J Child Psychol Psychiatry [JOURNAL]
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200 papers
Perinatal hardship and infant neurodevelopment: insights from a global pandemic.
Posner J, Michael A, Kashyap P … +10 more , Fay M, Milani ACC, Silva I, Abdala N, de Araújo CM, Ramos AC, Wang Y, Mazzaferro M, Jackowski A, Duarte CS
J Child Psychol Psychiatry · 2026 May · PMID 41122075 · Full text
BACKGROUND: Material and emotional hardship during pregnancy can shape early brain development and behavior in infants. This study used the COVID-19 pandemic as a natural context in which such hardships were widespread,...
BACKGROUND: Material and emotional hardship during pregnancy can shape early brain development and behavior in infants. This study used the COVID-19 pandemic as a natural context in which such hardships were widespread, particularly in low-resource settings. METHODS: This cohort study examined associations between pandemic-related maternal emotional distress and material hardship during pregnancy and early neurodevelopmental outcomes in infants. A total of 235 mother-infant dyads from low-resource healthcare settings in Brazil were enrolled during the COVID-19 pandemic. Maternal hardships were assessed using a COVID-19-specific questionnaire, which included self-reported COVID-19 exposure/infection. Infant neurodevelopment was evaluated via MRI at 2-6 weeks of age and behavioral assessments at 14 months using the Bayley Scales of Infant Development. RESULTS: Material hardship was associated with reduced hippocampal volumes in the left (p = .008) and right (p = .025) hemispheres. Among female infants, material hardship was linked to lower functional connectivity between the right hippocampus and the right rostral anterior cingulate cortex (p = .004). Smaller hippocampal volumes correlated with weaker gross motor skills at 14 months (r = .23; p = .02). Maternal emotional distress and self-reported COVID-19 exposure/infection were not significantly associated with infant neurodevelopmental outcomes. CONCLUSIONS: Material hardship may adversely affect early neurodevelopment, particularly hippocampal structure and connectivity, with potential downstream effects on motor skills. These findings underscore the importance of addressing material hardship during the perinatal period to support infant brain health and development.
The spectrum of communication abilities in children with 12 rare neurodevelopmental disorders: a qualitative study with caregivers.
Zigler CK, McFatrich M, Lucas N … +29 more , Plyler K, Zapata-Leiva L, Gordon K, Jones HN, Lin L, Kern J, Radar A, Chen D, Bergelson E, Still K, Hinger B, Delagrammatikas CG, Poliquin S, Short BP, Marfia-Ash L, Stephens K, Oyler HO, Graglia JM, Worth K, Son Rigby C, Goss JR, Bigelow B, Bliss G, Beatty K, Schust Myers L, Thelen M, Summerfield N, Bichell TJ, Reeve BB
J Child Psychol Psychiatry · 2026 May · PMID 41114730 · Full text
BACKGROUND: Our aim was to update an existing model of communication ability for children with rare neurodevelopmental disorders (NDDs) by centring caregiver and family perspectives. This project is part of a larger init...
BACKGROUND: Our aim was to update an existing model of communication ability for children with rare neurodevelopmental disorders (NDDs) by centring caregiver and family perspectives. This project is part of a larger initiative to improve the measurement of communication ability for these children in the context of clinical trials. METHODS: We conducted concept elicitation interviews with purposively selected clinical experts and caregivers of children with 12 NDDs, focusing on a broad definition of communication ability based on the Observer-Reported Communication Ability (ORCA) measure, which is inclusive of different communication modalities and covers expressive, receptive and pragmatic communication concepts. Content-based and thematic analysis was performed on the qualitative data. RESULTS: Altogether, 115 interviews were conducted with caregivers across the 12 NDDs and with 9 clinicians. Commonly mentioned concepts across NDDs included requesting an object, refusing an object, responding to familiar directions and seeking attention. There was notable heterogeneity within and across NDD groups in terms of the specific communication behaviours described for each communication concept. One common example was requesting; children used verbal speech, gestures, sign language, eye gaze, body movements and augmentative and assistive communication to ask for what they wanted. Novel communication concepts identified that were not part of the existing model were (1) feelings, emotions, and bodily sensations, (2) commenting on likes and dislikes, and (3) communicating and understanding humour. CONCLUSIONS: Caregivers offered a detailed and nuanced picture of their child's day-to-day communication. There was a considerable overlap between the communication concepts discussed by caregivers in the interviews and the existing conceptual model of communication ability. Some newly identified concepts underscore the need for further adaptation of the model and subsequent validation of any clinical outcome assessment before communication ability can be confidently measured for these individuals in clinical trials.
Editorial: The acetaminophen scare: association vs causation.
Fombonne E
J Child Psychol Psychiatry · 2025 Nov · PMID 41104705 · Publisher ↗
With high twin concordance and sibling recurrence risk, the influence of genetic factors in the etiology of autism is not disputed. The contribution of environmental risk to the etiology of autism is less well establishe...
