Exploring Risk Factors for ADHD Among Children at a Mongolian Public School: A Cross-Sectional Analysis

INTRODUCTION

Attention Deficit Hyperactivity Disorder (ADHD) is a complex neurodevelopmental disorder with numerous hypothesized risk factors that have not yet been thoroughly investigated in many non-Western populations, including Mongolian schoolchildren. Exploring these risk factors could yield insight on which children are more likely to be impacted and on how risk differs across locations and cultures.

OBJECTIVE

The aim of the study was to assess whether elevated scores reported by parents and teachers on the Conners-3 Assessment, a detailed survey tool used to assess ADHD symptoms, correspond with indicators of lower socioeconomic status.

METHODS

We conducted a cross-sectional analysis involving 201 schoolchildren aged 8 to 13 attending a public school in Ulaanbaatar, Mongolia. We investigated associations between factors including student age, parental education level, family income, exposure to cigarette smoke, calcium intake and vitamin D status with Conners-3 scores for inattention, hyperactivity, and defiance/aggression. Cohen's d effect sizes and adjusted mean differences (aMD) for Conners-3 scores between groups were calculated using multivariable analysis.

RESULTS

Our findings revealed large effect sizes between different types of accommodation, a key indicator of socioeconomic status in modern Mongolia, and moderate effect sizes between different levels of parental education. Other findings included that engaging in over 2 hr of outdoor activity was independently associated with an increased inattention score (aMD 0.53, 95% CI [0.03, 1.03]) and increased hyperactivity score (aMD 0.63, 95% CI [0.10, 1.16]). A lower household income was independently associated with an increased inattention score (aMD 0.0005, 95% CI [0.000011, 0.001042]) and increased defiance/aggression score (aMD 0.0009, 95% CI [0.0004, 0.0015]). Factors such as calcium intake, Vitamin D level, exposure to cigarette smoke, and parental employment status did not yield significant associations.

CONCLUSION

We found that Conners-3 scores indicating higher symptoms of ADHD among Mongolian schoolchildren were associated with lower household income and high outdoor activity, and should be further investigated in relation to type of accommodation.

Reciprocal relationships between depressive symptoms and peer attachment in Chinese adolescents: The influence of early parental harsh discipline

BACKGROUND

Despite high social acceptance and prevalence of harsh discipline in China, its long-term cascading effects on adolescent emotional/interpersonal challenges remain unclear.

OBJECTIVE

This study examined whether peer attachment and depressive symptoms would be reciprocally related over time and how early harsh discipline influences these dynamics.

PARTICIPANT AND SETTING

Data was drawn from a longitudinal study over a 9-year period. Parental harsh discipline was reported by both parents at Grade 1-3 (N = 403), and depressive symptoms and peer attachment were reported by adolescents at Grade 7-9 (N = 651).

METHODS

The random intercept cross-lagged panel model was used to assess the reciprocal association between adolescents' depressive symptoms and peer attachment. Furthermore, the predictive effects of early parental harsh discipline were examined.

RESULTS

There was a significant association between adolescents' depressive symptoms and peer attachment at between-person level, and these two constructs were also predicted each other at within-person level expected for the path from peer attachment at Grade 7 to depressive symptoms at Grade 8. Paternal but not maternal early harsh discipline from Grade 1 to Grade 3 could drive the dynamic within-person relations between adolescents' depressive symptoms and peer attachment.

CONCLUSIONS

These findings reveal the antecedent or concurrent factors and their processes that account for early adolescents' depressive symptoms. Intervention targeted at reducing early parental harsh discipline and improving peer relationship quality may be beneficial for alleviating adolescents' depressive symptoms.

NapBiome trial: Targeting gut microbiota to improve sleep rhythm and developmental and behavioural outcomes in early childhood in a birth cohort in Switzerland - a study protocol

INTRODUCTION

The gut-brain axis plays a crucial role in the regulation and development of psychological and physical processes. The first year of life is a critical period for the development of the gut microbiome, which parallels important milestones in establishing sleep rhythm and brain development. Growing evidence suggests that the gut microbiome influences sleep, cognition and early neurodevelopment. For term-born and preterm-born infants, difficulties in sleep regulation may have consequences on health. Identifying effective interventions on the gut-brain axis in early life is likely to have long-term implications for the health and development of at-risk infants.

METHODS AND ANALYSES

In this multicentre, four-group, double-blinded, placebo (PLC)-controlled randomised trial with a factorial design, 120 preterm-born and 260 term-born infants will be included. The study will investigate whether the administration of daily synbiotics or PLC for a duration of 3 months improves sleep patterns and neurodevelopmental outcomes up to 2 years of age. The trial will also: (1) determine the association between gut microbiota, sleep patterns and health outcomes in children up to 2 years of age; and (2) leverage the interactions between gut microbiota, brain and sleep to develop new intervention strategies for at-risk infants.

ETHICS AND DISSEMINATION

The NapBiome trial has received ethical approval by the Committee of Northwestern and Central Switzerland and Canton Vaud, Switzerland (#2024-01681). Outcomes will be disseminated through publication and will be presented at scientific conferences. Metagenomic data will be shared through the European Nucleotide Archive.

TRIAL REGISTRATION NUMBER

The US National Institutes of Health NCT06396689.

Global burden of diseases attributable to childhood sexual abuse and bullying: findings from 1990 to 2019 and predictions to 2035

PURPOSE

Childhood sexual abuse (CSA) and bullying are serious public health concerns that influence child, adolescent, and adult health. This study aims to provide updated estimate of age- and sex- specific deaths and disability-adjusted life years (DALYs) associated with CSA and bullying from 1990 to 2019 at the global, regional, and national levels, and to forecast the global burden of disease attributed to it from 2020 to 2035.

METHODS

We used the data for the number of deaths, DALYs, age-standardized rate (per 100,000 population), percentage change, and population attributable fraction (PAF) from the Global Burden of Disease Study 2019 (GBD 2019) to assess the disease burden attributable to CSA and bullying. We further applied an autoregressive integrated moving average (ARIMA) model to predict the disease burden for the period 2020 to 2035.

RESULTS

In 2019, CSA and bullying accounted for 0.02% and 0.28% of global all-cause deaths and DALYs, respectively. The highest deaths rates were observed in men aged 45-49, and women aged 50-54. The highest DALYs rates were observed in men aged 20-24 and women aged 15-19. The highest age-standardized deaths and DALYs rates were observed in the Eastern Europe region (1.222 [95% UI 0.161, 3.013]) and in High-Income North America region (176.613 [95% UI 79.02, 312.064]) per 100,000 people respectively. El Salvador (1.523 [95% UI 0.209, 3.589]) and Greenland (298.014 [95% UI 138.745, 518.086]) per 100,000 people had the highest age-standardized- deaths and DALYs rates, respectively. The highest age-standardized rates of CSA and bullying related deaths and DALYs were observed in high-socio-demographic Index (SDI) quintile. The age-standardized deaths rate attributable to CSA and bullying is projected to decrease in both sexes between 2019 and 2035, whereas the age-standardized DALYs rate is projected to decrease in male and increase in female between 2019 and 2035.

CONCLUSIONS

CSA and bullying contributed to the global disease burden. Action is needed to develop effective policies. Our study provides policymakers with up-to-date and comprehensive information.

Contributions of Working Memory, Inhibition, and Processing Speed to Writing Composition in Attention-Deficit/hyperactivity Disorder

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often struggle with writing composition, possibly due to deficits in executive functions and processing speed. This study examined 518 children with ADHD and 851 controls to assess these effects. Multiple mediation tested whether executive functions (i.e., working memory, inhibition) and processing speed partially mediated the association between inattention and writing composition, controlling for transcription. Results showed inattention negatively predicted writing composition. Executive function accounted for nearly 10%, and processing speed nearly 17%, of the variance in this association. Findings highlight the contributions of executive functions and processing speed to writing difficulties in ADHD.

The Impact of Pediatric Disorders of Gut-Brain Interaction on the Family: The Mediating Role of Child Somatic Symptoms

BACKGROUND

It is important to identify modifiable factors to reduce the negative impact of pediatric disorders of gut-brain interaction (DGBIs) on the family. The current study examined whether child somatic symptoms and caregiver mental health negatively influenced caregiver and family functioning.

METHODS

Participants were 84 children (8-17 years old) with DGBI symptoms and their caregivers presenting to a specialty DGBI clinic. Participants completed measures assessing demographics, child somatic symptoms, caregiver anxiety and depressive symptoms, and the impact of the child's illness on the family. Regression analyses examined if child somatic symptoms and caregiver and mental health were associated with family outcomes (i.e., Caregiver Health-Related Quality of Life [HRQoL], Family Functioning, Total Family Impact). Mediation analyses examined if child somatic symptoms mediated the association between caregiver mental health and Total Family Impact.

