Do school and equality education characteristics influence young children's understanding of sex/gender constancy?

In many cognitive developmental studies, young children ( < 6 years) fail to understand that changing the appearance of a person, object, or animal does not change its underlying reality. They appear to believe that a cat wearing a dog mask is genuinely a dog (appearance/reality distinction) and that a boy wearing a dress is genuinely a girl (sex/gender constancy). These skills may be affected by various influences: testing methods, training on the constancy of biological traits, child's or sibling's diagnosis of gender dysphoria, and child's diagnosis of autism. This study aimed to partially replicate the study of Arthur et al. (Journal of Experimental Child Psychology, 2009, Vol. 104, pp. 427-446) showing that experimental lessons emphasizing the constancy or otherwise of biological traits affected appearance/reality and sex/gender constancy performance. The study examined the influence of school lessons with content on sex/gender stereotyping and pro/anti constancy on the performance of young English children (mean age = 5;6 [years;months]; N = 58) on appearance/reality and sex/gender constancy tasks. Children performed above chance on sex/gender stability (change over time) but performed below chance on sex/gender constancy and appearance/reality tasks (change due to superficial alterations). These scores are comparable to those in nearly all previous studies. Children's scores were not influenced by school lesson content, although not all schools provided content. Conclusions are drawn about the effect of lesson content, which may be too diffuse and long term to affect performance. The level of children's performance and what this means in absolute terms about children's understanding of sex/gender stereotypes and the possibility of a child changing sex/gender is also discussed.

Commentary: Integrative, multi-level explanatory models are needed to understand recent trends in sex, gender, and internalizing conditions, reflections on Keyes and Platt (2023)

Keyes' and Platt's (The Journal of Child Psychology and Psychiatry, 2023) review provides much-needed systematic evidence about why internalizing symptoms have increased and it clarifies the role of novel risk factors. The findings highlight that multiple factors at multiple levels are responsible for this phenomenon, many with small effects, within a complex interplay that is rarely well captured. As new insights emerge across disciplines, an important step is to renew efforts to integrate them to understand how internalizing symptoms develop for different people.

Prolonged development of forced-choice recognition when targets are paired with non-corresponding lures

Previous research suggests that mnemonic discrimination (i.e., the ability to discriminate between previously encountered and novel stimuli even when they are highly similar) improves substantially during childhood. To further understand the development of mnemonic discrimination during childhood, the current study had 4-year-old children, 6-year-old children, and young adults complete the forced-choice Mnemonic Similarity Task (MST). The forced-choice MST offers a significant advantage in the context of developmental research because it is not sensitive to age-related differences in response criteria and includes three test formats that are theorized to be supported by different cognitive processes. A target (i.e., a previously encountered item) is paired with either a novel item (A-X), a corresponding lure (A-A'; i.e., an item mnemonically similar to the target), or a non-corresponding lure (A-B'; i.e., an item mnemonically similar to a different previously encoded item). We observed that 4-year-olds performed more poorly than 6-year-olds on the A-X and A-A' test formats, whereas both 4- and 6-year-olds performed more poorly than young adults on the A-B' test format. The MINERVA 2.2 computational model effectively accounted for these age-related differences. The model suggested that 4-year-olds have a lower learning rate (i.e., probability of encoding stimulus features) than 6-year-olds and young adults and that both 4- and 6-year-olds have greater encoding variability than young adults. These findings provide new insight into possible mechanisms underlying memory development during childhood and serve as the basis for multiple avenues of future research.