With high twin concordance and sibling recurrence risk, the influence of genetic factors in the etiology of autism is not disputed. The contribution of environmental risk to the etiology of autism is less well established. While the prevalence increase observed worldwide has fueled beliefs of an epidemic driven by environmental changes, the evidence for such interpretations of the secular change in prevalence is lacking (Fombonne, 2025). In epidemiological surveys, no clustering in time or space has been reported that could point to candidate exposures. Thus, observational (cohort and case-control) studies have been wide-ranging and exploratory rather than hypothesis-driven. In light of growing evidence of atypical development occurring in the first months of life (Dawson et al., 2023, Lancet Neurology, 22, 244), environmental risk research in autism has focused on prenatal or periconceptional exposures. In the last 20 years, a myriad of associations have been reported between autism risk and prenatal exposure to: pesticides, phthalates, air pollutants, maternal fever or infection during pregnancy, inter-pregnancy interval, lack of folic acid supplementation, vitamin D deficiency, maternal diet, advancing parental age, exposure to heavy metals, prenatal exposure to antidepressants, valproic acid, benzodiazepines, acetaminophen, maternal smoking, cannabis or alcohol use during pregnancy, maternal obesity and excessive gestational weight gain, prematurity, low birth weight, maternal immune activation, C-section, use of oxytocin, assisted reproductive technologies, and countless others. With few exceptions (advanced parental age, prenatal exposure to valproic acid), associations have not been replicated, or when they have, their causal nature has not been established.
Longitudinal co-development of mental and cardio-metabolic health from childhood to young adulthood.
Defina S, Cecil CAM, Felix JF … +2 more , Walton E, Tiemeier H
J Child Psychol Psychiatry · 2026 Mar · PMID 41104580 · Full text
BACKGROUND: Depressive symptoms and cardio-metabolic risk factors often co-occur. However, our understanding of the potential mechanisms and temporal dynamics underlying their co-development remains elusive. METHODS: Thi...
BACKGROUND: Depressive symptoms and cardio-metabolic risk factors often co-occur. However, our understanding of the potential mechanisms and temporal dynamics underlying their co-development remains elusive. METHODS: This population-based cohort study examined bidirectional longitudinal associations between depressive symptoms and cardio-metabolic risk factors from age 10 to 25 years, using prospective data from the ALSPAC Study. Participants with at least one (of six) follow-up measurement for each outcome were included in the analyses. We measured depressive symptoms through self- as well as parent-reports, and assessed several cardio-metabolic risk factors (including adiposity measures, lipid profiles, and inflammation). RESULTS: Among our 7,970 (47% male, 96% White) participants, we found bidirectional, within-person associations between self-reported depressive symptoms and adiposity (i.e., fat/lean mass index, but not body mass index), across the study period. Adiposity was more stable over time (β [range] = 0.75 [0.54; 0.84]), compared to depressive symptoms (0.26 [0.12; 0.38]), and it had a stronger prospective (i.e., cross-lagged) association with future depressive symptoms (0.07 [0.03, 0.13]) compared to that between depressive symptoms and future adiposity (0.04 [0.03, 0.06]). The magnitude of these associations reached its peak between 14 and 16 years. We did not find evidence of cross-lagged associations in either direction between depressive symptoms and waist circumference, insulin, triglycerides, LDL cholesterol, or C-reactive protein. CONCLUSIONS: These findings suggest a bidirectional relationship between depressive symptoms and cardio-metabolic risk factors, particularly adiposity (i.e., fat/lean mass). Adiposity showed a stronger prospective association with future depressive symptoms than vice versa; however, their relationship revealed more reciprocal than previously thought.
Editorial Perspective: How spreading mental health information can be (un-) helpful - a dynamic systems approach.
Marcotulli D, Foulkes L, Stringaris A
J Child Psychol Psychiatry · 2026 Mar · PMID 41088568 · Full text
Increasing awareness of mental health problems, including that of young people, is generally seen as positive, and many interventions to increase awareness are underway internationally. Yet, a principled evaluation of th...
Increasing awareness of mental health problems, including that of young people, is generally seen as positive, and many interventions to increase awareness are underway internationally. Yet, a principled evaluation of the benefits and harms of increasing awareness is still lacking. Here, we present a conceptual framework for the evaluation of information interventions that are aimed at increasing public awareness of mental health problems. We borrow concepts from dynamic systems, such as infection spread and related population growth, to ask how benefits, but also harms of information on mental health, may accrue over time. We argue that as information spreads, several cascades of events are set off that involve members of the general public but also clinicians and healthcare services. These cascades entail positive and negative feedback loops. We discuss not only how increased diagnoses can lead to positive outcomes (e.g. increasing diagnostic rates and appropriate treatments in those who would otherwise have remained undiagnosed) but also how increased awareness can lead to decreases in diagnostic accuracy, to service overload, and how they may expose people to unnecessary or harmful treatments. We argue that the need for a framework founded on modelling societal dynamics is needed to ensure that both the benefits and the downsides of mental health information are accurately gauged and to help the planning of better public health campaigns.
Machine learning prediction of conduct problems in children using the longitudinal ABCD study.
Berluti K, Amormino P, Potter A … +2 more , Wshah S, Marsh A
J Child Psychol Psychiatry · 2026 Mar · PMID 41077549 · Full text
BACKGROUND: Children with conduct problems are at elevated risk for negative psychosocial, educational, and behavioral outcomes. Identifying at-risk children can aid in providing timely intervention and prevention, ultim...
