Comer JS, Salem H, Urcuyo AE
… +13 more, Sáez-Clarke E, Karlovich AR, Coxe S, Ehrenreich-May J, Evans AD, Galvan A, Malloy LC, Pincus DB, Dick AS, Furr JM, Green JG, Gurwitch RH, Peris TS
J Clin Child Adolesc Psychol
· 2026 · PMID 40669036
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OBJECTIVE: Disasters and public health emergencies raise child/adolescent risk for posttraumatic stress (PTS). This study examined prospective predictors of COVID-related PTS in a large sample of U.S. and Canadian youth....OBJECTIVE: Disasters and public health emergencies raise child/adolescent risk for posttraumatic stress (PTS). This study examined prospective predictors of COVID-related PTS in a large sample of U.S. and Canadian youth. Demographics, pre-pandemic contextual factors, baseline clinical factors, and pandemic experiences were examined. We hypothesized pandemic proximity/exposure and pandemic-related financial hardship in the first seven months, as well as baseline resource insecurity, internalizing symptoms, and female gender, would predict subsequent COVID-related PTS. METHOD: A prospective two-wave study of English- or Spanish-speaking youth ages 5-17 years ( = 1,413; 46.2% female; 33.4% racial/ethnic minority youth), and their caregivers, was conducted. The sample was recruited via crowdsourcing methods (e.g. existing community samples, advertisements, online recruitment). Data were collected via online caregiver-report surveys. Recruitment began 3/20/2020 (<10 days after pandemic declaration); follow-up assessments were collected = 6.56 months later (7 months into pandemic). RESULTS: Maximum likelihood estimation linear regression indicated baseline internalizing problems, pre-pandemic food insecurity, and COVID-19-related financial hardship predicted youth PTS at follow-up, whereas COVID-19 proximity/exposure and youth gender, age, and race/ethnicity did not. Youth with baseline internalizing problems had eight times the odds of developing probable PTSD than youth without baseline internalizing problems. The effect of COVID-19-related financial hardship on PTS was particularly high among youth who went into the pandemic with food insecurity. CONCLUSION: The financial toll the pandemic took on a child's family and whether there were pre-pandemic mental health or resource-related vulnerabilities may have been more determinant of individual youth PTS than the child's degree of direct COVID-19 proximity or family exposure.
Griffith RL, Henry LC, Raine A
… +2 more, Stepp SD, Byrd AL
J Clin Child Adolesc Psychol
· 2025 Jul · PMID 40669035
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OBJECTIVE: Aggression is a transdiagnostic indicator of psychopathology and one of the most common reasons for youth mental health referrals. Deficits in executive function are linked to aggression in youth, yet few long...OBJECTIVE: Aggression is a transdiagnostic indicator of psychopathology and one of the most common reasons for youth mental health referrals. Deficits in executive function are linked to aggression in youth, yet few longitudinal studies exist and fewer examine differential associations between components of executive function (inhibition, working memory, cognitive flexibility) and subtypes of aggression (reactive and proactive). METHOD: This preregistered study investigated longitudinal associations between shared and unique components of executive function and trajectories of reactive and proactive aggression over 18 months in adolescents at high risk for aggression ( = 103, M = 16.1, 53% female, 60% racial/ethnic minoritized groups). The NIHToolbox Cognition battery was used to assess components of executive function at baseline, and subtypes of aggression were measured using youth- and parent-report on the Reactive-Proactive Aggression Questionnaire at baseline, 9-months, and 18-months. Trajectories of reactive and proactive aggression were modeled using latent growth curve modeling and associations between executive function and aggression were examined using structural equation modeling. RESULTS: Trajectories of reactive and proactive aggression showed an overall decline across informants. Contrary to prediction, associations between executive function and aggression trajectories were specific to youth-reported proactive aggression and only found when examining associations with unique (versus shared) components of executive function. Specifically, lower inhibition was associated with steeper declines in proactive aggression and lower cognitive flexibility was associated with steeper increases in proactive aggression. CONCLUSIONS: Findings underscore the importance of examining components of executive function, particularly inhibition and cognitive flexibility, in the development of subtypes of aggression among high-risk youth.
