Child Psychiatry Hum Dev
· 2025 Aug · PMID 40802208
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This study investigates the relationship between therapeutic process variables and child outcomes following exposure therapy for specific phobias (SPs) in children. SPs are a common childhood disorder and a predictor of...This study investigates the relationship between therapeutic process variables and child outcomes following exposure therapy for specific phobias (SPs) in children. SPs are a common childhood disorder and a predictor of future mental health conditions. While Cognitive Behavioural Therapy (CBT) and One-Session Treatment (OST) are effective in treating SPs, a notable percentage of children do not fully respond. The study examined key therapeutic process variables among a sample of 52 children and their parents who participated in the broader Preschoolers' Overcoming Phobias randomised controlled trial. Variables included child and parent therapeutic alliances, child motivation, homework adherence, therapist treatment fidelity, parent satisfaction, and parental confidence in implementing exposure and managing their own fears. Results indicated that child therapeutic alliance and parental confidence in managing fears were significant predictors of child outcomes at six months post-treatment. Specifically, parental confidence mediated the relationship between their ability to conduct exposure and the child's approach behaviour. This suggests that effective SP treatments should focus on both the child's direct therapy and supporting parents in managing their child's anxieties.
Child Psychiatry Hum Dev
· 2025 Aug · PMID 40802207
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Childhood trauma is a significant public health concern linked to increased psychiatric morbidity. In clinical practice, timely and accurate identification of post-traumatic stress disorder (PTSD) symptoms in children is...Childhood trauma is a significant public health concern linked to increased psychiatric morbidity. In clinical practice, timely and accurate identification of post-traumatic stress disorder (PTSD) symptoms in children is essential, yet comprehensive diagnostic assessments are often time-consuming and resource-intensive. Therefore, there is a need for brief, reliable screening tools adapted for diverse populations. The UCLA PTSD Reaction Index for DSM-5 Brief Form (RI-5-BF) is one such tool, though its use in non-Western contexts remains understudied. This study examined the psychometric properties of the RI-5-BF in a Turkish clinical sample of children exposed to at least one traumatic event. The RI-5-BF demonstrated strong internal consistency, test-retest reliability, and diagnostic accuracy. These findings support its utility as a culturally appropriate, efficient screening measure for identifying children in need of further PTSD assessment and intervention.
Child Psychiatry Hum Dev
· 2025 Oct · PMID 40782173
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Herein we introduce the Collection "Measurement Based Care in Youth Depression and Suicidality." Measurement-based care (MBC), or the systematic use of measurement tools to inform treatment decisions, has been identified...Herein we introduce the Collection "Measurement Based Care in Youth Depression and Suicidality." Measurement-based care (MBC), or the systematic use of measurement tools to inform treatment decisions, has been identified as a key component of providing evidence-based psychiatric care. However, the implementation of MBC at the clinic or health system level is not trivial; barriers to successful implementation are widespread but can be overcome. This Collection presents five manuscripts that cover a range of topics related to the implementation of MBC. The first two articles provide guidance to clinicians and researchers in careful selection of validated measurement tools for depression and suicidality. Next, our authors describe an effort to assess the fidelity of MBC use across the Texas Youth Depression and Suicide Research Network registry study, a statewide longitudinal cohort of depressed and suicidal youth. The following article outlines the benefits, barriers, and implementations strategies to implementing MBC at the health system level. Our final article details the implementation of MBC into a health system and provides data on screening outcomes and related clinical associations.
The contextual parenting perspective in the integrative model of parenting emphasizes the combined impact of parental involvement (process) and parenting style (context) on adolescent psychological adjustment. The primar...The contextual parenting perspective in the integrative model of parenting emphasizes the combined impact of parental involvement (process) and parenting style (context) on adolescent psychological adjustment. The primary goal of this study was to identify distinct patterns of parental involvement and parenting styles. Additionally, the study aimed to investigate the long-term predictive impacts of these parenting profiles on adolescent psychological adjustments. A longitudinal survey was conducted in mainland China with 930 intact families, including fathers, mothers, and adolescents. Latent profile analysis was employed to classify parenting profiles based on standardized scores of parental involvement and parenting styles (warmth and rejection) at Time (1) Six months later, a regression mixture model was utilized to assess how these parenting profiles influenced adolescent psychological adjustment at Time (2) Three classes best characterized the profiles of parental involvement and parenting style at Time 1: warm-involved parenting (49.1%, N = 457), average parenting (39.6%, N = 368), and rejecting-involved parenting (11.3%, N = 105). Compared to adolescents in the other two groups, adolescents in the warm-involved parenting profile scored lowest on anxiety symptoms, depression symptoms, and short-form video addiction at Time 2. Moreover, adolescents in warm-involved group scored highest on self-compassion, and compassion for others at Time 2. Adolescents in the warm-involved group adjusted best. Intervention programs aimed at improving adolescents' mental health should integrate both parental involvement and parenting style, recognizing their combined influence on developmental outcomes.
