Child Psychiatry Hum Dev [JOURNAL]
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200 papers
Parental Psychological Distress and Perceived Child Externalizing Behaviors: Examining Mediators and Bidirectional Effects.
Anderson AJ, Rodriguez CM, Henson JM
Child Psychiatry Hum Dev · 2026 Mar · PMID 41838337 · Publisher ↗
Parental psychological distress is a commonly examined risk factor for the emergence of child problem behaviors, but the factors that contribute to that relationship-such as limited parental resources like greater social...
Parental psychological distress is a commonly examined risk factor for the emergence of child problem behaviors, but the factors that contribute to that relationship-such as limited parental resources like greater social support and coping skills-have not been adequately explored, particularly with attention to potential bidirectional relations that incorporate child evocative effects. The current longitudinal study examined maternal and paternal psychological distress in relation to perceived child externalizing behaviors, considering parental resources as mediators within a bidirectional model. The sample included a racially and socioeconomically diverse group of 201 primiparous mothers and 151 fathers. Mothers and fathers reported their current psychological distress, social support satisfaction, and problem-focused coping prenatally, at child age 18 months and at child age 4 years, as well as reporting on child externalizing behaviors in these latter two waves. Results suggest that mothers' psychological distress predicted perceived child externalizing behaviors in both toddlerhood and early childhood. However, for fathers, although their psychological distress did not predict their reports of child externalizing behaviors, perceived child externalizing appeared to predict later paternal psychological distress and social support satisfaction in early childhood, evidencing child evocative effects. No mediation by parental resources was identified for either mothers or fathers. Overall, this study underscores the intricate processes involved in understanding parent-perceived child externalizing behaviors and the importance of examining fathers and the role of children.
Beyond Fear of Failure: Exploring the Relationships between Parental Overprotection, Parental Criticism, Children's/Adolescents' Self-Compassion and their Performance Anxiety.
Dias TM, Moreira HC
Child Psychiatry Hum Dev · 2026 Mar · PMID 41831147 · Publisher ↗
In recent years, there has been a noticeable increase in performance-related concerns and a heightened fear of failure among children and adolescents across various settings, such as academics and sports. Despite this tr...
In recent years, there has been a noticeable increase in performance-related concerns and a heightened fear of failure among children and adolescents across various settings, such as academics and sports. Despite this trend, research specifically addressing performance anxiety remains limited, with most studies focusing on the broader category of social anxiety. This study addresses this gap by investigating how perceived parental criticism and self-compassion among children/adolescents mediate the relationship between parental overprotection and performance anxiety during childhood and adolescence. The sample comprises 428 dyads of children/adolescents (M = 10y 9 m, SD = 1y 8 m; range = 6-15 years) and their respective educational guardian (85.6% female), recruited from school settings. A sequential mediation model was estimated to analyze the direct and indirect effects of parental overprotection on children's/adolescents' performance anxiety, through their perception of parental criticism and levels of self-compassion. Higher levels of parental overprotection were linked to higher levels of performance anxiety through the children's/adolescents' perception of parental criticism and the sequence of the two mediators under study. This study underscores the need for parental interventions to reduce parental overprotection and criticism and suggests that compassion-based interventions could be particularly effective in helping children/adolescents lower their levels of performance anxiety.
Prevention of Obsessive-Compulsive Disorder in At-Risk Children: A Feasibility Trial.
Aspvall K, Kraepelien M, Peterson J … +5 more , Nilsson J, Cervin M, Åhlén J, Andersson E, Mataix-Cols D
Child Psychiatry Hum Dev · 2026 Mar · PMID 41831146 · Publisher ↗
Preventing obsessive-compulsive disorder (OCD) before it emerges has long been considered a central, yet elusive, goal for researchers. Achieving this will likely require identifying individuals at elevated risk and inte...