Grieshaber A, Perlman G, Kotov R
… +1 more, Klein DN
J Clin Child Adolesc Psychol
· 2026 · PMID 40638658
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OBJECTIVE: Although anxiety disorders elevate risk for subsequent depressive disorders, most anxious youth do not develop depression. However, the factors that influence the sequential comorbidity between anxiety and sub...OBJECTIVE: Although anxiety disorders elevate risk for subsequent depressive disorders, most anxious youth do not develop depression. However, the factors that influence the sequential comorbidity between anxiety and subsequent depression have received little attention. METHOD: We followed two samples of majority-White suburban youth. Sample 1 included 504 girls (13.5-15.5 years) who did not meet criteria for depression at baseline and assessed the presence of anxiety and depressive disorders for five follow-ups spanning 6 years. Sample 2 consisted of 437 children who never met the criteria for depression through age 12 and assessed the presence of anxiety and depressive disorders every 3 years until age 18. We examined whether established risk factors for depression, including biological sex, depressive, anxiety, and irritability symptoms, rumination, temperament, interpersonal functioning, parental history of mood disorders, parenting, reward processing, and basal cortisol moderated the association between childhood/early-adolescent anxiety disorders and the subsequent development of depressive disorders in later adolescence/early adulthood. RESULTS: Compared to nondepressed/nonanxious youth, the presence of a childhood/early-adolescent anxiety disorder increased the risk for subsequent depression through later adolescence/early-adulthood by 63% to 90%. Although many risk factors prospectively predicted first-onset depression over and above a history of youth anxiety disorders, none of these variables moderated the effects of prior anxiety on later depression in either sample. CONCLUSIONS: Childhood/early-adolescent anxiety disorders and a number of other risk factors predict subsequent first-onset depression, but the predictors of depression in anxious youth do not differ from those in non-anxious youth.
Davis NO, Carpenter KLH, Sabatos-DeVito M
… +13 more, Spanos M, Reed A, Aiello RE, Schechter JC, Chandrasekhar T, Compton S, Franz L, Goldstein BA, Howard J, Vermeer S, Sikich L, Kollins SH, Dawson G
J Clin Child Adolesc Psychol
· 2026 · PMID 40631962
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OBJECTIVE: Co-occurring attention-deficit/hyperactivity disorder (ADHD) is present for many autistic children and is associated with increased impairments, unique treatment needs, and decreased response to autism-specifi...OBJECTIVE: Co-occurring attention-deficit/hyperactivity disorder (ADHD) is present for many autistic children and is associated with increased impairments, unique treatment needs, and decreased response to autism-specific interventions. Diagnosing ADHD in autistic children during the preschool and early school-age periods presents unique challenges for clinicians. METHODS: This work describes a clinically informed diagnostic framework for assessing ADHD in young autistic children. Clinical complexities are illustrated using descriptive data from caregiver and clinician ratings of ADHD symptoms in autistic children without ADHD ( = 83; mean age 63.6 months [SD = 19.2]) and with ADHD ( = 102; mean age 85.9 months [SD = 23.7]). Patterns of caregiver and clinician symptom endorsement are described. Logistic regression is employed to explore clinician confidence in diagnostic decision-making. RESULTS: Clinical interview probes are presented to help clinicians explore caregiver ratings of ADHD symptoms in the context of an autistic child's presentation. Demonstrating the complexity of diagnosing ADHD in autistic children, caregiver-rated ADHD Rating Scale scores were elevated for both the autistic ( = 27.8; SD = 11.5) and autistic+ADHD groups ( = 34.9; SD = 9.37). Patterns of clinician-caregiver agreement on ADHD symptom ratings showed more disagreement on inattention items than on hyperactivity/impulsivity items across both groups. Clinicians were more confident in ADHD diagnosis in autistic children who were girls, older, and had higher developmental levels. CONCLUSIONS: This manuscript highlights the clinical complexity of evaluating young autistic children for ADHD. Practical tips for addressing the unique challenges of diagnosing ADHD in autistic children are presented. Continued refinement and future validation of this diagnostic framework will help clinicians improve assessment of young children.