BACKGROUND: Children with conduct problems are at elevated risk for negative psychosocial, educational, and behavioral outcomes. Identifying at-risk children can aid in providing timely intervention and prevention, ultimately improving their long-term outcomes. There is a need to develop screening tools to better identify at-risk children who may benefit from early intervention. METHODS: Data were collected from the longitudinal Adolescent Brain Cognitive Development (ABCD) Study. Children completed a baseline visit at age 9-10, then returned annually for 3 years (n = 3,517). We used machine learning classifiers (logistic regression, Naïve Bayes, support vector machine, and random forest) to predict conduct problems (i.e., conduct disorder or oppositional defiant disorder) in children after 1, 2, and 3 years. RESULTS: The best-performing model (the random forest classifier) predicted children at risk for conduct problems with an accuracy of 90% or greater (AUC = 0.98 at 1 year, AUC = 0.97 at 2 years, AUC = 0.97 at 3 years). A random forest classifier simplified to include only 10 features was able to predict conduct problems nearly as well (AUC = 0.97 at 1 year, AUC = 0.96 at 2 years, AUC = 0.97 at 3 years). CONCLUSIONS: Using factors previously linked to conduct problems, we built machine learning models to identify predictors of conduct problems in children over a 3-year period. A small number of self-report features can be used to predict persistent conduct problems with 90% or greater specificity and sensitivity up to 3 years after initial assessment. This suggests that parent and child self-report data, along with machine learning, can identify children at risk for persistent conduct problems.
Annual Research Review: Improving school climate to improve child and adolescent mental health and reduce inequalities.
Moore G
J Child Psychol Psychiatry · 2026 Apr · PMID 41077548 · Full text
Schools are important settings for intervention to improve mental health. Much school mental health research has focused on schools as an avenue to reach large numbers of young people with new interventions, added on top...
Schools are important settings for intervention to improve mental health. Much school mental health research has focused on schools as an avenue to reach large numbers of young people with new interventions, added on top of what schools currently do. However, research is increasingly focused on changing the school system itself to improve mental health, with a growing emphasis on improving school climate. This article begins by exploring wider debates on the benefits and harms of school-based interventions, before focusing on school climate as a target for intervention. It reviews evidence from intervention studies and systematic reviews to understand effectiveness, how interventions reduce or amplify inequalities, and real-world impacts. School climate research has grown rapidly since the turn of the century. It remains difficult to define. Definitions vary in whether they include focus on physical environments and educational instruction. However, they converge on focus on positive relationships among a school community and safety. Several large trials of interventions to improve mental health, by improving school climate, have been conducted in a range of international contexts. While many have not been effective, recent trials provide evidence that interventions can improve school climate and mental health, as well as a range of risk behaviours. Few studies examine effects on inequalities in mental health, with tentative evidence that school climate interventions have been more effective for some groups than others (e.g., bigger effects for boys than for girls). Evidence on scalability and sustainability indicates that typically small effects from trials may not fully translate into real-world change. There is growing evidence that improving school climate interventions can improve child and adolescent mental health. More research is needed on how such interventions can contribute to reducing inequalities. Further work is needed to understand how effects translate into real-world public health impact.
Cannabis and pediatric cannabis exposure - evidence from America's Poison Centers.
Steuart SR, Bethel V, Bradford WD
J Child Psychol Psychiatry · 2026 Mar · PMID 41077545 · Publisher ↗
BACKGROUND: There is limited evidence from systematic nationwide studies evaluating the impact of cannabis legalization on cannabis-related exposures among the pediatric population. Using the National Poison Data System...
BACKGROUND: There is limited evidence from systematic nationwide studies evaluating the impact of cannabis legalization on cannabis-related exposures among the pediatric population. Using the National Poison Data System (NPDS), we calculated the effects of medical and recreational cannabis dispensaries on reported pediatric cannabis exposures. METHODS: We analyzed data from 36,161 reported cannabis-related exposures for individuals aged 2-20 between 2016 and 2021, comparing states with and without open medical cannabis dispensaries and states with open recreational cannabis dispensaries to states with open medical cannabis dispensaries. Using a difference-in-difference design, we estimated the effects of cannabis dispensary openings on semi-annual cannabis exposures by age group: young children (2-6 years old), children (7-11), adolescents (12-17), and young adults (18-20). RESULTS: Patients aged 2-6 (96.3%) and 7-11 (82.4%) frequently incurred unintentional exposures, while patients aged 12-17 (79.9%) and 18-20 (77.5%) more often incurred intentional exposures. Medical cannabis dispensary openings were associated with a 52.3% increase (CI 37.5-67.0; p < .001) in cannabis-related exposure rates in individuals aged 2-6. However, we found a 42.4% decrease (95% CI: -62.2 to -22.6; p < .001) in the number of exposures occurring per 100,000 population when recreational dispensaries opened, relative to states with only medical cannabis dispensaries open. While we did not find statistically significant increases among children aged 7-11 following medical cannabis dispensary openings, we did see a 26.6% (95% CI: -45.1 to -8.1) decrease following recreational cannabis dispensary openings. We did not find statistically significant effects for other age groups. CONCLUSIONS: Our findings indicate policymakers may need to invest in providing cannabis safety education when medical cannabis dispensaries open to avoid unintended exposures, though some of that effect appears to be mitigated by the time recreational dispensaries (eventually) open. Professionals that provide medical cannabis or provide care in medical cannabis states should consider providing education about how to safely use and store cannabis in the household to prevent cannabis-involved exposures.
