent care.

The increasing prevalence of digital media use among children and adolescents has raised concerns about its potential impact on attention deficit hyperactivity disorder (ADHD) symptoms. This narrative review explores the relationship between screen time and ADHD in young people, with a particular focus on the impact of different treatment approaches in the context of digital engagement. A structured search identified 147 studies published between January 2018 and December 2024, of which 14 met the inclusion criteria for detailed review.The findings indicate that excessive and unstructured screen time is consistently associated with the worsening of ADHD symptoms, particularly inattention and hyperactivity. Sleep disruption and neurobiological vulnerabilities, including altered reward processing and white matter changes, appear to mediate these associations. At the same time, certain forms of digital activity, particularly interactive or cognitively engaging tasks, may provide benefits, highlighting the complexity of this relationship.Treatment approaches reflected a similar complexity. Pharmacological interventions remain central but are most effective when complemented by behavioural therapies and lifestyle modifications, such as structured screen time reduction, improved sleep routines, and increased physical activity. This review suggests that the management of ADHD in the digital era requires a holistic approach that recognises both the risks and potential benefits of screen use. Further longitudinal research is needed to clarify long-term effects and identify which forms of digital media can be harnessed constructively in clinical care.

BackgroundVoice-hearing is increasingly being recognised as a transdiagnostic experience which is common for children and adolescents. However, little is known about how young people seek help and disclose voice-hearing within mental health services.MethodThis qualitative study explored the disclosure and help-seeking experiences of nine young people (aged 14-18) receiving care from mental health services in the UK. Semi-structured interviews were conducted and analysed using thematic analysis within a critical realist framework.ResultsTwo superordinate themes were identified: barriers to accessing help; facilitators to accessing help; and the impact of practitioner response on young people's engagement. Stigma, long waiting lists for services, and practitioners' lack of knowledge often acted as barriers to disclosure and help-seeking, whereas trust and clear communication facilitated disclosure and engagement. Participants often wished to be listened to, to be offered a more personalised approach and greater flexibility from mental health services. When practitioners demonstrated empathy and allowed trust to build in the therapeutic relationship, participants felt valued.ConclusionsFindings suggest that practitioners might need to be supported to build confidence in discussing voice-hearing with young people to facilitate therapeutic conversations about these experiences, and that offering flexible, person-centred support may support young people's engagement with mental health services.

Psychological trauma and post-traumatic stress disorder (PTSD) are under-researched in autistic individuals. We explored the experience of trauma and PTSD symptoms in a sample of autistic adolescents (n = 30) aged 10-16 years (without a maltreatment history; 47% female), compared to a group of typically-developing (TD; n = 29) and a group of (non-autistic) maltreatment-exposed adolescents (n = 28), matched on key demographics. Caregiver reports indicated that a wide range of events were deemed traumatic to autistic adolescents, including those not meeting DSM-5's Criterion A for trauma for a PTSD diagnosis (e.g., bullying and bereavement). Caregiver- and self-reports converged to show more severe PTSD symptoms, and higher rates of probable PTSD, in autistic adolescents (43-57%) relative to the TD adolescents (7-32%). Symptom severity and rates of probable PTSD were comparable between the autistic and maltreatment-exposed adolescents (50-54%), except that, for autistic adolescents, the index trauma mostly did not match DSM-5 criteria, whereas it did for maltreatment-exposed adolescents. This short report's early findings supports the need for improved assessment of trauma exposure and PTSD symptoms in autistic adolescents. A flexible approach to how trauma is defined in this population may be needed, considering subjective experiences and autism-related processing differences.

ObjectivesTo address the gap in accessibility of mental health services for Mandarin-speaking families in Canada, this study evaluated the uptake, acceptability, and preliminary effectiveness of Connect for Mandarin Speaking Families, a culturally-inclusive and attachment-focused parenting program designed to promote youth and family wellbeing.MethodsParticipants were 17 birth and 1 kinship immigrant parents from China to Canada (age 39-69, M_age = 49.42, SD = 7.25; 14 mothers; 4 fathers) seeking support for concerns about their children's mental health problems (age 12-18, M_age = 14.44, SD = 1.80; 27.8% male, 72.2% female). Parents completed self-report pre- and post-measures assessing their child's mental health and evaluated the perceived fit and helpfulness of the program in this single-arm pilot study.ResultsPreliminary evidence was found for the program's effectiveness in reducing adolescent emotional and behavioural problems and improving family satisfaction. Importantly, parent attendance and retention were high (85%), and parents reported the program was very helpful and a good fit with their cultural values.ConclusionsThis pilot study is among the first to evaluate a culturally-inclusive, attachment-based parenting intervention for Chinese immigrant families in Canada, delivered in their native language. Future research with larger samples and further adaptations to address immigrant-specific family challenges is warranted.

Care-experienced young people (CEYP)'s sense of belonging is challenged by systemic instability of frequent placement and support networks changes. Belonging is critical for well-being and identity development, however, there are no known reviews scoping the available information on CEYP's belonging development. This scoping review aimed to identify what features aid the development of CEYP's sense of belonging. JBI scoping review methodology guided the search for English qualitative studies on CEYP's belonging experiences. A framework analysis using Bronfenbrenner's ecological systems model (1979) organised findings. Results showed a global increase in interest in belonging for CEYP, particularly from Western countries over the last five years. Direct relations (microsystems) with caregivers and peers were most frequently considered important for CEYP's belonging. This was alongside cooperation between care and birth families and an accepting culture for their identity characteristics, including their care status. Belonging was nurtured by services providing opportunities for connections and links formed between CEYP's microsystems over time. This review provides a synthesised definition of belonging for CEYP and raises awareness of ways to form belonging. Implications require society to provide opportunities for experiences that promote belonging for CEYP across ecological systems, focussing on community, ethnic, cultural and religious spaces.

ObjectivesCaregivers of children with Pediatric Feeding Disorder (PFD) are at-risk for experiencing anxiety and stress. Given the high prevalence of PFD, many caregivers are susceptible to such symptoms. However, regular screening for caregiver mental health concerns within pediatric clinics is scarce. This study examined rates of caregiver mental health screening completion and levels of anxiety and stress among caregivers of children with PFD.MethodsCaregivers (n = 67) were approached about completing a mental health screener. Descriptive statistics were used to explore completion rates of screenings and levels of stress and anxiety.ResultsSixty-three caregivers (94%) completed the mental health screening and findings reflect high rates of anxiety and stress for this population.ConclusionsThese results highlight the high rates of anxiety and stress in this caregiver population and demonstrate the need for universal screening for caregiver mental health among pediatric feeding clinics.