J Child Psychol Psychiatry [JOURNAL]
Sun
200 papers
Prediction versus explanation of preadolescents' psychopathology: environmental data predict while brain measures moderate effects.
Juarez DG, Jennings KE, Keller AS … +1 more , Miller JG
J Child Psychol Psychiatry · 2026 Jul · PMID 42402937 · Publisher ↗
BACKGROUND: Brain characteristics, environmental risks, and their interactions are believed to contribute to the development of psychopathology. However, it is unclear whether these factors differ in their utility for pr...
BACKGROUND: Brain characteristics, environmental risks, and their interactions are believed to contribute to the development of psychopathology. However, it is unclear whether these factors differ in their utility for predictive versus explanatory goals; few predictive studies have combined and compared neuroimaging and environmental features, and Brain × Environment studies of explanatory processes have not adopted comprehensive, data-driven methods. Here, we integrated neuroimaging and environmental data to predict youths' psychopathology and to explore brain-based measures of sensitivity to environmental influence. METHODS: Leveraging the Adolescent Brain Cognitive Development (ABCD) Study (release 5.1), we conducted analyses with up to 9,370 participants with complete baseline environmental, neuroimaging, and psychopathology data. Symptoms were assessed using the Child Behavior Checklist. Environmental exposures measured from parent-report, youth-report, and geocoded data were used to create a general exposome factor and six specific subfactors. Anatomical, resting-state functional connectivity, and diffusion MRI data were included as brain-based predictors. Nested cross-validated models assessed the predictive utility of environmental data, neuroimaging data, and their interactions. Elastic net models identified Brain × Environment interactions in nonpredictive analyses. RESULTS: Environmental data far outperformed neuroimaging in predicting psychopathology in unseen data. Although Brain × Environment interactions did not improve prediction accuracy, they revealed neural moderators of environmental effects in nonpredictive models. Measures involving the hippocampus, amygdala, salience network, and attentional networks were overrepresented among neural moderators. Certain brain features conferred increased or decreased sensitivity to supportive and adverse environments. CONCLUSIONS: Our findings not only highlight the value of environmental data for predicting preadolescents' psychopathology but also show that neuroimaging data play a role in supporting explanatory models of neural sensitivity to context.
Co-development of ADHD symptoms and emotional problems from childhood to adulthood: predictors and developmental outcomes.
You Y, Zavos HMS, Hannigan LJ … +6 more , Zhang L, Bignardi G, Han MX, Palaiologou E, Rayner C, McAdams TA
J Child Psychol Psychiatry · 2026 Jun · PMID 42381280 · Publisher ↗
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) symptoms and emotional problems frequently co-occur. Longitudinal data provide opportunities to understand how and why they co-develop. METHODS: Data were drawn...
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) symptoms and emotional problems frequently co-occur. Longitudinal data provide opportunities to understand how and why they co-develop. METHODS: Data were drawn from the Twins Early Development Study, which included 27,890 participants. Emotional problems and ADHD symptoms were parent-reported using the Strengths and Difficulties Questionnaire and Conners' Parent Rating scales. We modeled the co-development of ADHD symptoms and emotional problems from ages 4 to 21 using joint trajectory analysis. The predictors included polygenic scores (PGSs) for multiple psychiatric symptoms, maternal depression, family chaos, and socioeconomic status (SES). The outcomes included SES, lifetime psychiatric diagnoses, undergraduate diploma attainment, and entry into parenthood at age 26. RESULTS: A four-class joint trajectory model was selected as best fitting and included: 'Low ADHD, Low emotional problems', 'High-decreasing ADHD, Low emotional problems', 'Mid-decreasing ADHD, Increasing emotional problems', and 'Increasing ADHD, Increasing emotional problems'. The consistently low-symptom group reported lower ADHD and had lower externalizing PGSs, lower maternal depression, higher SES, and less home chaos at baseline, and higher educational attainment and fewer lifetime depression/anxiety diagnoses at 26 than groups with higher symptom levels. Those with high ADHD symptoms in childhood or increasing ADHD symptoms from childhood to adulthood had the lowest educational attainment and SES in adulthood. CONCLUSIONS: Groups characterized by increasing ADHD symptoms also tended to show increases in emotional problems, whereas increases in emotional problems did not necessarily coincide with increases in ADHD symptoms. The trajectories had distinct early-life predictors and adult outcomes, highlighting potential intervention targets.
Individualized EEG functional connectivity predicts clinical symptoms in ADHD, dyslexia, and their comorbidity.
Chen C, Xu S, Zhao J … +7 more , Xie Y, Yao D, Li F, Liu W, Wang Y, Xu P, Wang J
J Child Psychol Psychiatry · 2026 Jun · PMID 42345591 · Publisher ↗
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) and developmental dyslexia (DD) are two prevalent neurodevelopmental disorders (NDDs) that frequently co-occur, resulting in comorbidity (COM), which is associa...