Preventing obsessive-compulsive disorder (OCD) before it emerges has long been considered a central, yet elusive, goal for researchers. Achieving this will likely require identifying individuals at elevated risk and intervening during critical developmental periods before the onset of impairing symptoms. This trial evaluated the feasibility of a brief parent-guided online targeted prevention program for children at-risk of developing OCD. We enrolled 35 children aged 5-12 years with a first-degree relative with OCD and/or subclinical obsessive-compulsive symptoms. None met diagnostic criteria for OCD at baseline. The four-week intervention targeted known maintaining factors (compulsions, avoidance and family accommodation) and was delivered online without scheduled therapist contact. The outcomes included feasibility and acceptability measures, along with preliminary efficacy in reducing the targeted maintaining factors. Assessments were conducted at baseline, post-intervention, and at 6-month and 12-month follow-ups. All families initiated the intervention, and 66% completed at least three of the four modules during the study period. Parents reported high credibility and satisfaction with the intervention. At the 12-month follow-up, 33 parents completed the assessment and statistically significant within-group improvements were observed for compulsions (d = 0.66, 95% CI 0.31-1.00), avoidance (d = 0.56, 95% CI 0.12-1.00), and family accommodation (d = 0.75, 95% CI 0.43-1.07). One child met diagnostic criteria for OCD at the 12-month follow-up. This study supports the feasibility and acceptability of a brief prevention program for children at-risk of developing OCD. A randomized controlled trial is now warranted.
Mediation of Treatment Effects in Problem-Focused Social Skills Training versus Resource Activation for Children with Disruptive Behavior Problems: A Cross-Sectional Analysis.
Hofmann L, Dose C, Döpfner M … +1 more , Görtz-Dorten A
Child Psychiatry Hum Dev · 2026 Mar · PMID 41824141 · Publisher ↗
A previous randomized controlled trial comparing problem-focused computer-assisted skills training (ScouT) with supportive resource activation treatment (STARK) in children (6-12 years) with disruptive behavior disorders...
A previous randomized controlled trial comparing problem-focused computer-assisted skills training (ScouT) with supportive resource activation treatment (STARK) in children (6-12 years) with disruptive behavior disorders (DBD) demonstrated significant pre-post changes in both treatment conditions, with ScouT being slightly superior on some outcomes. Based on the same sample (N = 99), the present study examined cross-sectional indirect associations between treatment condition and outcomes via intermediate variables, which conceptually correspond to mediation. We hypothesized that ScouT would lead to stronger reductions in the peer-related aggression-maintaining factor (PAM factor; including dysfunctional social information processing, emotional dysregulation, impulse control problems, deficits in social skills, and dysfunctional social interactions), whereas STARK would lead to greater improvements in self-concept, which in turn would be associated with lower concurrently assessed clinician-, parent- and teacher-rated DBD symptoms and overall externalizing behaviors. Our analysis yielded support for the hypothesized indirect association through the PAM factor, with consistency across all outcome measures. Unexpectedly, compared with STARK, ScouT also led to a more favorable self-concept, which was indirectly associated with less severe clinician-rated DBD symptoms, but not with the other outcomes. This latter indirect association was small and should additionally be interpreted with caution given the low reliability of the clinician-rated scale. These findings may indicate that the treatment of children with DBD may benefit from directly targeting aggression-maintaining factors. Limitations include the concurrent assessment of the intermediate variables (PAM factor, self-concept) and the outcomes, which does not permit causal conclusions. Future research should refine methodologies and explore additional treatment mechanisms.Trial Registration: The study was registered at clinicaltrials.gov on 2014-05-18 (Identifier: NCT02143427).
Examining the Mental Health of Siblings of Children with a Mental Disorder: A Scoping Review.
Goddard-Polly JA, Wade TJ, Andrade BF … +3 more , Browne DT, Krzeczkowski JE, Patte KA
Child Psychiatry Hum Dev · 2026 Mar · PMID 41817791 · Publisher ↗
Mental disorders tend to cluster within families, yet the majority of research focuses on one child per family. There is a paucity of research examining the impact of a child's mental disorder on siblings. This scoping r...
Mental disorders tend to cluster within families, yet the majority of research focuses on one child per family. There is a paucity of research examining the impact of a child's mental disorder on siblings. This scoping review addresses the following questions: (i) How do mental disorders in children impact the mental health of their sibling(s)? (ii) Which resources exist that address the needs of siblings of children with mental disorders? We searched eight databases for empirical studies and screened for those published since 2011. n = 27 studies were included; n = 21 studies addressed research question one and n = 6 addressed research question two. Pertaining to research question one, quantitative studies found that siblings of children with mental disorders are at risk for developing mental health problems or psychopathology themselves and experience a wide range of symptoms across many diagnostic categories. Qualitative studies reported siblings' negative emotions and experiences (e.g., confusion about child's disorder, fearful of violence from the child). Pertaining to research question two, we found a paucity of research (n = 6 studies) that assessed resources or interventions for siblings, indicating that there is likely a lack of interventions available for siblings. Future research should look to use more robust quantitative study designs (e.g., longitudinal, mixed-methods) in diverse samples and qualitative methodologies that can investigate particularly concerning instances. While we did identify that sibling interventions exist, those created with sibling and family voices may be better positioned to address sibling's needs.
