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Given the importance of the link between mental and other medical conditions, JCPP Advances organized a special issue on the topic; yet since then, very few papers have focused on this area. As such, this editorial perspective aims not only to highlight the link between mental and other medical conditions, but also to (1) explore the origins of the divide between mental and "physical" health, (2) provide evidence that this so-called divide does not exist in actuality, (3) highlight the harms of maintaining such a divide, and (4) discuss strategies to bridge this divide to address this monumental mistake, which has been perpetuated throughout medicine.
There is a critical lack of reliable, high-quality epidemiological data on mental health and/or social and emotional wellbeing (SEWB) outcomes for First Nations children, partly, due to the limited availability of culturally valid assessment tools. This review aims to assess the cultural validity of mental health and SEWB assessment tools used with First Nations children aged 4-12 years in Australia, and identify gaps, strengths, and opportunities for reform that enhance cultural safety, and self-determination in assessment practices. A systematic search of five electronic databases (Web of Science, PubMed, PsycINFO, Informit, and CINAHL) identified English-language studies (1980-2025) assessing mental health or SEWB in Aboriginal and/or Torres Strait Islander children aged 4-12 years. Data on assessment tools were extracted and their cultural validity analysed using the First Nations Cultural Validity Assessment Tool. Tools were classified, as bespoke, culturally adapted or generic, using the CBSPATSISP definitions. This review examined the cultural validity across 10 studies, including 11 unique tools and 16 assessments of cultural validity. Three tools were bespoke, eight culturally adapted, and five generic. Over three quarters of tools used to assess SEWB or mental health in First Nations children had poor or limited cultural validity. Two bespoke SEWB tools were identified, although none specifically targeted mental health. Culturally valid assessment tools for First Nations children remain limited, with research predominantly relying on inappropriate measures. Improving the measurement of mental health and SEWB outcomes requires a shift towards First Nations-led, co-designed tools grounded in Indigenous knowledges, strengths, and cultural frameworks. The evidence base was limited by reliance on published academic sources, which may have missed community-used assessment tools, a focus on cultural validity rather than broader study quality, and limited psychometric reporting for some First Nations-specific measures. PROSPERO (CRD42024542866). 13 May 2024. www.crd.york.ac.uk/PROSPERO/view/CRD42024542866.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition with significant cognitive and social impacts. Identifying reliable biomarkers for ADHD is crucial for developing personalised therapies. Electroencephalography (EEG) alpha oscillations (8-12 Hz) have been suggested as a potential biomarker, but findings have been inconsistent. This study aimed to investigate whether alpha oscillations in young adulthood are associated with high ADHD traits using EEG data from a large twin sample (N = 556) enriched with participants with ADHD and autism. We assessed whether alpha oscillations during rest were associated with high ADHD traits. In addition, we used twin modelling to estimate the heritability of EEG alpha measures and their relationship with ADHD traits. Results showed that relative alpha peak amplitude was a significant predictor of ADHD traits when controlling for other factors such as age, sex and autistic traits. Specifically, we found that for each unit decrease in relative alpha peak amplitude (z-scored), the likelihood of being in the high ADHD trait group increased by approximately 26%. Further analysis suggested that group differences were due to a reduced occurrence (but not amplitude) of oscillatory bursts in the alpha range. Finally, our twin modelling results suggested that although these alpha measures are heritable, the genetic factors contributing to individual differences in alpha measures and ADHD traits were largely independent. Together, these findings suggest that reduced alpha oscillations, particularly the occurrence of alpha bursts, may serve as a potential biomarker for ADHD. Our results may have implications for neuromodulation therapies targeting alpha rhythms in ADHD, such as neurofeedback and transcranial alternating current stimulation.