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) and developmental dyslexia (DD) are two prevalent neurodevelopmental disorders (NDDs) that frequently co-occur, resulting in comorbidity (COM), which is associated with significant cognitive and behavioral difficulties. These disorders are characterized by considerable clinical and neurobiological heterogeneity. The functional connectivity (FC) patterns within each disorder may consist of both individual-shared and individual-specific components. Disentangling these patterns may provide more in-depth insights into the neural mechanisms underlying these conditions. METHODS: In this study, the common orthogonal basis extraction (COBE) method was applied to the resting state electroencephalography (EEG) FC data from children with ADHD, DD, COM, and age-matched typical development (TD) controls, aiming to separate individual-shared and individual-specific FC patterns. RESULTS: Individual-specific FC could significantly predict clinical symptoms in ADHD, DD, and COM, with distinct predictive connectivity patterns across different groups. The predictive features in ADHD were primarily located in the left central and parietal regions. In DD, they involved the left temporal lobe, left parietal lobe, and right central region. In COM, they involved the left frontal lobe and the right parietal lobe. At the group level, compared with TD, individual-shared FC showed significantly enhanced posterior FC in all clinical groups. The differences in shared FC among the three clinical groups further allowed for the classification of ADHD, DD, and COM with an accuracy of 73.55%. CONCLUSIONS: By disentangling the shared and individualized components of EEG FC, this study provides novel insights into the neural organization of ADHD, DD, and their COM. The results suggest that individual-specific FC is more strongly associated with clinical symptoms, whereas shared FC captures group-level connectivity alterations and differences among clinical groups. This framework may present a promising approach for investigating biological heterogeneity in NDDs.
Mechanism-based subtypes of problematic use of the internet and corresponding neurobehavioral characteristics among children and adolescents.
Deng H, Song K, Xu L … +8 more , Zhang J, Geng X, Zhang Y, Zhao Z, Kang M, Lin X, Potenza MN, Zhang J
J Child Psychol Psychiatry · 2026 Jun · PMID 42345570 · Publisher ↗
BACKGROUND: The global prevalence of problematic use of the internet (PUI) has increased over time, particularly among youth. To enhance the efficacy of treatments and identify personalized intervention targets, it is im...
BACKGROUND: The global prevalence of problematic use of the internet (PUI) has increased over time, particularly among youth. To enhance the efficacy of treatments and identify personalized intervention targets, it is important to classify subtypes based on differences in underlying mechanisms rather than solely on symptom severity. This study aimed to identify reliable subtypes of PUI among youth by examining three neurofunctional domains commonly implicated in addictive behaviors-reward processing, negative emotionality, and executive function - and to assess how the identified subtypes differed regarding clinical characteristics and resting-state functional connectivity. METHODS: Data were drawn from the Healthy Brain Network (HBN) study, comprising 484 children and adolescents (ages 6-21; 37.4% female), including 242 individuals with PUI and 242 matched controls. Latent profile analysis, along with sensitivity analyses, was conducted on phenotypic data reflecting the three addiction-related domains. The resulting subtypes were then evaluated for clinical characteristics and resting-state brain functional connectivity to consider their clinical and biological relevance. RESULTS: Three stable PUI subtypes were identified: a 'High approach with low executive function' subtype characterized by steeper delay discounting and poorer executive function, frequently co-occurring with learning disorders (n = 20); a 'Negative emotionality' subtype with elevated negative affect, frequently co-occurring with affective disorders (n = 37); an 'Emotional stress' subtype that only exhibited higher negative affect compared to matched controls and showed no marked dysfunction across other domains (n = 185). Furthermore, each subtype demonstrated distinct patterns of resting-state functional connectivity. CONCLUSIONS: The findings provide empirical evidence that youth with PUI are heterogeneous across three core neurofunctional domains, offering insights for the development of more tailored, subtype-specific interventions.
Personally meaningful life events from adolescence to young adulthood: a longitudinal natural language processing analysis.
Bürgin D, Haag C, Büeler LA … +7 more , Bechtiger L, Janousch C, Feldmann E, Ribeaud D, Eisner M, von Wyl V, Shanahan L
J Child Psychol Psychiatry · 2026 Jun · PMID 42324969 · Publisher ↗
BACKGROUND: Large-scale population-based studies of risk and protective factors for youth mental health rarely assess youths' first-hand experiences in their own words. This longitudinal study analyzed young people's sel...
BACKGROUND: Large-scale population-based studies of risk and protective factors for youth mental health rarely assess youths' first-hand experiences in their own words. This longitudinal study analyzed young people's self-reported most important life events and examined how the key topics changed from midadolescence to young adulthood and are associated with internalizing symptoms. METHODS: N = 1,442 participants from an urban, multiethnic cohort reported their most important life events at ages 15, 17, 20, and 24 in open-text segments. Themes in N = 5,670 descriptions were analyzed using topic modeling with the Python library BERTopic. RESULTS: Most reported events were positive in valence (83.1%), and were often 'normative', commonly occurring experiences spanning diverse life domains (education and career development, social relationships, leisure activities and successes, mental health and well-being, and other life transitions and independence). Event topics displayed systematic developmental shifts from midadolescence to adulthood. Higher internalizing symptoms were associated with a greater likelihood of reporting interpersonal and stressful events rather than positive or achievement-related ones. CONCLUSIONS: Longitudinal population-based research can draw on open-text data and employ NLP techniques to assess young people's lived experiences. The predominance of positive events and their associations with internalizing symptoms suggest that an increased focus on promoting beneficial experiences, next to reducing stressful events, may promote youth mental health.