Attention Focusing Moderates the Association Between Parent Anxiety and Attention Bias to Threat in Youth with Social Anxiety Disorder.
Falcone MM, Chong LJ, Buzzell GA … +10 more , Crowley MJ, Yang Y, Rey Y, Magnotti AM, Lebowitz ER, Lazarov A, Bar-Haim Y, Pine DS, Silverman WK, Pettit JW
Child Psychiatry Hum Dev · 2026 Mar · PMID 41784901 · Publisher ↗
Despite theory and research linking parent anxiety to youth attention bias to threat, knowledge gaps remain regarding potential moderators. We examined youth attention focusing (i.e., ability to inhibit distractors and s...
Despite theory and research linking parent anxiety to youth attention bias to threat, knowledge gaps remain regarding potential moderators. We examined youth attention focusing (i.e., ability to inhibit distractors and sustain attention) and attention shifting (i.e., ability to flexibility shift attention) as moderators of the association between parent anxiety and youth attention bias to threat among peripubertal youth with social anxiety disorder. We expected that parent anxiety would be associated with youth attention bias to threat at low levels of attention focusing and shifting. Participants were 165 clinically referred peripubertal youth (ages 9-14 years, M = 12.21 years; SD = 1.55; 73.9% White, 57.0% Hispanic or Latino; 63.0% females) with social anxiety disorder. We used a free-viewing task with eye tracking to measure youth attention bias to threat, self-ratings to measure youth attention focusing and shifting, and self-ratings to measure parent anxiety. Attention focusing, but not shifting, moderated the association between parent anxiety and youth attention bias to threat. At low levels of attention focusing, high parent anxiety was associated with high youth attention bias to threat. Findings suggest that parent anxiety serves as a signal that enhances socially anxious youths' attention to threat, particularly among those who struggle to sustain focused attention. We extend our findings to implications for theory and treatment of social anxiety in youth.
From Playground to Psychiatry: Examining the Predictive Validity of Childhood Behavioral Assessments for Adult Mental Health Outcomes.
Ntumi S, Miezah D
Child Psychiatry Hum Dev · 2026 Mar · PMID 41779275 · Publisher ↗
Childhood behavioral difficulties are recognized as early indicators of future psychiatric disorders, yet their long-term predictive validity in non-Western settings remains underexplored. This study investigated the pre...
Childhood behavioral difficulties are recognized as early indicators of future psychiatric disorders, yet their long-term predictive validity in non-Western settings remains underexplored. This study investigated the predictive value of childhood behavioral assessments in determining adult psychiatric outcomes among 300 individuals in Ghana followed longitudinally from childhood to early adulthood. Using the Child Behavior Checklist (CBCL), both externalizing behaviors (e.g., aggression, hyperactivity) and internalizing behaviors (e.g., anxiety, withdrawal) were assessed between 2005 and 2015, while adult mental health outcomes including mood, anxiety, substance use, and psychotic disorders were measured with standardized diagnostic instruments such as the MINI, PHQ-9, and GAD-7. Logistic regression analyses revealed that both internalizing (B = 0.87, OR = 2.39, p < .001) and externalizing (B = 1.23, OR = 3.42, p < .001) behaviors significantly predicted adult psychiatric outcomes, even after controlling for sociodemographic factors. Exposure to trauma (OR = 4.67, p < .001) and low parental education (OR = 1.80, p < .01) increased risk, while early intervention (OR = 0.54, p < .01) served as a protective factor. The overall model demonstrated good fit and strong discriminative power (Nagelkerke R² = 0.29; AUC = 0.83). Cross-cultural validity analyses showed that childhood behavioral scores predicted adult psychiatric disorders effectively, with the strongest accuracy for mood disorders (AUC = 0.82) and overall psychiatric risk (AUC = 0.85). Moderate predictive power was found for psychotic (AUC = 0.73) and neurodevelopmental disorders (AUC = 0.75), and weaker for substance use (AUC = 0.68). Moderation analyses indicated that gender, socioeconomic status, family structure, exposure to trauma, parental involvement, and residence significantly influenced these relationships, with trauma being the strongest risk enhancer. The study highlights the predictive utility of culturally adapted behavioral assessments and underscores the need for early screening and family-centered interventions within Ghana's education and health systems to mitigate long-term mental health risks.