The transition from childhood to adolescence is marked by significant developmental, social, and contextual changes that present practical challenges for the measurement of emerging mental health symptoms. This study explores transdiagnostic symptoms across three core dimensions from the Achenbach system of empirically based assessment brief problem monitor-internalizing, inattention (INA), and externalizing (EXT) (aggressive/rule-breaking behavior)-as well as across reporters (youth, caregiver, teacher), reporter characteristics, and developmental and social contexts. Four years of longitudinal data from the Adolescent Brain Cognitive Development (ABCD®) release 5.1 study sample included 11,832 youth (age: 9.67-14.75 years; 48% girls) from 21 sites across the United States. Youth symptoms of internalizing, INA, and EXT problems were reported by youth, caregivers, and teachers. Analyses examined mean-level directional discrepancies in the reporters' overall ratings and whether those discrepancies were predicted by reporters' characteristics and socio-experiential environments (e.g., parental warmth, school environment), and developmental change over time. Discrepancies in youth symptom ratings varied systematically across reporters, youth and caregiver characteristics, and socio-experiential factors. Overall, youth consistently rated their symptoms higher than caregivers and teachers across all domains, with discrepancies widening over time. Reporter discrepancies were greater if the youth was female, non-white, or showed advanced pubertal development. Symptom ratings were higher from caregivers with higher education and depression symptoms. Teachers reported higher symptoms for youth with non-white caregivers, but lower symptoms for youth with immigrant caregivers. Socio-experiential factors show that caregiver reports of youth symptoms were higher than self-reports in contexts of greater caregiver warmth and more prosocial school environments. Self-reports were also higher than both caregivers and teacher reports of youth symptoms when experiencing higher levels of family conflict. When capturing youth symptoms, whom you ask matters. The impact of reporters varies in complex ways, including by features of the reporter, environment, developmental stage, and symptom dimension.
Numerous meta-analyses have established associations between child maltreatment (CM) and mental health difficulties (MH). However, variation exists between meta-analyses regarding the magnitude of these predictions. A systematic, quantitative umbrella synthesis (i.e., meta-analysis of meta-analyses) was undertaken to describe the associations between various types of CM and MH. Meta-analyses were included if they examined CM, including but not limited to retrospective reports in adulthood, and MH at any point. Included forms of CM were: physical abuse, emotional abuse, sexual abuse, neglect, and exposure to intimate partner violence. MH outcomes were: externalising problems, internalising problems, thought problems, suicidal distress, substance misuse, and other psychological difficulties. Searches were run in January 2024. Random effects models were created in R version 4.2.0. We analysed and combined effect sizes from 148 quantitative meta-analyses, including 668 effect sizes and over 9.5 million data points. CM was associated with all MH outcomes: (1) externalising problems (r = 0.21; 95% CI = 0.18-0.24; k = 32), (2) internalising problems (r = 0.22; 95% CI = 0.20-0.24; k = 46), (3) thought problems (r = 0.24; 95% CI = 0.21-0.27; k = 38), (4) suicidal distress (r = 0.23; 95% CI 0.18-0.28; k = 19), (5) substance misuse (r = 0.19; 95% CI = 0.13-0.26; k = 13), (6) other psychological difficulties (r = 0.24; 95% CI = 0.20-0.28; k = 50). Associations tend to be of similar magnitude for different forms of CM. CM is robustly associated with MH. A parsimonious explanation for these findings would be a common mechanism(s) or a general psychopathology factor conferring high-risk for different mental health difficulties following CM. The results possibly question the conventional wisdom that suggests some forms of maltreatment are intrinsically more harmful to mental health than others. However, further work is required to understand how potentially confounding factors (e.g., age, measurement of CM) influence these associations.
Brief emotion-focused family therapy (EFFT) interventions have demonstrated numerous positive outcomes across the domains of child mental health and parent psychosocial well-being. However, there is limited research examining interpersonal processes at the family-level of analysis following 2-day EFFT programs. This study explored family functioning in the year following a virtual, parent-focused EFFT intervention (n = 159 caregivers, representing 124 families and 264 children). Caregivers completed the General Functioning subscale of the Family Assessment Device at 6 timepoints from baseline to 12-month post-intervention. Multilevel modeling was used to complete growth curve analysis, exploring post-intervention changes in family functioning over time. This allowed for the exploration of between versus within family differences pre- to post-intervention in the study sample. Variance in family functioning was attributable to stable differences between caregivers (level 2; 59%) and change over time (level 1; 41%), including measurement error. Growth curve analysis identified positive changes in family functioning post-intervention, with a cubic trajectory of improvement. Higher COVID-19 disruption, caregiver psychological distress, and parenting stress significantly predicted lower baseline family functioning, but did not significantly interact with change over time. These results suggest that there is a general pattern of non-linear change following EFFT workshops, specifically relating to family interpersonal dynamics. Overall, the study findings expand the evidence base for this promising, brief, relational intervention, now available in virtual formats, thereby increasing access for busy families.