Trajectories of childhood adversity, social welfare dependence in young adulthood, and the mediating role of mental health problems: a Danish population-based cohort study.
de Vries TR, Bennetsen SK, Elsenburg LK … +4 more , Andersen SH, Kreshpaj B, Thielen K, Rod NH
J Child Psychol Psychiatry · 2026 May · PMID 41039948 · Full text
BACKGROUND: Childhood adversity is associated with increased risks of long-term social welfare dependence in young adulthood. Mental health problems may mediate this relation, but evidence remains lacking. METHODS: 613,6...
BACKGROUND: Childhood adversity is associated with increased risks of long-term social welfare dependence in young adulthood. Mental health problems may mediate this relation, but evidence remains lacking. METHODS: 613,643 individuals from the Danish Life Course cohort (DANLIFE) were categorized into five trajectory groups based on their annual exposure to adversity: low adversity, early-life material deprivation, persistent material deprivation, loss or threat of loss, or high adversity. Mental health problems were identified through hospital contacts and psychotropic medication use. Long-term social welfare dependence was defined as receiving social benefits for at least 52 consecutive weeks within the follow-up period. We examined the contribution of differential exposure and susceptibility to mental health problems in relation to childhood adversity and long-term social welfare dependence through causal mediation analysis. RESULTS: The different childhood adversity groups saw 54-319 additional cases of long-term social welfare dependence per 1,000 individuals compared with the low adversity group. These associations were partly mediated through mental health problems. To illustrate, in the high adversity group, differential exposure to mental health problems accounted for 15.0% (95% CI: 14.4-15.6) of the total effect, while differential susceptibility accounted for an additional 9.8% (95% CI: 8.8-10.9). CONCLUSIONS: Mental health problems partly mediate the relation between childhood adversity and long-term social welfare dependence in young adulthood through both elevated exposure and increased susceptibility. Addressing mental health problems and increasing resilience among individuals with a history of childhood adversity may mitigate the risk of subsequent social welfare dependence.
Editorial Perspective: Smoking, vaping and mental health - a perspective on potential causal mechanisms.
Treur JL, Vermeulen JM, van de Weijer MP
J Child Psychol Psychiatry · 2026 Mar · PMID 41028976 · Full text
This editorial perspective focuses on the complex relationship of cigarette smoking and e-cigarette use ('vaping') with mental health problems. It is challenging to reliably determine the causal nature of these associati...
This editorial perspective focuses on the complex relationship of cigarette smoking and e-cigarette use ('vaping') with mental health problems. It is challenging to reliably determine the causal nature of these associations because both (e-)smoking and mental health problems generally arise during adolescence, and both are highly multifactorial in their aetiology. While there is now scientific consensus that cigarette smoking is a causal risk factor for mental health problems, there is still a scarcity of causal research and conclusions with respect to e-cigarette use. In order to more reliably determine whether and how (e-)smoking affects mental health, it is important to better understand the potential causal pathways. Here, we discuss the main biological mechanisms that might explain causal effects of smoking and e-cigarettes on mental health, including (neuro-)inflammation, oxidative stress and nicotine binding. We showcase informative studies that have been conducted using sophisticated causally informative study designs and identify in which areas robust causal knowledge is especially lacking. In future work, evidence 'triangulation', where different types of research methods are integrated to look for converging results, seems to be the most promising approach to obtain reliable causal evidence.
Brief digital psychological intervention to prevent relapse of non-suicidal self-injury behavior in adolescents: A randomized controlled trial.
Zhang C, Qu D, Chong D … +7 more , Lei C, Shen Y, Cui X, He Y, Li Y, Ou J, Chen R
J Child Psychol Psychiatry · 2026 Mar · PMID 40999958 · Publisher ↗
BACKGROUND: Non-suicidal self-injury (NSSI) poses a significant mental health challenge among adolescents, necessitating accessible and effective interventions. While the development of technology offers new opportunitie...
