Klein CS, Seyboth L, Conzelmann A
… +6 more, Schröder PA, Alt AK, Pascher A, Renner TJ, Gawrilow C, Hollmann K
Child Psychiatry Hum Dev
· 2025 Nov · PMID 41236692
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Obsessive-compulsive disorder (OCD) is a common mental health concern in young people, as it is often severe and can become chronic without adequate psychotherapeutic intervention. As a first-line treatment, cognitive be...Obsessive-compulsive disorder (OCD) is a common mental health concern in young people, as it is often severe and can become chronic without adequate psychotherapeutic intervention. As a first-line treatment, cognitive behavioral therapy (CBT) has been extensively studied in both face-to-face and online trials. However, low remission rates may indicate that not all young patients benefit from treatment. To further improve the effectiveness of digital CBT, treatment moderators should be investigated thoroughly. We analyzed data from n = 12 children and adolescents with OCD who received 14 weeks of digital sensor-assisted CBT via videoconferences (vCBT). We assessed patients' self-ratings of OCD symptom course, affect, and arousal and examined the effects of potential moderating variables (e.g., treatment satisfaction, technical usability, self-regulation, self-control, and self-efficacy) on treatment outcomes. The results revealed a significant improvement in obsessive thoughts and compulsive behavior during online CBT. Higher treatment satisfaction and perceived usability of technical devices was associated with greater decreases in obsessive thoughts and compulsive behavior. A significant moderating effect on self-rated decreases in symptoms was also found for patients with higher levels of self-efficacy, self-regulation, and self-control. Our results highlight that digital sensor-assisted CBT led to a subjective decrease in symptoms. The moderating effects of patient satisfaction and usability on symptom improvement emphasize the need for participative design approaches in the development of digital mental health interventions. The different constructs of mastery and volition appear to be moderators of decreases in OCD symptoms and should be further investigated in future trials with larger patient samples.Clinical trial registration: [ www.ClinicalTrials.gov ], identifier [NCT05291611], first submission: 2021-12-10.
Child Psychiatry Hum Dev
· 2025 Nov · PMID 41217568
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Adolescents with attention-deficit/hyperactivity disorder (ADHD) exhibit heightened vulnerability to school bullying, with sex-specific patterns. This study analyzed data from the 2021 Korean National Survey on Mental He...Adolescents with attention-deficit/hyperactivity disorder (ADHD) exhibit heightened vulnerability to school bullying, with sex-specific patterns. This study analyzed data from the 2021 Korean National Survey on Mental Health of Youth, comprising 6,689 adolescents (ages 12-18; 50.9% male). After inverse probability of treatment weighting (IPTW) adjustment, the effective sample comprised 3,1789 adolescents at risk of ADHD and 3,511 controls. Logistic regression analyses revealed pronounced sex differences. Female adolescents with ADHD symptoms showed significantly elevated odds of overall victimization, teasing/verbal provocation, and bullying perpetration, particularly verbal abuse. Conversely, male adolescents with ADHD symptoms demonstrated reduced odds of social exclusion and sexual harassment victimization, but an increased risk of verbal abuse perpetration. These findings underscore the critical role of sex in shaping the dynamics of ADHD-related bullying behaviors. They highlight the need for tailored, sex-sensitive interventions targeting emotional regulation and social skills deficits in adolescents with ADHD.
Child Psychiatry Hum Dev
· 2025 Nov · PMID 41217567
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Children of mentally ill parents are at a higher risk of developing mental health disorders and experiencing maltreatment. Identifying predictors of maltreatment in this risk group may help provide support at an earlier...Children of mentally ill parents are at a higher risk of developing mental health disorders and experiencing maltreatment. Identifying predictors of maltreatment in this risk group may help provide support at an earlier stage. A random forest classifier was applied to a sample of psychiatric inpatients (n = 330, 59.70% female, M = 41.15 years, SD = 7.12) and their children (n = 95, 60.00% female, M = 15.03 years, SD = 2.14) to examine whether child maltreatment could be predicted based on reports from both parents and children. Maltreatment symptoms were assessed using a cut-off score from the Childhood Trauma Questionnaire Short-Form. Model 1, which predicted children's trauma scores as estimated by the parents, achieved 76.62% accuracy with an area under the curve (AUC) of .85. Model 2, which used only parental data to predict children's self-assessed maltreatment scores, showed a slightly lower accuracy of 68.42% and an AUC of .69. Model 3, which predicted children's maltreatment scores based solely on children's self-reports, showed an accuracy of 73.68% and an AUC of .84. These findings indicate moderate-to-good predictability of children's maltreatment scores and provide initial insights into the risk-assessment of children's maltreatment in families with a mentally ill parent.This study was preregistered as a clinical trial (28.04.2017, DRKS00011533) at the Deutsches Register Klinischer Studien (DRKS).