Increased inflammation during pregnancy may increase the risk for child psychopathology, though prospective data remain preliminary. Child symptoms of attention-deficit/hyperactivity disorder (ADHD) are particularly important due to ADHD's role as an early precursor of many later forms of externalizing and internalizing problems. Despite strong theories surrounding the ways in which pre- and postnatal environmental factors may interact in the prediction of child risk, few studies have examined how the postnatal social environment moderates prenatal effects. This study examined whether gestational inflammation was prospectively related to ADHD symptoms and whether this association was moderated by postnatal caregiving behaviors. Data came from a prospective cohort of pregnant individuals and their offspring (N = 302). Second trimester inflammation was assessed in maternal plasma using a comprehensive panel of cytokines. ADHD symptoms were assessed at 36 months of age using parent-report and clinician ratings. Observer ratings of maternal sensitive caregiving behaviors were assessed when infants were 6 months old. The effect of gestational inflammation on child ADHD symptoms was moderated by maternal sensitive caregiving during infancy. Increased inflammation during pregnancy was associated with greater child ADHD symptoms only when children experienced lower levels of maternal sensitivity. Early sensitive caregiving appears to buffer children against the negative effects of gestational inflammation. Interventions that decrease gestational inflammation and those that support early caregiver-child relationships may both be effective at reducing child ADHD risk.
Cognitive theories suggest that negative self-perception is central to the development and maintenance of depression. One way self-perception is represented is through mental imagery of the self. Despite its theoretical importance, the role of mental images of the self in depression has not been systematically examined. This study investigated cross-sectional and longitudinal associations between self-perception, mental images of the self, and depressive symptoms in young people. A total of 796 young people (aged 12-24) recruited from school and university populations completed surveys at two timepoints, 1 month apart. Measures included the Harter Self-perception Profile Global Self-Worth subscale, the Mental Imagery Questionnaire for Youths and the Revised Child Anxiety and Depression Scale-Short Version. Self-perception was negatively associated with depressive symptoms both cross-sectionally and longitudinally ( b  = -2.57, 95% CI [-2.87, -2.27]; b  = -0.83, 95% CI [-1.22, -0.45]). Positive and negative mental images of the self were associated with depressive symptoms (t = -5.61; t = 10.73). Frequency of positive and negative images of the self were associated with self-perception ( b  = -0.57, 95% CI [-0.76, -0.39]; b  = 0.38 95% CI [0.18, 0.58]) and depression ( b  = 0.12, 95% CI [0.09, 0.16]; b  = -0.10, 95% CI [-0.14, -0.06]), cross-sectionally. Positive imagery vividness was linked to self-perception in the full sample ( b  = 0.09, 95% CI [0.01, 0.16]) and school subgroup ( b  = 0.14, 95% CI [0.03, 0.24], but not in the university subgroup. Longitudinally, both frequency and vividness of positive imagery were associated with self-perception in the university subgroup only ( b  = 0.05, 95% CI [0.01, 0.10]; b  = 0.09, 95% CI [0.01, 0.16]). Young people's self-perceptions, whether expressed through evaluative thoughts or mental images, play a critical role in depressive symptoms. Findings support cognitive models of depression and highlight self-perception as a promising intervention target. The study also underscores limitations of current mental imagery measures and the need for more robust tools to clarify these relationships.
Children who show difficult temperament are at risk of peer victimisation, which in turn associates with numerous negative outcomes later in life. We used network analysis to examine whether specific aspects of difficult temperament contributed to these associations, and whether the links were moderated by variations in genetic liability for ADHD, schizophrenia, and depression. In 3354 mother-child dyads (51.8% female), we examined in three steps: (i) the network structure of difficult temperament as indexed by adaptability, intensity, and mood (age 2), (ii) its item-level associations with peer victimisation (ages 8, 10, and 13), and (iii) moderation of these associations by polygenic risk scores (PRS) for ADHD, schizophrenia, and depression. Indicators of difficult temperament formed a coherent network that was associated with peer victimisation. Regarding PRS moderation, for those high in PRS (top 10%) for ADHD and schizophrenia, indicators of temperamental intensity and mood were associated with peer victimisation, respectively. For those high in PRS for depression, however, aspects of temperament were no longer associated with peer victimisation. Finally, the network results for those in the general population across all PRS (bottom 90%) largely resembled the model estimated using the full sample. The findings highlight specific temperamental behaviours as risk factors for peer victimisation; additionally, children high in PRS for neurodevelopmental disorders may be at especially high-risk for this outcome early in development.
