BackgroundAdolescents' access to mental health care depends partly on their ability to recognize when rights related to emotional distress, confidentiality, participation, non-discrimination, continuity of care, and support are respected or violated. This study developed and evaluated the Know and Act Scale, a vignette-based instrument designed to assess situated recognition of mental health-related human rights among Colombian adolescents.MethodsAn instrumental, cross-sectional psychometric study was conducted in urban, semi-urban, and rural educational contexts in Colombia. Scale development included theoretical construction, Delphi expert consensus, cognitive interviews, exploratory factor analysis, confirmatory factor analysis, and ll consistency testing. The exploratory sample included 860 adolescents, and the confirmatory sample included 145 adolescents.ResultsExploratory factor analysis supported a three-domain structure: Right to Feel, Right to Participate, and Right to Be Helped, which explained 73.06% of the variance. Internal consistency was good for the overall scale (α = .869; ω = .894). Confirmatory factor analysis showed adequate comparative fit, supporting the proposed structure in an independent sample.ConclusionsThe Know and Act Scale offers a theoretically grounded and psychometrically supported tool for assessing adolescents' situated recognition of mental health-related human rights. It may support research, school-based mental health promotion, and rights-informed care in adolescent populations.
IntroductionChildren and young people (CYP) with long-term physical health conditions (LTCs) are at increased risk of emotional and behavioural difficulties, yet barriers to psychological support remain, particularly for families from ethnic minority backgrounds. Mental health drop-in services were set up and evaluated at 6 paediatric healthcare settings, aiming to provide a more accessible route to care.MethodsThis study conducted a secondary analysis of quantitative and qualitative data collected as part of the multi-site roll-out of mental health drop-in services in paediatric healthcare settings to explore their accessibility and acceptability. The services provided short-term psychological interventions delivered by child wellbeing practitioners or equivalent, under supervision of a clinical psychologist 120 families provided quantitative data, and 104 families shared qualitative feedback. Differences in access routes and mental health symptoms were compared across White British families and those from different ethnicities. Inductive, latent content analysis of the open text feedback was conducted to understand families' experiences of the drop-in services.ResultsCYP from ethnic minority backgrounds were over-represented in the present study (32%), when compared with nationwide CAMHs users that identify as non-white British (21%). Families from ethnic minority backgrounds reported comparable mental health outcomes and satisfaction levels to White British families. There was a significant difference in mental health change scores, with ethnic minority families showing greater improvements after accessing the service, t (46) = -3.05, p < .01, d = -1.08. Qualitative analysis found that the services were highly acceptable across ethnicities, highlighting themes of life-changing support, therapeutic relationships, and improved parent and family wellbeing.DiscussionDrop-in services embedded in paediatric healthcare settings are both accessible and acceptable, demonstrating positive clinical outcomes, and positive family feedback across different ethnic groups. This model may help reduce inequalities by improving access to psychological support for ethnic minority families with CYP living with LTCs.
BackgroundPaediatric cancer profoundly disrupts children's lives, with wide-ranging consequences. Hospital-at-Home (HaH) has been developed as an alternative to traditional hospitalisation, yet the subjective experiences of the children remain largely unknown. The aim of this study is to understand these experiences as they are perceived and described by the children themselves and to provide more meaningful insight into their subjective trajectories.MethodA qualitative study based on interpretative phenomenological analysis (IPA) was conducted with seven children aged 7 to 12 receiving HaH.ResultsFour main themes emerged. (1) Homecare - a structured and reassuring routine: the children describe a reassuring environment that fosters continuity of identity and a sense of normality; (2) Perception of parenting - "I became their concern": the children acutely perceive their parents' increased attention, hypervigilance and emotional burden; (3) Discovery of an unprecedented power: physical vulnerability becomes a subtle lever of agency and negotiation in the care relationship; and (4) Parentification of children with cancer: some children protect their parents by concealing their pain or concerns.ConclusionHaH involves complex emotional and relational processes. While reinforcing the child's security and continuity, HaH may also intensify emotional dynamics within the family. These results highlight the need for appropriate psychological support to ensure that the child remains, above all, a child despite their illness.