A double-blind randomized controlled trial of personalized upper-alpha neurofeedback in children with ADHD.
Wang Y, Hui KY, Lu SF … +8 more , Lui QCH, Ma L, Theparambil Asharaf S, Lak D, Coghill D, Ip P, Lee TMC, Tso WWY
J Child Psychol Psychiatry · 2026 Jun · PMID 42324882 · Publisher ↗
BACKGROUND: Neurofeedback (NF) is a nonpharmacological approach for ADHD, but standard protocols often overlook individual EEG variability, potentially limiting efficacy. We report the first double-blind randomized contr...
BACKGROUND: Neurofeedback (NF) is a nonpharmacological approach for ADHD, but standard protocols often overlook individual EEG variability, potentially limiting efficacy. We report the first double-blind randomized controlled trial of a session-adaptive individualized upper-alpha NF protocol in children with ADHD, based on individualized 1/f + alpha model. METHODS: Forty-eight children (6-12 years) diagnosed with ADHD were randomized to individualized upper-alpha NF (n = 26) or sham feedback (n = 22). Participants completed eight 1-h sessions over four weeks. The primary outcome was parent-rated ADHD symptoms on the SWAN scale, measured at baseline, post-treatment, and follow-up. Secondary outcomes included PedsQL, CBCL, SDQ, and neuropsychological tests. Intention-to-treat linear mixed-effects models assessed Time × Condition interactions; within-group changes were evaluated via paired t-tests. EEG learning was defined as the change in each session's upper-alpha/theta-to-lower-alpha ratio. RESULTS: Blinding was preserved (Bang's Index: caregivers = 0.13; staff = 0.21). In the NF group, 21/26 children (80.7%) achieved 'learner' status versus 36.4% in sham. Both groups showed significant reductions in ADHD symptoms post-treatment (SWAN Total: NF, d = -0.879, p < .001; sham, d = -1.261, p < .001), with no between-group difference (d = -0.062, p = .881). At six months, NF maintained improvements in ADHD symptoms (SWAN Total: d = -0.713, p = .006), without superiority over sham (d = 0.221, p = .633). Neuropsychological testing revealed NF-specific gains in Purdue Pegboard non-preferred hand (d = 1.093, FDR q = .042) and faster CPT-3 reaction time (d = -1.210, FDR q = .025). CONCLUSIONS: Personalized upper-alpha NF produced higher EEG learning and selective motor-speed improvements but did not outperform sham in reducing parent-rated ADHD symptoms. Eight sessions sufficed for robust EEG modulation, yet non-specific training effects likely drove clinical gains, indicating NF alone may not be an adequate ADHD treatment.
Self-administered single-session interventions for mental health in young people: A systematic review and meta-analysis.
Ball J, Meiser-Stedman R, Thompson Z … +1 more , Chiu K
J Child Psychol Psychiatry · 2026 Jun · PMID 42318615 · Publisher ↗
BACKGROUND: Children and young people's mental health is an area of concern worldwide. In the face of barriers such as long waits to access evidence-based treatment, perceived stigma, and a desire to tackle challenges in...
BACKGROUND: Children and young people's mental health is an area of concern worldwide. In the face of barriers such as long waits to access evidence-based treatment, perceived stigma, and a desire to tackle challenges independently, self-administered single-session interventions (SSIs) have arisen as one potential solution. The aim of this systematic review and meta-analysis is to synthesise evidence of the efficacy of self-administered SSIs for youth mental health. METHODS: This random-effects meta-analytic review was preregistered on PROSPERO (CRD42023457030). Systematic search of randomised controlled trials (RCTs) from the Cochrane CENTRAL Register of Trials, EMBASE, MEDLINE and PsychINFO databases was conducted. RESULTS: Following screening, 25 RCTs met eligibility criteria (5,628 participants), 19 of which were meta-analysed. Most of the included studies exhibited either 'Low Risk' or 'Some Concerns', with several of them having a 'High Risk' of bias. We found a small effect for anxiety symptoms (g = -0.24, 95% CI [-0.41, -0.07]) with substantial heterogeneity (I = 62.68%) and a wide prediction interval (95% PI [-0.67, 0.19]). Furthermore, there was a small effect for depressive symptoms (g = -0.11, 95% CI [-0.22, -0.02]) with substantial heterogeneity (I = 53.86%) and a wide prediction interval (95% PI [-0.42, 0.19)]. Studies not included in the quantitative synthesis were discussed narratively. CONCLUSIONS: The findings suggest that self-administered SSIs may be efficacious in reducing anxiety and depressive symptoms in young people. Although the evidence has limitations, including a small number of studies and diverse clinical and statistical characteristics, these findings indicate the need for further exploration of SSIs to address the treatment gap in child and adolescent mental health care.