BACKGROUND: Non-suicidal self-injury (NSSI) poses a significant mental health challenge among adolescents, necessitating accessible and effective interventions. While the development of technology offers new opportunities, higher costs remain a concern. In this context, digital psychological interventions such as text message intervention (SMS) present a convenient and low-cost delivery method that requires no face-to-face contact. However, the extent to which this method could function as a viable strategy remains underexplored. OBJECTIVE: To evaluate the effectiveness of an SMS intervention specifically developed for NSSI among adolescents when combined with treatment as usual (TAU), compared to TAU alone. METHODS: A randomized controlled trial (RCT) was conducted with 86 Chinese adolescents, randomly assigned to either the SMS intervention plus TAU or TAU alone. The SMS intervention, consisting of text messages addressing NSSI-related knowledge, distress tolerance skills, and emotion regulation strategies, was administered over 8 weeks. Assessments were conducted at baseline, 4 weeks, and 8 weeks. RESULTS: Participants in the intervention group showed a significant reduction in NSSI behavior at 4 weeks (RR = 0.43, p < .001), though this effect was not significant at 8 weeks (RR = 0.84, p = .265). No significant changes in NSSI ideation were observed at 4 weeks (RR = 0.87, p = .221) or 8 weeks (RR = 1.10, p = .437). Resistance to NSSI urges increased significantly at 8 weeks in the intervention group (RR = 1.93, p = .002), but not at 4 weeks (RR = 1.44, p = .063). Secondary outcomes showed no significant changes. CONCLUSIONS: The low cost, scalability, and accessibility of SMS interventions make them a potentially valuable complementary tool for supporting self-harm populations. However, further research is necessary to confirm their efficacy across diverse settings and to determine how best to integrate them with comprehensive treatment strategies.
Adolescence under fire: a multi-method study of psychological vulnerability and resilience among adolescents impacted by war.
Haham L, Aderka IM, Pine DS … +2 more , Abend R, Shechner T
J Child Psychol Psychiatry · 2026 Mar · PMID 40999924 · Full text
BACKGROUND: Given the long-term negative impact of exposure to military conflict, identifying its immediate psychological effects is crucial to develop prevention and intervention approaches, especially in adolescents, a...
BACKGROUND: Given the long-term negative impact of exposure to military conflict, identifying its immediate psychological effects is crucial to develop prevention and intervention approaches, especially in adolescents, a group particularly vulnerable to mental health challenges. METHODS: We examined 198 war-exposed Israeli adolescents (M = 16.35 years; 131 females, 65 males), 1-3 months into the Israel-Hamas war (2023), using a multi-method approach combining mental health questionnaires with week-long momentary sampling throughout the day and nightly diary measures. We focused on risk and protective factors affecting mental health. RESULTS: Most adolescents reported clinical levels of anxiety (M = 28.54, SD = 15.88) and trauma-related symptoms (M = 46.78, SD = 15.61). Female gender, increased tiredness, and avoidant coping strategies constituted risk factors for lower psychological well-being; in-person social interaction and emotional and problem-focused coping strategies represented resilience factors. CONCLUSIONS: By providing comprehensive information on risk and protective factors, this study informs the development of targeted prevention and intervention approaches to support adolescent well-being in times of extreme stress.
Association of prenatal antidepressant use with internalizing behaviors from kindergarten to adolescence.
Nitschke AS, Kaur P, Phagau N … +7 more , do Valle HA, Bone JN, Poon B, Guhn M, Vigod SN, Oberlander TF, Hanley GE
J Child Psychol Psychiatry · 2026 Mar · PMID 40996369 · Full text
BACKGROUND: To examine, using repeated measures, whether prenatal serotonin/norepinephrine reuptake inhibitor (SRI) antidepressant exposure is associated with increased anxious behaviors at kindergarten age and anxiety a...
BACKGROUND: To examine, using repeated measures, whether prenatal serotonin/norepinephrine reuptake inhibitor (SRI) antidepressant exposure is associated with increased anxious behaviors at kindergarten age and anxiety and/or depression behaviors after kindergarten and into adolescence. METHODS: This population-based retrospective cohort study included all live singleton infants delivered in British Columbia, Canada between January 2001 and December 2012 with complete outcome data. Follow-up lasted until December 2022. Logistic regression models were used to estimate unadjusted and adjusted odds ratios (OR). To minimize confounding, high-dimensional propensity score adjustment and a matched discordant sibling-pair analysis were conducted. RESULTS: Prenatal SRI exposure was associated with increased anxious behaviors in kindergarten (OR 1.77 [95% CI 1.59-1.97]) and anxiety and/or depression diagnostic codes in later childhood or adolescence (OR 2.09 [95% CI 1.97-2.22]). These associations attenuated but remained positive after high-dimensional propensity score adjustment; however, the associations did not remain in the conditional logistic regression of discordant sibling pairs (aORs 0.92 [95% CI 0.61-1.37] and 1.02 [95% CI 0.79-1.33]). Regardless of SRI exposure, children with high levels of anxious behaviors at kindergarten were more likely to receive anxiety and/or depression diagnostic codes later on (SRI exposed: aOR 1.59 [95% CI 1.24-2.06]; SRI unexposed: aOR 1.64 [95% CI 1.51-1.77]). CONCLUSIONS: The associations of prenatal SRI exposure with increased internalizing behaviors at kindergarten and into adolescence are likely due to shared genetics or environmental factors. Findings also suggested kindergarten as a time for targeted interventions to address developmental vulnerabilities and prevent later development of anxiety and/or depression.
Adolescent eating behaviours: associations with autistic and ADHD traits in childhood and the mediating role of anxiety.
Keller J, Mandy WPL, Herle M … +1 more , Carter Leno V
J Child Psychol Psychiatry · 2026 Mar · PMID 40977579 · Full text
BACKGROUND: Autistic individuals and individuals with ADHD are more likely to experience eating disorders, yet the reasons for this are not well understood. We investigated whether childhood neurodivergent (i.e. autistic...