BackgroundOppositional defiant disorder (ODD) has substantial comorbidity with depression. However, their comorbidity at the symptom level, including potential gender differences, is currently underspecified. This study aimed to explore the comorbidity network of ODD and depression in a longitudinal sample, as well as the gender differences.MethodThe sample included Chinese children aged 7 to 12 years (N = 418, Mage = 9.02, SD = 1.44, 59.6% boys). Children and their parents completed questionnaires about ODD (parent-reported) and depression (child-reported) symptoms in two surveys conducted 6 months apart. The cross-sectional and cross-lagged panel networks of ODD and depression symptoms were estimated.Results(1) In the cross-sectional network, ODD and depression were linked via associations between interpersonal symptoms of depression and behavioral or emotional symptoms of ODD; (2) In the cross-sectional network, behavioral symptoms of ODD connecting ODD and depression symptoms differed by gender, with "annoy" and "defy" specific to boys and "argue" to girls; (3) In the longitudinal network, behavioral symptoms of ODD played important roles in predicting depression symptoms at the later timepoint; (4) There were positive paths from depression to ODD symptoms in the boys' longitudinal network while there were negative paths from ODD to depression symptoms in the girls' longitudinal network.ConclusionsThese findings identify symptom connections between ODD and depression and associated gender differences, providing new insights into screening and intervention for the co-occurrence of ODD and depression which are informed by symptom prominence.
This study investigated the preliminary effectiveness of Experiential Play Therapy (EPT) integrated with behavioral techniques for a 4.5-year-old girl with selective mutism (SM). Using a single-case A-B-A experimental design, the study examined phase-based changes in anxiety, communication, social interaction, and behavioral responses. The research adhered to the SCRIBE 2016 reporting guidelines, with the A1 (baseline), B (intervention), and A2 (follow-up) phases consisting of 6, 23, and 2 sessions, respectively. Anxiety levels were assessed using the parent-reported Revised Preschool Anxiety Scale (RPAS), while clinical progress was evaluated through systematic therapist ratings. Data were analyzed using visual analysis, phase medians, the Theil-Sen slope, non-overlap indices (NAP), and Tau-U. Results showed a substantial reduction in total RPAS scores, decreasing from 113 during the A1 phase to a final measurement of 66 at the end of the B phase, with further improvement to a final measurement of 59 during the A2 follow-up phase. Systematic therapist ratings demonstrated substantial and consistent improvements across all behavioral and communicative domains. These findings provide preliminary evidence supporting the integration of EPT and behavioral techniques as a promising intervention for preschool children with SM. Further comparative research with larger samples is warranted to confirm these findings.
The rapid emergence of generative artificial intelligence (AI) has prompted growing debate about its role in academic writing and the implications for scholarly integrity. This editorial arose from an increasing number of manuscript submissions to the journal that appeared unusually polished, leading editors and reviewers to question whether AI-assisted writing had been used and, if so, whether this should influence editorial decisions. While AI has the potential to enhance clarity, accessibility, and efficiency, concerns remain about transparency, authorship, accountability, and the authenticity of scholarly contribution. To explore these issues, we conducted an experiment in which one section of this editorial was written entirely by a human co-author, while the second was developed using outputs from multiple generative AI tools that were subsequently substantially edited by the other human co-author, who retained responsibility for the final text. By juxtaposing these pieces, we invite readers to consider whether AI-assisted scholarship is distinguishable from human-authored writing, whether such distinctions matter, and how AI use might be disclosed. We argue that transparent reporting of AI assistance, rather than its prohibition, is essential to maintaining trust, accountability, and integrity in academic publishing.