OBJECTIVE: Studies demonstrating associations between experiences of racism and traumatic stress symptoms have predominantly been conducted in adults, due in large part to the lack of available tools for assessing racism...OBJECTIVE: Studies demonstrating associations between experiences of racism and traumatic stress symptoms have predominantly been conducted in adults, due in large part to the lack of available tools for assessing racism-based traumatic stress symptoms (RBTSS) in youth. This investigation sought to address this gap by developing and validating the first measure of RBTSS for ethnoracially minoritized adolescents. METHOD: The Youth Racism-Based Traumatic Stress Symptom Scale (YRaBTSSS) was developed by drawing on relevant literature. Following iterative refinement based on feedback obtained via focus groups with adolescents, it was tested in two U.S. samples of 12-17-year-old ethnoracially minoritized adolescents (Study 1: = 401, 50.6% female; Study 2: = 651; 48.08% female) recruited through CloudResearch. Participants completed a demographic survey, the YRaBTSSS, and measures of trauma, racial/ethnic discrimination, and mental health. RESULTS: An exploratory factor analysis in Study 1 indicated that the YRaBTSSS is comprised of a single factor representing RBTSS. The final RBTSS scale had excellent internal consistency (α = 0.98) and significant factor loadings (0.72-0.87). The factor structure was replicated in Study 2. The YRaBTSSS demonstrated convergent validity through significant associations with related measures of PTSD symptoms ( < .001) and racial stress ( < .001). Finally, RBTSS were significantly associated with symptoms of anxiety ( < .01), depression ( < .01), and conduct problems ( < .05). CONCLUSIONS: Findings show preliminary evidence for the reliability and validity of the YRaBTSSS. This measure presents new opportunities to investigate the effects of racism on ethnoracially minoritized adolescents from a traumatic stress perspective.
Dreier MJ, Horne SJ, Kleiman EM
… +1 more, Hamilton JL
J Clin Child Adolesc Psychol
· 2026 · PMID 40512458
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OBJECTIVE: Anhedonia is a risk factor for suicidal thoughts. Treatment for anhedonia (behavioral activation) involves engaging in rewarding activities. Social media use is a rewarding activity for adolescents, and thus,...OBJECTIVE: Anhedonia is a risk factor for suicidal thoughts. Treatment for anhedonia (behavioral activation) involves engaging in rewarding activities. Social media use is a rewarding activity for adolescents, and thus, a possible behavioral activation tool for adolescents experiencing anhedonia, reducing further symptom escalation (e.g. suicidal thoughts). THE CURRENT STUDY TESTED: (1) Is momentary anhedonia negatively associated with looking forward to checking social media (predicted pleasure)? (2) Is momentary anhedonia associated with subsequently experiencing less positive mood on social media (actual pleasure)? (3) Are within-person changes in positive mood on social media (actual pleasure) associated with reduced likelihood of suicidal thoughts, and does this vary by levels of anhedonia? METHOD: Sixty-two adolescents (M = 16.15 (0.97); 49.3% girls, 16.4% boys, 34.4% nonbinary; 40.3% white) completed ecological momentary assessments three times daily for eight weeks. All prompts asked about anhedonia, predicted pleasure from social media, and actual pleasure on social media. Evening prompts assessed daily suicidal thoughts. Multilevel models tested the above research questions. RESULTS: Adolescents experiencing momentary anhedonia above their average levels looked forward to checking social media less. However, more-than-usual momentary anhedonia was not associated with positive mood on social media (actual pleasure). Experiencing above-average positive mood on social media was associated with decreased probability of suicidal thoughts at the daily level. This relationship was not moderated by anhedonia. CONCLUSION: For adolescents experiencing more-than-usual anhedonia, using social media for positive mood-boosting activities could be a behavioral activation tool and may be an important protective factor against suicidal thoughts.
