IntroductionAdolescents in low- and middle-income countries experience high rates of common mental disorders (CMDs) but have limited access to adolescent-friendly, evidence-based care. While Interpersonal Psychotherapy for Adolescents (IPT-A) is effective, brief group IPT-A delivered through task-shifted, stepped-care has not been rigorously evaluated in Kenyan primary care.MethodsWe conducted a pilot randomized controlled trial to examine the acceptability, feasibility, and preliminary effectiveness of the Ushirikiano treatment model, a task-shifted, stepped-care approach combining a brief (four-session) group IPT-A (IPT-G-A) delivered by community health promoters, with fluoxetine for severe cases where indicated. Adolescents aged 12–18 years with DSM-5 TR depression, anxiety, and/or somatic symptom disorder (N = 32) were randomized to the Ushirikiano Model or enhanced treatment as usual (eTAU). Quantitative and qualitative data were collected at baseline, post-treatment, and at follow-up at months 1 and 2. The COM-B framework informed the assessment of behavior change.ResultsAll adolescents in the intervention arm were retained compared with 69% in eTAU. Intervention fidelity ranged from moderate to high and showed improvement with supervision. Participants found the intervention acceptable, relevant, and supportive, and reported applying IPT-G-A skills to handle interpersonal and school-related stressors. Community health promoters reported increased confidence with blended training and ongoing supervision. Preliminary outcomes trends suggested potential reductions in depressive symptoms and modest functional improvement in the Ushirikiano arm, with most participants achieving symptomatic remission at the month 2 follow-up. As a pilot study, these findings provide preliminary evidence of potential benefit and support further evaluation of the intervention in a fully powered trial.ConclusionThe Ushirikiano treatment model appears acceptable and feasible for addressing adolescent depression in Kenyan primary care. While preliminary findings suggest the potential for improvements in depressive symptoms and functioning, the study was not designed to establish effectiveness and did not assess for anxiety and somatic symptom disorder. These findings support further evaluation in fully powered trials to determine clinical effectiveness for CMDs, cost-effectiveness, and optimal implementation strategies.Clinical Trial registrationhttps://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=33227, Pan African Clinical Trial Registry, PACTR202503728947243.
IntroductionArmed conflict and forced displacement disrupt the safety, caregiving, education, and healthcare essential for healthy child development, placing children and adolescents at increased risk for adverse mental health outcomes. This narrative review summarizes the psychological consequences of war and displacement and highlights trauma-informed interventions across different stages of recovery.MethodsA narrative review of the literature was conducted using PubMed and Google Scholar. Studies published between January 2000, and January 2025 were identified using keywords related to children, adolescents, armed conflict, war, forced displacement, refugee populations, mental health outcomes, post-traumatic stress disorder (PTSD), depression, anxiety, and psychosocial interventions. Relevant English-language articles addressing psychological outcomes and intervention strategies among conflict-affected youth were reviewed and synthesized.ResultsAcross studies, exposure to armed conflict and displacement was consistently associated with elevated rates of PTSD, depression, anxiety, behavioral disturbances, sleep problems, and impaired social functioning. Mental health effects were observed during acute crises and often persisted long after conflict exposure, increasing the risk of chronic psychiatric disorders and intergenerational transmission of trauma. Protective factors included stable caregiving relationships, educational continuity, social support, and access to community-based psychosocial services. However, significant disparities in service availability and accessibility were reported, particularly among displaced and refugee populations.ConclusionArmed conflict and forced displacement harm children through direct trauma exposure, disrupted caregiving, loss of educational and social structure, chronic deprivation, and barriers to care, with effects that persist well beyond the acute phase. Trauma-focused cognitive behavioral therapy and narrative exposure therapy have the strongest supporting evidence but are the least scalable in active conflict, whereas group and non-specialist approaches offer reach with more variable effects. Intergenerational transmission is best supported for psychological, familial, and social pathways; biological mechanisms remain preliminary. Stepped, layered, and culturally adapted delivery embedded in schools, families, and primary care is needed.