Sex-Based Differences in Clinical and Social Outcomes in Qatari Youth with ADHD.
Hashem S, Elhag SF, Awada Z … +8 more , Aamer W, Bhat AA, Al-Maraghi A, Shaif A, Aldhaibani H, Fakhro K, Nemer G, Kamal M
Child Psychiatry Hum Dev · 2026 Feb · PMID 41746460 · Publisher ↗
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with substantial academic and social impairments, yet evidence from Middle Eastern populations remains limited. This stud...
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with substantial academic and social impairments, yet evidence from Middle Eastern populations remains limited. This study examined demographic, clinical, academic, and social functioning profiles of Qatari youth with ADHD, with a particular focus on sex-based differences. A cross-sectional study was conducted at a tertiary service in Qatar between 2022 and 2025, involving 131 Qatari youth aged 7-17 years with a confirmed diagnosis of ADHD. Parents completed the Vanderbilt ADHD Diagnostic Parent Rating Scale, and clinical data on comorbidities, treatment, academic performance, and social functioning were extracted from medical records. Males comprised 71% of the sample. Although most clinical features were comparable between male and female ADHD patients, females demonstrated significantly greater peer relationship difficulties compared with males, suggesting a need for targeted social intervention in females. Academic impairments were also prevalent across both sexes. Findings underscored the functional impact of ADHD and the importance of culturally and gender-sensitive care.
Attention Bias Training for Youth with Anxiety from a Rural Latine Community.
Chang S, Rozenman M, Ramos G … +2 more , Delgadillo D, Chavira DA
Child Psychiatry Hum Dev · 2026 Feb · PMID 41729446 · Publisher ↗
Scant research exists for interventions that are accessible and effective for rural Latine youth with mental health needs. The current study examines the feasibility and preliminary effectiveness of a community health wo...
Scant research exists for interventions that are accessible and effective for rural Latine youth with mental health needs. The current study examines the feasibility and preliminary effectiveness of a community health worker-facilitated, attention bias modification (ABM) intervention for rural Latine youth with anxiety. Sixty-nine Latine youth (M = 11.74; 67% males; 44.5% low-income) with clinical levels of anxiety were randomized to either ABM (n = 34) or to an attention control condition (ACC) (n = 35). ABM included the dot-probe attention training task, where probes appeared in the location of neutral faces on 100% of trials. For ACC, probes appeared in the location of neutral faces on 50% of trials. Participants completed questionnaires, measures of attention bias and attention control, and clinician administered interviews at baseline, post-treatment, and 3-month follow-up. Findings revealed low attrition, excellent training adherence, and favorable treatment satisfaction. There were no statistically significant differences between groups, but both groups showed significant decreases in anxiety symptoms at post-treatment. Clinician ratings of global improvement were 51% and 53% for the ABM and ACC groups respectively. Exploratory analyses examining attention bias and attention control as mechanisms of change on treatment outcomes were not significant. This is the first feasibility study of ABM in a rural Latine community, using a novel mode of delivery. Findings are promising, given excellent rates of engagement and significant decreases in anxiety over time. However, additional research is necessary to optimize anxiety improvement and identify the mechanisms of change in ABM interventions.
The Association Between Youth Screentime, Suicide Behaviors, and Protective and Risk Factors in a United States Post-COVID-19 Pandemic Sample.
Berg O, Mikulich-Gilbertson SK, Bhatia D
Child Psychiatry Hum Dev · 2026 Feb · PMID 41729445 · Publisher ↗
Adolescent screentime and suicide rates increased during the coronavirus disease 2019 (COVID-19) pandemic. This study assesses whether specific risk and protective factors moderate the relationship between screentime and...