BACKGROUND: Autistic individuals and individuals with ADHD are more likely to experience eating disorders, yet the reasons for this are not well understood. We investigated whether childhood neurodivergent (i.e. autistic and ADHD) traits are associated with patterns of emotional/restrained eating and externally driven eating behaviours in adolescence, whether these associations differed by sex and if they are mediated by anxiety. METHODS: We tested the association between parent-reported childhood (age 7 years) autistic and ADHD (i.e. hyperactivity/impulsivity, inattention) traits and self-reported adolescent (age 13) eating behaviours in a large population-representative prospective cohort (N = 7,572; Avon Longitudinal Study of Parents and Children). We performed multi-group longitudinal analysis stratified by sex to understand whether sex moderates' associations between neurodevelopmental traits and adolescent eating behaviours. Mediation models tested the extent to which observed associations were driven by mid-childhood (age 10) anxiety symptoms. All analyses were adjusted for child sex, child ethnicity, maternal education levels and maternal age at birth. RESULTS: Individuals who had higher childhood autistic traits were more likely to report emotional/restrained (b = 0.59, 95% CI [0.29, 0.88], p < .001, B = 0.07) and externally driven (b = 0.17, 95% CI [0.05, 0.28], p < .01, B = 0.06) eating behaviours during adolescence. Additionally, individuals with higher childhood inattention traits were more likely to report externally driven eating behaviours (b = 0.10, 95% CI [0.03, 0.19], p = .02, B = 0.05). No sex differences were identified in the associations. Mediation models suggested a significant indirect effect of anxiety for the association between autistic traits and emotional/restrained eating (b = 0.08, bootstrapped 95% CIs [0.02, 0.13]). CONCLUSIONS: Autistic and ADHD traits in childhood may share some eating behaviour phenotypes in adolescence (externally driven eating), whereas others are specific to autism (emotional/restrained eating). We present evidence for the role of anxiety in underpinning the association between autistic traits and emotional/restrained eating behaviours, suggesting an important potential intervention target.
Mapping phenotypic and genetic relationships among irritability, depression and ADHD in adolescence using network analysis.
Shakeshaft A, Farhat LC, Dennison CA … +8 more , Eyre O, Oginni O, O'Donovan MC, Stringaris A, Leibenluft E, Polanczyk GV, Riglin L, Thapar A
J Child Psychol Psychiatry · 2026 Mar · PMID 40974183 · Full text
BACKGROUND: Irritability is a common reason for referral to child and adolescent mental health services. However, debate exists as to whether irritability is best conceptualised and treated as a feature of mood disorder,...
BACKGROUND: Irritability is a common reason for referral to child and adolescent mental health services. However, debate exists as to whether irritability is best conceptualised and treated as a feature of mood disorder, oppositional defiant disorder or a core symptom of ADHD. METHODS: We use network analyses to examine the relationships between adolescent irritability, headstrong/hurtful ODD items, depression and ADHD phenotypes, and polygenic scores (PGS) for depression and ADHD using the Avon Longitudinal Study of Parents and Children (ALSPAC). In primary analysis, irritability, depression, headstrong/hurtful ODD items and ADHD were defined using the Development and Well-Being Assessment (DAWBA) at age 15. In secondary analysis, phenotypes were defined using the Short Mood and Feelings Questionnaire (SMFQ) and the Strengths and Difficulties Questionnaire (SDQ) ADHD and behavioural subscales at age 13. Finally, we tested for network replicability using confirmatory network analysis in the Millennium Cohort Study (MCS). RESULTS: Results of network analyses using the DAWBA in ALSPAC indicated irritability was most strongly associated with headstrong/hurtful ODD items, followed by ADHD and depression. When including PGS, we observed an edge between irritability and depression PGS but not between irritability and ADHD PGS. Irritability appeared to be the primary pathway between ADHD and depression as well as between headstrong/hurtful ODD items and depression. Results were similar using SMFQ/SDQ in ALSPAC and confirmatory network analysis indicated excellent model fit in MCS. CONCLUSIONS: Although irritability appears to be transdiagnostic, phenotypically, it was most strongly associated with headstrong/hurtful ODD items and broader behavioural problems, which favours the ICD-11 approach of including irritability as a specifier of ODD. However, irritability appeared to be a key connector between both ADHD and behavioural problems to depression; thus, is important to monitor and treat in affected youth with ADHD or behavioural problems.
Have parenting programs for disruptive child behavior become less effective?
Leijten P, Melendez-Torres GJ, Backhaus S … +15 more , Gardner F, Groenman AP, Dekkers TJ, van den Hoofdakker BJ, Laas Sigurðardóttir LB, Liu D, Luman M, Mansur L, Nieterau M, van der Oord S, Overbeek G, Psyllou C, Rienks K, Schulz S, Weisz JR
J Child Psychol Psychiatry · 2026 Jan · PMID 40968482 · Full text
BACKGROUND: Behavioral parenting programs have been exhaustively studied over the past five decades. We used this wealth of research to examine how estimates of parenting program effects have evolved over time, and if an...