ObjectivesAdolescent depression is a major public health concern with important psychosocial and educational implications. This study examined the distribution of a depressive-symptom-risk/general-distress composite and its psychosocial correlates among secondary school students in Bisha Province, Saudi Arabia, and explored teachers' perspectives on how depressive symptoms or distress affect students in school settings.MethodsA school-based cross-sectional mixed-methods study was conducted during the 2024–2025 academic year. Quantitative data were analyzed from 425 secondary school students using a self-administered questionnaire containing a 17-item depressive-symptom-risk composite and psychosocial stressor items. Composite items were coded from 0 to 7 (theoretical total range 0–119; observed range 0–84). For descriptive purposes, four sample-specific, non-diagnostic score bands were used (0–24, 25–38, 39–67, and ≥68), and the primary logistic-regression outcome was dichotomized as 0–24 vs. ≥25. Analyses included chi-square tests, Spearman correlation, Kruskal–Wallis tests, and multivariable logistic regression, with p-values corrected for multiple comparisons using the Benjamini–Hochberg procedure. Qualitative data were obtained through semi-structured interviews with 42 teachers and analyzed thematically. Ethical approval was obtained from the University of Bisha Institutional Review Board.ResultsOverall, 47.1% of students had an elevated composite score (≥25). In the 425-student analytical sample, family conflict (aOR = 5.47) and emotional or physical violence (aOR = 3.40) remained significantly associated with elevated scores after correction for multiple comparisons; bullying showed a positive uncorrected association (aOR = 1.68) that did not survive correction. Health-related conditions, smoking, and family history of mental illness were also associated with higher score bands in bivariate analyses. Gender-stratified analyses showed that, after correction, family conflict remained significant among male students, while family conflict and emotional/physical violence remained significant among female students; associations for bullying among males and sexual harassment among females were positive but did not survive correction and should be interpreted as suggestive. Composite scores were not significantly associated with academic performance (CGPA). Teachers reported emotional withdrawal, behavioral changes, reduced classroom engagement, and limited training in identifying and supporting affected students.ConclusionsElevated depressive-symptom-risk composite scores were common among secondary school students and were strongly associated with modifiable psychosocial stressors, particularly family conflict and exposure to violence. Because the instrument and its score bands are not diagnostic thresholds, the findings should be interpreted as relative psychosocial/depressive-symptom risk rather than prevalence of clinical depressive disorder. Given the cross-sectional design, these associations are correlational rather than causal. Findings highlight the need for validated school-based mental health screening, teacher training, and family-centered interventions.
IntroductionNot all gifted students realize their full potential and many gifted students are underachieving. To examine whether gifted primary school students at risk for underachievement can be identified by their teachers early on, the current study aimed to examine (1) whether different profiles can be distinguished among gifted students based on teacher ratings of observable characteristics (classroom behavior, task commitment, educational performance, teacherchild relationship quality, and peer relations), (2) to what extent the identified profiles and students' profile membership are stable over time, and (3) to what extent profile membership is associated with achievement (growth).MethodsParticipants were two cohorts of Grade 3 students from primary schools in all districts of the Netherlands achieving above the 90th percentile on a cognitive ability test (N = 1,303; Mage = 8,44 years), who were assessed again in Grade 6.ResultsLatent Profile Analyses revealed four profiles of gifted students in Grade 3, which mostly represented general quantitative differences in teacher ratings: above average, average independent and low conflict, average, and below average. Similar profiles were found in Grade 6, having similar sizes as in Grade 3. Latent Transition Analyses showed that half of the students changed profile between Grades 3 and 6. Profile membership in Grade 3 was related to achievement in Grades 3 and 6 (reading fluency, reading comprehension, and math) and, to a small extent, to achievement growth between Grades 3 and 6.DiscussionThis study suggests that quantitatively distinct groups of gifted students can be distinguished based on teacher ratings of students' characteristics and that students' cognitive and non-cognitive characteristics, as observed by their teacher, could help to identify students at risk for underachievement.