Machine learning-based early warning model for adolescent mental health risk using the p factor.
Li Y, Bian W, Wen X … +3 more , Fang Y, Wang Y, Li H
J Child Psychol Psychiatry · 2026 Jun · PMID 42313070 · Publisher ↗
BACKGROUND: Accurate identification of adolescents at high mental health risk is essential for timely intervention and improved service delivery. The general factor of psychopathology (p factor), capturing shared varianc...
BACKGROUND: Accurate identification of adolescents at high mental health risk is essential for timely intervention and improved service delivery. The general factor of psychopathology (p factor), capturing shared variance across mental disorders, was used as a transdiagnostic outcome to develop a machine learning model for risk identification. METHODS: Data from 5,283 Chinese adolescents were used for model training and testing, with an additional 968 participants for external validation. Guided by ecological systems theory, a multidimensional early warning framework covering 59 indicators across individual, school, family, and society domains was constructed. Seven machine learning algorithms were tested using the p factor as the outcome. Shapley Additive exPlanations (SHAP) values ranked predictor importance and identified an optimal feature subset. RESULTS: The XGBoost model showed the best performance (macro F1 = 0.73 on internal validation, 0.80 on external validation). The final model used 23 predictors. SHAP confirmed sleep quality as the most influential factor, followed by repetitive negative thinking, interpersonal stress, impulsivity, and emotional intensity. CONCLUSIONS: This study suggests that a p-factor-based machine learning model can effectively identify adolescents at mental health risk, with sleep quality emerging as the most influential predictor, suggesting potential intervention targets for early prevention.
Managing the consequences of rising mental-health awareness-a commentary on Marcotulli et al. (2025).
Pierce M
J Child Psychol Psychiatry · 2026 Jun · PMID 42312899 · Publisher ↗
The editorial by Marcotulli, Foulkes and Stringaris presents a dynamic-systems framework for understanding the effects of mental-health information campaigns. They argue that surges in help-seeking may lead to poorer dia...
The editorial by Marcotulli, Foulkes and Stringaris presents a dynamic-systems framework for understanding the effects of mental-health information campaigns. They argue that surges in help-seeking may lead to poorer diagnostic accuracy and reduced treatment efficacy, with potential harm to patients. Their systems-level approach is timely and valuable. The editorial's predictions rest on several assumptions: new help-seekers have lower severity, diagnostic thresholds drift downward and the benefit-harm ratio of treatment declines. Empirical evidence supporting these assumptions remains limited. Where these mechanisms do operate, several strategies may mitigate their impact. This commentary outlines key assumptions requiring empirical testing and discusses mitigation approaches, including targeted campaigns and effective triage systems, which may reduce the risk that increased awareness leads to net harm.
A randomized controlled trial of brief interoceptive exposure and family-based treatment for adolescents with low-weight eating disorders.
Sysko R, Schulz KP, Hildebrandt T
J Child Psychol Psychiatry · 2026 Jun · PMID 42310840 · Publisher ↗
BACKGROUND: Family-Based Treatment (FBT) is evidence based for patients younger than 18 with anorexia nervosa; however, continued refinement of FBT is needed to increase response and remission rates. AIMS: This study aim...
BACKGROUND: Family-Based Treatment (FBT) is evidence based for patients younger than 18 with anorexia nervosa; however, continued refinement of FBT is needed to increase response and remission rates. AIMS: This study aimed to compare traditional FBT with an interoceptive exposure (IE) intervention that targets visceral sensitivity and autonomous eating in a family context. We hypothesized that IE would reduce food avoidance to a greater degree than FBT, as measured by laboratory feeding independent of weight gain. METHODS: Adolescents diagnosed with a low-weight eating disorder (LWED) were randomized to six sessions of FBT or IE. Before and after the intervention, patients completed interviews and self-report questionnaires, laboratory test meals (single and multi-item), and functional magnetic resonance imaging. Healthy controls provided a comparison group for these assessments. The study was registered as follows: clinicaltrials.gov NCT02795455 (https://clinicaltrials.gov/study/NCT02795455?term=NCT02795455&rank=1), GCO 15-0939 Reward Systems and Food Avoidance in Eating Disorders. RESULTS: Adolescents receiving IE (n = 30) consumed significantly more energy (kcal) during the post-treatment single item (M = 98.12 kcal, SD = 119.84, d = 0.82) and multi-item meals (M = 137.11 kcal, SD = 301.85, d = 0.45) than the FBT group (n = 30). No significant differences were found for age and sex adjusted % expected body weight between groups. Adolescents with LWED reported significantly more symptoms on all clinical measures than controls (n = 27). CONCLUSIONS: Six sessions of a novel form of IE yielded significant changes in eating behavior, namely an approximately two-fold increase in energy consumed in both multi-item and single-item meals among those randomized to IE. Additional research using a fully expanded version of these treatments is needed.