KEY RESULTS

Child somatic symptoms (self- and caregiver-report) were negatively related to Caregiver HRQoL, Family Functioning, and Total Family Impact (ps < 0.01). Caregiver anxiety was related to poorer Caregiver HRQoL (p < 0.001) and Total Family Impact (p = 0.01), while caregiver depression was negatively related to Family Functioning (p = 0.01). Self-report of child somatic symptoms partially mediated the association between caregiver anxiety and depressive symptoms and the Total Family Impact.

CONCLUSIONS AND INFERENCES

Findings indicate that child somatic symptoms are one pathway by which caregiver mental health may amplify the impact of pediatric DGBIs on the family. This highlights the importance of screening for child somatic symptoms and caregiver mental health in pediatric DGBI treatment.

Inhibitory control of speech production in the human premotor frontal cortex

Voluntary, flexible stopping of speech output is an essential aspect of speech motor control, especially during natural conversations. The cognitive and neural mechanisms of speech inhibition are not well understood. Here we have recorded direct high-density cortical activity while participants engaged in continuous speech production and were visually cued to stop speaking. Neural recordings revealed distinct activity in the premotor frontal cortex correlated with stopping speech. This activity was found in largely separate cortical sites from regions encoding vocal tract articulatory movements. Moreover, this activity primarily occurred with abrupt stopping in the middle of an utterance, rather than naturally completing a phrase. Electrocortical stimulation at many premotor sites with inhibitory stop activity caused involuntary speech arrest, which contradicts previous clinical interpretations of this effect as evidence for critical centres of speech production. Together, these results suggest a previously unknown premotor cortical network that supports the inhibitory control of speech, providing implications for understanding both natural and altered speech production.

Frailty in motion: Amnestic mild cognitive impairment and Alzheimer's disease cohorts display heterogeneity in multimorbidity classification and longitudinal transitions

BACKGROUND

Data-driven examination of multiple morbidities and deficits are informative for clinical and research applications in aging and dementia. Resulting profiles may change longitudinally according to dynamic alterations in extent, duration, and pattern of risk accumulation. Do such frailty-related changes include not only progression but also stability and reversion?

OBJECTIVE

With cognitively impaired and dementia cohorts, we employed data-driven analytics to (a) detect the extent of heterogeneity in frailty-related multimorbidity and deficit burden subgroups and (b) identify key person characteristics predicting differential transition patterns.

METHODS

We assembled baseline and 2-year follow-up data from the National Alzheimer's Coordinating Center for amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) cohorts. We applied factor analyses to 43 multimorbidity and deficit indicators. Latent Transition Analysis (LTA) was applied to the resulting domains in order to detect subgroups differing in transition patterns for multimorbidity and deficit burden. We characterized heterogeneity in change patterns by evaluating key person characteristics as differential predictors.

RESULTS

Factor analyses revealed five domains at two time points. LTA showed that two latent burden subgroups at Time 1 (Low, Moderate) differentiated into an additional two subgroups at Time 2 (adding Mild, Severe). Transition analyses detected heterogeneous changes, including progression, stability, and reversion. Baseline classifications and transitions varied according to clinical cohort, global cognition, sex, age, and education.

CONCLUSIONS

Heterogeneous frailty-related subgroup transitions can be (a) detected in aging adults living with aMCI and AD, (b) characterized as not only progression but also stability and reversion, and (c) predicted by precision characteristics.

Mapping vulnerability factors of chronic emotional and social loneliness: A network analysis

BACKGROUND

Chronic loneliness adversely impacts both mental and physical health. As current interventions are only moderately effective, examining vulnerability factors reflected in interpersonal behavior and their relationships with specific chronic loneliness subtypes may provide insights. The present study explored the associations between loneliness vulnerability factors and two subtypes of chronic loneliness: chronic emotional loneliness (a longing for intimate connections) and chronic social loneliness (dissatisfaction with the quantity and quality of one's social network).

METHODS

The sample consisted of 294 university students who had recently started at a new university. Participants completed surveys across three time points, separated by three-month intervals, including questionnaires on emotional and social loneliness, adult attachment styles, interpersonal behavioral styles, and features of emotional disorders. To explore relationships, we used network analysis by estimating a Mixed Graphical Model (MGM), in which chronic emotional loneliness and chronic social loneliness were dichotomized as binary variables (absence versus presence), while vulnerability factors were treated as continuous variables.

RESULTS

The network analysis demonstrated that chronic loneliness subtypes were differentially linked to vulnerability factors. Chronic emotional loneliness was predominantly linked to features of emotional disorders, whereas chronic social loneliness demonstrated a negative conditional association with secure attachment style.

LIMITATIONS

The assessment of chronic loneliness was based on three time points, which does not capture potential fluctuations between assessments.

CONCLUSIONS

These findings highlight the importance of differentiating between chronic loneliness subtypes when examining vulnerability factors. By distinguishing these subtypes, tailored interventions for loneliness can be developed to enhance prevention.

Irritability and stress: Prospective, bidirectional relationships in adolescence

BACKGROUND

Irritability is a transdiagnostic risk factor for psychopathology and interpersonal problems in youth. However, there is little research on the role of life stress in irritability. The association between stress and irritability may be bidirectional, with irritability leading to stress exposure and stress aggravating irritability. Moreover, it is conceivable that there are sex differences in these relationships. Therefore, we examined the prospective, bidirectional relationships between irritability and stressful life events in a sample of adolescents while considering the role of biological sex.

METHODS

We tested multi-group path models investigating bidirectional associations of irritability with dependent and independent episodic stressors in a community sample of 520 adolescents (52.1 % male) across ages 12, 15, and 18.

RESULTS

All models had acceptable fit. For males, dependent stress at age 12 predicted irritability at age 15, which in turn predicted more stress at age 18. For females, irritability at age 12 predicted dependent stress at age 15, which in turn predicted more irritability at age 18. For independent events in males, irritability at age 15 predicted stress at age 18. For females, independent stress at age 12 predicted irritability at age 15, which in turn predicted more stress at age 18.

CONCLUSION

There are significant bidirectional relationships between irritability and episodic stressors, although the relationships varied depending on youth's age, sex, and role in contributing to stressor occurrence.

Psychometric properties of the Persian version of Self-Injurious Thoughts and Behaviors Questionnaire-Nonsuicidal (SITBQ-NS) in an Iranian outpatient sample

Nonsuicidal self-injury (NSSI) is a clinically significant behavior often associated with several psychiatric disorders, underscoring the importance of accurately assessing both NSSI thoughts and behaviors. The Self-Injurious Thoughts and Behaviors Questionnaire-Nonsuicidal (SITBQ-NS) is a self-report instrument designed to assess the full range of NSSI thoughts and behaviors. However, the psychometric properties of the SITBQ-NS have not been adequately investigated, particularly in Eastern cultures. To address this gap, the present study examined the psychometric properties of the Persian version of the SITBQ-NS using data from 350 outpatients (age range: 18-60 years, M = 27.65, SD = 6.61; 20 % male) recruited from two psychiatric hospitals and two university counseling and psychological services centers in Tehran, Iran. Confirmatory factor analysis (CFA) supported the originally proposed two-factor model, showing excellent internal consistency and the expected associations with relevant external correlates. Furthermore, receiver operating characteristic (ROC) analysis revealed excellent sensitivity and specificity for the SITBQ-NS subscale scores, demonstrating its effectiveness in identifying NSSI. Overall, the results suggest that the Persian version of the SITBQ-NS has a robust factor structure and is a reliable, valid tool for assessing NSSI thoughts and behaviors in clinical and research settings in Iran.

Psychometric Properties of the Modified Scale for Suicidal Ideation-Self-Report-Revised With High-Risk Adolescents

In treatment-seeking samples, approximately 40% of adolescents with suicidal ideation transition to engaging in suicidal behavior. Thus, assessment of the severity of suicidal ideation during care is critically important. However, few free, self-report, evidence-based measures that assess for severity of suicidal ideation exist. To address this need, the present study examined several psychometric properties of a revised version of the Modified Scale for Suicidal Ideation-Self Report (MSSI-SR-R) with adolescents. A sample of 284 adolescents (Mage = 15.30; SD = 1.42; range = 12-18; 62.7% White; 75.7% Non-Hispanic/Latinx) enrolled in a partial hospital program (PHP) completed the MSSI-SR-R at the beginning of treatment. The factor structure of the MSSI-SR-R was assessed using bifactor exploratory structural equation modeling. Measurement invariance across sexual identity was also examined. Internal consistency was calculated using omega. Validity was assessed by comparing scores on the MSSI-SR-R to well-validated self-report measures of suicidal thought and behaviors as well as depressive symptoms. Results supported a bifactor model with a general factor and two specific factors (i.e., Desire/Ideation and Plans/Preparation), which was invariant across sexual identity. The MSSI-SR-R total score demonstrated good reliability and was positively associated with measures of suicidal ideation and behaviors as well as depressive symptom severity. Though additional psychometric work is needed, the MSSI-SR-R demonstrated good psychometric properties. It may offer utility in clinical settings as a brief, free, and validated assessment of severity of suicidal ideation.