Adolescent screentime and suicide rates increased during the coronavirus disease 2019 (COVID-19) pandemic. This study assesses whether specific risk and protective factors moderate the relationship between screentime and suicide outcomes in a post-COVID-19, nationally-representative sample of US adolescents. Data are from the Center for Disease Control and Prevention's 2021 Youth Risk Behavior Survey (n = 17,232). Weighted logistical ANCOVAs tested relationships between screentime (low [≤2 h/day], medium [3-4 h/day], high [≥5 h/day]) and suicide (suicidal ideation [SI], plan, attempt), interactions of screentime and risk/protective factors (feeling sad, being bullied/cyberbullied, feeling close to people at school, sleep, and exercise), and the relationship between screentime and suicide behaviors, adjusting for significant risk/protective factors. Compared to low screentime, high screentime was associated with higher odds of all suicide behaviors (aORs = 1.30-1.96; 95% CI from 1.02 to 2.35), while medium screentime's effect varied by behavior (SI: aOR = 1.19; 95% CI 1.02-1.38; Plan: aOR = 1.09; 95% CI 0.92-1.29; Attempt: aOR = 0.80; 95% CI 0.65-0.98). After adjusting for combined risk factors, high screentime remained significantly associated with SI and plan (aORs = 1.39-1.62; 95% CI from 1.12 to 1.97) but not attempt (aOR = 1.10; 95% CI 0.85-1.41). In combined models, feeling close to people at school was significantly protective against SI for all levels of screentime (aORs 0.43-0.59; 95% CI from 0.35 to 0.70), and sleep was protective for SI and plan (aORs 0.59-0.60; 95% CI from 0.45 to 0.78). Among US adolescents, high screentime is a significant risk factor for suicidal ideation and plan, above and beyond other known risk factors. Findings underscore school connectedness and adequate sleep as potential areas for intervention alongside guidance on high daily screentime.
Family Factors Associated with Adolescent Internalizing Symptoms: Longitudinal Findings from the ABCD Study.
Huynh KL, Zamora RJ, George GC … +4 more , Kuckertz JM, Kovarsky Rotta G, Beard C, De Nadai AS
Child Psychiatry Hum Dev · 2026 Feb · PMID 41729444 · Publisher ↗
Family factors, such as parental symptomatology and parenting behaviors, are related to adolescent internalizing symptoms. Yet fewer studies have evaluated how family factors relate to the emergence of internalizing symp...
Family factors, such as parental symptomatology and parenting behaviors, are related to adolescent internalizing symptoms. Yet fewer studies have evaluated how family factors relate to the emergence of internalizing symptoms during the pubertal transition with large-scale longitudinal data. The present study addressed this issue using data from the Adolescent Brain Cognitive Development Study in adolescents who were prepubertal at baseline and had manifested puberty at 4-year follow-up (N = 2,276). Participants completed the Child Behavior Checklist (CBCL), Adult Self Report (ASR), Child Report of Parenting Behavior Inventory (CRPBI), Parental Monitoring Survey (PMQ), and Family Environment Scale (FES). Structural equation modeling revealed that higher levels of parent internalizing symptoms and parent-reported family conflict at baseline were associated with higher levels of adolescent internalizing symptoms at the 4-year follow-up. Higher baseline parental monitoring was associated with lower adolescent internalizing symptoms at the 4-year follow-up. Baseline parental acceptance and youth-reported family conflict were not related to adolescent internalizing symptoms. Adolescent sex did not moderate any associations in our models. Our results offer insights into how research, prevention, and intervention strategies can be developed to address the development of adolescent internalizing psychopathology.
The Role of Adverse Childhood Experiences in the Development of Major Depressive Disorder and Treatment-Resistant Depression.
Dos Santos MAB, Guerra AEP, Sayão MMA … +4 more , da Silva Selani AL, Betarelli BC, de Faria Siqueira I, Forgerini M
Child Psychiatry Hum Dev · 2026 Feb · PMID 41721954 · Publisher ↗
This review examined adverse childhood experiences (ACEs) associated with the risk of major depressive disorder (MDD) and treatment-resistant depression (TRD). A search was conducted in PubMed, Scopus, PsycINFO, SciELO,...
This review examined adverse childhood experiences (ACEs) associated with the risk of major depressive disorder (MDD) and treatment-resistant depression (TRD). A search was conducted in PubMed, Scopus, PsycINFO, SciELO, and LILACS. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Twenty-four studies were included, encompassing 1,119,606 participants. Family structure adversities and sexual and physical abuse were the most frequently examined exposures, although their associations with MDD varied across studies. Emotional abuse, domestic violence, and bullying were less commonly assessed but showed more consistent associations with MDD. Evidence regarding TRD was limited, with childhood neglect as a risk factor for poorer treatment response. Greater cumulative exposure to ACEs was associated with higher risk of MDD and TRD. Overall, the findings support childhood adversity as a clinically relevant determinant of depressive risk and clinical course, although heterogeneity across study designs and high risk of bias limit causal inference.