Parenting of children with ADHD has rarely been studied longitudinally. This paper documents the proportion of children with ADHD (n = 117) living in 10 locations in the US who experienced low maternal supportiveness at...Parenting of children with ADHD has rarely been studied longitudinally. This paper documents the proportion of children with ADHD (n = 117) living in 10 locations in the US who experienced low maternal supportiveness at six different age points between 3 and 15 years. Children from the same sites without ADHD (n = 864) were used for comparison. Children with ADHD were more likely to experience very low maternal supportiveness at each age point as well as experience very low maternal supportiveness at two or more age points. Boys with ADHD were more likely than girls with ADHD to experience very low maternal supportiveness. Mothers with higher levels of education were less likely to display low supportiveness for ADHD and non-ADHD children.
Research is currently limited on the association of maternal and especially paternal postpartum bonding with child social-emotional development. This study is part of the nationally representative CHILD-SLEEP -sample (n ...Research is currently limited on the association of maternal and especially paternal postpartum bonding with child social-emotional development. This study is part of the nationally representative CHILD-SLEEP -sample (n = 710 families), where postpartum bonding was assessed with Postpartum Bonding Questionnaire (PBQ) at the child age of eight months, and child social-emotional problems were assessed with the Five to Fifteen (FTF) and the Strengths and Difficulties Questionnaire (SDQ) at child age of five years. Both maternal and paternal postpartum bonding problems at eight months were associated with child externalizing and internalizing problems at five years. When parental depressive symptoms were controlled, the association remained significant only with internalizing problems. When investigating joint maternal and paternal bonding, we found both cumulative and mother-driven effects with child internalizing problems. The results emphasize the role of early parental bonding for later child mental health, highlighting the importance of early parental support.
This study investigated the clinical characteristics of missed child-to-parent violence (CPV) in child and adolescent psychiatric patients via a retrospective case-control design. Data were obtained from 177 patients age...This study investigated the clinical characteristics of missed child-to-parent violence (CPV) in child and adolescent psychiatric patients via a retrospective case-control design. Data were obtained from 177 patients aged under 15 years during their initial consultation at the National Kohnodai Medical Center, Japan, between April 2022 and March 2023. We obtained CPV cases identified via the Child-to-Parent Violence Questionnaire Parents' Version (CPV-Q-P), distinguishing missed CPV cases (n = 45) detected exclusively through the questionnaire from reported CPV cases by parents or attending doctors (n = 18), and no CPV cases (n = 114). Logistic regression comparing missed and no CPV cases revealed that missed CPV was associated with younger age and higher scores on attention-deficit/hyperactivity disorder (ADHD)-related measures. This finding highlights a notable prevalence, with 28.3% (45 out of 159) of patients identified via the CPV-Q-P scale. Comparison of missed and reported CPV cases indicated that those in the missed cases had milder oppositional defiant behaviors and higher daily functioning scores, suggesting that parents may have missed less severe forms of CPV. Moreover, female CPV cases were more frequently missed, which potentially reflects gender-based biases in recognizing violent behavior. Our findings underscore the limitations of conventional interviews in detecting CPV and the critical role of systematic screening tools, such as the CPV-Q-P, in identifying missed CPV cases. Future research should make use of these findings to facilitate early detection and targeted intervention.