Remembering the bad times: Autobiographical memory fluency, specificity, and fading affect bias in adolescents at clinical risk of affective disorder.
Roe A, Gormley S, Stephens E … +2 more , Mapleston E, Dalgleish T
J Child Psychol Psychiatry · 2026 Jun · PMID 42307449 · Publisher ↗
BACKGROUND: Distortions in autobiographical memory processing are implicated in the onset and maintenance of multiple mental health problems in adults. While reduced personal memory specificity has been identified as a t...
BACKGROUND: Distortions in autobiographical memory processing are implicated in the onset and maintenance of multiple mental health problems in adults. While reduced personal memory specificity has been identified as a transdiagnostic risk factor in adolescents, less is known about other domains of memory processing, including biases in the accessibility and affective intensity of negative and positive memories. METHODS: We administered a novel recall paradigm, the Good Day-Bad Day task (Hitchcock et al., Journal of Experimental Psychology: General, 2019, 149, 198), to assess autobiographical memory fluency for positive and negative events, memory specificity, and the Fading Affect Bias (FAB) - the extent to which the emotional intensity associated with positive memories fades less than for negative memories overtime - in adolescents, aged 16-18, at high (n = 201, M = 17.20, SD = 0.60, 84.6% female, 2% other) and low clinical risk (n = 117, M = 17.10, SD = 0.60, 77.8% female) of affective disorder. RESULTS: We found that superior recall for positive relative to negative events and a strong FAB were associated with good mental health. Risk of affective disorder was associated with a significant reduction in these positive biases and recall of a higher number of negative memories compared with Low-Risk adolescents. Memory specificity did not differ by risk status. CONCLUSIONS: Findings extend research on autobiographical memory processing to two novel domains in adolescence and further elucidate how differences in autobiographical memory recall may underlie mental health, with implications for the development of memory-based interventions.
Childhood internalising symptoms at ages 3 and 6: a meta-analysis of epigenome-wide associations from cord and peripheral blood.
Schellhas L, Luo M, Felix JF … +7 more , Page CM, Bekkhus M, Munafò MR, Zuccolo L, Havdahl A, Cecil CAM, Sharp GC
J Child Psychol Psychiatry · 2026 Jun · PMID 42304632 · Publisher ↗
BACKGROUND: Pre- and postpartum environments and genetic effects influence childhood internalising problems, which increase depression risk. DNA methylation (DNAm) may capture some of these effects. We therefore investig...
BACKGROUND: Pre- and postpartum environments and genetic effects influence childhood internalising problems, which increase depression risk. DNA methylation (DNAm) may capture some of these effects. We therefore investigated associations between child blood DNAm and internalising problems. METHODS: We meta-analysed probe and region-level epigenome-wide association studies using data from 3 European birth cohorts (ALSPAC, MoBa, Generation R; analytic N = 1,121-3,011) from the Pregnancy And Childhood Epigenetics (PACE) Consortium. DNAm was assessed at birth (cord blood) and age 6 years (peripheral blood). Internalising problems (ages 3 and 6) were reported by mothers using the Child Behaviour Checklist or Strengths and Difficulties Questionnaire. Models were adjusted for age at DNAm assessment, 20 surrogate variables, estimated cell proportions, maternal education, age, smoking and, in secondary analysis, maternal anxiety and depression. Public databases were searched for mental health associations with top CpG sites and regions. RESULTS: No significant probe-level associations were found between cord- or peripheral-blood DNAm and internalising problems. In region-level analyses, two differentially methylated regions (DMRs) in cord blood were associated with internalising problems at age 3 (annotated to STK32C, MIR886) and one at age 6 (PFKFB2). At age 6, peripheral-blood analyses identified two DMRs (C10orf26 (WBP1L), FAM125A). Several genes showed prior associations with psychiatric phenotypes, including depression. CONCLUSIONS: The higher-powered regional-level analyses revealed more associations than probe-level. Among others, we identified a region annotated to STK32C that has previously been linked to adolescent depression. Larger samples and refined phenotyping are needed to clarify the role of DNAm in internalising problems.
Editorial: Integrating multilevel environmental influences on child brain development.
Rakesh D, Brieant A, McLaughlin KA
J Child Psychol Psychiatry · 2026 Jun · PMID 42303942 · Publisher ↗
Environmental influences on child brain development operate across multiple levels of context, including family, neighbourhood and broader structural environments. While developmental cognitive neuroscience has generated...
Environmental influences on child brain development operate across multiple levels of context, including family, neighbourhood and broader structural environments. While developmental cognitive neuroscience has generated substantial evidence linking proximal experiences to neurodevelopment, neighbourhood and especially macrolevel structural influences remain less well-integrated into prevailing models. In this editorial, we argue for a multilevel developmental framework that considers the independent and interactive effects of environmental factors across contexts and how their influence changes over development. We highlight evidence that proximal, neighbourhood and structural conditions each contribute to neurodevelopment and that their effects are often interdependent. Advancing the field will require greater integration across levels of analysis to better understand how environments shape brain and behaviour development.