Children in care have historically been under-represented in mental health research, despite high levels of need. Consequently, there is a lack of high-quality empirical evidence to drive advocacy, practise, and policy, and the direct voice of children in care is often absent. In this Editorial Perspective, we outline three key areas of consideration, that must be understood and addressed to maximise the success of primary mental health research with this group of children. Specifically, we focus on: capacity issues in children's social care and partnership working; consent and assent procedures; and supporting children in care through mental health research. The paper is informed by the ReThink Project, a longitudinal mixed-methods study involving 450 care-experienced young people across 13 local authorities in England and Wales. The issues and solutions we discuss have implications for future study design, including timelines and funding.
Genetic epidemiological analyses of child and adolescent mental health often use data from prospective longitudinal cohorts. Missingness due to selective attrition is therefore an important potential source of bias in such analyses. Informatively reporting on missingness and taking appropriate steps to handle it in analyses can mitigate this potential bias. Here, we aim to systematically assess how researchers report and address missingness in genetic epidemiological studies of child and adolescent mental health-related outcomes using cohort data. We systematically searched the Ovid Medline database for studies published between August 2012 and August 2025, reporting polygenic score, genome-wide association, or Mendelian randomization analyses, of data on children or adolescents participating in cohort studies. We extracted information from eligible studies based on criteria adapted from the strengthening and reporting of observational studies in epidemiology (STROBE) guidelines. A total of 133 eligible studies were included, of which 125 (93.98%) reported the number of complete cases in all waves, while 84 (63.16%) detailed the amount of missingness on all key variables. Most studies used complete case analysis, while 39 studies explicitly reported applying other methods to handle missingness, with multiple imputation (n = 20, 15.04%) being the most common, followed by full information maximum likelihood 10 (8.1%). Only 18 studies (13.53%) reported an assumed missing mechanism along with the method used to address missingness. Full reporting of both the extent and handling of missingness at the item level was rare, occurring in only 5 (3.76%) and 15 (11.28%) studies, respectively, among the 123 studies that used multi-item instruments. Best practice recommendations for reporting on missing data handling emphasize the importance of detailing the proportion of missingness, types of mechanisms underpinning missingness, and details of approaches used. Based on this review, these recommendations for proper reporting of missing data are rarely followed in full.
Sexual and gender minority youth (SGMY) often experience discrimination and stigma related to their sexual orientation or gender identity. This increases their vulnerability to HIV, poor mental health outcomes, including suicide, and low uptake of HIV prevention through bidirectional causal relationships that suggest integrating mental health support with HIV prevention. This study evaluates the impact of three intervention strategies (automated text messages, online peer support, and coaching) on secondary mental health outcomes among SGMY. From May 2017 to August 2019, 895 SGMY (40% Black, 29% Latino) ages 16-24 years were enrolled in Los Angeles and New Orleans via 13 community sites and social media. Participants were randomized to: (a) automated text-messaging and monitoring (AMM), (b) AMM plus online peer support (AMM + PS), (c) AMM plus strengths-based coaching by telehealth or in-person by near-peers (AMM + C), or (d) all three interventions (AMM + PS + C). The interventions targeted HIV risk reduction primary outcomes and mental health and substance secondary outcomes. Assessments occurred over 24 months (70%-90% retention). Multivariate regressions compared interventions' efficacy on depression, anxiety, and mental health services use using intent-to-treat models stratified by high risk mental health (HRMH; n = 342; 38% with history of suicide attempts or psychiatric hospitalization) and low risk mental health (LRMH; n = 553; 62%). Participants reported mild anxiety and depression symptoms over time. At baseline, HRMH youth had more symptoms and greater service use than LRMH peers. Both outcomes significantly declined over time across groups. The two coaching arms were associated with an increased number of times receiving mental health specialist services among LRMH compared to HRMH youth. While over a third of SGMY (38%) reported past mental health events, recent symptoms of anxiety and depression were mild. Interventions did not significantly reduce symptoms or stabilize mental health service use, though coaching promoted greater services utilization among LRMH youth.