Impact of fidget devices on anxiety and physiological responses in adults with ADHD

BACKGROUND

Fidgeting devices are popular for managing ADHD, but their effectiveness remains unclear. This study investigated whether fidgeting modulates self-regulation in adults with ADHD during stress, exploring intrinsic versus extrinsic fidgeting with a fidget ball. We hypothesized that individuals with a fidget ball would demonstrate improved self-regulation under stress, reflected by higher heart rate variability (HRV) and lower anxiety levels.

METHODS

Adults with ADHD were randomly assigned to a fidget ball (n = 49) or no fidget ball (n = 24) group. Physiological stress was measured via HRV and intrinsic fidgeting, that is, ankle and wrist movements, were measured via actigraphy. Physiological data were collected at baseline and during the Trier Social Stress Test (TSST). Self-rated anxiety was measured using the State Anxiety Inventory.

RESULTS

Heart rate and fidgeting increased across TSST stages for both groups, with no significant differences in heart rate, HRV, or intrinsic fidgeting between groups. Notably, the fidget ball group had weaker correlations between fidgeting and HRV compared to the no fidget ball group. At baseline, the no fidget ball group showed a positive correlation between intrinsic fidgeting and HRV, suggesting an association between intrinsic fidgeting and self-regulation, however during stress the no fidget ball group showed a significant negative correlation between intrinsic fidgeting and HRV. The relationship between physiological measures and anxiety differed between groups and TSST stages.

CONCLUSIONS

These results provide preliminary evidence that the fidget ball may disrupt the expected association between intrinsic fidgeting and HRV, emphasizing the need for further studies to explore its impact on self-regulation.

Interpersonal Problem Profiles of Personality and Psychopathology Constructs in Chinese Undergraduates and Offenders

The interpersonal problem circumplex is extensively used in the field as an assessment framework for understanding the interpersonal implications of a range of personality and psychopathology constructs. The vast majority of this large literature has been conducted in Western convenience and clinical samples. We computed interpersonal problem structural summary parameters for a range of personality and psychopathology variables in two Chinese offender samples (N = 424 and N = 555) and one undergraduate sample (N = 511) to test how well findings from Western samples generalize to Chinese undergraduates and offenders. The results showed that findings in Western samples generalized reasonably well to Chinese young adult and forensic contexts, although the interpersonal profiles of external variables were less specific in Chinese samples. Compared with undergraduates, interpersonal distress has stronger associations with the mental health of offenders. This study further elaborates the interpersonal correlates of individual differences in personality and psychopathology across cultures and assessment contexts, and it also extends the literature examining interpersonal problems in forensic settings.

Adolescent-Mother Attachment and Dyadic Affective Processes: Predictors of Internalizing and Externalizing Symptoms

Given that adolescence is a critical period for socioemotional development, marked by shifting dynamics in the parent-child relationship, parent-adolescent dyadic regulation may serve as a key mechanism linking the quality of the parent-adolescent relationship to adolescent mental health. The current study investigated two dyadic regulatory processes during mother-adolescent conflictual interactions as interpersonal mechanisms underlying the link between adolescent-mother attachment security and adolescents' internalizing and externalizing symptoms: (a) mutual engagement in positive affect (i.e., dyadic positivity) and (b) mutual engagement in re-coordination following relational mismatches (i.e., dyadic repair). Eighty-six adolescents (Mage = 13.3 years, SD = 0.6, 37% girls) and their mothers participated. Path models revealed that attachment security was associated with greater engagement in dyadic positivity and repair. Moreover, the indirect effect of attachment security on adolescents' symptoms (i.e., internalizing symptoms at age 13 and externalizing symptoms at age 14) was significant via dyadic positivity, but not dyadic repair. Dyadic positivity during mother-adolescent conflictual interactions may be one interpersonal process that underlies the link between a secure child-mother attachment and mental health during adolescence.

Clinical utility and psychometric properties of tools for early detection of developmental concerns and disability in young children: A scoping review

AIM

To explore the clinical utility and psychometric properties of standardized tools for the early detection of developmental concerns or disability in young children.

METHOD

Systematic reviews and clinical practice guidelines containing psychometric data on tools appropriate for use with children from birth to 5 years 11 months were searched for in MEDLINE, CINAHL, Embase, and PsycINFO for the years 2000 to 2023, with no language restrictions.

RESULTS

Eighty-six systematic reviews and six clinical practice guidelines guided identification of tools. A total of 246 tools were identified across domains of neurological, motor, cognition, communication/language, social-emotional, sensory processing, and/or specific diagnostic conditions of attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental coordination disorder, and fetal alcohol spectrum disorder. After critical evaluation, 67 tools were included in the recommendations. Recommendations for screening and diagnostic assessment tools were based on best available evidence for predictive and discriminative validity, diagnostic accuracy, together with consideration of resource use and accessibility.

INTERPRETATION

This comprehensive scoping review provides recommendations on the best tools for primary care, medical, allied health professionals, nursing, and other health workers to detect and identify developmental concerns or disability in young children using evidence-based tools.

Longitudinal associations between appearance evaluation during video chat and body image concerns: A test of the "Perfect Storm" framework

Body image development is a critical task of adolescence, necessitating the study of experiences that shape how adolescents perceive their appearance. Video chatting is one such experience, as default self-view settings render an environment in which one's physical appearance is highly salient. Although numerous studies have examined how digital technology use relates to body image, few have examined video chatting, especially longitudinally. Research is also needed examining how self-oriented digital experiences may indirectly relate to mental health via body image concerns. This three-wave longitudinal study examined bidirectional associations between self-reported appearance evaluation during video chat, body image concerns (appearance esteem and self-objectification), and depressive symptoms among a socio- and ethnically-diverse sample of early-to-middle adolescents (N = 1157, Mage = 13.14, 53 % girls, 47% boys). Bidirectional associations emerged for both boys and girls, in which appearance evaluation during video chat was linked with lower appearance esteem and greater self-objectification. Both appearance esteem and self-objectification mediated the longitudinal association between appearance evaluation during video chat and depressive symptoms. Findings suggest that appearance evaluation during video chat may have important long-term associations with body image and mental health, which future research should explore further, particularly with objective assessments of self-focused attention during video chat.

Sex Differences in Adult Autism Screening: A Comparison of Current Self-Report and Retrospective Parent-Report Measures

This study investigated sex differences in adult autism screening by comparing self-reports on current traits (Autism Spectrum Quotient; AQ) and parent-reports on childhood traits (Relatives Questionnaire; RQ). The aim was to examine the differential contribution of these distinct measures to diagnostic classification in both sexes. The study compared 102 clinically diagnosed autistic adults (30 females) and 152 non-autistic adults (60 females), aged 17-35 years. Participants completed the AQ, while their parents completed the RQ. Multivariate analysis of variance and sex-stratified discriminant analyses were employed to evaluate measurement patterns in males and in females. Significant main effects were found for diagnostic group on both measures and for sex on the RQ only. Group × sex interactions were significant for both measures. Within the autistic group, males and females showed no significant difference in AQ scores, but females scored significantly lower than males on the RQ. Discriminant analyses revealed high classification accuracies for both males (95.1%) and females (96.7%), with different weighting patterns between males (AQ = 0.597 [CI: 0.413-0.720], RQ = 0.712 [CI: 0.553-0.789]) and females (AQ = 0.763 [CI: 0.637-0.898], RQ = 0.478 [CI: 0.191-0.616]). The findings suggest that current self-report may be more central for identifying autism in females, while a more balanced combination of current-self and past-parent reports may be optimal for males. These sex-specific patterns highlight the importance of considering both current self-reported traits and developmental history in adult autism screening, with potential implications for improving diagnostic accuracy across sexes.

Multi-Informant Universal Mental Health Screening for Preschool-Aged Children by Parents and Educators: A PRISMA Systematic Review

Children develop rapidly in the preschool period, making accurate appraisals of mental health (MH) difficult. The preschool years are a key period for early identification of MH concerns and could benefit from multi-informant, universal MH screening (UMHS). This systematic review aimed to identify multi-informant UMHS measures for preschool-aged children, and to examine their clinical utility, effectiveness, and acceptability. Studies reporting the predictive and incremental validity, effectiveness or acceptability of parent and educator-report UMHS measures for children aged 3-5 years were identified through CINAHL, Embase, ERIC, Medline, PsycINFO, Scopus and Web of Science. Studies were excluded if screening was not the primary focus, not universal, single informant, or primarily focussed on Autism Spectrum Disorder. A total of 11 studies using 10 measures was identified. Ten studies screened for broad MH difficulties. Three educator-report and one parent- and educator-report measures had acceptable predictive validity. One study reporting incremental validity found that adding educator-report to parent ratings significantly improved the identification of MH concerns. No studies reported on effectiveness. Three studies that explored acceptability reported strong support for either UMHS in general or specific measures. There are promising results that UMHS can accurately identify child MH concerns in the preschool period using parent and educator reports. However, with few of the examined measures reaching the benchmark standards for predictive validity and only one study examining incremental validity, further research is needed to establish clinical utility. UMHS with preschool populations appears to be acceptable; future studies should further examine multi-informant screening in preschool populations. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; https://www.crd.york.ac.uk/prospero ; registration number: CRD 42022383426).