The Mediator Testing of Association Between Fear of Hypoglycemia and Diabetes Self-Management in Chinese Adolescents with T1DM: Diabetes Distress or Depressive Symptoms?
Li Q, Yang J, Fan L … +5 more , Lei R, Jia Z, Luo J, Shi J, Guo J
Child Psychiatry Hum Dev · 2026 Feb · PMID 41718843 · Publisher ↗
Fear of hypoglycemia may represent an important target for improving diabetes self-management among adolescents with T1DM. However, whether fear of hypoglycemia is associated with diabetes self-management remains undeter...
Fear of hypoglycemia may represent an important target for improving diabetes self-management among adolescents with T1DM. However, whether fear of hypoglycemia is associated with diabetes self-management remains undetermined, and the factors contributing to this uncertain association are poorly understood. This study aims to (1) examine the association between fear of hypoglycemia and diabetes self-management in Chinese adolescents with T1DM, and (2) explore potential mediators in this relationship. This muti-site cross-sectional study was conducted between January 2021 and December 2022 across three hospitals of China. Validated questionnaires assessed fear of hypoglycemia, depressive symptoms, diabetes distress and diabetes self-management. Two path analysis models were then conducted using Mplus 8.0 to test the mediating effects of diabetes distress and depressive symptoms on the relationship between fear of hypoglycemia and diabetes self-management in adolescents with T1DM. A total of 174 valid questionnaires were retained (effective response rate: 82.08%). Adolescents reported moderate fear of hypoglycemia was moderate (mean score = 14.04). Path analysis revealed that the mediating effect of diabetes distress between fear of hypoglycemia and diabetes self-management was significant(indirect effect: β = -0.165 and - 0,161, p = 0.001), whereas the mediating effect of depressive symptoms was not significant. Diabetes distress partially mediated the association between fear of hypoglycemia and diabetes self-management in adolescents with T1DM. Chinese adolescents with T1DM exhibited moderate fear of hypoglycemia. Diabetes distress partially mediated the relationship between fear of hypoglycemia and diabetes self-management, whereas depressive symptoms demonstrated no significant mediating effect in adolescents with T1DM. These findings suggest that interventions targeting diabetes distress reduction while maintaining fear of hypoglycemia at moderate levels may enhance diabetes self-management.
Predictors of Change in Treatment Response to Group-Based Cognitive Behavioral Therapy for Adolescents with Social Anxiety Disorder.
Agersnap TN, Lomholt JJ, Jensen MB … +1 more , Thastum M
Child Psychiatry Hum Dev · 2026 Feb · PMID 41706281 · Publisher ↗
Research indicates that remission rates for social anxiety disorder are significantly lower (35%) than for any other anxiety disorder (54%) following cognitive behavioral therapy (CBT). Nevertheless, CBT remains the reco...
Research indicates that remission rates for social anxiety disorder are significantly lower (35%) than for any other anxiety disorder (54%) following cognitive behavioral therapy (CBT). Nevertheless, CBT remains the recommended treatment for adolescents with social anxiety disorder. The literature shows limited knowledge regarding which adolescents with primary social anxiety disorder respond better or worse to group-based cognitive-behavioral therapy (CBT). The current study aimed to identify baseline predictors of change in treatment response from group-based CBT for 90 adolescents aged 12-17 years with a primary diagnosis of social anxiety disorder. Treatment response was evaluated as changes from baseline to three-month follow-up in self-reported social anxiety symptoms and clinician-rated social anxiety diagnosis. The examined predictors were as follows: Demographic predictors included age, gender, and parents' education level. Clinical predictors included social anxiety symptoms, anxiety symptoms, interference in daily life, depressive symptoms, parents' overall anxiety, depression, and stress level. Theory-derived predictors were based on theoretically maintaining factors of social anxiety disorder and included safety behaviors, self-focused attention, post-event processing, and distorted cognitions. Mixed linear models were applied to analyze the predictor's effect on each outcome variable over time. Results indicated that higher severity of safety behaviors and social anxiety symptoms at baseline predicted larger improvement in self-reported social anxiety symptoms. Moreover, higher severity of social anxiety symptoms and anxiety symptoms predicted less likelihood of being free of social anxiety diagnosis. None of the other variables predicted significant change in either self-reported social anxiety symptoms or clinician-rated social anxiety diagnosis. In conclusion, the findings indicate that adolescents with a high degree of safety behaviors and social anxiety symptoms improved the most from group-based CBT, but also, that high baseline symptom severity remains elevated and have an increased risk of a social anxiety diagnosis at three-month follow-up. However, replication of these findings is needed in more sufficient powered trials.