The longitudinal relationship between school absence and mental health has important policy implications; if school absence predicts later mental health problems, it could be used to identify young people at increased risk and enable further assessment, prevention, and early intervention. We analysed an existing data linkage between the National Pupil Database and healthcare records representing a sample of 47,926 young people aged 11-15 in the UK. We used logistic regression to examine the longitudinal association between persistent school absence (defined by the Government Department for Education in England as missing more than 10% of available school sessions) and later contact with secondary care mental health services. We also compared the sensitivity and positive predictive value of the >10% absence threshold to alternative thresholds for predicting adverse mental health outcomes. At the currently applied threshold of >10%, persistent school absence was associated with 2.77 (95% CI 2.33-3.30, girls) and 1.58 (95% CI 1.29-1.95, boys) times the odds of accepted referral to secondary care mental health services in the following year, after adjustment for sociodemographic and educational factors. The absolute risk difference for girls was 4.7% (95% CI 3.9-5.4) and for boys, 2.8% (95% CI 2.1-3.4). Compared to other thresholds, the >10% absence threshold provided a good balance between sensitivity (40.5%), positive predictive value (5.5%), and identifying a manageable proportion of young people as high risk (18%). The longitudinal relationship between school absence and later secondary care mental health service contact suggests that school absence may be a useful marker for educators to identify children in need of support. The >10% absence threshold used in education policy in England may also serve as a useful marker of later mental health risk in other national policy contexts.
Behavioral parent training (BPT) is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD); however, evidence from low- and middle-income Asian countries remains scarce. This randomized controlled trial evaluated a culturally adapted blended BPT program for Vietnamese parents of elementary school-aged children with ADHD. Eighty-six parents of children (6-11 years) with a clinician-confirmed DSM-5 diagnosis of ADHD were randomized to a blended BPT program (n = 43) or treatment as usual plus psychoeducational materials (n = 43). The intervention comprised six weekly 2-h online group sessions, each followed within the same week by a 1-h individual home-based support session, and 12 weekly support telephone calls across a 3-month maintenance period. Parenting skills (Parenting Skills Assessment Scale), parent-rated child ADHD symptoms (Vanderbilt ADHD Diagnostic Parent Rating Scale), and parenting stress were assessed at baseline (T1), post-intervention (T2), and 3-month follow-up (T3). The analyses included 80 participants with complete data (intervention, n = 37; control, n = 43). Parenting skills improved substantially in the intervention group relative to the control group (group × time interaction: F (2, 156) = 20.75, p < .001, partial η 2  = 0.21; baseline-adjusted between-group d = 1.28 at follow-up). Parent-rated ADHD symptoms decreased significantly within the intervention group (T1→T3: -4.14 points, p < .001), but the baseline-adjusted between-group differences were small and not statistically significant (T2: p = .057; T3: p = .075; adjusted d ≈ 0.28-0.30). Parenting stress declined similarly in both groups. Exploratory mediation analyses indicated a significant indirect effect on follow-up ADHD symptoms through improved parenting skills (ab = -1.86, 95% bootstrap CI [-4.01, -0.37]). The culturally adapted blended BPT program was feasible and produced large, sustained improvements in parenting skills among Vietnamese parents. The effects on parent-rated ADHD symptoms were small and require confirmation in adequately powered trials. Thai Clinical Trials Registry, TCTR20260212003 (retrospectively registered on February 12, 2026). Registration number: TCTR20260212003. Available at: https://www.thaiclinicaltrials.org/show/TCTR20260212003.