Background Parenting programmes are widely implemented to help alleviate conduct problems in children. This qualitative study was undertaken as part of the Personalised Programmes for Children Randomised Controlled Trial (PPC RCT) which evaluated a personalised parenting programme for those who had either declined or not responded to previous standard group-based parenting interventions. The narratives of parents or carers taking part in the RCT were explored to understand their experiences of personalisation. Methods Twenty-five parents took part in semi-structured interviews either in person or online. Verbatim transcripts were analysed using a thematic codebook approach. Results Three main themes were identified from the parents’ narratives: (1) the importance of choice, (2) the importance of the relationship with the practitioner, and (3) the importance of going beyond the usual. Conclusions Our findings demonstrate that offering parents choices within an intervention (such as location or time) is essential in creating an appropriate personalised approach that was valued by the study participants. Parents also highly valued the inclusion of their children. To engage parents who have previously not engaged or responded to prior group interventions, a more personalised approach utilising the element of choice and parent-led approaches should be considered.
Background/objectives Loneliness, characterized by the absence of meaningful social and personal connections, is recognized as a significant adverse health condition. This study aimed to evaluate the psychometric properties of the Persian version of the 8-item UCLA Loneliness Scale (P-ULS-8) among Iranian children and adolescents. Methods This cross-sectional study was conducted in 2024 among 100 school-aged students in Isfahan, Iran. Standard forward-backward translation procedures were used, and content validity indices were calculated. Reliability was assessed using Cronbach’s α and intraclass correlation coefficients (ICC). Convergent validity was evaluated via Spearman’s correlation between the 20-item UCLA Loneliness Scale (ULS-20) and P-ULS-8. Confirmatory factor analysis was performed to approve construct validity. Results Cronbach α and ICC for the overall scale were 79.0% and 0.86, respectively. Scale content validity indices for relevancy, clarity, and comprehensiveness were 95%, 90%, and 80%, respectively. A significant correlation was found between P-ULS-8 and ULS-20 (r Pearson = 0.74, p < .001), suggesting satisfactory convergent validity. Confirmatory factor analysis approved a two-factor structure for the Persian version of ULS-8. Conclusions P-ULS-8 demonstrated acceptable reliability and validity indices. Considering its brevity, the Persian version of ULS-8 can be easily used in large-scale studies.
This systematic review examined two questions regarding youth mental health intervention research: (1) how is co-design practiced? (2) what clinical and implementation-related outcomes are reported? Eligible studies were primary research published from 2008 involving youth aged 15-24 years co-designing mental health interventions. Studies were excluded if they were descriptive only, focused on prevention/screening, involved only adult perspectives, or were grey literature, conference proceedings, dissertations, or protocols. We searched seven databases (Medline, PsycINFO, CINAHL, Scopus, Global Health, EMBASE, Cochrane) using terms mapped to youth, co-design, mental health, and interventions, and conducted a narrative synthesis. Study quality was independently assessed by two reviewers with discrepancies resolved through consultation. Fifty-eight studies were included, predominantly from high-income, English-speaking settings, with a majority of qualitative (57%) and mixed-methods (36%) designs. Co-design typically involved small-group workshops with youth in consultative roles focused on adapting content or design. Over half of the studies did not report an explicit theoretical framework, and few examined relational dynamics within co-design. Only 12 studies evaluated mental health outcomes, with most reporting moderate-to-large improvements. Implementation outcomes were reported in 38% of studies, with generally high usability, engagement and improved alignment with user needs. Co-design evidence remains limited by inconsistent reporting and lack of rigorous outcome evaluation.
PurposeClinical psychology graduate trainees may pursue training in child, youth, and family services, which often encompasses the delivery of parenting interventions. Two broad and fundamentally different parenting approaches are Parent Behaviour Management and Positive Parenting. We examined the types of parenting approaches to which child/family clinical psychology trainees were exposed, along with their attitudes toward child rights and punitive parenting.Major FindingsWe collected data for 73 Canadian doctoral students. For the subset of 54 child/family trainees, about one-third were not exposed to any parenting programs in clinical supervision or coursework. The remaining students learned about programs that fell within a Parent Behaviour Management approach only or within both Parent Behaviour Management and Positive Parenting. The majority (90.4%) of the larger sample were not familiar with the UN Convention on the Rights of the Child, although their child rights attitudes were highly favourable and associated with lower punitive parenting approval.ConclusionsThese preliminary findings suggest that clinical psychology trainees are learning about the two broad parenting approaches. However, they do not have much training in children's rights, which is concerning given the associations with punitive parenting attitudes and the importance of centering children's perspectives in clinical work with parents.