BACKGROUND: Behavioral parenting programs have been exhaustively studied over the past five decades. We used this wealth of research to examine how estimates of parenting program effects have evolved over time, and if any time trends in effect estimates can be explained by trial, sample, or intervention characteristics. METHODS: We based our meta-analysis on a systematic search of 22 international and regional databases, gray literature, and 4 trial registries for randomized controlled trials of behavioral parenting programs. RESULTS: We identified 244 eligible trials (1,100 effect sizes; 28,916 families) from 36 countries. Parenting program effects initially reduced and then stabilized. More recent trials used more rigorous methods (e.g., more active control conditions and less risk of bias), samples that were generally older and included more girls, and evaluated interventions that on average had fewer sessions, were more often delivered by independent staff and made less use of time-out. However, none of these developments explained the initial reduction in effect size estimates during the first decades. CONCLUSIONS: Our findings suggest that estimates of parenting program effects are currently stable: Effect sizes are no longer reducing but there is also no evidence of increases over time. Experimentation with the content, delivery, and personalization of parenting programs is needed to identify ways to increase program effects.
Psychostimulant treatment uniquely reduces left uncinate fasciculus microstructural integrity in ADHD youth with a familial risk for bipolar I disorder: a 12-week DTI study.
Qin K, Chen W, Lei D … +8 more , Zhu Z, Tallman MJ, Pan N, Zhang L, Rodrigo Patino L, Sweeney JA, DelBello MP, McNamara RK
J Child Psychol Psychiatry · 2026 May · PMID 40960004 · Full text
BACKGROUND: Bipolar I disorder (BD) is associated with reduced white matter microstructural integrity in the uncinate fasciculus (UF), a primary fiber tract connecting frontolimbic systems. Although familial history for...
BACKGROUND: Bipolar I disorder (BD) is associated with reduced white matter microstructural integrity in the uncinate fasciculus (UF), a primary fiber tract connecting frontolimbic systems. Although familial history for BD, attention-deficit/hyperactivity disorder (ADHD), and psychostimulants are important risk factors implicated in BD pathoetiology, their impact on UF microstructure remains poorly understood. METHODS: This diffusion tensor imaging study investigated UF microstructural integrity prior to and following 12 weeks of psychostimulant treatment in ADHD youth with ('high-risk', HR) and without ('low-risk', LR) a first-degree relative with BD. Healthy controls were included for comparative purposes. LR youth received 12-week open-label mixed amphetamine salts-extended release (MAS-XR), and HR youth were randomized to either MAS-XR or placebo (PLA). Bilateral UF fractional anisotropy (FA) and axial diffusivity (AD) were assessed using automated fiber quantification. RESULTS: A total of 137 participants were included in the analyses. At baseline, there were no significant group differences in bilateral UF microstructural metrics. Following 12-week MAS-XR treatment, significant group-by-time interactions were found for left UF FA and AD between HR-MAS and LR-MAS, as well as for left UF FA between HR-MAS and HR-PLA. Specifically, left UF FA and UF AD decreased significantly in HR-MAS but remained unchanged in LR-MAS and HR-PLA groups. At week 12, left UF FA was lower in HR-MAS relative to HC but not in LR-MAS or HR-PLA. Segment-wise analyses further revealed that UF microstructural changes in the HR-MAS group were localized to the anterior segments. CONCLUSIONS: These results suggest that HR-ADHD youth are uniquely vulnerable to reductions in left UF microstructural integrity following psychostimulant treatment, suggesting potential relevance to BD pathoprogression.
Long-term follow-up of a randomised controlled trial of a brief home-based parenting intervention to reduce behavioural problems in young children.
Ramchandani P, Elkes J, Cornelius V … +15 more , Byford S, Oxley L, Babalis D, Barker B, Bibby E, Chere B, Ganguli P, Griffith S, Iqbal Z, Kamarudin A, Lui K, Scott S, Tassie E, Viding E, O'Farrelly C
J Child Psychol Psychiatry · 2026 Mar · PMID 40959892 · Full text
BACKGROUND: Behaviour problems are common in childhood and are associated with higher rates of mental health problems, educational and relationship difficulties throughout life. This study assessed whether a Video-feedba...
BACKGROUND: Behaviour problems are common in childhood and are associated with higher rates of mental health problems, educational and relationship difficulties throughout life. This study assessed whether a Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) has sustained benefit 6 years after delivery. It had previously been shown to reduce behavioural problems in children aged 2 and 4 years old. METHODS: The Healthy Start, Happy Start study was a 2-arm, multisite randomised clinical trial conducted in 6 NHS trusts in England. Participants (N = 300) were parents/caregivers of children (aged 12-36 months) at risk of behaviour problems. Participants were randomised to receive either VIPP-SD (n = 151) or usual care (n = 149). Those allocated to VIPP-SD were offered 6 home-based video-feedback sessions. Six-year follow-up data were collected from May 2022 to July 2023. The primary outcome was the total score on Parental Account of Children's Symptoms (PACS). The analysis used prespecified longitudinal Bayesian models to handle missing data, and findings are reported as posterior probabilities of superiority alongside treatment effect estimates with 95% credible interval. RESULTS: Analysis included 294 of the 300 participants, with 6-year primary outcome data available for 244/300 (81%) (106 girls [43%]; mean age, 8.2 years). The probability of superiority for VIPP-SD on PACS was 86%. The mean difference in the total PACS score was -1.23 (95% Cred.I [-3.34, 0.90]); d = -0.11 (95% Cred.I [-0.032, 0.09]), with fewer behavioural problems in children in the VIPP-SD group (mean [SD] score of 25.30 [9.63] vs. 26.36 [11.05]). CONCLUSIONS: This trial found a probability of 86% that VIPP-SD was superior for reducing behaviour problems in children up to 6 years later. Taken together with the earlier positive trial findings, this suggests a small enduring positive impact of a brief early intervention with potential for scaling.