Child Psychiatry Hum Dev
· 2025 Nov · PMID 41212405
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Voices and experiences of youth aged 12-15 years are rarely heard and prioritized. Understanding their perspectives is essential for tailoring effective mental health interventions and supports. As such, this qualitative...Voices and experiences of youth aged 12-15 years are rarely heard and prioritized. Understanding their perspectives is essential for tailoring effective mental health interventions and supports. As such, this qualitative study, co-designed with a youth advisory committee (n=7), interviewed 19 youth (aged 12-15 years) to explore their understanding of good mental health. Interviews were analyzed thematically following a reflexive thematic analysis approach. Three overarching themes were identified: 1) Everything is OK, describing a state of being able to manage the challenges of life, 2) Building Personal Strength and Resources, needed to maintain good mental health as an adolescent, and 3) Seeking Acceptance and Community, emphasizing the profound influence of social connections. Addressing adolescent mental health effectively requires a nuanced understanding of their perspectives to develop responsive and impactful mental health interventions and their active involvement in all facets of service design, research, and policymaking. PLAIN LANGUAGE TITLE: "My day is already planned out before I even get to choose it": Understanding what matters to youth aged 12-15 years and the implications for mental health services Youth aged 12-15 years are at a key developmental age and actively seek mental health services, yet their perspectives on these mental health services are rarely heard. Understanding what good mental health means to them is essential for creating support systems that meet their needs. This study explored how youth define good mental health. We worked with a youth advisory committee (n=7, aged 12-15 years) to co-design the research. Then, we interviewed 19 youth (aged 12-15 years, median age 14) from British Columbia, Canada, to learn about their views. Using an analysis approach that identifies patterns or themes in a way that reflects on the authors own perspectives and the process of analysis, we identified three key themes: 1. Everything is OK - Youth described good mental health as balancing their emotions to be able to handle life's challenges, including school and family pressures. 2. Building Personal Strength and Resources - Youth emphasized the importance of developing coping skills, confidence, and self-awareness to support their mental well-being. 3.Seeking Acceptance and Community - Youth highlighted the role of supportive relationships in having good mental health. These findings show that youth mental health is deeply connected to youths' environment, social connections, and ability to navigate challenges. To support them effectively, we must listen to their perspectives and include them in shaping mental health services, research, and policies. By prioritizing their voices, we can create meaningful and accessible mental health resources that align with their needs.
Wang H, Yu C, Liao X
… +3 more, Ni X, Liu X, Chen P
Child Psychiatry Hum Dev
· 2025 Nov · PMID 41212404
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Non-suicidal self-injury (NSSI) is prevalent among early adolescents. However, few studies have explored the complex psychosocial mechanisms underlying NSSI among this population. This study aimed to examine the roles of...Non-suicidal self-injury (NSSI) is prevalent among early adolescents. However, few studies have explored the complex psychosocial mechanisms underlying NSSI among this population. This study aimed to examine the roles of Internet gaming disorder (IGD) and peer victimization by linking emotional insecurity to NSSI during early adolescence. Data were collected from 886 adolescents across four primary schools at three time points, spaced six months apart, using multi-stage random sampling. All participants were of Han ethnicity, with a mean age of 10.17 years. Girls accounted for 47.4% of the sample. The results indicated that IGD served as a mediator in the relationship between emotional insecurity and adolescent NSSI. Furthermore, this indirect effect was significantly moderated by peer victimization, such that the mediating role of IGD was only significant among adolescents experiencing high levels of peer victimization. These findings emphasized the longitudinal pathways through which emotional insecurity contributes to NSSI and have important implications for prevention and intervention strategies targeting NSSI among early adolescents.