Predicting psychopathology symptom trajectories using machine learning: a 33-year prospective study.
Sacu S, Streit F, Witt SH … +3 more , Banaschewski T, Holz NE, Schultebraucks K
J Child Psychol Psychiatry · 2026 Jun · PMID 42294587 · Publisher ↗
BACKGROUND: While previous literature has established a link between psychopathology symptom trajectories and psychosocial risk, most studies have not extended into adulthood or incorporated comprehensive risk measures....
BACKGROUND: While previous literature has established a link between psychopathology symptom trajectories and psychosocial risk, most studies have not extended into adulthood or incorporated comprehensive risk measures. We aimed to identify symptom trajectories for externalizing and internalizing symptoms over a 25-year span and predict them using machine learning. METHODS: We used data from a longitudinal birth cohort study (N = 317, 171 females). Psychopathology symptoms were measured between age 8 and 33. Symptom trajectories were identified using growth mixture models. An extensive battery of risk and protective measures over the lifespan (e.g., polygenic scores, psychosocial risk factors, temperament) was used to train machine learning-based classification models. RESULTS: We identified three trajectories for both externalizing and internalizing symptoms (entropy > 0.8, likelihood ratio test p < .05): Low, increasing (late-adolescent emergence), and decreasing (childhood-limited) symptoms classes. Both genetic (e.g., polygenic scores for cognition and mental disorders) and environmental factors (e.g., adverse family characteristics, poor social functioning) predicted symptom trajectories. For externalizing symptoms trajectories, random forest achieved fair discriminatory power with a multiclass macro-average AUC of 0.77 and a multiclass micro-average of 0.88. For internalizing symptoms trajectories, logistic regression achieved modest discriminatory power with a multiclass macro-average AUC of 0.75 and a multiclass micro-average of 0.83. CONCLUSIONS: Psychopathology risk trajectories vary across development and are influenced by diverse risk factors. Understanding these risk factors can support early identification of at-risk individuals and inform targeted prevention and intervention efforts.
Randomised controlled trial of a web-based mental health, self-harm and suicide gatekeeper resource for parents and caregivers.
Calear AL, McCallum SM, Kazan D … +7 more , Torok M, Werner-Seidler A, O'Dea B, Morse A, Farrer LM, Shand F, Batterham PJ
J Child Psychol Psychiatry · 2026 Jun · PMID 42281529 · Publisher ↗
BACKGROUND: Parents and caregivers play key roles in recognising early signs of mental distress and facilitating access to support, yet often lack the confidence and knowledge to respond effectively. Gatekeeper training...
BACKGROUND: Parents and caregivers play key roles in recognising early signs of mental distress and facilitating access to support, yet often lack the confidence and knowledge to respond effectively. Gatekeeper training programs can improve skills, but few are specifically designed for parents. The aim of the current study was to assess the effectiveness of the Recognise, Respond and Support - A Parent's Guide to Youth Mental Health resource in improving parental capacity to support their child's mental health. METHODS: A two-arm randomised controlled trial was conducted with Australian parents and caregivers of children aged 5-17 years. Outcomes were assessed at baseline, post-intervention and 12-week follow-up. The primary endpoint was parental self-efficacy to recognise, respond to, and access support for mental health problems and suicide risk in their child/ren at post-intervention. Secondary outcomes included perceived gatekeeper knowledge, mental health and suicide literacy, stigma, and help-seeking attitudes, intentions and barriers. The trial was prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000933651). RESULTS: A total of 509 participants were recruited (97% female; mean age 43 years). At post-intervention, mixed-model repeated-measures ANOVA indicated significant intervention effects for self-efficacy for mental health (p = .04) and suicide (p = .01), perceived knowledge (p < .001), barriers to help-seeking (p = .02) and suicide stigma (p = .02) and literacy (p = .01), with some effects maintained at 12-week follow-up. No significant changes were observed for mental health literacy and stigma, or help-seeking attitudes or intentions. CONCLUSIONS: Gatekeeper training targeted to parents and caregivers can be effective in improving participant confidence and knowledge to support their child's mental health. Future research would benefit from identifying strategies to improve participant engagement with web-based interventions.
Disentangling direct and indirect genetic pathways to neurodevelopmental risk: brain structure and behavior in a population-based parent-offspring trio study.
van Uum FJE, Xerxa Y, Neumann A … +8 more , Pingault JB, Cecil CAM, Shahisavandi M, Bolhuis K, Kovacs B, Tiemeier H, Muetzel RL, van Haren NEM
J Child Psychol Psychiatry · 2026 Jun · PMID 42272254 · Publisher ↗
BACKGROUND: Neurodevelopmental disorders (NDDs) are highly heritable, yet the pathways linking parental genetic liability to child outcomes remain poorly understood. Traditional designs cannot easily separate genes trans...