A developmental perspective on mind wandering and its relation to goal-directed thought

Mind wandering (i.e., thoughts drifting from one topic to another, with no immediate connection to the perceptual field or the ongoing task) is a widespread cognitive phenomenon. There has been increasing research interest in mind wandering in children and adolescents. However, the developmental origins of this phenomenon remain largely unknown. In the present article, I summarize the purported cognitive mechanisms of mind wandering in adults and review the empirical findings on mind wandering and automatic memory retrieval in children and adolescents. I propose a comprehensive account of the emergence of mind wandering in early and middle childhood, covering the development of its central components identified in the adult literature: motivational and emotional processes, episodic and semantic processes, perceptual decoupling, and meta-awareness. Paying special attention to the roles of developing motivation and executive control, I then address the relationship between mind wandering and goal-directed thought in children.

Exploring the associations between the presence, characteristics, and biopsychosocial covariates of pain and lifetime depression in adolescents: A cross-sectional ABCD study analysis

INTRODUCTION

Depression and pain co-occur, even during adolescence. However, there is limited knowledge on the association between pain and lifetime depression, and which biopsychosocial measures are associated with this co-occurrence.

METHODS

Cross-sectional analysis of the Adolescent Brain and Cognitive Development (ABCD) two-year follow-up. We explored associations between the presence and characteristics of past month pain (intensity, duration, activity limitations, and number of pain sites) and lifetime depression using logistic regression. We explored associations of brain structure, physical, behavioural, emotional, social, and cognitive measures with lifetime depression and past month pain compared to having had one or neither condition using multinomial logistic regression.

RESULTS

A total of 5211 adolescents (mean age = 12.0 years) who had: (1) no lifetime mental ill-health and no pain (n = 3327); (2) pain only (n = 1407); (3) lifetime depressive disorder but no pain (n = 272); and (4) lifetime depressive disorder and pain (n = 205) were included. Pain presence was associated with lifetime depression (OR[95%CI]: 1.76 [1.45, 2.13], p < 0.001). Pain-related activity limitations (1.13 [1.06, 1.21], p < 0.001) and the number of pain sites (1.06 [1.02, 1.09], p < 0.001) were associated with lifetime depression. Various behavioural, emotional, social, and cognitive, but not brain structure or physical measures, were associated with lifetime depression and past month pain.

LIMITATIONS

Longitudinal analyses should validate prognostic markers for predicting co-occurring depression and pain.

CONCLUSIONS

Results support an association between the presence and characteristics of pain and lifetime depression during adolescence and could indicate the need for more integrated recognition and clinical care of youth experiencing both depression and pain.

Parents' Experiences of Raising 7- to 11-Year-Old Children With ADHD and Perception of a Proposed Parenting Program: A Qualitative Study

OBJECTIVE

To examine the experiences of Australian parents raising primary school-aged children with ADHD and gather feedback on a proposed ADHD parenting program.

METHODS

Reflexive thematic analysis of semi-structured interviews undertaken with 11 Australian parents of 7- to 11-year-old children with ADHD. Interviews were conducted over Webex, audio recorded, transcribed verbatim, and analyzed in NVivo Ltd. software.

RESULTS

We identified four themes: (1) "I love my child but their ADHD traits are challenging," (2) "Compliance, control, and completion," (3) "It's hard, burdensome, and exhausting and I can feel like I'm alone," and (4) "What a welcome relief."

CONCLUSION

Parents report that although raising neurotypical children is difficult, the presence of childhood ADHD increases the emotional and support burden placed on them. Parents were also very interested in and supportive of the proposed ADHD parenting program. The program aims to enhance parents' understanding of the neurocognitive implications of ADHD and to foster secure parent-child attachment, attuned parental responsiveness, and age-appropriate development of traits that promote well-being, adaption and recovery in people with ADHD.).

Digit-in-Noise Test as a Hearing Screening Test for Individuals With Intellectual Disability

BACKGROUND

Diagnosis of intellectual disability (ID) may overshadow, or co-occur with, hearing impairment, but screening is frequently inaccessible due to various factors that prevent successful test execution. There is a pressing need for easily, locally administered hearing tests. This study aimed to assess the efficacy of the digit-in-noise (DIN) test, as well as three variations of it, as a hearing screening for individuals with mild to moderate ID. Additionally, we explored correlations between participant characteristics and cognitive-linguistic abilities, with DIN test performance.

METHOD

Forty participants with ID aged 21-40 were recruited from two supported employment centres, 31 of whom met full inclusion criteria. Controls were 20 typically developed (TD) participants, aged 21-40. The original DIN test (DIN(3)) was administered, and those unable to recall the three digits were administered a version with two digits (DIN(2)). Participants unable to successfully complete DIN(3) or DIN(2) were administered versions with added visual and verbal performance feedback.

RESULTS

A significant difference in speech receptive threshold in noise (SRTn) between DIN(2) and DIN(3) was only present for the ID group. A moderate negative relationship between DIN(2) SRTn and vocabulary and a positive relationship with age was found for the ID group; no correlation was found with digit span or matrices. The DIN(2) SRTn was correlated with the average hearing level of pure tones measured by audiometry.

CONCLUSIONS

Our findings highlight the DIN(2) as the most effective version, as its signal-to-noise ratio (SRTn) threshold was closest to the typically developed (TD) control group. This study is the first step towards developing a hearing screening test for individuals with ID who are at elevated risk of impairment and who have insufficient evaluation access. Our findings suggest that adults with mild to moderate ID can sufficiently perform the adapted DIN(2) as a hearing screening test.

Feeling socially connected to others is linked to better emotion regulation in adolescent girls' daily lives: An ecological momentary assessment study

Developing effective emotion regulation ability to manage negative emotion (NE) is critical during adolescence. Social baseline theory posits social connectedness may impact adolescents' everyday emotion regulation. This study examined the relation between social connectedness and NE after a negative social interaction (emotion regulation) and whether contextual factors moderate the association. Adolescent girls (N = 114; Mage = 12.26, SD = 0.8) from a midsized Midwestern U.S. city (67.5% White, 19.3% Black/African American, 9.6% biracial, 1.8% Asian, 1.8% Native American/other race; 8.8% Latinx) completed a 16-day ecological momentary assessment (EMA) protocol, reporting current NE, current social context and social connectedness, peak NE, and receipt of co-regulatory support. Multilevel models were used to examine direct associations of social connectedness on emotion regulation, defined as current NE regressed on peak NE, and moderation of the social connectedness-emotion regulation association by social context, co-regulatory support, and adolescent shyness. Greater within- and between-person social connectedness was associated with better emotion regulation (greater reductions in NE). However, the within-person association depended on girls' social context: Compared to being with solely peers and/or non-family, being with family was associated with a weaker association between social connectedness and emotion regulation. Similarly, receiving in-the-moment co-regulatory support was associated with a weakened link between within-person social connectedness and emotion regulation, which appeared to be driven by reports of co-rumination. Results indicate that social connectedness is associated with better emotion regulation among girls, particularly in interactions with peers and non-family compared to family, highlighting the value of social connection with peers and non-family members. However, co-rumination disrupts the benefits of social connectedness, suggesting social connectedness is not beneficial during maladaptive co-regulatory processes.

Social isolation, loneliness, and their joint effects on cognitive decline and incident Alzheimer's disease: Findings from the Chicago health and aging project

BACKGROUND

There has been contradictory evidence on the prospective associations between social isolation/loneliness (SI/L) and cognitive decline (CD). There is also a scarcity of large and diverse population-based cohort studies examining SI/L that have confirmed clinical diagnoses of Alzheimer's Disease (AD). Notably, beyond individual associations, whether the effects of SI/L compound and accelerate CD and incident AD are not known.

OBJECTIVES

We hypothesized that SI and L, independently, would be associated with CD and incident AD to a similar extent, and the association of SI with CD and incident AD would be higher in lonely older adults.

DESIGN

Prospective cohort study.

SETTING

Urban Chicago areas.

PARTICIPANTS

We analyzed data in the Chicago Health and Aging Project (CHAP), which comprised 7,760 biracial community-dwelling older adults [mean age (standard deviation (SD))=72.3 (6.3); 64 % Black & 63 % women; mean (SD) of follow-up=7.9 (4.3) years].

INTERVENTION (IF ANY)

NA MEASUREMENTS: Linear mixed and logistic regression models were used to regress CD and incident AD separately on the SI index/L.