Tully LA, Roach A, Lechowicz M
… +8 more, Turnell A, Northam J, Liew O, McFarlane L, Carl T, Moelle E, Dadds MR, Hawes DJ
Child Psychiatry Hum Dev
· 2025 Nov · PMID 41191266
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Diagnostic labelling is a controversial issue, particularly when it comes to children. There are concerns about potential harmful effects of diagnosis, especially for Oppositional Defiant Disorder (ODD). There is a lack...Diagnostic labelling is a controversial issue, particularly when it comes to children. There are concerns about potential harmful effects of diagnosis, especially for Oppositional Defiant Disorder (ODD). There is a lack of research on parent perceptions of helpfulness of diagnosis, which is an important gap since parents of children with ODD are both the gatekeepers for treatment and the targets of parenting interventions. This study aimed to examine parent perceptions of the helpfulness of receiving a diagnosis of ODD for their child in families receiving an evidence-based parenting intervention, and to explore the reasons why it was considered helpful or unhelpful. Parents participating in parenting intervention for child ODD retrospectively completed questionnaires about receiving a diagnosis of ODD for their child on commencement of treatment. Of 244 parents completing questions at post-treatment, 134 parents (54.9%) reported that their psychologist diagnosed ODD for their child. Of those who reported receiving a diagnosis, 75.4% rated it extremely or somewhat helpful, 23.9% reported that it was neither helpful nor unhelpful, and just one parent (0.7%) rated it as somewhat unhelpful. The reasons for helpfulness were endorsed at high rates, with more than 90% reporting increased understanding of child behavior, understanding effective programs or strategies, and increased motivation to implement intervention strategies. No significant differences in perceptions of helpfulness emerged for parent gender, child exposure to adverse experiences, and previous ODD diagnosis. The findings appear to challenge concerns about the harmful effects of diagnostic labelling for children and point to a need for further research.
Gomez GJ, Wen A, Silvers JA
… +2 more, Gonzalez MR, Chavira DA
Child Psychiatry Hum Dev
· 2025 Oct · PMID 41171333
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Racial/ethnic discrimination is associated with elevated internalizing symptoms. However, the psychological processes through which discrimination affects internalizing symptoms in ethno-racially minoritized youth are le...Racial/ethnic discrimination is associated with elevated internalizing symptoms. However, the psychological processes through which discrimination affects internalizing symptoms in ethno-racially minoritized youth are less understood. The current study examined the role of emotion dysregulation in the association between racial/ethnic discrimination and internalizing symptoms. Participants were 5,693 ethno-racially minoritized youth (M = 9.89; 48% female; 42.3% Hispanic) enrolled in the Adolescent Brain Cognitive Development Study. Path analysis revealed that experiences of racial/ethnic discrimination were associated with greater emotion dysregulation in the following year, which was, in turn, associated with greater internalizing symptoms concurrently, covarying for sex assigned at birth and caregiver education level. Findings suggest emotion dysregulation may play a key role in the link between racial/ethnic discrimination and internalizing symptom development in minoritized youth. Targeting emotion dysregulation in clinical interventions to address internalizing symptoms related to racial/ethnic discrimination may improve well-being in this population.
Ishikawa SI, Sakai M, Kikuta K
… +2 more, Oya A, Mitamura T
Child Psychiatry Hum Dev
· 2025 Oct · PMID 41165956
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This study investigated the inter-rater agreement, test-retest reliability, and convergence validity of the Japanese-translated Anxiety Disorders Interview Schedule (ADIS) for the Diagnostic and Statistical Manual of Men...This study investigated the inter-rater agreement, test-retest reliability, and convergence validity of the Japanese-translated Anxiety Disorders Interview Schedule (ADIS) for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The ADIS was administered to 71 children and adolescents (53.52% females, M = 10.70 years, SD = 2.05) and their parents, with a two-month test-retest interval. Participants also completed questionnaires on anxiety and depression. Test-retest reliability was good for the presence or absence of a diagnosis and clinical significance ratings for all diagnoses. Inter-rater reliability was good to excellent. Strong convergent validity was observed for the separation anxiety disorder, generalized anxiety disorder, dysthymia, and depression domains in both the child- and parent-reported measures. However, correlations with parent-reported social phobia and specific phobia were not statistically significant. These results support moderate stability across time, consistent diagnostic results among independent diagnosticians, and convergent validity of the Japanese version of the ADIS for the DSM-IV.