Hung IT, Stringaris A, Liu C
… +2 more, Ganiban JM, Saudino KJ
J Clin Child Adolesc Psychol
· 2025 Apr · PMID 40262282
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OBJECTIVE: Irritability is genetically influenced and is associated with internalizing and externalizing psychopathology. However, little is known about the etiology of the development of irritability in the preschool pe...OBJECTIVE: Irritability is genetically influenced and is associated with internalizing and externalizing psychopathology. However, little is known about the etiology of the development of irritability in the preschool period. The present study examined this from rank-order stability and developmental trajectories perspectives. METHOD: The irritability of 310 same-sex twin pairs (monozygotic = 123; dizygotic = 187; 51% female) was longitudinally assessed at ages 3, 4 and 5 years via parent-reports on the Child Behavior Checklist. Biometric Cholesky models and latent growth curve models were used to examine genetic and environmental influences on both the rank-order stability and instability, and within individual changes in levels of irritability across age (i.e. developmental trajectories), respectively. RESULTS: The heritability of irritability ranged from 53% to 60%, with the remaining variances explained by nonshared environmental influences. Age-to-age stability was largely due to genetic influences. Novel genetic and nonshared environmental effects emerged at ages 4 and 5, indicating genetic and environmental contributions to instability. Approximately 42% and 22% of genetic influences at ages 4 and 5, respectively, were independent of prior ages, and over 85% of nonshared environmental influences were age-specific. Individual differences in developmental trajectories of irritability were entirely due to nonshared environmental influences. CONCLUSIONS: The rank-order stability of irritability and within-individual change in levels of irritability across age are governed by different etiological processes, emphasizing the importance of examining development from multiple perspectives. Both perspectives highlight the role of nonshared environmental factors in early irritability development. Interventions could benefit from leveraging these factors to redirect early irritability development.
OBJECTIVE: Experts have called for tools to enhance the effectiveness and acceptability of youth psychotherapy, such as methods designed to increase clinician-client alignment. Transdiagnostic youth psychotherapies, such...OBJECTIVE: Experts have called for tools to enhance the effectiveness and acceptability of youth psychotherapy, such as methods designed to increase clinician-client alignment. Transdiagnostic youth psychotherapies, such as (MATCH), may be particularly strong candidates for these methods, as they involve complex decision-making processes that influence treatment plans and outcomes. In this study, we explored clinician-client alignment in the selection of an initial MATCH treatment protocol (anxiety, depression, trauma, or conduct problems). METHOD: We used data from 196 youths (7-15 years old; 54% male; 32.5% White, 28% Black, 24% Latinx/Hispanic, 1% Asian, 13.5% multi-racial) receiving MATCH. We tested whether alignment - i.e. the extent to which the clinician-selected protocol aligned with the "best-fit" protocol for a given youth, based on youth and caregiver pre-treatment data - might predict trajectories of change in youth- and caregiver-reported severity of youth symptoms (Brief Problem Monitor) and idiographic top problems (Top Problems Assessment) across treatment. RESULTS: Overall, outcomes tended to improve more when the clinician-selected protocol aligned with the best-fit protocol of at least one of the clients (i.e. caregiver client and/or youth client) than when the clinician-selected protocol did not align with the best-fit protocol of either client. CONCLUSIONS: To our knowledge, this is the first study to demonstrate that clinician-client alignment may be associated with improved outcomes in youth psychotherapy. These findings highlight the potential clinical value of using pre-treatment client data to inform the clinician's critical decision of which treatment focus to pursue.
OBJECTIVE: The family environment of adolescents with body dysmorphic disorder (BDD) is under researched. The current study aimed to investigate family psychiatric history, as well as parental distress, rearing practices...OBJECTIVE: The family environment of adolescents with body dysmorphic disorder (BDD) is under researched. The current study aimed to investigate family psychiatric history, as well as parental distress, rearing practices, accommodation of appearance concerns, and appearance messages in a clinical sample of adolescents with BDD. METHOD: Twenty-six adolescents (12-17 years) with BDD were compared to 27 adolescents with anxiety disorders and 25 adolescents without mental disorders. Adolescents and their primary caregivers completed self-report measures and participated in a discussion task that was independently coded for parental rearing styles. RESULTS: Parents of adolescents with BDD reported experiencing significantly more emotional distress than parents in the non-clinical group ( = .003, = 1.02). The majority (92%) of parents in the BDD group reported accommodating their child's appearance concerns and reported performing significantly more frequent appearance accommodations than parents of anxious adolescents ( < .001, = 1.40) and the non-clinical group ( < .001, = 1.83). An independent observer rated parents of adolescents with BDD ( = .002, 1.19) and anxiety disorders ( = .008, 0.87) as more critical than parents in the non-clinical group during a body-image related discussion, but parents of adolescents with BDD were not rated as more critical in other discussion scenarios. There were no significant differences in parental warmth, overprotection, or appearance messages between parents in the BDD group and comparison groups. CONCLUSIONS: Results of the study can inform cognitive-behavioral models of adolescent BDD as well as family-based treatment approaches.