The purpose of this study was to: 1) examine the co-occurrence of household and community adverse childhood experiences (ACEs) among preadolescent youth using latent class analysis (LCA), and 2) examine the association o...The purpose of this study was to: 1) examine the co-occurrence of household and community adverse childhood experiences (ACEs) among preadolescent youth using latent class analysis (LCA), and 2) examine the association of ACE latent clusters to clinical-range scores on the Child Behavior Checklist (CBCL). Data came from the baseline and year 1 survey of the Adolescent Brain Cognitive Development (ABCD) Study with 10,915 youth recruited from school-based catchment areas in the United States. We used LCA to examine 6 types of household adversity and 7 types of community adversity, including 4 types of discrimination. We identified 5 latent classes of household/community ACEs. The class with high levels of household and community ACEs together was most strongly associated with clinical-range CBCL scores in adjusted models. Assessing adversity comprehensively may improve identification of youth with elevated risk for behavioral symptoms, who are greatest in need of intervention.
Childhood conduct problems are associated with high medical service use in adolescence, though the mechanisms are unclear. The current study examined whether sleep and internalizing problems mediate the association betwe...Childhood conduct problems are associated with high medical service use in adolescence, though the mechanisms are unclear. The current study examined whether sleep and internalizing problems mediate the association between childhood conduct problems and adolescent medical service usage. Participants were drawn from a longitudinal study (N = 744; 53% boys) evaluating the development of conduct problems among girls and boys (6.3-9.9 years at baseline; Mage = 8.43). Conduct problems, sleep, and internalizing problems were assessed by parents, teachers, and youth. Service use data was collected from public medical records. Significant indirect effects between childhood conduct problems and medical service usage via parent-reported sleep and internalizing problems were observed. Histories of conduct problems were associated with higher levels of sleep and internalizing difficulties which were subsequently linked to higher service usage. Findings support the importance of addressing sleep and internalizing problems in mitigating future health consequences for youth with conduct problems.
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition with complex, multifactorial origins. While its heritability is well established, growing evidence highlights the role of early...Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition with complex, multifactorial origins. While its heritability is well established, growing evidence highlights the role of early environmental risks, particularly those related to poverty, in shaping neurodevelopmental trajectories associated with ADHD. This narrative review synthesizes research on poverty-related risks for childhood ADHD, with a focus on prenatal, infancy, and early childhood periods as windows of heightened neuroplasticity and vulnerability. Key domains of risk include maternal stress and depression, nutritional deficits, limited cognitive stimulation, and exposure to environmental toxins. These adversities often cluster in structurally disadvantaged communities, compounding developmental risk through cumulative and interacting pathways. Notably, poverty-related adversity is neither deterministic nor irreversible. Protective factors, such as responsive caregiving, early psychosocial support, and enriched learning environments, can buffer risk and foster resilience, even in high-adversity contexts. The review also highlights how structural determinants such as parental education, access to healthcare, and neighborhood quality shape both risk and opportunity. Recent research suggests that integrated, developmentally tailored interventions may offer sustainable benefits, particularly those targeting co-regulation and executive functioning during the preschool years. Based on the findings, this review calls for multisectoral prevention strategies that begin before birth and prioritize equity across healthcare, education, and public policy. Future research should address causal mechanisms through longitudinal, culturally inclusive studies and explore the conditions under which resilience emerges. Understanding how poverty "gets under the skin" to shape attention and behaviour, and how supportive environments can mitigate these effects, is critical for reducing disparities in ADHD and promoting healthy development for all children.
It may be possible to identify infants at risk of developing behavioural problems and to intervene early to improve outcomes. Atypical mother-infant attachment could be one indicator of risk. The primary aim of this stud...It may be possible to identify infants at risk of developing behavioural problems and to intervene early to improve outcomes. Atypical mother-infant attachment could be one indicator of risk. The primary aim of this study was to examine the association between self-assessed mother-infant attachment and the offspring´s behavioural problems in childhood and early adolescence. This study was based on data from the first Growing up in Scotland (GUS) birth cohort (n = 2225). Mother-infant attachment was assessed with the Maternal Postnatal Attachment Scale 10 months postnatally and child mental well-being was assessed with the Strengths and Difficulties Questionnaire collected when the child was 7-8 years, 10-11 years and 12 years old. Multinomial logistic regression was used to examine the association between mother-infant attachment and mental health. Weaker reported mother-infant bonds were associated with later higher risk of child problems in most SDQ subscales at ages 7-8 and 10-11. For boys, some risks persisted until age 12, while all associations faded for girls. The study confirms a link between maternally reported weak attachment and behavioural problems, with the strongest effects in boys.