BackgroundIn recent decades, advances in neonatal care have led to a substantial reduction in mortality associated with prematurity. However, preterm birth remains the leading contributor to long-term neurodevelopmental impairment across the lifespan. The present study aimed to longitudinally assess neurodevelopmental outcomes in individuals born very preterm (VPT) or extremely preterm (EPT) and to retrospectively investigate associations between early neurodevelopmental trajectories and psychopathological and functional profiles in adolescence.MethodsThe study included 52 adolescents aged 14–18 years, drawn from an original cohort of 118 individuals born before 31 weeks of gestation between 2005 and 2011. Neonatal clinical and anamnestic data were collected, and early neurodevelopment within the first two years of life was assessed using the Bayley Scales of Infant and Toddler Development, Second Edition. Fifteen years later, participants underwent a multidimensional follow-up assessment via self-administered questionnaires delivered through a secure web-based platform. Both participants and one parent completed a comprehensive psychopathological evaluation, including the Child Behavior Checklist (CBCL), Autism Spectrum Quotient (AQ), Obsessive–Compulsive Inventory (OCI), Prodromal Questionnaire–16 (PQ-16), and Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE).ResultsThe mean gestational age was 28 weeks (SD = 1.8; range: 23–31), and the mean birth weight was 1,120.8 g (SD = 322.4). VPT individuals showed higher AQ scores, suggesting increased vulnerability to autistic traits, whereas EPT individuals exhibited higher CBCL Attention Problems scores, consistent with ADHD-related features. Latent Profile Analysis identified a two-profile solution: Profile 1 (“High autism traits”) was characterized by elevated AQ scores and relatively low OCI, PQ-16, and IPASE scores, whereas Profile 2 (“High psychotic and OCD traits”) showed markedly elevated PQ-16, IPASE and OCI scores. Hierarchical multiple regression analyses revealed that the Psychomotor Development Index slope was the only significant predictor of later social functioning (B = −5.782, β = −.289, p = .040), with more favorable early motor trajectories associated with fewer social difficulties in adolescence.ConclusionsVery and extremely preterm birth are associated with long-term neurodevelopmental and psychopathological vulnerability. Early motor development appears to be a key predictor of later social functioning, potentially shaping distinct developmental trajectories toward autism-related features or psychosis vulnerability.
ObjectiveThis retrospective chart review examined clinical changes in ADHD symptoms and global functioning following guanfacine extended-release (GXR) initiation in a diagnostically heterogeneous clinical sample of children and adolescents with ADHD.MethodsThirty-eight children and adolescents aged 6–18 years with ADHD, with or without comorbid neurodevelopmental or psychiatric conditions, who were prescribed guanfacine extended-release were included in the tolerability analysis. Pre–post clinical outcome analyses were conducted in 33 patients who continued GXR for at least three months and had follow-up scale assessments available between weeks 4 and 12 after treatment initiation. Clinical data, including ADHD-related rating scales and autism-related clinical measures, were obtained retrospectively from medical records. Diagnoses were based on DSM-5 criteria, and psychiatric comorbidities were assessed using K-SADS-PL.ResultsOf the participants, 76.3% were male. All participants had ADHD, and 63.2% had comorbid ASD. The mean final weight-adjusted GXR dose was 0.05 ± 0.03 mg/kg/day. Adverse effects were reported in 28.9% of patients, most commonly restlessness. Among 33 patients with follow-up assessments obtained between weeks 4 and 12, median CGI-S scores decreased from 5 to 3, while GAS scores increased from 55 to 75. ADHD symptom ratings decreased in most Turgay scale subdomains, particularly attention deficit, hyperactivity/impulsivity, and oppositional defiant symptoms.ConclusionGuanfacine extended-release use was associated with improvements in ADHD symptom ratings and global functioning in this retrospective clinical sample. Adverse effects were observed in a clinically relevant subset of patients and led to discontinuation in some cases. Given the retrospective design, lack of a control group, small sample size, and concomitant medication use, these findings should be interpreted as preliminary real-world observations.
ObjectiveTo explore the relationship between college medical students' Perceived Social Support and learning engagement and the mediating role of psychological resilience and coping styles.MethodsThe Perceived Social Support Scale (PSSS), the Simple Medical Coping Style Questionnaire (SCSQ), Ego-resiliency Scale (ER89), and the Undergraduate Work Engagement Scale (UWES-S) were selected to conduct a questionnaire survey of 2,375 medical students.ResultsThe analysis showed that there was a significant positive relationship between perceived social support, psychological resilience, positive coping styles and learning engagement(r = 0.274∼0.973,P < 0.01);The results of the mediated effects test indicated that the mediated paths of perceived social support affecting learning engagement through psychological resilience and positive coping styles and their chain mediated effects all showed statistical significance respectively (β = 0.083,0.033,0.071).ConclusionsMedical students' perceived social support not only affects learning engagement directly, but also indirectly through the mediating role of psychological resilience and positive coping style and the chain mediating role of psychological resilience-positive coping style.