BACKGROUND: Neurodevelopmental disorders (NDDs) are highly heritable, yet the pathways linking parental genetic liability to child outcomes remain poorly understood. Traditional designs cannot easily separate genes transmitted to the child from environmental influences shaped by parental genotypes. METHODS: In 3,270 families from the Generation R Study, we applied a mother-father-offspring trio design to disentangle direct genetic effects from indirect parental influences ('genetic nurture'). Polygenic scores (PGSs) included a transdiagnostic neurodevelopmental score (NDV) and disorder-specific scores for ADHD, ASD, and major depressive disorder (MDD). Offspring brain structure (cortical surface area, subcortical gray matter, cerebellar volume) at age 9 and behavioral problems at age 14 were assessed. Structural equation modeling was used to test direct, indirect, and brain-mediated genetic pathways. RESULTS: Transdiagnostic NDD genetic liability predicted multiple behavioral domains, primarily via direct genetic effects, with similar influence on internalizing and externalizing problems. ADHD PGS effects closely paralleled those of the NDV PGS, whereas ASD and MDD PGSs showed more domain-specific associations. Notably, maternal, but not paternal, MDD genetic liability was indirectly related to behavioral problems across domains, independent of the child's own genetic risk. This maternal pathway was partly reporter-specific but robust for attention problems across both parent and child reports. Global brain measures did not mediate any of the identified genetic pathways. CONCLUSIONS: Intergenerational NDD risk is predominantly driven by direct genetic transmission. However, maternal depression liability exerts additional influence through environmentally mediated pathways. The absence of brain-mediated effects suggests that the gross neural phenotypes examined here do not capture the mechanisms underlying these pathways. Our findings highlight the importance of maternal influences on child NDD outcomes and underscore the need for longitudinal, multimodal research designs that integrate genetic, caregiving, and fine-grained neural phenotyping data to inform targeted prevention and early intervention strategies for at-risk families.
Early outdoor play predicts trajectories of child mental health in a population-based cohort.
Dodd HF, Cordwell K, Hesketh K … +3 more , Johnstone A, de la Torre-Luque A, McCrorie P
J Child Psychol Psychiatry · 2026 Jun · PMID 42252867 · Publisher ↗
BACKGROUND: Outdoor play may offer developmental opportunities that support good mental health. Cross-sectional data indicate that more outdoor play is associated with better mental health, particularly internalising pro...
BACKGROUND: Outdoor play may offer developmental opportunities that support good mental health. Cross-sectional data indicate that more outdoor play is associated with better mental health, particularly internalising problems (e.g. anxiety and depression), but longitudinal research is lacking. We used a longitudinal cohort dataset to evaluate whether outdoor play at 2-4 years predicted children's mental health trajectories into middle childhood. METHODS: Data were from the Growing up in Scotland dataset. Parents/caregivers were asked how many days their child had played outside over the previous week when children were aged ~2, 3 and 4 years. When the children were aged ~4, 5, 6 and 8 years, parents/caregivers completed the Strengths and Difficulties Questionnaire measure of child mental health. We used growth mixture modelling (GMM) to identify trajectories over time for internalising and externalising symptoms separately. Next, we used multilevel multinomial regression to evaluate whether early outdoor play predicted trajectory classification. RESULTS: The analysis sample included 4,151 children. A three-class solution was optimal for internalising and externalising symptoms. The three trajectory groups differed on both symptom level at age 4 and slope as follows: normative (low with stable trajectory); increasing (moderate with increasing trajectory); decreasing (high with decreasing trajectory). After controlling for covariates, outdoor play significantly predicted trajectory class; children who played outdoors more often as preschoolers had significantly decreased odds (p < .001) of belonging to the increasing or decreasing trajectory groups, relative to the normative group, for internalising (increasing: OR = 0.92, decreasing: OR = 0.88) and externalising (increasing: OR = 0.94, decreasing: OR = 0.94) symptoms. CONCLUSIONS: This study uses nationally representative longitudinal data and provides the first evidence that early outdoor play predicts mental health trajectories across childhood. A key limitation is reliance on parent-report measures. The findings indicate that increasing outdoor play may be a useful public health approach to reduce child mental health problems.
'Sawa Aqwa' (Stronger Together): A multi-site randomized controlled trial of a brief family systemic intervention for adolescent mental health in Lebanon.
Bosqui T, Brown FL, Farah S … +19 more , Elias J, Ghossainy ME, Mayya A, Nakkoul DA, Walsh B, Chreif S, Einein A, Meksassi B, Saad RA, Naal H, Donnelly M, Betancourt TS, Carr A, Puffer ES, Hanna E, Mansour H, Semaan F, Chammay RE, Jordans MJD
J Child Psychol Psychiatry · 2026 Jun · PMID 42241029 · Publisher ↗
BACKGROUND: There are no evaluated family-based mental health and psychosocial support (MHPSS) interventions for adolescents in Southwest Asia (known as the Middle East), and few whole-family interventions in low- and mi...