RESULTS

SI index and L were significantly associated with CD, with one-point increase of beta estimate (SE, p-value) = -0.002 (0.001,0.022) and -0.012 (0.003,<0.001), respectively. Given that the SI index ranges from 0 to 5 and the L from 0 to 1, they had similar effect sizes. Similarly, there were significant associations between SI index and incident AD, odds ratio (95 % CI, p-value) = 1.183 (1.016-1.379,0.029), and between L and incident AD, 2.117 (1.227-3.655,0.006). When stratified by loneliness status, compared to older adults who were not isolated and not lonely, older adults who reported being socially isolated and not lonely experienced accelerated CD, -0.003 (0.001,0.004), despite no significantly increased odds of incident AD.

CONCLUSIONS

SI/L had significant associations with CD and incident AD. Notably, socially isolated older adults who reported not being lonely appeared to be most socially vulnerable to CD. These findings suggest a specific at-risk subgroup of socially vulnerable older adults for future targeted interventions to improve cognitive health.

Caregiving stress and maternal mental health during the COVID-19 pandemic

It has now been extensively documented that parental mental health has deteriorated since the beginning of the COVID-19 pandemic. Although pandemic-related stress has been widespread, parents faced the unique challenge of navigating remote schooling. Parental oversight of children's education, loss of access to school supportive resources, and the challenges of remote learning may have been most problematic for parents of children with or at elevated risk for mental health difficulties. In the current study, we examined interactive effects of parent-reported pandemic-related caregiving stress and child internalizing and externalizing problems on parental depressive symptoms in a community-based cohort (N = 115) in the Northeast of the United States. Results indicated that parents experiencing higher levels of pandemic-related caregiving stress whose children exhibited elevated externalizing behaviors reported heightened levels of depressive symptoms. Greater child internalizing problems were associated with higher parental depressive symptoms independent of caregiving stress. These findings point to conditions that might heighten risk for parent mental health challenges in the context of ongoing remote or hybrid learning and pandemic-associated restrictions. Further, the findings point to conditions and characteristics that may be screened to identify and intervene with vulnerable families to mitigate mental health problems.

Why are adolescent girls more prone to stress-induced depression? Testing moderation, mediation, and reciprocal causality in a three-wave longitudinal study

The prevalence of depression in females after puberty is twice as high as in their male peers. Considering numerous studies that associate the onset of depression with stress, we tested three hypotheses to elucidate the role of biological sex in stress-induced depression on a sample of 1618 secondary school students from Zagreb, Croatia (Males, N = 671, Mage at baseline = 16.4 years, SD = 0.60; Females, N = 947, Mage at baseline = 16.3 years, SD = 0.65), in a three-wave longitudinal study. The study tested the hypotheses regarding: (a) sex-related differences in reciprocal causation of stress and depression, (b) the moderating role of biological sex in the effect of stress on depression, and (c) the mediating role of stress on the pathway from biological sex to depression. The data were analyzed using a random intercept cross-lagged panel model (RI-CLPM) and standard moderation and mediation analyses. Females consistently reported higher levels of stress (Cohen's d ranged from 0.76 to 0.83) and depression (0.59 to 0.69) compared with their male peers. The hypothesis that biological sex moderates the effect of stress on depression was not supported, as the interaction between sex and subjective stress was mostly nonsignificant or small in magnitude, with standardized regression coefficients not exceeding .126. The hypothesis of sex-differentiated reciprocal causation of stress and depression was also not supported since cross-lagged relations were found to be mostly nonsignificant, indicating that the association between stress and depression rests largely on stable dispositions. The data supported the hypothesis of stress mediating the effect of biological sex on depression, with indirect effects ranging from 0.23 to 0.25 (95% CI 0.19 to 0.30). The findings suggest that the increased vulnerability of adolescent girls may lie in stable dispositions possibly responsible for higher sensitivity and less effective coping with stressful situations that lead to depression.

Irritability as a Transdiagnostic Construct Across Childhood and Adolescence: A Systematic Review and Meta-analysis

This meta-analytic review examined irritability across childhood and adolescence as it relates to symptoms of common mental health disorders in these periods. Of key interest was whether the relationship between irritability and symptom severity varies according to symptom domain. This was tested at the level of broad symptom dimensions (internalizing versus externalizing problems) as well as discrete diagnostic domains (e.g., anxiety, depression, oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder; autism spectrum disorder). Following PRISMA guidelines, a systematic search of five databases was conducted to identify studies reporting on associations between irritability and mental health symptoms in samples of children aged 2-18 years. Meta-analytic tests based on random effects models examined concurrent and longitudinal associations between irritability and symptom severity. Meta-regression tested potential moderators including symptom domain, child age, sex, informant type, and study quality. 119 studies met inclusion criteria with a total of 122,456 participants. A significant and positive association was found between irritability and severity of concurrent overall psychopathology in the order of a moderate effect size, while small to moderate effect sizes characterized the association between irritability and later mental health outcomes in prospective data. Further variation in this association was seen across specific diagnostic domains and methodological moderators. Findings support the conceptualization of irritability as a transdiagnostic construct reflecting emotion dysregulation across diverse forms of psychopathology in childhood and adolescence. Further research into the risk mechanisms underlying irritability is needed, in addition to translational approaches to early intervention.

Neurocognitive Functioning in Tourette Syndrome: From Research Findings to Clinical Implementation

Individuals living with Tourette syndrome (TS) may benefit from cognitive assessment, as it may elucidate specific difficulties for which someone could receive accommodation and highlight relative strengths to build upon. Eventually, cognitive assessment could help predicting symptom trajectory or treatment outcome. However, the literature on cognition in TS is often equivocal, which may be at least partly attributed to small samples, inconsistent consideration of co-occurring conditions, psychotropic medication, and developmental influence. Here, we aimed to provide a comprehensive overview of the literature on cognition in TS, to disentangle conflicting findings and make suggestions of how the findings can be applied to promote better outcomes.

The psychometric properties of the Mini Social Phobia Inventory in a treatment seeking sample of children and their caregivers

The Mini Social Phobia Inventory (Mini-SPIN) is a short 3-item measure of social anxiety disorder (SAD). Using existing data, the current study examined the psychometric properties of the Mini-SPIN using a large, treatment seeking sample of children aged 6-16 years with data available for youth (n = 695, 170) and their caregivers (n = 703, 177) at pre-treatment and follow-up, respectively. The ability of the Mini-SPIN to discriminate between those with and without SAD was examined at pre-treatment and 6-month follow-up, across caregiver and child report. The criterion group validity, internal consistency and construct validity of the measure was also examined. Results revealed that at pre-treatment the Mini-SPIN demonstrated good discriminant validity in detecting cases of SAD from non-SAD (with cut-off of 4 on child report, and 6 on caregiver report). At 6-month follow-up, the discriminant ability of the Mini-SPIN was found to be less than acceptable for child reported scores, but acceptable for caregiver reported scores. The Mini-SPIN further demonstrated good criterion group validity, internal consistency and construct validity across caregiver and child report. Overall, the findings from the current study lend further support for the use of the Mini-SPIN as a screening tool for SAD.

Neural Correlates of Irritability and Potential Moderating Effects of Inhibitory Control

Background

Irritability affects up to 20% of youth and is a primary reason for referral to pediatric mental health clinics. Irritability is thought to be associated with disruptions in processing of reward, threat, and cognitive control; however, empirical study of these associations at both the behavioral and neural level have yielded equivocal findings that may be driven by small sample sizes and differences in study design. Associations between irritability and brain connectivity between cognitive control and reward- or threat-processing circuits remain understudied. Furthermore, better inhibitory control has been linked to lower irritability and differential neural functioning among irritable youth, suggesting that good inhibitory control may serve as a protective factor.

Methods

We hypothesized that higher irritability scores would be associated with less positive (or negative) connectivity between cognitive control and threat-processing circuits and between cognitive control and reward-processing circuits in the Healthy Brain Network dataset (release 10.0; N = 4135). We also hypothesized that these associations would be moderated by inhibitory control such that weaker associations between irritability and connectivity would be detected in youths with better than with worse inhibitory control. Regression models were used to test whether associations between irritability and between-network connectivity were moderated by inhibitory control.

Results

Counter to our hypothesis, we detected higher irritability associated with reduced connectivity between threat- and reward-processing and cognitive control networks only in 5- to 9-year-old boys. Inhibitory control did not moderate associations of irritability with between-network connectivity.

Conclusions

Exploratory findings indicate that reduced between-network connectivity may underlie difficulty regulating negative emotions, leading to greater irritability.