Autism care policy is at a critical inflection point. Applied behavior analysis (ABA), long established as the “gold standard” through state insurance mandates in the US, has functioned as the default reimbursable intervention for autistic children. However, advances in genomics, neuroscience, developmental psychology, and scholarship on autistic lived experience have expanded understanding of autism as a heterogeneous neurotype characterized by meaningful differences in neural organization rather than a unitary disorder. Contemporary models emphasize neurodiversity, strengths-based perspectives, and the interaction between developmental processes and environmental contexts in shaping functional outcomes. Many autistic children also meet criteria for complex care needs, requiring coordinated, interdisciplinary services across health, educational, and community systems. This manuscript proposes reframing the “autism spectrum” from a hierarchy of symptom severity to a prevention-oriented “spectrum of care.” Adapting a public health taxonomy, interventions are organized into universal, selective, and indicated levels, targeting the prevention of avoidable disability, distress, and participation barriers. This model aligns autism services with whole-child, neurodiversity-affirming, and developmentally informed care, emphasizing relational health, autonomy, and life-course participation.
BackgroundAutism spectrum disorder (ASD) is a neurodevelopmental condition characterised by restricted and repetitive behaviours (ICD-11) and severe and persistent difficulties in social interaction and communication. A marked male predominance has consistently been reported, with ASD being three times more common among boys than girls, although the biological mechanisms underlying this sex difference remain unknown. Physical and chemical stressors occurring during critical windows of development may alter foetal and infant physiology and interfere with neurodevelopmental trajectories. Among these stressors, endocrine-disrupting chemicals (EDCs), including phthalates, have been proposed as potential environmental contributors to neurodevelopmental vulnerability. In this systematic review, we examined whether early-life exposure to phthalates may be associated with sex-specific vulnerability to ASD and autistic traits.MethodsThe systematic review was conducted in accordance with the PRISMA guidelines and followed a PECO framework. The target population included human children of both sexes, ranging from early childhood to adolescence. Exposures of interest included prenatal and/or early-life exposure to phthalates, assessed through biological matrices during prenatal and/or postnatal periods. Eligible outcomes included ASD and autistic-like traits assessed using validated diagnostic or screening tools. The review was registered in PROSPERO (CRD420261438630).ResultsA total of 18 studies were included. Phthalates exposure was assessed across a broad developmental window, ranging from the preconception period to 8 years of age. Urinary biomarkers represented the primary method for assessing chemical exposure, while a smaller proportion of studies also relied on blood samples. Sample size ranged from 77 to 3,220, and the age at assessment of autistic traits or ASD-related outcomes ranged from 18 months to 15 years. The Social Responsiveness Scale (SRS) was the most frequently used instrument for assessing autistic traits, followed by the Autism Diagnostic Observation Schedule (ADOS).ConclusionPrenatal exposure to phthalates, especially during early and mid-gestation, appears to be associated with subtle increases in autistic traits, with some evidence suggesting greater susceptibility among boys, particularly in relation to MBP, MEP, and DEHP-related metabolites. However, evidence remains limited and heterogeneous, and current findings require further confirmation.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/home, PROSPERO CRD420261438630.
Background:Non-suicidal self-injury (NSSI) is a prevalent behavior among adolescents and young adults. According to the Integrated Motivational-Volitional (IMV) model, pre-motivational vulnerabilities such as depression, anxiety, and low self-efficacy underlie self-harming behavior. It remains unclear how these factors combine into distinct clinical profiles and how such profiles differ regarding intrusive prospective mental imagery, emotion regulation, and NSSI frequency. Therefore, this study aimed to identify psychological subgroups based on distress and self-efficacy using a person-centered cluster approach, and to examine how these profiles, together with NSSI age of onset, relate to imagery intrusiveness, emotion regulation strategies, and NSSI frequency. Methods:Five hundred fifty-seven adolescents and young adults with a history of NSSI completed an online survey. A TwoStep cluster analysis based on depression (BDI-II), anxiety (STAI-T), and self-efficacy (WIRKALL_r) identified psychological profiles. General Linear Models (GLMs) with bootstrapping (1,000 resamples) examined the independent and interactive effects of cluster membership and NSSI age of onset (early: <12 vs. late: ≥12 years) on intrusive imagery (IFES-S), emotion regulation strategies (ERQ), and NSSI behavior (SITBI). Results:Two profiles emerged: a High-Risk cluster (high distress, low self-efficacy) and a Low-Risk cluster (low distress, high self-efficacy). The High-Risk cluster showed significantly higher NSSI frequency, greater intrusive imagery, increased suppression, and reduced cognitive reappraisal. Early NSSI age of onset was independently associated with higher lifelong NSSI frequency and greater imagery intrusiveness across both clusters. No significant cluster-by-onset interactions were found, supporting an additive risk model. Discussion:Findings support the pre-motivational phase of the IMV model and suggest that intrusive imagery and maladaptive emotion regulation align with the transition from distress to NSSI. The additive effects of psychological risk profile and early NSSI age of onset highlight the need for targeted interventions, including Imagery Rescripting and self-efficacy training.