Adults formerly placed out-of-home (care leavers) often accumulate multiple psychosocial adversities that can lead to poor quality of life (QoL) and place them at high risk for developing mental disorders persisting into adulthood. This study examines the development of mental disorders among care leavers and their QoL, differentiating by disorder groups. The sample consisted of 119 young adults formerly placed out-of-home (Mage at baseline = 15.0 years; Mage at follow-up = 25.4 years). Mental disorders were assessed at baseline using the Kiddie Schedule for Affective Disorder and Schizophrenia-Present and Lifetime Version and at a 10-year follow-up with the Structured Clinical Interview for DSM-5 Disorders-Clinician Version. Personality disorders were evaluated at both time points using the Structured Clinical Interview for DSM-IV-TR Axis II. QoL was measured at follow-up using the World Health Organization QoL-BREF questionnaire. Four groups based on the presence or absence of mental disorders at baseline and follow-up were identified: resilient (n = 24, 20.2%), persistent (n = 56, 47.0%), remitted (n = 25, 21.0%), and newly occurring (n = 14, 11.8%). Regarding the mental disorder groups, internalizing disorders at baseline (β = -0.44, p < .05, 95% CI [-0.85, -0.04]) and internalizing (β = -0.78, p < .001, 95% CI [-1.14, -0.43]) and externalizing disorders (β = -0.50, p < .01, 95% CI [-0.86, -0.13]) at follow-up were negatively associated with QoL in young adulthood. Mental disorder trajectories from childhood to young adulthood can negatively impact care leavers' QoL. Prevention and early intervention, as well as addressing mental health during out-of-home placement and transition into young adulthood, are important to reduce the risk of persistent psychopathology and lower QoL.
Multiple psychiatric disorders are associated with later dementia, but it remains unclear whether these associations reflect a shared liability toward all psychiatric conditions (general psychopathology factor) or diagnosis-specific effects (specific psychopathology factors). In this Swedish register-based cohort study, we investigated these questions while adjusting for familial confounding shared by siblings (N = 2 543 621 individuals, 1 485 880 full-sibling pairs). Exposures were (i) six psychiatric diagnoses recorded by age 35 and (ii) a latent bifactor model fit to these diagnoses that identified one general and three specific (internalizing, externalizing, and psychotic) psychopathology factors. Outcomes were all-cause dementia and Alzheimer's disease recorded after age 50. For observed psychiatric diagnoses, we estimated between-individual (HR) and within-sibling hazard ratios (HRwn) using Cox regression; for latent factors, we estimated between-individual (OR) and within-sibling odds ratios (ORwn) using exploratory structural equation modelling. All psychiatric diagnoses were significantly associated with increased risk of all-cause dementia (HR range 2.03-3.59; HRwn range 1.72-2.94) and Alzheimer's disease (HR range 1.89-3.47; HRwn range 1.77-3.22). These associations were largely attributable to the general psychopathology factor, even after adjusting for familial confounding (ORwn with 95% CI: 1.25 [1.17-1.32] for dementia; 1.24 [1.16-1.32] for Alzheimer's disease). After accounting for the general factor, only the psychotic-specific factor remained associated (ORwn with 95% CI: 1.20 [1.07-1.36] for dementia; 1.20 [1.06-1.37] for Alzheimer's disease). These results suggest that liability toward general psychopathology and, independently, psychotic conditions, by early adulthood might be early markers of increased dementia risk and targets for timely identification and prevention.
Young children with emerging mental health problems and neurodevelopmental differences often do not receive the support they need early in life, and if they do receive support, it may not be appropriately targeted towards their individual needs. The Neurodevelopment Assessment Unit (NDAU) was established to meet this need, offering an innovative method for evaluating young children through developmental profiling guided by the NIMH Research Domain Criteria (RDoC). Children (4-7 years) identified as experiencing social, emotional, and/or cognitive difficulties by education practitioners were referred to the NDAU to complete a comprehensive battery of assessments. We present an overview of the first cohort of children (N = 486) who were referred between September 2017 and January 2023. We first provide an overview of children's performance on constructs within the Cognitive Systems and Systems for Social Processes domains of the RDoC. As an exploratory analysis, we used latent profile analysis to identify subgroups of children with similar patterns of performance on assessments within these domains. Children demonstrated most difficulties with recognition of negative emotions (81.6% below average in at least one negative emotion), understanding mental states (51.4% below average), and sustained attention (47.6% below average). Next, we identified three distinct subgroups of children, each defined by unique patterns of performance across Cognitive Systems and Social Processing domains. These findings highlight the NDAU as a promising model for dimensional assessment and underscore the importance of investigating variability and heterogeneity in the neuropsychological profiles of young children with emerging difficulties.