Unraveling psychosis risk in sexual minorities: temporal dynamics of social defeat and suspiciousness in adolescence.
Sageot M, Achterhof R, Hiekkaranta AP … +4 more , Lecei A, Vansteeland K, Myin-Germeys I, van Winkel R
J Child Psychol Psychiatry · 2026 Feb · PMID 40928071 · Publisher ↗
BACKGROUND: Previous research suggests that sexual minorities are at higher risk for psychotic experiences, possibly due to repeated social defeat experiences. However, empirical research investigating this hypothesis is...
BACKGROUND: Previous research suggests that sexual minorities are at higher risk for psychotic experiences, possibly due to repeated social defeat experiences. However, empirical research investigating this hypothesis is largely lacking. This study examined how experiences of "feeling excluded" and "not belonging" impact the prospective development of psychotic experiences in an adolescent sexual minority group, defined here as non-heterosexual attraction to others. METHODS: Experience sampling method (ESM) data from 1913 Flemish adolescents (aged 11-20) in the SIGMA study were analyzed. They reported their momentary feelings of exclusion when alone, belonging when in the company of others (both operationalizations of social defeat), and suspiciousness. Multilevel linear regression models tested the bidirectional, within- and between-person associations between social defeat and suspiciousness, and the effects of sexual minority status. RESULTS: Lower feelings of belonging when in company significantly predicted higher suspiciousness at the next beep [95% CI: -0.03, -0.01], whereas increased feelings of exclusion when alone did not. Moreover, suspiciousness did not significantly predict feelings of exclusion and belonging at the next beep, confirming the direction of effect. Sexual minority participants reported generally lower belonging in social settings [95% CI: -0.68, -0.29] and higher suspiciousness [95% CI: 0.16, 0.57], but not higher feelings of exclusion. The interaction between social defeat and sexual minority status was not significant, indicating no differential sensitivity to social defeat experiences. CONCLUSIONS: The experience of "not fitting in" when in company may be the most poignant social factor increasing risk for psychotic experiences in sexual minority youth. The findings highlight the need for inclusive environments where sexual minority individuals feel supported and integrated.
Emotional and behavioural difficulties in gender minority compared to cisgender adolescents: identity specific findings from a contemporary national study.
Page N, Angel L, Borgia S … +5 more , Reynolds C, Zubizarreta D, Young H, Ashton MR, White J
J Child Psychol Psychiatry · 2026 Mar · PMID 40926578 · Full text
BACKGROUND: Gender minority adolescents are more likely to report emotional and behavioural difficulties compared to their cisgender peers. However, little is known about these experiences for adolescents with specific g...
BACKGROUND: Gender minority adolescents are more likely to report emotional and behavioural difficulties compared to their cisgender peers. However, little is known about these experiences for adolescents with specific gender minority identities. METHODS: Cross-sectional data were obtained from the 2021/22 Student Health and Well-being survey, a national survey of 11-16-year-olds in Wales, UK. Emotional and behavioural difficulties were measured using the Strengths and Difficulties Questionnaire. Gender identity and assigned sex at birth were self-reported. Multivariable linear regressions with robust standard errors were used to examine associations between gender identity and emotional and behavioural difficulties, adjusting for age, ethnicity, household-level affluence and correction for multiple testing. RESULTS: Of the 122,766 participants, 2.0% (2,455) identified as a person with a gender minority identity. Twenty-eight gender minority identities were self-reported, with the most prevalent being transgender boy and nonbinary assigned female at birth (both 0.6%). Young people assigned female at birth comprised 80% of gender minority adolescents. In the adjusted model, emotional and behavioural difficulties were reported most frequently by people who identified as non-binary (B = 7.66, 95% CI 7.25, 8.06) and another gender identity (B = 7.86, 95% CI 7.34, 8.38), then transgender (B = 5.05, 95% CI 4.58, 5.51), when compared to cisgender adolescents. Female sex assigned at birth was associated with more reported difficulties than male sex assigned at birth for adolescents with a transgender or cisgender identity, but not a nonbinary identity. CONCLUSIONS: In this population-based study, emotional and behavioural difficulties were reported most frequently by adolescents who identified as nonbinary and another gender identity, then transgender, then cisgender. Health and educational practitioners need to be aware that emotional and behavioural difficulties differ across gender minority identities.
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