Beyond Clinical Care: The Role of Pediatric Psychology in Supporting Postpartum Depression Screening in Primary Care

Maternal health is a critical component of optimal child health and development. Consequently, the American Academy of Pediatrics added postpartum depression (PPD) screening to their psychosocial screening guidelines in 2017. The Healthy Mothers, Healthy Children Project (HMHCP) was an interprofessional initiative aimed at preparing for, then implementing and maintaining pediatrician-completed PPD screening at 1-month well visits in a pediatric primary care clinic. Roles of pediatric psychology and rates of PPD screening were examined. Pediatric psychologists actively participated as leaders and collaborators in a variety of non-clinical roles from HMHCP preparation through maintenance. The clinic achieved high and continuously improving PPD screening rates following HMHCP implementation. Importantly, PPD screening rates were equitable across race and gender. The current study outlines feasible non-clinical roles that pediatric psychologists can fulfill in support of routine PPD screening within pediatric primary care. It also highlights associated benefits and outcomes for the clinic, providers, and patients.

Commentary: Cognitive stimulation and executive functions in the prevention and treatment of childhood disorders - reflection on Phillips et al., 2023

The study by Phillips et al. (Journal of Child Psychology and Psychiatry, 2023) shows that preschool executive functions (EF) are a transdiagnostic mechanism through which deprivation increases the risk for psychopathology in adolescence. In addition, deprivation appeared to be a key mechanism through which economic adversity (i.e., lower income-to-needs ratio and maternal education) undermines EF and increases the risk for psychopathology in adolescence. In this commentary, implications for early prevention and treatment of childhood disorders are discussed. In view of optimal EF development attention is needed to cognitive and social stimulation both in: (a) selective prevention targeting preschool children at high risk for childhood disorders due to low socioeconomic status; (b) indicated prevention targeting preschool children with minimal but detectable symptoms from low socioeconomic status families; and (c) treatment targeting preschool children with a clinical disorder from low socioeconomic status families.

Commentary: The evidence base regarding the long-term effects of childhood mental disorder treatments needs to be strengthened - reply to Dekkers et al. (2023)

In their reply to our editorial (Journal of Child Psychology and Psychiatry, 2023, 64, 464), Dekkers et al. (Journal of Child Psychology and Psychiatry, 2023, 64, 470) argue that treatment is the best choice for children with mental disorders because there is 'sound evidence' that interventions are effective, also in the long term. We agree that there is sound evidence for treatment effectiveness in the short-term and there is some evidence for longer-term effects of certain specific treatments, such as behavioral parent training in children with behavioral disorders, as acknowledged in our editorial. However, we strongly disagree that there is sound evidence for long-term effectiveness.

Editorial: Generative artificial intelligence and the ecology of human development

Commercial applications of artificial intelligence (AI) in the form of Large Language Models (LLMs) and Generative AI have taken centre stage in the media sphere, business, public policy, and education. The ramifications for the field of child psychology and psychiatry are being debated and veer between LLMs as potential models for development and applications of generative AI becoming environmental factors for human development. This Editorial briefly discusses developmental research on generative AI and the potential impact of generative AI on the hybrid social world in which young people grow up. We end by considering that the rapid developments justify increasing attention in our field.

Commentary: The roles of mothers versus fathers in intergenerational family risk - a commentary on Rothenberg et al. (2023)

Basic research studies in the past 2 decades have established that conduct problems and antisocial behavior are associated across generations within families. The Fast Track study represents a major prevention effort with children showing higher levels of conduct problems in childhood, and the Rothenberg et al. (Journal of Child Psychology and Psychiatry, 2022) study sheds light on whether this intervention has beneficial effects on the family of procreation. In this commentary, we consider the implications of the major finding that such effects were found for women but not for men. We discuss evidence that men's parenting behavior is influenced by the parenting behavior and overall risk of their women partners, and thus preventive interventions in childhood may have beneficial influences on fathers through mothers.

Addressing Barriers to Career Development Awards for Early Career Women in Pediatric Psychology

OBJECTIVE

To provide person and system-level recommendations for supporting early career women in the field of pediatric psychology in writing and submitting National Institutes of Health (NIH) Career Development Award (K award) applications. Recommendations are provided in the context of common barriers, with a focus on practical solutions.

METHODS

Publicly available NIH reporter data were compiled to examine rates of funding for Society of Pediatric Psychology (SPP) members. Barriers that women face when initiating programs of research are described and applied to the field of pediatric psychology.