Research indicates dissociative experiences (DE) are prevalent in adolescents. However, the exact phenomenology and underlying mechanisms of dissociation in adolescence have yet to be clarified. The current study explores the presentation of, and possible psychological factors maintaining, dissociation in this population. Two online self-report surveys captured data from 3076 adolescents aged 13-18 years. Participants completed the Černis Felt Sense of Anomaly (ČEFSA) scale of felt sense of anomaly-type dissociation, alongside measures of mechanisms chosen to test the relevance of a cognitive-behavioural model of dissociation in adults (cognitive appraisals, alexithymia, healthy affect regulation, and affect intolerance in the form of expressive suppression (ES)). N = 409 completed the ČEFSA scale at a second timepoint, one month later, enabling exploration of proposed maintenance factors. Most (91.87%) adolescents endorsed at least one ČEFSA item. The mean number of endorsed items was 13.00 (SD = 9.67). The most endorsed factors of the ČEFSA were Altered Sense of Agency (82.96%), Anomalous Experience of the Self (76.76%), and Altered Sense of Connection (73.76%). Mediation analysis indicated that affect intolerance (ES) mediated the relationship between Time One and Time Two dissociation scores: greater suppression was associated with greater dissociation 1 month later. No other tested variables showed statistically significant mediation. Adolescents are likely to experience dissociation as detachment and disconnection, particularly relating to their selfhood and external world (i.e., depersonalisation and derealisation). This study suggests that the key element of a recent cognitive-behavioural model of DE in adults-that affect intolerance perpetuates dissociation-may also be applicable in adolescence.
Depression is a highly heterogeneous condition. Depression with an onset in childhood and early adolescence has a worse clinical course, is more heritable, and shows a lower genetic correlation with other depression subtypes, than does later-onset depression. It is also more strongly associated with neurodevelopmental (ND) comorbidities and genetic liability to attention-deficit hyperactivity disorder. Thus, we hypothesised that early-onset depression represents a distinctive 'neurodevelopmental' depression subtype associated with an increased burden of rare copy number variants (CNVs) that are enriched in ND conditions. We tested this hypothesis using four population cohorts across the UK, Norway, and Sweden. Participants were ascertained from four population cohorts across the UK, Norway, and Sweden. Early-onset depression was defined as a score >11 on the self-reported Short Mood and Feelings Questionnaire between ages 10 and 14 years (cases n = 5994 vs. controls n = 26,388) and, for secondary analyses, using ICD-10 criteria for major depressive disorder (MDD) with onset  ≤ 14 years (cases n = 856 vs. controls n = 96,769). Carriers of large, rare (>500 kb, <1% frequency) CNVs and known ND CNVs were identified. Primary analyses tested associations between early-onset depression and (i) large, rare CNVs, and (ii) ND CNVs. Secondary analyses investigated parent-reported measures of early-onset depression. Meta-analysis did not identify any robust associations between early-onset depression (SMFQ-defined) and large, rare CNVs (OR = 0.92 [95% CI = 0.84-1.02], p = 0.12) or ND CNVs (OR = 1.06 [0.85-1.31], p = 0.60). No robust associations were observed between early-onset depression, defined using ICD-10 MDD criteria, and large rare CNVs (OR = 1.08 [0.86-1.36], p = 0.49) or ND CNVs (OR = 0.69 [0.34-1.39], p = 0.30). Our findings did not support the hypothesis that individuals with early-onset depression show enrichment for large, rare or known ND CNVs.
Anxiety is the most prevalent mental health difficulty in adolescence, a period characterised by a shift towards an eveningness chronotype that is not aligned with societal demands (i.e., school start times). Experiencing "social jetlag" (SJL), a discrepancy in weekday-weekend sleep timing, is proposed to be associated with increased anxiety. A PRISMA-compliant systematic review and meta-analysis was conducted to investigate the relationship between SJL and anxiety in adolescents (age range: 12-18 years). Systematic searches were conducted in PsycINFO, Web of Science, Embase, PubMed, MEDLINE, and ProQuest Dissertations & Theses Global on 14th November 2024 to retrieve empirical studies analysing the relationship between SJL and anxiety in 12-18-year-olds. A multi-level random-effect meta-analysis was conducted in R to estimate the magnitude of the association between SJL and anxiety. After screening 2,138 records, 18 studies were included in the systematic review, with 12 included in the meta-analysis (235,526 participants in total) and six in a narrative review. A small association was found between increased SJL and more severe anxiety (Fisher's z = 0.0614, 95% CI [0.0268, 0.0961], p = 0.0011). These findings highlight the importance of addressing behavioural strategies targeting healthy regular sleep as a tool to improve mental health in adolescence.