BackgroundNo validated Persian version of the short-form Child Parental Acceptance-Rejection Questionnaire (Child-PARQ) has been available for Iranian populations. The present study aimed to examine the psychometric properties, internal consistency, and factor structure of the Persian short form of the Child-PARQ among Iranian adolescents.MethodsA total of 1075 adolescents aged 12-17 years participated in this cross-sectional study. Participants completed the Persian Child-PARQ, the Strengths and Difficulties Questionnaire, and the WHO-5 Well-Being Index. Data were analyzed using exploratory and confirmatory factor analyses, reliability tests, and validity assessments.ResultsThe EFA and CFA supported a two-factor model, Warmth/Affection and Rejection which demonstrated excellent model fit. Internal consistency was high across both forms. Convergent and discriminant validity were confirmed through significant correlations with SDQ and WHO-5. ROC analysis supported criterion validity. Measurement invariance was established across gender, and developmental comparisons indicated higher perceived rejection among adolescents relative to adults.ConclusionThe Persian short-form Child-PARQ demonstrated robust psychometric properties and a stable two-factor structure, making it a reliable and valid tool for assessing perceived parental acceptance and rejection among Iranian adolescents. Although suitable for large-scale research and screening, its moderate discriminative power suggests that the long form is preferable for clinical assessments.
BackgroundIdentifying specific patterns of somatic expressions of depression among children from Global South countries may help inform health promotion, screening, referral pathways, assessments and interventions in various contexts (e.g., schools and clinics).Method1541 children from Barbados, Colombia and Jamaica completed the Adolescent Depression Rating Scale (ADRS) and the Children's Somatization Iventory-24 (CSI-24). For each country, item discrimination indices (IDIs) were calculated for each item of the CSI-24 to determine which items best identified persons with the highest depression scores. Scales consisting of the six CSI-24 items with the highest IDIs in each country were then created and assessed for their association with clinically significant depression using regression analyses.ResultsThe CSI-24 items with the highest IDIs were different for each country, but with physically restrictive somatic symptoms being consistently prominent. The country-specific six-item somatic subscales were significant predictors of depression, with odds ratios (95% CI) of 1.56 (1.41, 1.73), 1.29 (1.21, 1.37) and 1.24 (1.15, 1.35) for Colombia, Jamaica and Barbados respectively.Conclusions"Difficulty moving forward" was symbolically represented in the restrictive somatic symptoms with high IDIs. The different findings among countries may reflect unidentified cultural nuances. Depression screening strategies that consider relevant somatic symptoms could be valuable.
This research is an update of the systematic review conducted by Ni Chobhthaigh and Duffy in 2019, which included data up to 2017. The updated review covers a later period (2018-2023) and follows the updated PRISMA 2020 guidelines. The aim is to identify new evidence regarding the effectiveness of psychological interventions with adoptive parents on the well-being of their adopted children, and to provide an updated profile of the characteristics of effective interventions in this field.The literature review was conducted across two relevant databases and grey literature sources. Documents published in English between 2018 and 2023 that reported on the effectiveness of psychological interventions delivered to adoptive parents, measuring psychological outcomes in their adopted children, were included. The design of the interventions had to be evaluative, empirical, and quantitative. In total, eleven studies with 748 adoptive families or individuals describing seven different types of interventions were included, and the risk of bias in each was assessed in accordance with the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions.Most interventions targeted adoptive families or adoptive parent couples. All interventions were based on attachment theory and measured the psychological well-being of adopted children (Cohen's d range: nonsignificant to 1.2), as well as the parent-child relationship (Cohen's d range: 0.21 - 0.97); in some cases, they also examined the behavioural functioning of the target population (Cohen's d range: 0,45 - 0.68).The findings from the two systematic reviews indicate promising results regarding the effectiveness of certain interventions based on the use of video feedback and the therapeutic effect of play. However, the high levels of risk of bias observed in some studies suggest caution when interpreting the findings.