RESULTS

Of current SPP members, 3.9% (n = 50) have ever received an NIH K award. Approximately 88.5% of SPP members identify as women, including 89.0% of SPP K award recipients. A table of person- and systems-level recommendations is provided to offer strategies for mentees, mentors/sponsors, institutions, and national organizations to address the barriers discussed.

CONCLUSIONS

By addressing gender-specific barriers to submitting K award applications, we hope to increase the number of women K awardees and support the scientific advancement of pediatric psychology.

Alternative hypotheses regarding the association between early engagement in gambling and gambling-like activities and later problem gambling - a commentary on Richard and King (2023)

This issue of the Journal of Child Psychology and Psychiatry includes a systematic review on the emergence of problem gambling from childhood to emerging adulthood (Richard & King, 2023). The importance of understanding the risks for problem gambling earlier in development is clear, given the increasing availability of gambling to minors, especially online gambling.

Negative impact of daily screen use on inhibitory control network in preadolescence: A two-year follow-up study

The COVID-19 pandemic has made an unprecedented shift in children's daily lives. Children are increasingly spending time with screens to learn and connect with others. As the online environment rapidly substitutes in-person experience, understanding children's neuropsychological trajectories associated with screen experiences is important. Previous findings suggest that excessive screen use can lead children to prefer more immediate rewards over delayed outcomes. We hypothesized that increased screen time delays a child's development of inhibitory control system in the brain (i.e., fronto-striatal circuitry). By analyzing neuropsychological data from 8324 children (9-11ys) from the ABCD Study, we found that children who had more screen time showed a higher reward orientation and weaker fronto-striatal connectivity. Importantly, we found that the daily screen exposure mediated the effect of reward sensitivity on the development of the inhibitory control system in the brain over a two year period. These findings suggest possible negative long-term impacts of increased daily screen time on children's neuropsychological development. The results further demonstrated that screen time influences dorsal striatum connectivity, which suggests that the effect of daily screen use is a habitual seeking behavior. The study provides neural and behavioral evidence for the negative impact of daily screen use on developing children.

The Spanish Version of the Childhood Anxiety Sensitivity Index: Factorial Dimensions and Invariance across Gender in a Sample of Adolescents

Anxiety sensitivity is a transdiagnostic construct that has been associated with the etiology of emotional disorders, especially panic and other anxiety disorders. Although it is well known that, for the adult population, the factor structure of anxiety sensitivity includes three separate facets (physical, cognitive, and social concerns), the facets of anxiety sensitivity for adolescents have not yet been established. The main goal of the present study was to examine the factor structure of the Spanish version of the Childhood Anxiety Sensitivity Index (CASI). A large sample of nonclinical adolescents completed the Spanish version of the CASI in school settings (N = 1655; aged 11-17 years; 800 boys and 855 girls). Exploratory and confirmatory factor analyses of the full scale (CASI-18) indicate that a three first-order factor solution represents appropriately the three anxiety sensitivity facets previously defined for the adult population. The 3-factor structure had a better fit and was more parsimonious than a 4-factor solution. Results also indicate that the 3-factor structure remains invariant across genders. Girls scored significantly higher than boys on the total scale and on all three dimensions of anxiety sensitivity. In addition, the present study provides information concerning normative data for the scale. The CASI holds promise as a useful tool for assessing general and specific facets of anxiety sensitivity. It could be helpful for the assessment of this construct in clinical and preventive settings. The limitations of the study and suggestions for further research are outlined.

Commentary: Global perspectives on resilience and callous-unemotional traits - a reflection on Obando et al. (2022)

Obando, Wright and Hill's (Journal of Child Psychology and Psychiatry, 2022) study of young children exposed to community violence in Colombia is a most welcome addition to the literature on risk and protective pathways related to callous and unemotional (CU) traits. The key contributions of this study can be viewed in light of calls for a new wave of global research into resilience in children and youth. These contributions also highlight the need for further research into CU traits in diverse sociocultural contexts, and in particular, research addressing questions concerning (a) multiple pathways to CU traits; (b) community violence and other forms of adversity; and (c) the developmental timing of adversity.