Anhedonia in flux: Understanding the associations of emotion regulation and anxiety with anhedonia dynamics in a sample with major depressive disorder

Negative rumination and emotion regulation difficulties have been consistently linked with depression. Despite anhedonia-the lack of interest in pleasurable experiences-being a cardinal symptom of depression, emotion regulation of positive emotions, including dampening, are considered far less in the literature. Given that anhedonia may manifest through blunted responses to previously positive or enjoyable experiences, it is vital to understand how different positive emotion regulation strategies impact anhedonia symptom severity and how it can vary or change over time. Moreover, understanding the detrimental or protective nature of positive emotion regulation on anhedonia can aid with future anhedonia-focused treatments. Therefore, the current study examined the temporal association between anhedonia dynamics and two different emotion rumination strategies in response to positive emotions: dampening and positive rumination. Depressed persons (N = 137) completed baseline measures of positive emotion regulation, difficulties regulating negative emotions, and anxiety, and completed ecological momentary assessments three times per day for 90 days regarding their depressive symptoms, including anhedonia. We assessed baseline dampening and amplifying scores to predict anhedonia dynamics through four linear models with interactions. Providing partial support for our hypotheses, results indicate that amplifying positivity is positively associated with fluctuations, instability, and acute changes in anhedonia over the course of 90 days; however, neither dampening, difficulties regulating negative emotions, nor anxiety were related to anhedonia dynamics. The current findings suggest that amplifying positivity may be able to predict changes in anhedonia over time and should further be examined as a potential protective factor of anhedonia.

Operationalizing In-session Treatment Engagement Strategies and Behaviors for Adolescents With ADHD and Their Parents

OBJECTIVE

Many treatment engagement challenges are documented for adolescents with ADHD. Across contexts, helping professionals (i.e., therapists, prescribers, educators, coaches) might benefit from an engagement strategy toolbox to facilitate work with adolescents with ADHD and their families.

METHOD

The current study describes the development and psychometric testing of the ADHD Engagement Process Code (AEPC), a measure that operationalizes engagement strategies in the context of a blended behavioral/motivational interviewing treatment for adolescent ADHD (Supporting Teens' Autonomy Daily; STAND). The AEPC also operationalizes in-session parent and adolescent engagement-related behaviors. Behavior counts and global codes were coded for 840 audio-recorded STAND sessions delivered by 21 therapists to 121 adolescents. Subsets of tapes were double coded using the AEPC's parent, adolescent, and therapist coding systems to assess kappa for line-by-line verbalizations and intraclass correlations for session-level behavior counts and global scores. Construct validity was assessed. We explored low frequency and low variability codes and examined correlations between codes.

RESULTS

AEPC codes possessed good to excellent inter-rater reliability and strong discriminant validity. Three low frequency codes and one low variability global were identified indicating opportunities for AEPC refinement.

CONCLUSIONS

The AEPC is publicly available (https://osf.io/kshfy/) and offers a library of adolescent-specific codes for those interested in measuring provider, parent, or adolescent engagement behaviors in relevant populations or contexts.

Loudness of snoring, not apnea-hypopnea index, is associated with hyperactivity behavior in snoring children and adolescents

STUDY OBJECTIVES

It is unknown whether loudness of snoring or hypoxic burden are related to higher hyperactivity scores in habitually snoring children and whether this effect is impacted by the severity of sleep-disordered breathing (SDB). This study investigates the prevalence of hyperactivity in children with habitual snoring and the independent effects of loudness of snoring, as reported by the parents, hypoxic burden and obstructive sleep apnea syndrome's severity (OSAS) on hyperactivity, as measured by the Conners' Parent Rating Scale-Hyperactivity Index (CPRS-HI).

METHODS

Children with habitual snoring aged 3-18 years were recruited for an overnight polysomnography reporting apnea-hypopnea index (AHI) and hypoxic burden, acoustic rhinometry, clinical examination and parental questionnaires assessing snoring loudness and CPRS-HI.

RESULTS

The study analysis included 512 children (median (25th; 75th percentile) age, 10.6 (7.6; 13.4) years; 295 (58 %) males), of whom 358 (70 %) were overweight or obese and 179 (35 %) had an obstructive AHI >3/h. Findings revealed that 36 % [95 % CI: 32%-41 %] of children exhibited increased hyperactivity/impulsivity, and 25 % [21%-29 %] showed emotional lability. Snoring loudness was significantly correlated with higher hyperactivity scores, particularly for hyperactivity/impulsivity, while hypoxic burden showed no significant association (rhos = -0.09; p = 0.082). Multivariate analysis showed that the presence of very loud as compared to mildly quiet snoring was an independent predictor of hyperactivity symptoms, while an obstructive AHI >3/h was associated with decreased hyperactivity scores.

CONCLUSIONS

These results suggest that the loudness of snoring, independent of OSAS severity, contributes to hyperactivity in children.

Linking Parent-Adolescent Congruence in Perceived Parental Emotional Support to Adolescent Developmental Outcomes: The More, the Better?

Parents and their children can have congruent or incongruent perceptions of parenting, which has been shown to have downstream effects on certain adolescent outcomes. However, little is known about whether such effect holds for various domains of developmental outcomes or across adolescent boys and girls. Investigating 2268 parent-girl (Mage = 15.73, SDage = 0.29, 75.5% were mothers) and 2090 parent-boy (Mage = 15.75, SDage = 0.29, 71.8% were mothers) dyads from Hong Kong, this study examined the associations between parent-adolescent (in)congruence and adolescent emotional symptoms, positive emotions, and academic performance. Polynomial regression and response surface analyses revealed that both congruence and incongruence were linked to emotional symptoms and positive emotions in varying patterns, but only congruence was tied to academic performance. Associations between (in)congruence and developmental outcomes generally were similar between boys and girls. These findings underscore the importance of decomposing (in)congruence effects in family processes and emphasizing the complexity of adolescent development.

Emotion-specific recognition biases and how they relate to emotion-specific recognition accuracy, family and child demographic factors, and social behaviour

The errors young children make when recognising others' emotions may be systematic over-identification biases and may partially explain the challenges some have socially. These biases and associations may be differential by emotion. In a sample of 871 ethnically and racially diverse preschool-aged children (i.e. 33-68 months; 49% Hispanic/Latine, 52% Children of Colour), emotion recognition was assessed, and scores for accuracy and bias were calculated by emotion (i.e. anger, sad, happy, calm, and fear). Child and family characteristics and teacher-reported social behaviour were also collected. Multilevel structural equation modelling revealed emotion-specific recognition accuracies varied between 36 and 65% whereas biases varied between 4 and 13%. Anger was the strongest bias followed by sad, happy, fear, and calm, in contrast to the pattern for accuracy - happy, sad, angry, fear, and calm. More variance was explained in emotion-specific recognition accuracies by child and family characteristics - 7-38% - than biases - 3-7%. Negatively-valanced emotion recognition biases associated with positively-valanced accuracies, and positively-valued emotion recognition biases associated with negatively-valued accuracies. Biases did not have meaningful associations with social behaviour. This study highlights that children's emotion recognition errors may partially be systematic, but future studies are needed to understand the underlying cognitive mechanisms.

Child maltreatment and psycho-social impairments among child laborers in rural Bangladesh

PURPOSE

The current study focused on exploring the impact of maltreatment of child laborers on their psychosocial health condition from the views of their parents.

METHODS

A total of 100 parents of child laborers were recruited using snowball sampling. The structured questionnaire comprised two validated scales including ISPCAN Child Abuse Screening Tool (ICAST-P), and Paediatric Symptom Checklist (PSC) were used for the survey. Factor analysis and multivariable linear regression analysis were performed to examine the data using SPSS version 26, and Stata version 16.1.

RESULTS

A three-factor model consisting of internalizing, externalizing, and attention associated psycho-social impairments of child laborers were derived from the 35-item scale of PSC tool and represented a good fit to the data. A mean estimate of maltreatment indicates that a majority of child laborers are maltreated psychologically, followed by physical maltreatment and neglect. The factor analysis resulted that maltreated child laborers are highly prone to exhibit internalized psycho-social difficulties, followed by externalized and attention-associated emotional and behavioral difficulties among child laborers. The regression model further depicts that child laborers, who had been physically and psychologically maltreated, are significantly more likely to be affected by internalized and attention-related psycho-social impairments.

CONCLUSIONS

The study concluded that victimized child laborers exhibited significant internalized, as well as attention-related problems. These findings may be useful for future studies that examine emotional and behavioral problems among maltreated child laborers and, therefore, for developing prevention strategies.

Daily association between parent-adolescent emotion contagion: The role of parent-adolescent connectedness

Emotion contagion between parents and adolescents is crucial for understanding adolescents' emotional experiences. However, little is known about how emotion contagion unfolds in daily life and the unique contributions of parent-adolescent relationships. This study examines the associations between parent and adolescent positive and negative emotions, and the moderating role of daily parent-adolescent connectedness. Participants were 191 Taiwanese adolescents (Mage = 12.93; SDage = 0.75; 53% female) and their parents who completed 10-day diary reports of emotions and parent-adolescent connectedness. Results indicate that higher daily parent negative emotions were associated with more adolescent negative emotions, and higher average parent negative emotions were associated with greater average negative emotions and fewer positive emotions in adolescents. Similar bidirectional effects were also found in adolescent-to-parent emotion contagion. Moreover, on days when connectedness was high, parent negative emotions were not associated with adolescent negative emotions but were related to increased positive emotions. Parent positive emotions were related to more positive emotions and fewer negative emotions when connectedness was low. The findings provide important insights into daily parent-adolescent emotion contagion and highlight parent-adolescent connectedness as a modifying factor in shaping dyadic emotional processes.