Gonzalez JC, Garcia S, Ijadi-Maghsoodi R
… +7 more, Spillane J, De La Cruz SA, Lee K, Lee D, Kataoka S, Porche MV, Fortuna LR
Child Psychiatry Hum Dev
· 2025 Oct · PMID 41144128
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Given the ongoing youth mental health crisis amid limited resources, young people and their families need sustainable, low-cost school-based interventions to support their wellbeing and connect them to vital services. As...Given the ongoing youth mental health crisis amid limited resources, young people and their families need sustainable, low-cost school-based interventions to support their wellbeing and connect them to vital services. As a first developmental phase of a clinical trial to integrate innovative digital mental health intervention into high schools, we first sought to understand the lived experience of students and parents. This study used qualitative methods to analyze diverse high school student, young adult, and parent reports of accessing in-person school-based mental health supports and use of health-related apps. Two-thirds of young people reported using health-related apps with common use related to entertainment, fitness, and mental health. Further qualitative analysis regarding access identified themes around availability, experience with services, and normalizing mental health vs. stigma in schools. Findings suggest opportunities for digital interventions to increase mental health literacy and address stigma through psychoeducation. Digital health tools may support schools as an adjunct to in-person services in reaching under-resourced students in need.
Regan M, Levey E, Basu A
… +9 more, Chen Y, Sanchez SE, Rondon MB, Yousafzai AK, Koenen K, Saxena S, Sudfeld CR, Tiemeier H, Gelaye B
Child Psychiatry Hum Dev
· 2025 Oct · PMID 41137880
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This study investigates the association between maternal trauma history (lifetime exposure to physical and sexual violence), maternal mental health and child behavior. Pregnant women attending the Instituto Nacional Mate...This study investigates the association between maternal trauma history (lifetime exposure to physical and sexual violence), maternal mental health and child behavior. Pregnant women attending the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru, were recruited to join the study beginning in February 2012. Maternal trauma history and prenatal mental health were assessed at 16-weeks gestation and mothers completed the Child Behavior Checklist when children were four years old. We used causal mediation analysis to examine the association between maternal trauma history and child behavior. This study population included 631 mother-child dyads; 74% of mothers reported one or more lifetime episodes of intimate partner violence (IPV). We found that 32% of the association between maternal lifetime exposure to IPV and child internalizing behavior was mediated by prenatal anxiety. Our findings suggest that prevention and treatment of perinatal IPV and mental health disorders should be prioritized.
Okumuş HG, Öksüzoğlu ME, Çelik YS
… +2 more, Yıldırım SK, Kaşak M
Child Psychiatry Hum Dev
· 2025 Oct · PMID 41091435
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Trichotillomania (TTM), skin-picking disorder (SPD), and nail-biting (NB) are classified as Body-Focused Repetitive Disorders (BFRBDs), which share characteristics with both obsessive-compulsive and impulse control disor...Trichotillomania (TTM), skin-picking disorder (SPD), and nail-biting (NB) are classified as Body-Focused Repetitive Disorders (BFRBDs), which share characteristics with both obsessive-compulsive and impulse control disorders. This study aimed to compare impulsivity, metacognitions, and clinical characteristics across BFRBDs. Ninety adolescents (aged 10-18 years) with BFRBDs and 40 healthy controls (HC) completed the Revised Children's Anxiety and Depression Scale-Child Version (RCADS-CV), the Metacognitions Questionnaire for Children and Adolescents (MCQ-CA), the Barratt Impulsiveness Scale-Brief (BIS-Brief), and the Pediatric Quality of Life Inventory (PedsQL). Symptom severity was assessed using disorder-specific measures. There were no significant age differences between the BFRBDs and HC groups. However, within the BFRBDs subgroups, adolescents with TTM and SPD were significantly older than those with NB (p = .028). Notably, despite being younger, the NB group exhibited the longest duration of BFRBDs symptoms (p < .001). The TTM group showed higher MCQ-CA total, positive beliefs about worry, and cognitive monitoring. In contrast, the SPD group had higher poor self-regulation scores (all p < .05). Symptom severity across BFRBDs was negatively associated with PedsQL total scores and positively associated with MCQ-CA total and RCADS-CV total scores (all p < .05). These findings suggest that while metacognitions are more prominent in TTM, impulsivity plays a greater role in SPD. Understanding the distinct contributions of impulsivity and metacognitions in BFRBDs may facilitate the development of targeted treatment approaches tailored to each behavior.