BackgroundCurrent theoretical models emphasize sadness as a functional and multifaceted emotion, yet research often neglects the heterogeneity of children's co-occurring emotional responses to sad events.AimThis study investigated the heterogeneity in children's emotional responses to sad events, moving beyond variable-centered approaches that assume uniform emotionality.MethodUsing a person-centered approach grounded in the core affect framework, the primary aim was to identify distinct configurations of sadness, anger, fear, and confusion in middle childhood. A secondary aim explored whether mother's and father's attachment security and loneliness predicted membership in emotional profiles. A total of 174 children (age range: 7-11 years-old; M = 8.79, SD = 1.03; 55.9% female) participated.ResultsLatent Profile Analysis identified four distinct profiles: Sadness-Focused Response, Anxious Sadness, Emotional Overwhelming, and Externalized Sadness. ANOVAs revealed that sadness-focused profile showed higher loneliness than Emotional Overwhelming. Furthermore, Externalized Sadness showed lower attachment security for both mother and father than Sadness-Focused Response and Anxious Sadness.ConclusionThese findings underscore that sad events elicit qualitatively different emotional configurations, highlighting the need for tailored assessment and intervention strategies based on distinct emotional response patterns.
Dialectical behavior therapy-informed (DBT) techniques have shown efficacy in reducing emotional dysregulation incidents among pediatric inpatient populations. In this study, a DBT-informed training intervention was administered to elementary school educators to assess its efficacy in reducing dysregulation incidents in the classroom and increasing confidence in de-escalation. A 60-min de-escalation training equipped educators with evidence-based strategies to reduce dysregulation incidents among elementary-aged children through early non-confrontational intervention. Participants tracked the number of dysregulation episodes three weeks before and after the intervention. Additionally, pre- and post-training surveys assessed the impact of the intervention on educator knowledge and confidence in de-escalation techniques. Data demonstrated a 22% improvement in educators' confidence in addressing emotional dysregulation in students, a 52% increase in knowledge of trauma-informed care, 100% increase in knowledge of DBT principles, and 41% increase in knowledge of trauma presentations. There was also a 50% reduction in the number of post-training dysregulation incidents in the classroom. Most participants found the training valuable (89%) and were likely to recommend the training to others (94%). This pilot study suggests that a de-escalation training for educators may be effective in improving educator confidence in supporting students and reducing dysregulation incidents in the classroom.
BackgroundLoneliness during adolescence has increased worldwide in recent years and has been consistently associated with a broad range of adverse psychosocial outcomes. The availability of valid and reliable measures is essential for the early identification of loneliness and for the rigorous evaluation of intervention effectiveness. Nevertheless, multidimensional, psychometrically validated instruments for assessing loneliness in Greek adolescents remain limited.ObjectiveThe aim of the present study was to examine the psychometric properties of the Greek version of the Relational Provisions Loneliness Questionnaire (RPLQ; Hayden-Thomson, 1989), which assesses social and emotional dimensions of loneliness (i.e., integration and intimacy) within family and peer relationships.MethodsThe sample consisted of 503 students aged 13-14 years, recruited from secondary schools through stratified random sampling. The factor structure was tested via Confirmatory Factor Analysis, while internal consistency, validity evidence, and measurement invariance across gender were examined.ResultsThe four-factor model demonstrated the best fit (CFI = .997, TLI = .997, RMSEA = .032, SRMR = .050) and yielded high standardized factor loadings (λ = .63-.93). Internal consistency was high across all dimensions (ω = .87-.92), and convergent, discriminant, and concurrent validity were supported. Measurement invariance across gender was supported at the configural, metric, and scalar (threshold) levels.ConclusionsThe Greek version of the RPLQ is a valid and reliable instrument for the multidimensional assessment of adolescent loneliness, supporting its use in research and prevention efforts.