Emotional reactivity mediates and moderates the longitudinal associations between mothers' depressive symptoms and behavioral problems in youth

Despite the well-established link between mothers' depressive symptoms and youth behavioral problems, it remains unclear whether the mechanism by which mothers' depressive symptoms promote behavioral problems may also be related to individual differences in this relation. Following the three-variable system integrating mediation and moderation, this study used an integrative model to simultaneously examine the mediating and moderating role of emotional reactivity in the longitudinal associations between maternal depressive symptoms and internalizing and externalizing problems in youth. Participants were 1060 youth and their mothers from the NICHD Study of Early Child Care and Youth Development (49.7% boys, 81.6% white). Mothers reported their own depressive symptoms at nine waves from infancy through the fifth grade. They also rated adolescents' emotional reactivity in the fifth grade and behavioral problems in the fifth and sixth grades. The results showed that emotional reactivity mediated the longitudinal relations between maternal depressive symptoms and internalizing and externalizing problems in youth. The results also supported the moderation of emotional reactivity. That is, mothers' depressive symptoms were associated with high levels of internalizing and externalizing problems, particularly among youth who were high in emotional reactivity. The findings highlight the dual role of emotional reactivity to better understand the associations between mothers' depressive symptoms and offspring behavioral problems, and emphasize the need to target emotional reactivity to alleviate the adverse impacts of maternal depressive symptoms on behavioral adjustment in early adolescence.

The impact of adverse childhood experiences on postpartum post-traumatic stress disorder in women: A prospective cohort study in China

BACKGROUND

Women are more prone to experience adverse childhood experiences (ACEs), placing them at higher risk of postpartum mental health disorders. However, research on ACEs, particularly their association with postpartum Post-Traumatic Stress Disorder (PTSD) in non-Western contexts, is limited.

OBJECTIVE

To utilize a cumulative risk approach and latent class analysis (LCA) to operationalize ACEs among postpartum women in China and examine their association with postpartum PTSD.

METHODS

In this prospective cohort study, 856 eligible participants from a tertiary hospital in Guangdong province of China between October 2022 and August 2023 completed assessments of demographic and obstetric characteristics, and ACEs within 2-3 days postpartum, followed by PTSD evaluation at 42 days postpartum. The cumulative risk approach and LCA were employed to operationalize ACEs, and their association with postpartum PTSD was assessed using log-binomial regression models, adjusting for potential confounders.

RESULTS

Among the participants, 80.4 % (688/856) reported ACEs, with 18.2 % experiencing four or more ACEs, a threshold above which there was a particularly higher risk of postpartum PTSD in the adjusted model (OR = 8.27, 95 % CI = 3.08-22.20). LCA identified three groups: low ACEs, household and community violence, and multiple ACEs, with women in the multiple ACEs group exhibiting the most severe postpartum PTSD symptoms in the adjusted model (OR = 4.39, 95 % CI = 1.58-12.24).

CONCLUSIONS

This study demonstrates that ACEs are a significant risk factor for postpartum PTSD, especially for women who have experienced four or more ACEs, or multiple ACEs, placing them at particularly high risk for developing postpartum PTSD.

Impact of an 8-Week, Intensive Summer Treatment Program on Improving Coercive Caregiver-Child Interactions Among Children With and Without Callous Unemotional Traits

The coercive process is the primary explanatory mechanism implicated in the maintenance of disruptive behavior disorders (DBDs), and understanding the coercive cycle may be especially important for caregivers with children with elevated callous-unemotional (CU) traits. The purpose of the current pilot study is twofold. First, we assessed whether the Summer Treatment Program (STP), an established intensive behavioral intervention for children with DBDs, reduced coercive caregiver-child interactions using a novel parent-report measure of coercive interactions. We then sought to assess whether the STP improved coercive caregiver-child interactions among children with elevated CU traits (i.e., moderated the effect). Thirty-three caregivers and their children who had been diagnosed with DBDs participated in the STP, which involved the children receiving behavior modification for 9 hours per day and caregivers attending a weekly behavioral parent training group session over the course of 8 weeks. Children (Mage = 8.51 years old, SD = 1.70, range 6-12) were primarily male (78.5%) and Hispanic/Latine (84.8%). A linear multilevel model revealed a statistically significant improvement in caregiver-child coercive interactions from pre- to posttreatment. However, child pretreatment CU traits moderated this effect such that families with children with elevated CU traits did not show improvement in caregiver-child coercive cycles following treatment. Results suggest the benefits of intensive behavioral treatment on the caregiver-child coercive cycle for many families, but the need to modify the intensity or dose of treatments for those with children with DBDs and elevated CU traits.

Genetic and environmental contributions to individual differences in visual attention and oculomotor control in early infancy

Infants differ in their level of eye movement control, which at the extreme could be linked to autism. We assessed eye movements in 450 twins (225 pairs, 57% monozygotic, 46% female, aged 5-6 months) using the gap-overlap eye-tracking task. Shorter latency in the gap condition was associated with having more parent-rated autistic traits at 2 years. Latency across the task's three conditions was primarily explained by one highly heritable latent factor likely representing individual differences in basic oculomotor efficiency and/or in visual information processing. Additionally, disengagement of attention was linked to unique genetic factors, suggesting that genetic factors involved in visual attention are different from those involved in basic visual information processing and oculomotor efficiency.

Playful activities mitigate relations between parental mental health difficulties and child verbal outcomes

This study examined the role of parental involvement in the home learning environment in the association between parental mental health and child cognitive performance. In a sample of 174 three- to five-year-old children (52% female, 97% White, 7% Hispanic, 2019-2022), playful activities moderated the relation between parental general depression and child verbal reasoning and acquired verbal knowledge. However, there was no evidence that parental involvement moderated the association between parental mental health and child spatial reasoning. These results improve our understanding of the pathways by which parental mental health, even in a non-clinical community sample, relate to child outcomes and raise the possibility of leveraging playful activities as one mechanism to alleviate the potential role of parental mental health difficulties.

Systematic review: REM sleep, dysphoric dreams and nightmares as transdiagnostic features of psychiatric disorders with emotion dysregulation - Clinical implications

BACKGROUND

Fragmented rapid eye movement (REM) sleep disrupts the overnight resolution of emotional distress, a process crucial for emotion regulation. Emotion dysregulation, which is common across psychiatric disorders, is often associated with sleep disturbances. This systematic review explores how REM sleep and nightmares affect emotion processing and regulation in individuals with psychiatric disorders where emotion dysregulation is a key concern, suggesting novel sleep-related treatment pathways.

METHODS

We performed a PRISMA-compliant systematic search of the PUBMED, Web of Science, and EBSCO databases from January 1994-February 2023. This systematic review targeted studies on REM sleep, nightmares, and emotion regulation in a postpubescent clinical population with affective dysregulation. The quality of the studies was assessed via the Newcastle‒Ottawa Scale (NOS), adapted for cross-sectional studies.

RESULTS

From the 714 screened records, 28 articles met the inclusion criteria and focused on REM sleep, dreams, or nightmares in individuals with mood disorders (k = 8), anxiety disorders (k = 1), posttraumatic stress disorder (PTSD) (k = 16), non-suicidal self-injury (NSSI), personality disorders (k = 2), and autism (k = 1). Fifteen studies used objective sleep measures, seventeen used self-reported assessments, six included treatment components, eight investigated nightmares, and three examined dreams. NOS scores ranged from moderate to high.

CONCLUSIONS

REM sleep disturbances represent a transdiagnostic feature across psychiatric disorders and are crucial for emotion regulation. Nightmares are associated with suicidal behaviour and emotion dysregulation. Targeted sleep interventions may improve emotion regulation and mental health outcomes. Future research should explore the role of REM sleep in disorder prognosis to develop tailored interventions.

Callous-unemotional traits, cognitive functioning, and externalizing problems in a propensity-matched sample from the ABCD study

BACKGROUND

Many studies show that both callous-unemotional (CU) traits (e.g., low empathy, lack of guilt) and cognitive difficulties increase risk for externalizing psychopathology across development. However, other work suggests that some aggression (e.g., relational, proactive) may rely on intact cognitive function, which could vary based on the presence of CU traits. Moreover, no prior research has adequately accounted for common risk factors shared by CU traits, cognitive difficulties, and externalizing problems, which confounds conclusions that can be drawn about their purported relationships. The current study addressed these knowledge gaps by leveraging rigorous propensity matching methods to isolate associations between CU traits and different dimensions of cognitive function and externalizing problems.

METHODS

Associations between CU traits, cognitive functioning, and externalizing outcomes were tested within dimensional (n = 11,868) and propensity-matched group-based (n = 1,224) models using data from the Adolescent Brain Cognitive Development Study®, with rigorous statistical control for shared sociodemographic risk factors. Cross-sectional outcomes were parent-reported symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), and attention deficit hyperactivity disorder (ADHD). Longitudinal outcomes were child-reported overt and relational aggression.