This study aims to systematically analyze the disease burden of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) in children aged 0-14 years, utilizing data from the Global Burden of Dis...This study aims to systematically analyze the disease burden of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) in children aged 0-14 years, utilizing data from the Global Burden of Disease (GBD) 2021 database. By examining their temporal trends, regional distributions, and demographic differences, the study seeks to elucidate the epidemiological similarities and differences between the two disorders, thereby providing a scientific foundation for the development of prevention, diagnosis, and treatment strategies. This study, based on GBD 2021 data, analyzed the incidence, prevalence, and disability-adjusted life years (DALY) of ASD and ADHD globally from 1990 to 2021. The research employed age-standardized rates (ASR) to eliminate the influence of population age structure and explored the contributions of epidemiological changes, including population size, aging, as well as disease incidence, prevalence, mortality, and risk factors, to DALY through decomposition analysis. Additionally, the study performed an analysis of health inequalities, conducted a frontier analysis, and predicted future trends utilizing the Bayesian Age-Period-Cohort (BAPC) model. In 2021, the prevalence of ASD among the global population aged 0-14 years was 857.14 cases per 100,000 individuals (95% UI: 723.16-1009.04), while the prevalence of ADHD was 1,661.61 cases per 100,000 individuals (95% UI: 1,128.43-2,414.83). Within this age group, the DALY for ASD were 3,318,058 (95% UI: 2,248,324-4,668,010), compared to 410,705 (95% UI: 209,548-714,682) for ADHD. The DALY burden for ASD was higher than that for ADHD. These two disorders exhibit differences in gender and age distribution, with higher incidence rates and DALY values observed in males. Projections indicate that from 2021 to 2050, the DALY for both ASD and ADHD in the 0-14 age group are expected to show an upward trend.
BACKGROUND: Declarative memory plays a crucial role in learning and may serve as a compensatory mechanism for phonological deficits in individuals with dyslexia. However, research on its variability within this populatio...BACKGROUND: Declarative memory plays a crucial role in learning and may serve as a compensatory mechanism for phonological deficits in individuals with dyslexia. However, research on its variability within this population remains limited. This study aimed to identify distinct declarative memory profiles in children and adolescents with dyslexia and examine their potential compensatory role. METHODS: A total of 714 participants aged 10-19 years, including 136 individuals with dyslexia and 578 neurotypical controls, completed the Test of Memory and Learning Second Edition (TOMAL-2). A Latent Profile Analysis was used to identify memory subgroups based on six TOMAL-2 indices. Group differences were analyzed using independent samples t-tests, and logistic regression was conducted to assess the predictive utility of memory indices for dyslexia classification. RESULTS: Four distinct declarative memory profiles emerged: Typical Memory Performance (78%), Divergent Memory Abilities (11%), Globally Impaired Memory (8%), and Verbal Delayed Recall Impaired Memory (3%). While most individuals with dyslexia exhibited typical declarative memory performance, they were significantly more likely to belong to the Divergent Memory Abilities or Globally Impaired Memory profiles compared to the controls. The logistic regression analysis revealed that lower sequential and free recall scores, combined with stronger nonverbal memory, were significant predictors of dyslexia. CONCLUSIONS: These findings highlight the heterogeneity of declarative memory in dyslexia, demonstrating that while some individuals rely on memory strength to compensate for phonological deficits, others experience broader memory impairments. This variability underscores the need for personalized interventions that leverage declarative memory strength while supporting those with deficits. Future research should explore longitudinal changes and cross-linguistic differences for targeted educational strategies.