Adolescent depression is shaped by biological, psychological, and social factors. Traditional models often fail to capture complex interrelations among depressive symptoms. This study uses network analysis to identify Ch...Adolescent depression is shaped by biological, psychological, and social factors. Traditional models often fail to capture complex interrelations among depressive symptoms. This study uses network analysis to identify Chinese adolescents' depressive symptoms and their key correlates. Data from a large sample of Chinese adolescents were analyzed using the EBICglasso method to construct a Gaussian graphical model, estimating partial correlations between depressive symptoms and 51 related factors. Centrality and bridge centrality analyses identified influential symptoms and connections. Robustness was assessed via bootstrapping, and symptom pathways via flow network analysis. Analyses revealed sadness, loneliness, and effort as the central symptoms, while the symptom anhedonia demonstrated low centrality among Chinese adolescents. Key correlates included academic pressure and health status, with the former closely linked to feelings of effort, and the latter to sleep disturbances and depressive mood. Parent-child interactions, particularly parental criticism, trust, and praise, showed strong associations with adolescents' depressive symptoms. This study highlights the centrality of sadness and the significant roles of academic pressure, health status, and parent-child interactions in shaping depressive symptoms among Chinese adolescents. The findings suggest that interventions targeting sadness, academic pressure and health-related concerns, and especially parent-child relationships, are promising strategies for reducing adolescent depression.
Racial disparities in diagnosis and treatment of pediatric mental health conditions are well-documented. Stimulants are the cornerstone of ADHD treatment, but long-term effects on growth remain a concern. We retrospectiv...Racial disparities in diagnosis and treatment of pediatric mental health conditions are well-documented. Stimulants are the cornerstone of ADHD treatment, but long-term effects on growth remain a concern. We retrospectively analyzed treatment history (e.g., duration, medication, comorbidity), growth, and demographics (e.g., socioeconomic status and race) from 197 pediatric patients with ADHD. We found Black and Hispanic patients were younger, had lower socioeconomic status, and were followed for longer than White patients. Despite similar amounts of comorbidities across racial groups, White patients received more antidepressants (p < 0.001). Stimulant users were prescribed fewer atomoxetine, antidepressant, and antipsychotic medications but had longer follow-up and more total medications. We saw a significant decrease in height Z-scores for the whole cohort, and an increase in BMI Z-scores in Hispanic patients. The findings highlight disparities in pharmacological treatment of pediatric patients with ADHD and more research is needed to understand factors contributing to potential biases to reduce inequities in care and improve patient outcomes.
Rates of maltreatment are high among justice-involved (JI) youth. Previous research demonstrates that maltreated JI youth are more likely to develop both internalizing and externalizing symptoms. However, fewer studies h...Rates of maltreatment are high among justice-involved (JI) youth. Previous research demonstrates that maltreated JI youth are more likely to develop both internalizing and externalizing symptoms. However, fewer studies have examined potential mechanisms that may explain this association, particularly as related to youth's cognitive abilities. The current study evaluated the indirect effect of executive function on the link from maltreatment exposure to internalizing and externalizing symptoms among a sample of JI youth. Participants included 144 JI (probationary or detained 64.8% male; 40.7% Hispanic/Latinx) adolescents in Texas. Participants provided self-reports of their maltreatment experiences, executive function, and psychological functioning. Results from path analysis models revealed a significant indirect effect of maltreatment exposure on internalizing and externalizing symptomology through global executive function. Findings suggest that treating JI youth's internalizing and externalizing symptoms without consideration for their executive function abilities may limit the effectiveness of existing treatments for this population. The juvenile justice system can provide the optimal treatment for these youth via tailoring current interventions and/or targeting executive function directly for youth presenting with maltreatment histories and executive function difficulties.
Partial hospitalization programs (PHPs) are a growing sector of the mental health landscape. Parent participation is likely critical for supporting youth skill acquisition and maintenance, but there are few investigation...Partial hospitalization programs (PHPs) are a growing sector of the mental health landscape. Parent participation is likely critical for supporting youth skill acquisition and maintenance, but there are few investigations in this area. Our aims were to examine: (1) changes in four parenting responses (accommodation, positive parenting, discipline, self-efficacy) from admission to 1-month post-PHP follow-up; and (2) associations between changes in parenting responses and changes in parent-reported youth symptoms, emotional reactivity, and impairment. Participants were parents of 152 youth (M age = 13.14, range = 6-17) who participated in a general psychiatric PHP using the Unified Protocols for Children and Adolescents. Latent growth curve modeling revealed significant reductions in accommodation and inconsistent discipline, as well as increases in self-efficacy and positive parenting. Changes in parental accommodation and self-efficacy were associated with changes in youth symptoms and impairment. Results highlight the importance of targeting specific parenting responses in intensive treatment settings.