Establishing a Valid, Reliable, and Efficient Chart Review Process for Research in Pediatric Integrated Primary Care Psychology

Retrospective chart review is an accessible form of research that is commonly used across medical fields but is underutilized in behavioral health. As a relatively newer area of research, the field of pediatric integrated primary care (IPC) would particularly benefit from guidelines for conducting a methodologically sound chart review study. Here, we use our experiences building a chart review procedure for a pediatric IPC research project to offer strategies for optimizing reliability (consistency), validity (accuracy), and efficiency. We aim to provide guidance for conducting a chart review study in the specific setting of pediatric IPC so that researchers can apply this methodology toward generating research in this field.

Changes in Attachment Disorder symptoms in children internationally adopted and in residential care

BACKGROUND

A high incidence of Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) has been reported for children with experiences of trauma and other forms of adversity.

OBJECTIVE

The present study aims to explore symptoms of RAD and DSED in children in two protection alternatives (international adoption and residential care) after experiences of early adversity.

PARTICIPANTS AND SETTING

The participants were 146 children: 40 children adopted into Spanish families from Russia, 49 children in residential care in Spanish institutions (40.8% in long-term foster centers) and 57 community comparison children.

METHODS

The Relationship Problems Questionnaire was used to explore both RAD and DSED. All adoptive parents and institutional caregivers retrospectively reported the problems at time of placement (Wave 0), as well as the symptoms observed at the time of the study, with children aged 4-8 years old (Wave 1). At this stage, the assessment of the community comparison group was added.

RESULTS

Adopted and children in residential care presented high levels of RAD and DSED symptoms at placement. For adoptees, previous experiences of abuse and neglect were marginally associated with the initial presence of RAD symptoms and a significant recovery was observed after an average of three years in their families, with a certain level of longitudinal continuity between initial and later assessments. In children currently placed in long-term residential centers in Spain, DSED symptoms worsened from W0 to W1.

CONCLUSIONS

Adoption appears to be an effective intervention that promotes recovery of RAD and DSED symptomatology after early adversity, whereas institutionalization causes negative effects.

Introduction to the Special Issue: Experimental Therapeutics in Clinical Child and Adolescent Psychology: Identifying Mechanisms and Moving the Needle

The premise of experimental therapeutics is that one can (a) target a process, or mechanism, underlying psychopathology and (b) that change in said mechanism can cause clinical improvement. Targeting specific mechanisms may permit more effective and personalized medicine. The experimental therapeutics approach holds promise for improving the potency and efficiency of treatments for childhood psychopathology, and for advancing our understanding of the factors that both cause and sustain psychopathology. This special issue presents new research utilizing this framework and offers guidelines for the application of the experimental therapeutics framework.

Effects of clown visits on stress and mood in children and adolescents in psychiatric care—Protocol for a pilot study

Scientific evidence has shown that healthcare clowning can decrease the level of stress and anxiety in pediatric patients. However, little attention has been devoted to the potentially beneficial impact of clown visits in the child and adolescent psychiatry setting. Therefore, this pilot study aims at investigating short-term effects of clown visits by RED NOSES Clowndoctors Austria on stress and mood levels of children and adolescents in psychiatric care. The sample will consist of approximately 50 children and adolescents in inpatient psychiatric wards who receive clown visits on a weekly basis over four consecutive weeks. The examined intervention, i.e., the clown visits, is an integral part within the selected psychiatric institutions. Using a non-controlled pre-/post-test design, the level of salivary cortisol and self-reported stress and mood will be measured as primary outcomes before and immediately after each clown visit. Additionally, self-reported effects on care staff at the health care facilities will be assessed based on a questionnaire after each clown visit within the same time period of four weeks. Secondary outcome measures (i.e., health-related quality of life, emotional and conduct problems, perceived chronic stress) will be assessed at baseline and at close-out assessment after the four intervention weeks. Further control variables and potential moderators are included at baseline. Due to the nested data structure, multilevel modeling will be used to analyze the data. To our knowledge, this is the first study to examine the stress-reducing and mood-improving effects of clown visits on inpatients in child and adolescent psychiatry. Results will be relevant for the design of future large-scale RCTs and might provide valuable implications for the use of healthcare clowning to reduce stress and improve mood in children and adolescents in psychiatric care. The study is registered at ClinicalTrials.gov (Identifier: NCT04844398).