Child Psychiatry Hum Dev
· 2025 Jul · PMID 40632207
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The effects of parenting behaviors on children's internalizing symptoms are influenced by numerous factors. Across prior studies, there is evidence that parental internalizing symptoms (anxiety and depression) are associ...The effects of parenting behaviors on children's internalizing symptoms are influenced by numerous factors. Across prior studies, there is evidence that parental internalizing symptoms (anxiety and depression) are associated with less consistent and structured parenting behaviors as well as higher child internalizing symptoms. Factors such as familial socioeconomic status and cultural identity have also been shown to interact with parental internalizing symptoms and parenting behaviors. Prior studies of these associations often do not include fathers and are not typically population representative. The goal of the present study was to leverage a nationally representative sample of U.S. parents to examine how parents' self-reported internalizing symptoms relate to their parenting behaviors and reports of their child's symptoms, accounting for familial factors (socioeconomic status, child age, sex, race, and ethnicity) known to influence parenting. Parents of 5-12-year-old children (N = 1570, 36% fathers) completed self-report measures of their parenting (inconsistent discipline and poor supervision and monitoring), their depression and anxiety symptoms, and their children's internalizing symptoms. Results from structural equation modeling demonstrated that maternal and paternal internalizing symptoms were associated with less consistent parenting behaviors and with greater child internalizing symptoms. Paternal internalizing symptoms were also indirectly associated with child symptoms via less consistent parenting. Associations among family sociodemographic factors and parenting behaviors varied across parents. Results are consistent with findings from previous studies in smaller samples, focused primarily on mothers. Findings support the generalizability of associations among parental internalizing symptoms, parenting behaviors, and child internalizing symptoms to fathers and to nonclinical samples of parents.
Norris LA, Stanojevic M, Skriner LC
… +7 more, Chu BC, Aalberg M, Silverman WK, Bodden D, Piacentini JC, Obradovic Z, Kendall PC
Child Psychiatry Hum Dev
· 2025 Jul · PMID 40608185
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Machine Learning (ML) is a promising approach for predicting outcomes of youth anxiety treatments. To this end, data from nine randomized controlled trials of youth anxiety treatments were concatenated into a dataset (N ...Machine Learning (ML) is a promising approach for predicting outcomes of youth anxiety treatments. To this end, data from nine randomized controlled trials of youth anxiety treatments were concatenated into a dataset (N = 1362; M = 10.59, SD = 2.47; 48.9% female; 71.9% White, 5.9% Black, Other, 5.9%; 10.8% Hispanic) and ML algorithms were used to predict outcomes. Models were then applied on an external validation sample in a research clinic (N = 50; M = 12.04, SD = 3.22; 56% female; 76% Caucasian, 10% Black, 6% Asian, 2% Other; 6% Hispanic). To examine predictive features by treatment type, Lasso Regression models were built separately for youth who completed individual cognitive behavioral therapy (CBT), family CBT (FCBT), sertraline alone (SRT), and combination of SRT and CBT (COMB). Automatic relevance determination (ARD) emerged as the best performing model in the concatenated (RMSE = 1.84, R = 0.28) and external validation datasets (RMSE = 1.87, R = 0.11). Predictive features of poorer outcomes were primarily indicators of symptom severity and trial effects, although predictors varied within treatments (e.g., caregiver psychopathology was predictive for FCBT; depressive symptoms were predictive for COMB). Implications for use of ML to predict outcomes are discussed.
Child Psychiatry Hum Dev
· 2025 Jun · PMID 40586947
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The purpose of this study was to assess the prevalence of parental accommodation in a clinical sample of children diagnosed with selective mutism (SM) (n = 38), SM and comorbid anxiety disorder(s) (n = 28), other anxiety...The purpose of this study was to assess the prevalence of parental accommodation in a clinical sample of children diagnosed with selective mutism (SM) (n = 38), SM and comorbid anxiety disorder(s) (n = 28), other anxiety disorders (n = 34), and non-anxiety disorders (n = 30) and to compare accommodation across these diagnostic groups. The study also sought to measure the relationship between accommodation and SM symptom severity. Parents who sought intakes at a private practice completed the Family Accommodation Scale-Anxiety questionnaire measuring accommodation behavior and other measures of anxiety and SM symptoms. The results highlighted that accommodation in the SM sample was prevalent, however reported at a lower frequency and with lower levels of parental distress than expected. Additionally, no correlation was found between accommodation and SM symptom severity. This study suggests a clinical need for a specific measure to assess unique parental accommodation behaviors in SM.