The Development and Application of a Potentially Traumatic Events Checklist for Conflict-Affected Pupils Living in the Occupied Palestinian Territory.
Forsberg JT, Diab SY, Schultz JH
Child Psychiatry Hum Dev · 2026 Feb · PMID 41706280 · Publisher ↗
Children and young people living in the Occupied Palestinian Territory (OTP) are repeatedly exposed to potentially traumatic events that can challenge their mental health and school functioning. This study aimed to devel...
Children and young people living in the Occupied Palestinian Territory (OTP) are repeatedly exposed to potentially traumatic events that can challenge their mental health and school functioning. This study aimed to develop a practical checklist of conflict-related potentially traumatic events of relevance in the school context throughout the OPT. Post-traumatic stress reactions (PTSR) and school functioning assessed the predictive validity of the checklist. Furthermore, we sought to explore the frequency of exposure, PTSR and school functioning between the areas in the OTP and explore how frequency and severity of exposure was associated to PTSR and school functioning. The study was conducted using a mixed method approach between January-June 2019. A qualitative approach with focus group workshops in Gaza city and Ramallah in the West Bank defined the checklist. Quantitative data and statistical analysis validated the checklist and explored the further objectives. The checklist was administered to pupils aged 12-16 (N = 789) recruited from 17 schools in East-Jerusalem, the West Bank and the Gaza Strip, which reported a mean of 5.06 (SD = 2.48) conflict-related potentially traumatic events within the past three months, regardless of where they came from. The predictive validity of the checklist was found to be significant (p < .01), and exposure predicted PTSR and school functioning. Since the checklist consists of only 12 items, it is practical to use for screening and monitoring in a school context. The extent to which the checklist can serve as a multipurpose checklist remains to be tested through practical use, followed by evaluations and further research.
Examining the Association Between Food Insecurity and Pediatric Irritability.
Wilner JG, Lee E, Cho E … +10 more , Salisbury AE, Arnott EG, Parker K, Shogren NP, Kaplan C, Naclerio M, Au JS, Russo JM, Cummings LR, Dickstein DP
Child Psychiatry Hum Dev · 2026 Feb · PMID 41706279 · Publisher ↗
Irritability is a transdiagnostic construct associated with diverse psychiatric disorders in youth. This study examined the association between food insecurity and irritability in a clinically and community-recruited sam...
Irritability is a transdiagnostic construct associated with diverse psychiatric disorders in youth. This study examined the association between food insecurity and irritability in a clinically and community-recruited sample of children aged 8-16 (N = 183). Participants and their parents completed structured interviews and measures assessing irritability, food security, and socioeconomic status (SES). Child-reported food insecurity was significantly associated with greater irritability, whereas parent-reported food insecurity was not. Regression analyses identified child-reported food insecurity as a unique predictor of irritability, independent of SES indicators. These findings underscore the clinical importance of assessing food insecurity from the childs perspective and suggest that subjective experiences of food insecurity may have a stronger emotional impact than previously recognized. Results highlight the need for multi-informant assessments and targeted interventions addressing basic needs within pediatric mental health care.
Differences in Clinical Profiles of Transgender and Gender Diverse Adolescents Compared to Cis-gender Adolescents Attending a Tertiary Mental Health Clinic.
Shah N, Hatchard T, Brittain H … +5 more , Zhao J, Duncan L, Pires P, Vaillancourt T, Boylan K
Child Psychiatry Hum Dev · 2026 Feb · PMID 41701297 · Publisher ↗
Transgender and gender diverse (TGD) adolescents experience disproportionately higher rates of mental health concerns compared to cisgender adolescents. This paper compares the clinical and psychosocial risk profiles of...