Children may experience pediatric medical traumatic stress as a consequence of exposure to medical procedures, illness, or injury that are perceived as distressing, threatening, or otherwise aversive. In order to address the traumatic stress, trauma-informed care practices are warranted. The application of trauma-informed care practices has been widely used in healthcare for over 25 years; however, its integration into behavior-analytic practice has emerged more recently. Although trauma-informed care principles have informed practice across multiple areas of behavior analysis, relatively few studies have addressed their application to the treatment of pediatric feeding problems. Rajaraman et al. proposed four tenets of trauma-informed care that complement behavior-analytic practice as a whole: (1) acknowledge trauma and its potential impact, (2) ensure safety and trust, (3) promote choice and shared governance, and (4) emphasize skill building. In this paper, we describe a novel framework of the application of these tenets into behavioral feeding treatment. Specifically, we examine a balanced progression in which trauma-informed care and evidence-based interventions are integrated and implemented in tandem.
IntroductionHealth-economic evidence comparing home treatment (HT) and inpatient treatment (IT) in child and adolescent psychiatry is scarce. This study assessed the cost-effectiveness of both interventions for children and adolescents in acute psychiatric crises using a decision analysis.MethodsWe developed a Markov state-transition model to evaluate the cost-effectiveness of HT compared to IT in children and adolescents with an acute psychiatric crisis, over a 3-year time horizon from a German healthcare provider perspective. Evaluated outcomes included quality-adjusted life years (QALYs) gained, total costs, and the incremental cost-utility ratio (ICUR; in Euro per QALY). Transition probabilities and utility values were obtained from the published literature. Direct medical and direct non-medical costs for IT were derived from German reference data published by the Institute for the Hospital Remuneration System (InEK). Costs for HT were estimated using micro-costing based on the German ward-equivalent treatment model (Stationsäquivalente Behandlung, StäB). Costs and effects were discounted at 3% annually. One-way and probabilistic sensitivity analyses assessed the robustness of the base-case analysis results. Results were reported in accordance with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist.ResultsHT was associated with lower discounted costs (61,213 €) and slightly fewer discounted QALYs (1.801 QALYs) compared to IT (total costs: 93,737 € and 1.807 QALYs). Moving from HT to IT was associated with 0.006 QALYs gained and resulted in an ICUR of 5,417,376 €/QALY gained. Results were robust in sensitivity analyses over a wide range of parameter variation.DiscussionThis cost-utility analysis suggests that HT may be a cost-effective alternative to IT in children and adolescents with acute psychiatric crises in Germany, primarily driven by substantial cost savings during the acute phase. However, due to limited and heterogeneous clinical data, results should be interpreted cautiously. Future randomized studies with longer follow-up and child and disease-specific quality-of-life measures are needed to validate these findings.
BackgroundHigh readmission rates after child and adolescent inpatient treatment point to underrecognized issues in the post-discharge period. With a shift towards early reintegration in youth mental health care, the family environment youth return to is of particular importance for post-discharge outcomes, but there is currently a knowledge gap on family-level risk and protective factors in this context. Caregiver burden may act as a crucial mechanism linking family context to youth recovery.Methods and designThe ReCoVer study investigates caregivers’ perspectives on family care and youth mental health following inpatient psychiatric treatment (minimum 24-hour stay) of youth aged 7–21 in Germany, Austria, and Switzerland. In a mixed-methods design, ReCoVer combines a longitudinal panel survey with semi-structured interviews. Caregivers of youth who received inpatient mental health treatment (target N = 70) will be recruited during discharge planning or follow-up sessions within one month after discharge. At baseline (T0) and after three (T1) and six (T2) months, participants will report on youth outcomes, caregiver well-being, and family processes. Primary outcomes (inpatient readmission, mental health problems) will be analyzed with regard to the contribution of caregiver burden and other family factors. Interview and survey data will be synthesized to identify burden, resources, and needs of families around their child's return to home care.DiscussionResults from this study are expected to provide insights into family challenges and their associations with youth mental health in the immediate and medium-term post-discharge period.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT06865573, NCT06865573.