Blevins EJ, Chen Y, Sanchez E
… +4 more, Rondon MB, Sanchez S, Gelaye B, Basu A
Child Psychiatry Hum Dev
· 2025 Jun · PMID 40571864
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During the COVID-19 pandemic, parents in low- and middle-income countries (LMICs) faced greater income loss, high fatality rates, and less accessible healthcare. Peru reported the highest COVID-19 mortality rate globally...During the COVID-19 pandemic, parents in low- and middle-income countries (LMICs) faced greater income loss, high fatality rates, and less accessible healthcare. Peru reported the highest COVID-19 mortality rate globally; yet no known study in Peru has examined the unique impact of COVID-related stressors on parents or their children's behavioral health. Cross-sectional data were drawn from 672 mothers (mean age = 32.5) on COVID-related perceived stress, as part of a longitudinal birth cohort. Factor analyses of COVID-related perceived stress identified three domains which were used in multivariate logistic regression to examine associations with children's (mean age = 7.6; 50.9% boys) internalizing and externalizing symptoms. Mothers reported worries about contracting COVID-19 (86%), losing a job/income (73%), family/friend dying (63.8%), and food intake (60%). Economic insecurity (OR = 1.38 [1.13, 1.68]; OR = 1.99 [1.55, 2.58]) and physical and mental health worries (OR = 1.77 [1.44, 2.18]; OR = 1.88 [1.46, 2.44]) were positively associated with children's symptoms. This is one of the few LMIC-based studies that examines the prevalence of COVID-19 perceived stress among mothers and how perceived stress relates to children's behaviors and emotions during the COVID-19 pandemic. Implications are discussed for improving parent-child well-being in LMICs with high rates of COVID-19 disease and death.
Schmidt LA, Brook CA, Hassan R
… +5 more, Kong X, MacGowan TL, Poole KL, Theall LA, Jetha MK
Child Psychiatry Hum Dev
· 2025 Jun · PMID 40571863
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Although early childhood shyness is known to portend later internalizing-related problems, we know relatively little about how broad socio-cultural and socio-historical factors shape children's shyness. In this study, we...Although early childhood shyness is known to portend later internalizing-related problems, we know relatively little about how broad socio-cultural and socio-historical factors shape children's shyness. In this study, we leveraged the COVID-19 pandemic as a quasi-experiment to examine generational and period differences in parent-reported children's shyness at the same age in three separate cohorts (N = 648): Generation Z (tested: 1999-2000, n = 217, M = 4.43 years), Generation Alpha: pre-pandemic (tested: 2018-2019, n = 217, M = 4.76 years) and mid-pandemic (tested: 2021, n = 214, M = 4.47 years). The two Generation Alpha groups did not differ on shyness levels despite the pandemic-related social restrictions, and both Generation Alpha cohorts had unexpectedly relatively lower parent-reported shyness levels today compared with Generation Z assessed approximately twenty years ago. Observed behavioral measures of shyness collected prior to the pandemic on a subset of children also revealed lower levels of shyness in Generation Alpha pre-pandemic compared with Generation Z, converging with parent-reported findings of shyness. Findings suggest that generational differences in children's shyness may result from more protracted socio-cultural influences than from acute period effects such as COVID-19 lockdowns.
Child Psychiatry Hum Dev
· 2025 Jun · PMID 40555887
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Little work has examined associations between interpersonal factors and changes in the therapeutic alliance. We examined the association between baseline youth family and peer interpersonal characteristics and therapeuti...Little work has examined associations between interpersonal factors and changes in the therapeutic alliance. We examined the association between baseline youth family and peer interpersonal characteristics and therapeutic alliance throughout treatment in a sample of anxious youths who received cognitive behavioral therapy or client-centered therapy. Youths (N = 135; M = 10.94; SD = 1.46) were in a randomized clinical trial for anxiety disorders. Interpersonal characteristics were assessed via parent-report, youth self-report, and observational methods. Lower levels of parent-rated shyness, higher levels of positive interpersonal style, and being female were associated with higher early therapist-rated alliance. Being female was associated with more rapid increases in therapist-rated alliance. Friendship quality, younger age, and lower aggressive interpersonal style predicted higher baseline youth-rated alliance. Positive interpersonal style and stronger family functioning were associated with more rapid increases in youth-rated alliance. Therapists should be aware of client interpersonal characteristics when working with youth.