Transgender and gender diverse (TGD) adolescents experience disproportionately higher rates of mental health concerns compared to cisgender adolescents. This paper compares the clinical and psychosocial risk profiles of TGD and cisgender adolescents seeking treatment for mental health concerns. Data was obtained from adolescents waiting for psychiatric care (age 12-17; N = 1362). Severity of mental disorder symptoms, substance use, self-harm, suicidal ideation, trauma experiences, and daily functioning were compared. TGD adolescents experienced significantly more symptoms of depression, anxiety and ADHD, self-harm, suicidal ideation and attempts and trauma experiences than cisgender peers. This data replicates previous findings that TGD adolescents experience greater psychopathology and psychosocial stressors than cisgender peers adding findings from a treatment seeking sample.
Predictive Relations Between Early Adversity, Nonlinear Trajectories of Hypothalamic-Pituitary-Adrenal Axis Functioning, and Later Callous-Unemotional Traits.
Huth N, Vogel SC, Cole V … +3 more , Mills-Koonce WR, Willoughby MT, Wagner NJ
Child Psychiatry Hum Dev · 2026 Feb · PMID 41701296 · Publisher ↗
Developmental pathways to callous-unemotional (CU) traits are heterogeneous, with early social experiences and stress physiology, such as hypothalamic-pituitary-adrenal (HPA) axis functioning, likely playing key roles. H...
Developmental pathways to callous-unemotional (CU) traits are heterogeneous, with early social experiences and stress physiology, such as hypothalamic-pituitary-adrenal (HPA) axis functioning, likely playing key roles. However, few studies have examined how adversity and HPA axis functioning in early childhood relate to later CU traits. Using Latent Basis Growth Mixture Modeling with a longitudinal sample (N = 1,292), we examined relations between trajectories of salivary basal cortisol in early childhood (6, 15, 24, and 48 months), adversity at 6 months, and CU traits at preadolescence (M = 13.22, SD = 0.62 years, range = 12.52-15.68 years). Results revealed a low-stable basal cortisol class (class 1, ~ 95%) and an unstable class (class 2, ~ 5%) transitioning from high to low cortisol. Class 2 had significantly higher levels of CU traits at preadolescence than class 1. Early adversity at 6 months predicted CU traits in class 2. These findings identify a specific physiological pattern under which early adversity relates to later CU traits.
Welcoming 2026: Interplay of Mind and Body in Youth.
Storch EA, Gadamsetty R
Child Psychiatry Hum Dev · 2026 Feb · PMID 41673378 · Publisher ↗
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An Evaluation of Treatment Effects of Acceptance and Commitment Therapy for Outpatient Group Treatment of Adolescents.
Uppal Dhariwal T, Ahmad JF, Gordeyko M … +3 more , Bell M, Duncan L, Turrell S
Child Psychiatry Hum Dev · 2026 Feb · PMID 41661487 · Publisher ↗
This study is an evaluation of group-based acceptance and commitment therapy (ACT)-a transdiagnostic therapeutic approach-in adolescents with anxiety and/or depressive psychiatric disorders in a community hospital outpat...
This study is an evaluation of group-based acceptance and commitment therapy (ACT)-a transdiagnostic therapeutic approach-in adolescents with anxiety and/or depressive psychiatric disorders in a community hospital outpatient setting. The objective was to evaluate treatment effects on 1) symptom reduction and 2) psychological flexibility measured by underlying ACT processes (avoidance, fusion, mindfulness, valued action) and evaluate whether improvements represent reliable and clinically significant change. Measures were completed by 99 outpatients aged 13 to 18 pre- and post-treatment and at 3-month follow-up. Generalized estimating equation analysis and pairwise comparisons were used to identify changes in symptoms and ACT processes over time. Results showed decreases in anxiety symptoms (pre to post d = -.50; post to 3-month follow-up d = -.41); 2) depression symptoms (d = -.51; d = -.46); 3) and avoidance/fusion (d = -.60; d = -.49), increased mindfulness (d = -.70; d = -.34); and enhanced commitment to values-based action from post-treatment to 3-month follow-up (d = .25). About half of participants reporting clinically elevated symptoms before treatment showed reliable and clinically significant improvement 3-months after treatment ended. Results support the utility of group-based ACT with adolescents. This is the first evaluation conducted in Canadian adolescents seeking community hospital outpatient services for wide ranging and complex mental health difficulties. Future research should continue to take a transdiagnostic perspective and include a control or comparison group and adolescents from different settings.
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