BackgroundCaregivers of children with tic disorders experience substantial psychological and social burdens; however, existing research is predominantly cross-sectional, and their lived emotional experiences remain insufficiently explored through qualitative approaches.ObjectiveThis study aimed to explore the emotional experiences of primary caregivers of children with tic disorders throughout the caregiving process.MethodsA descriptive phenomenological design was employed. Semi-structured in-depth interviews were conducted with 13 primary caregivers recruited through purposive sampling. Data collection continued until thematic saturation was reached. Interview transcripts were analyzed using Colaizzi's seven-step method.ResultsThree main themes emerged: multiple caregiving burdens, emotional and psychological distress, and caregiving challenges and coping strategies. Caregivers reported persistent negative emotions, including anxiety, guilt, and emotional exhaustion, which were intensified by financial strain, family conflict, and limited access to professional medical services.ConclusionCaregivers of children with tic disorders experience considerable caregiving burdens and psychological distress, which may hinder both caregiver well-being and the child's rehabilitation. Strengthening psychological support systems and improving access to professional healthcare resources are essential to address caregivers' multifaceted needs.
Despite the increase in research in parenting skills, intervention programs, methods, and their evaluation remain segmented across different disciplines. This systematic literature review assessed and synthesized the existing literature on intervention programs aimed at parents or caregivers of children, and how they can promote positive parenting skills. Based on studies published between 2020 and 2025 in various databases (Web of Science, EBSCO, and Scopus), 13 peer-reviewed articles that fully met the inclusion criteria were analyzed. The results demonstrated that parental interventions, even with different formats and applied in diverse cultural contexts, are effective in improving parenting practices and, outcomes for children. Interventions based on psychoeducation, modeling, reinforcement, and personalized feedback proved to be the most effective. Future research may adopt a more inclusive approach regarding languages and publication sources.
BackgroundMental disorders affect around 14% of adolescents worldwide and often lead to lasting cognitive and emotional difficulties. Executive functions (EF) are frequently impaired and health-related quality of life (HRQoL) is reduced. Chess has been proposed as a low-cost cognitive remediation training (CRT). This pilot study examined whether a chess-based CRT could enhance EF and HRQoL in adolescents with mental disorders.MethodsA quasi-experimental study was conducted at a child and adolescent psychiatry department. Participants aged 13-17 years were assigned to either a six-week chess intervention (experimental group, EG) or treatment as usual (control group, CG). Both groups received standard multidisciplinary therapy, while the EG additionally participated in weekly 90-min chess sessions based on The King's Plan for Kids. Cognitive flexibility (DCCS), inhibitory control (Stop-Signal Task), sustained attention (d2-R), and working memory (n-back task) were assessed alongside HRQoL (KIDSCREEN-27). Data were analyzed using t-tests.ResultsThirty-three adolescents were included (19 EG, 14 CG; 82% female). The EG showed significantly faster reaction times in the working memory task (p = .016, d = 0.79) and greater Psychological well-being CG (p = .035, d = 0.67). No significant group differences were found for other EF measures.ConclusionChess-based CRT was associated with improved working memory efficiency and psychological well-being, supporting its potential as a feasible, engaging, and low-risk adjunct to standard therapy. Larger randomized trials are needed to confirm these preliminary results.
BackgroundInsufficient school-night sleep is common among U.S. adolescents. The 2023 Youth Risk Behavior Survey (YRBS) includes a basic-needs support item about adult effort to ensure safety, clean clothes, and food.MethodsWe conducted a cross-sectional secondary analysis of the 2023 national YRBS. Insufficient sleep was defined as fewer than 8 hours on an average school night. Support was coded as present versus lacking. Survey-weighted models adjusted for demographic, behavioral, mental-health, and BMI covariates.ResultsAmong students with nonmissing sleep data (n = 17,441), 76.8% reported insufficient sleep. In the sleep/support frame (n = 15,607), prevalence was 76.0% with support present and 82.0% with support lacking. In the multiply-imputed primary model (m = 20), lacking support was associated with a small, statistically detectable increase in insufficient sleep (aPR = 1.052, 95% CI 1.007 to 1.098; ARD = +4.3 percentage points, 95% CI + 0.5 to +8.1). A complete-case sensitivity model gave a comparable but less precise estimate (aPR = 1.036, 95% CI 0.990 to 1.085).ConclusionsLacking perceived basic-needs support marked higher unadjusted insufficient-sleep prevalence, but adjusted estimates were modest. Sleep screening and basic-needs assessment may be clinically useful together; longitudinal work is needed to clarify directionality.