RESULTS

CU traits were uniquely related to more parent-reported CD, ODD, ADHD symptoms, as well as more child-reported aggressive behaviors. Effects of cognitive difficulties were domain specific and were not consistent across dimensional and propensity matched models. There was minimal evidence for divergent associations between CU traits and externalizing outcomes as a function of cognition (i.e., no moderation).

CONCLUSIONS

Rigorous control for sociodemographic factors within propensity-matched models establish CU traits as a robust and unique risk factor for externalizing psychopathology, over and above difficulties with cognitive functioning.

Concurrent Associations Between Callous-Unemotional Traits, Moral Disengagement, and Bullying Perpetration in Adolescence

The aim of the current study was twofold. The first aim was to examine whether callous-unemotional (CU) traits are directly related to moral disengagement and bullying perpetration as well as whether CU traits are indirectly related to bullying perpetration mediated by moral disengagement among adolescents. The second aim was to examine whether the three distinct dimensions of CU-callousness, uncaringness, and unemotionality-are directly related to moral disengagement and bullying perpetration, as well as whether they are indirectly related to bullying perpetration mediated by moral disengagement among adolescents. Self-report survey data from 706 adolescents (Mage = 14.5) from 20 schools in Sweden were gathered and analyzed using structural equation modeling. The findings suggest that CU traits were positively and directly linked to bullying perpetration, but also indirectly mediated by moral disengagement. Similarly, callousness and uncaringness showed direct and indirect associations with bullying perpetration, whereas unemotionality was found to be only indirectly associated with bullying perpetration. Unemotionality had the weakest connection to moral disengagement and was not directly related to bullying perpetration, whereas callousness, in particular, but also uncaringness, had stronger connections to moral disengagement and bullying perpetration. In sum, the findings underscore the importance of explicitly integrating moral considerations into endeavors aimed at preventing school bullying among adolescents.

Cannabinoids in hair and their prospective association with mental and physical health outcomes in adolescents

BACKGROUND

Cannabis is one of the most widely used drugs in early adolescence, a crucial time for development. Cannabinoids within the cannabis plant (e.g., delta-9-tetrahydrocannabinol [THC], and cannabidiol [CBD]) are suggested to have a range of health implications. These may differ by sex, given sex differences in the endocannabinoid system (ECS). Yet, how aspects of mental and physical health are related to cannabis use as measured by hair concentrations, both within early adolescence and across sexes, is so far inconclusive.

METHODS

We analyzed hair toxicology data from three cannabinoid analytes (THC, CBD, and 11-nor-9-carboxy-THC [THCCOOH]) and multiple mental and physical health measures in 9-15 year-old youth (49 % female) from the Adolescent Brain Cognitive Development (ABCD) Study (N = 2262). Two-part linear regression models were fit to assess the effects of cannabis constituent presence, concentrations, and THC concentrations + CBD presence on externalizing and internalizing symptoms, physical and strengthening exercise, asthma presence, and sleep duration. Secondary analyses fit the same models but stratified by sex. Finally, to further characterize these relationships, we conducted two exploratory analyses: we assessed health variables prospectively and concurrently predicting cannabinoid concentrations. False discovery rate corrections were employed for all analyses.

RESULTS

In the full sample, greater THC concentrations predicted more frequent strength exercise one year later; greater CBD concentrations predicted fewer strength exercise days; and greater THCCOOH concentrations predicted shorter sleep duration. Among males, cannabinoids differentially predicted exercise days; greater THC and THCCOOH concentrations predicted shorter sleep duration. Among females, greater THC and THCCOOH concentrations predicted strength exercise frequency, and THC concentrations predicted shorter sleep duration. In exploratory models, asthma presence predicted THCCOOH concentration one year later. Concurrently, THC concentration alone and in the presence of CBD predicted both sleep duration and lower exercise days, while THCCOOH concentration predicted lower exercise days, less asthma presence, as well as greater internalizing and externalizing symptoms.

CONCLUSION

In a nationwide study of youth ages 9-15 years old, we found cannabinoid hair concentrations predicted differences in health outcomes a year later, suggesting potential differential mechanisms for THC and CBD effects on health. Furthermore, sex-specific observations in these prospective associations emphasize the importance of considering sex assigned at birth when investigating correlates of cannabis use. Analysis of cannabinoid hair concentrations can reveal key links to mental health, physical activity, and sleep, aiding understanding of complex cannabis effects.

Motivations for Self-Harm in Young People and Their Correlates: A Systematic Review

Self-harm in young people is associated with increased risk of suicide and other negative long-term outcomes. Understanding the motivations driving self-harm behaviours among young people can help to inform the development of preventative and treatment interventions. Self-harm rates have been rising, but reviews of the recent quantitative literature have not been undertaken. PsycInfo, Embase and Medline were systematically searched in September 2024 for studies published in the past ten years. Quantitative studies that examined motivations for self-harm (including prevalence and/or correlates) among young people (aged 10 to 24 years) with a history of self-harm were included in the review. The review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42023429568). One hundred and seventeen studies met inclusion criteria. Intrapersonal motivations for self-harm (particularly emotion regulation, anti-dissociation and self-punishment) were more common than interpersonal motivations (e.g. peer bonding, communication). Intrapersonal motivations correlated with female gender, higher self-harm severity, current, repetitive and persistent self-harm, suicidality, poorer mental health and poorer emotion regulation. There was evidence to suggest that interpersonal motives are associated with younger age and some mental health difficulties (e.g. anxiety). Young people predominantly self-harm for intrapersonal reasons. Given that self-harm for intrapersonal reasons is associated with greater self-harm severity, suicidality and poor mental health, steps should be taken to prevent and reduce self-harm. Interventions for self-harm require a multifaceted approach that not only provides young people with alternate ways of regulating their emotions, but also targets risk factors that contribute to self-harm.

Valence and Intensity of Emotional Expression in Autistic and Non-Autistic Toddlers

PURPOSE

Differences in emotional experience and expression have long been recognized as common in the presentation of autism, yet research examining emotional expression in early childhood is limited, with mixed findings. Understanding emotional reactivity and expression in autism in early life is an essential step towards uncovering the mechanisms of these risks and identifying targets for intervention.

METHODS

The present study examined emotional expression in autistic (N = 17) and non-autistic (N = 20) toddlers (mean age = 25.27; SD = 1.88) during emotion elicitation tasks aimed at eliciting joy, frustration, and unease. Video recorded tasks were coded in ten second intervals for emotional valence and intensity, and the following variables were computed: proportion of time in positive, neutral, and negative affect; maximum intensity of positive and negative affect; and range of affect (i.e., most negative to most positive intensity).

RESULTS

Autistic toddlers spent more time in neutral facial expressions, less time displaying positive affect, and had somewhat less intense positive emotional expression than non-autistic peers. Small differences were apparent in intensity of negative affect expression, while no differences emerged in duration of time spent in negative affect.

CONCLUSION

Findings emphasize that differences may be more apparent in duration, rather than intensity of emotional expression, and that it may be particularly important to examine periods of "neutral" affect in young autistic children. Future research should consider the best ways to understand emotional reactivity in this population considering their unique interests, challenges, and communication styles.

Developmental Trajectories of Intrinsic and Extrinsic Goals From Early to Late Adolescence and the Association with Internalizing and Externalizing Problems

Although numerous studies have explored the causes and consequences of intrinsic and extrinsic life goals, the developmental trend of life goals during adolescence has not been well understood. To address this research gap, this study explored the developmental changes of the pursuit of intrinsic and extrinsic goals during early, middle, and late adolescence, and examined the relation between life goals and internalizing/externalizing problems from a developmental perspective. A total of 4703 Chinese adolescents from primary (N = 1819, 47.8% girls, Mage T1 = 9.34, SDage T1 = 0.58), middle (N = 1525, 47.5% girls, Mage T1 = 12.47, SDage T1 = 0.59), and high school (N = 1646, 51.9% girls, Mage T1 = 15.45, SDage T1 = 0.65) participated in this two-year, three-wave longitudinal study. The results revealed that the pursuit of intrinsic goals increased among primary school students, but decreased among middle and high school students. Conversely, the pursuit of extrinsic goals exhibited a consistent increase among adolescents in primary, middle, and high school. Girls have higher initial levels of intrinsic goals than boys in primary school, and boys' intrinsic goals declined faster than girls' in middle school. Additionally, the initial level and developmental rate of intrinsic goals among three developmental stages were significantly associated with internalizing/externalizing problems, with lower initial level, slower growth rate, and faster decline rate being associated with more internalizing and externalizing problems. The significant association between the initial level and developmental rate of extrinsic goals and internalizing/externalizing problems were mainly observed among late adolescents, with higher initial level and growth rate being associated with more internalizing and externalizing problems. These findings delineate the differences in developmental trends between intrinsic and extrinsic goals, underscore the robust relation between intrinsic goals and internalizing/externalizing problems, and figure out the development-stage differences in the relation between extrinsic goals and internalizing/externalizing problems.