Parental psychopathology can influence the development of internalizing and externalizing problems in children through its effects on the emotional climate at home. Expressed Emotion (EE) is a measure of family climate t...Parental psychopathology can influence the development of internalizing and externalizing problems in children through its effects on the emotional climate at home. Expressed Emotion (EE) is a measure of family climate that reflects the emotional quality of attributions parents make about their child and is proposed to be a transdiagnostic risk factor for the development of emotional and behavioral problems. The current study included children (N = 247; aged 4-7; 70.7% male) referred by teachers for emerging psychosocial problems at school and their caregivers. To assess psychopathology, parents completed the Hospital Anxiety and Depression Scale (HADS) and the Child Behavior Checklist (CBCL). The Five-Minute Speech Sample (FMSS) and Expressed Emotion Coding System [1] were used to measure EE. Correlations demonstrated that EE, symptoms of parental anxiety and depression, and child internalizing and externalizing problems were all significantly positively associated. Regression analyses revealed that EE was more strongly associated with severity of internalizing and externalizing problems than parental mental health symptoms. EE explained more variance in child internalizing problems than parental anxiety and was a particularly strong predictor of severity of externalizing problems in young children, alongside socioeconomic deprivation and parental anxiety. These findings support attributional models of EE and demonstrate its potential transdiagnostic role in the development of internalizing and externalizing problems in young children. This can inform the design of interventions to tackle emerging mental health problems in childhood.
Adaptive behavior comprises conceptual, social, and practical skills that individuals learn and express in their daily lives. Understanding the contextual factors that influence the development of adaptive behavior is cr...Adaptive behavior comprises conceptual, social, and practical skills that individuals learn and express in their daily lives. Understanding the contextual factors that influence the development of adaptive behavior is crucial for the well-being of children. Using path analysis, we cross-sectionally examined the relations between Vineland-II adaptive behavior of Italian girls (n = 156) and boys (n = 149) aged 3-14 and parental sociocultural dimensions (socioeconomic status, cultural capital, social capital) with attended school year as a moderator. Mothers' sociocultural level showed numerous and generally positive relations with their children's adaptive behavior, whereas fathers' sociocultural level exhibited fewer and more mixed relations. Furthermore, school year attended had direct negative effects on adaptive behavior and generally moderated in a positive or mixed way the relationships between parents' sociocultural level and daughters' and sons' adaptive behavior, respectively. Policymakers should be aware of the relations between parental sociocultural level and their offspring's adaptive behavior.
The integration of digital technologies into everyday life has contributed to an increased risk of digital violence, particularly in the form of cyberbullying. Cyberbullying experiences are associated with significant so...The integration of digital technologies into everyday life has contributed to an increased risk of digital violence, particularly in the form of cyberbullying. Cyberbullying experiences are associated with significant social and psychological challenges for those involved, especially within school contexts. This underscores the importance of comprehensive research into prevention, detection, and intervention strategies. Guided by the social-ecological diathesis-stress framework, the present systematic review aimed to examine verbal patterns associated with cyberbullying perpetration and to identify promising strategies for prevention and detection. Following PRISMA reporting guidelines, seven studies (N = 2,320; M = 12.66, SD = 0.66) were included. Most studies indicated that participation in cyberbullying prevention or intervention programs was associated with improvements in verbal expressions of social competencies, such as empathy, responsibility, and willingness to support victims. Some interventions also showed reductions in cyberbullying incidents and changes in the verbal behavior of perpetrators. However, the sustainability of these effects varied, with some studies reporting diminished impact over time. To remain effective, prevention and intervention programs require ongoing evaluation and adaptation, including the contextualization of content and integration of technological tools. Future research might consider a range of influencing factors within the social-ecological framework, including individual, familial, school-based, community-related, and societal dimensions, as well as the role of detection tools. Ongoing refinement and alignment with technological developments can increase the relevance and impact of these programs across diverse student populations. (230 words).