BACKGROUND: There are no evaluated family-based mental health and psychosocial support (MHPSS) interventions for adolescents in Southwest Asia (known as the Middle East), and few whole-family interventions in low- and middle-income countries, despite consistent evidence for the impact of family support on mental health and well-being. This study aims to evaluate the effectiveness of a brief family systemic mental health intervention, deliverable by non-specialists in mental health. METHODS: We conducted an assessor-blind type I hybrid effectiveness-implementation multi-site randomized controlled trial comparing the locally developed family intervention to a waitlist control group for randomly allocated families residing in North Lebanon and Beqa'a governorates. Eligible families presented with medium-to-high risk for child protection concerns (abuse, neglect, child labor, early marriage) and had at least one adolescent aged 12-17 who demonstrated psychological distress. Outcomes at the family, caregiver, and adolescent level were measured pre- and post-intervention, and at 3-month follow-up. RESULTS: Intent-to-treat analyses found a significant between-group effect of the intervention on adolescent-reported family functioning, caregiver mental health, and parenting. No change was found for adolescent psychological distress. Further analyses found effects on adolescent well-being for those who completed the intervention, and that father attendance was associated with better outcomes for adolescent well-being in the intervention group. No other significant moderators were found. At the 3-month follow-up for the intervention condition, family functioning and caregiver well-being significantly dropped from endline. CONCLUSIONS: The study demonstrates mixed results for a non-specialist-delivered family-systemic intervention developed in the context of humanitarian crises in Lebanon. While the intervention did not result in benefits in adolescent-reported symptoms of psychological distress, the intervention group did show greater improvements than the control group on a number of other outcomes, showing the potential impact of working with the wider family system to support adolescents in humanitarian settings.
Developmental language disorder and offending: a prospective longitudinal cohort study with linked education and crime data.
Frith M, Hobson H, Hutchinson J … +3 more , Leyland A, Hughes N, Toseeb U
J Child Psychol Psychiatry · 2026 Jun · PMID 42240172 · Publisher ↗
BACKGROUND: Individuals with developmental language disorder (DLD) are disproportionately represented in the criminal justice system. The prospective associations between DLD and offending, and the educational and crimin...
BACKGROUND: Individuals with developmental language disorder (DLD) are disproportionately represented in the criminal justice system. The prospective associations between DLD and offending, and the educational and criminal justice pathways through which DLD might increase the risk of offending and reoffending, remain unclear. METHODS: We analysed existing data from the Avon Longitudinal Study of Parents and Children (maximum N = 6,800; 51% female; 9% with DLD) with linked school data (national pupil database) and crime records (Avon and Somerset police records for offences committed between ages 13 and 29 years in the region). DLD was determined when the individuals were aged 7-9 years using direct assessments and parent reports. Regression and mediation models were fitted to the data. RESULTS: Individuals with DLD were more likely (odds ratio 1.74, 95% confidence intervals 1.25, 2.44) to have a recorded offence (i.e. charged or cautioned by the police) compared to those without DLD. School suspension was a significant mediator of the relationship between DLD and recorded offending. However, SEN identification was not associated with recorded offending for those with DLD. There was also no difference in the odds of being given an out of court disposal or reoffending for individuals with DLD compared to those without DLD. CONCLUSIONS: Individuals who have DLD are more likely to be cautioned or convicted for an offence by the police than those without DLD, and this may in part be because they are more likely than those without DLD to be suspended from school.
Mental disorders in childhood or adolescence and subsequent comprehensive school achievement.
Li Y, Niemi R, Gutvilig M … +3 more , Elovainio M, Flykt M, Hakulinen C
J Child Psychol Psychiatry · 2026 Jun · PMID 42237687 · Publisher ↗
BACKGROUND: Childhood mental disorders are associated with poorer school achievement, with potential negative long-term socio-economic consequences, but few large-scale studies have examined this association, particularl...
BACKGROUND: Childhood mental disorders are associated with poorer school achievement, with potential negative long-term socio-economic consequences, but few large-scale studies have examined this association, particularly the role of age at onset. Using a nationwide Finnish cohort, we examined the associations between mental disorders and school achievement, focusing on gender and age at onset. METHODS: This nationwide cohort study used data from Finnish national registers. The study population consisted of all individuals born between January 1, 1990, and December 31, 2003, who completed their comprehensive education in Finland during the years 2005 to 2019 (n = 837,546). The exposure was diagnosis of any mental disorder or specific mental disorders between the age of 1 year and graduation. School achievement was measured using the grade point average (GPA), a summative measure of performance across all subjects during the final three years of comprehensive school. RESULTS: Of the total study population (411,054 females, 426,492 males), 137,427 (16.41%) were diagnosed with a mental disorder before completing comprehensive school. Students with a mental disorder had lower school achievement compared with their peers without a diagnosis, -0.41 [95% CI, -0.41 to -0.40]. The association was stronger for female students, -0.45 [95% CI, -0.46 to -0.45], than for male students, -0.37 [95% CI, -0.38 to -0.37]. Later-onset mental disorders were associated with poorer school achievement, a pattern observed across most specific mental disorders. CONCLUSIONS: Childhood mental disorders are linked to lower school achievement, particularly among females and those diagnosed at a later age, underscoring the need for targeted psychological support for females and adolescents.
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