Examination of Early Childhood Temperament of Shyness and Social Avoidance and Associations With Cardiometabolic Health in Young Adulthood

Importance

A child temperament characterized by shyness and avoidance of social interactions is associated with poor peer relationships and emotional problems, yet its long-term associations with adult cardiometabolic health are largely unknown.

Objective

To examine whether a childhood temperament characterized by shyness and avoidance of social interactions is associated with poor cardiometabolic health.

Design, Setting, and Participants

This cohort study included participants who were recruited at birth between April 1991 to December 1992 as part of a prospective longitudinal cohort, the Avon Longitudinal Study of Parents and Children. Follow-up assessments of health behaviors and cardiometabolic health extended into young adulthood (age 24 years). Data analysis was conducted between April and October 2021.

Main Outcomes and Measures

Parent reports of temperament across ages 3 to 6 years were used to derive childhood temperament profiles in a longitudinal clustering analysis. Accelerometry measures of adolescent moderate to vigorous physical activity (MVPA) from ages 11 to 15 years and adult social occupation class were examined as mediators using path analyses. At age 24 years, 9 cardiometabolic outcomes were measured through anthropometrics and fasting blood samples: triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels, glycated hemoglobin levels, insulin levels, systolic and diastolic blood pressure, body mass index, and C-reactive protein (CRP) levels.

Results

Of the 9491 participants included in the analyses, 4908 (51.7%) were male, and 8668 of 9027 (96.0%) were White. Four childhood temperament profiles were identified: (1) introverted (2810 [29.6%]), (2) extraverted (2527 [26.6%]), (3) conflicted-shy (2335 [24.6%]), and (4) avoidant-shy (1819 [19.2%]). Lower childhood socioeconomic status was a precursor associated with the development of an avoidant-shy temperament (eg, introvert vs avoidant-shy: odds ratio, 1.13; 95% CI, 1.04-1.23). Path analyses showed that avoidant-shy children spent less time in MVPA in adolescence compared with all other temperament profiles (eg, introvert vs avoidant-shy: β = 0.10; b = 0.25; 95% CI, 0.14-0.35; P < .001), which in turn was associated with a cluster of cardiometabolic indices at age 24 years, including lower HDL cholesterol levels (β = 0.07; b = 0.95; 95% CI, 0.12-1.78; P = .03) and higher LDL cholesterol levels (β = -0.07; b = -1.69; 95% CI = -3.32 to -0.06; P = .04), insulin levels (β = -0.10; b = -0.57; 95% CI, -1.04 to -0.10; P = .02), diastolic blood pressure (β = -0.09; b = -0.59; 95% CI, -0.97 to -0.21; P = .002), and body mass index (β = -0.07; b = -0.32; 95% CI, -0.56 to -0.07; P = .01). Additionally, children classified as avoidant-shy attained lower social occupation classes at age 24 years, which was concurrently associated with higher BMI (β = 0.06; b = 0.21; 95% CI, 0.08-0.35; P = .002). Notably, these results were adjusted for a range of early developmental precursors and confounders, suggesting an independent association of temperament.

Conclusions and Relevance

In this cohort study, less engagement in physical activity across adolescence seemed to be a developmental mechanism connecting an avoidant-shy childhood temperament and greater cardiometabolic risks over the life course. Future studies should examine the efficacy of physical activity and social skill programs that specially target the needs of different children to thereby reduce cardiometabolic risks.