Background:Autism intervention research has largely prioritized children and adolescents, with limited guidance for adults. Social virtual environments (SVEs; e.g., VRChat) are widely used by autistic adults for connection, yet their role as intervention settings remains under-examined. This study explores clinicians' perspectives on feasibility, risks, and essential design requirements for clinician-informed SVE-based socio-relational interventions for autistic young adults with low support needs. Methods:We conducted nine semi-structured focus groups with Italian clinicians (N = 26) across three regions (Veneto, Trentino, Lazio) and five semi-structured international interviews (U.S. n = 4; Australia n = 1). Transcripts were analyzed via inductive, codebook-informed thematic analysis grounded in reflexive qualitative principles. Because the study involved four coders working across two linguistically distinct datasets, a shared coding framework was used as a pragmatic coordination tool to support transparency, interpretive consistency, and auditability across the research team (the intent was not to establish positivist inter-rater reliability or eliminate researcher subjectivity). Datasets were first coded separately and then integrated through matrix-based synthesis to identify contextually situated points of convergence and divergence. Results:Italian clinicians emphasized neurodiversity-affirming aims, context-dependent social difficulty (including anxiety/overwhelm), structured scaffolding and mediation, ecological generalization, and SVEs as conditional tools requiring boundaries. International clinicians foregrounded autonomy and choice, emotional safety in relation to masking, neurotype composition as an ingredient for belonging, identity-affirming collaboration, and regulation/repair practices. Across datasets, clinicians emphasized safety-contingent participation, non-negotiable personalization/controllability of demands (i.e., sensory, social), and the protective value of supported pauses and exits. Contextual differences centered on the dominant logic of support (competence-building scaffolding vs. liberation/identity integration), mediator-led structure vs. neurotype-aligned spaces, intersectionality as primary vs. contextual framing, and distinct risk emphases (avoidance/overuse vs. relational ambiguity and rejection). Conclusion:Clinicians conceptualize SVEs not as inherently therapeutic technologies but as conditional social infrastructures whose potential value depends on how safety, autonomy, and identity are supported. Clinician-informed SVE-based interventions for autistic adults may therefore require integrating structured mediation with explicit autonomy- and identity-affirming safeguards, offering a pathway beyond the traditional' skills vs. acceptance' divide in autism intervention research.
IntroductionThe current study examined longitudinal links between adolescent body mass index and body bulk with externalizing behaviors using data from the University of Southern California's Risk Factors for Antisocial Behavior twin project.MethodsThe sample included 1,260 individuals (51% females), with 603 twin pairs (254 monozygotic; 349 dizygotic). Body mass index and body bulk were derived from measures of height and weight obtained at age 13-14. Externalizing behavior was measured using the Youth Self-Report at age 13-14 and the Adult Self-Report at age 19-20.ResultsHigher body mass index and greater body bulk were associated with higher levels of externalizing behavior both concurrently at age 13-14, and prospectively at age 19-20 (B's = 0.11-0.42, p's < .05). Twin modeling indicated high heritability for body mass index and body bulk (h2 = 0.73-0.81) and moderate heritability for externalizing behavior (h2 = 0.31-0.41). Bivariate models suggested that genetic factors contributed to the modest covariance between body size and externalizing behavior, although the genetic correlation estimates were imprecise.ConclusionFindings are consistent with the possibility that some genetic influences are shared between body size and externalizing behavior; however, the modest phenotypic associations and uncertainty surrounding the genetic correlation estimates warrant cautious interpretation.
IntroductionThis study examines the impact of socio-environmental threats on various aspects of young adults' well-being in Malaysia. It focuses on understanding the odds posed by different threats in relation to broader global challenges to this population's quality of life, mental health, and psychological well-being.MethodsA cross-sectional quantitative design with a sample of 508 young adults was used in this study. Data were analysed using logistic regression.ResultsThe findings reveal that key threats to well-being, namely economic instability, career uncertainty, and family pressures, significantly impact the quality of life, mental health, and psychological well-being of young adults in Malaysia. Additionally, the threat of war is perceived to increase the odds of poor personal development. Global and environmental threats, along with societal expectations, were associated with greater odds of positive behaviour. Interestingly, concerns about unemployment were associated with stronger social bonding, suggesting varied responses to different threats.DiscussionThis study highlights the socio-environmental factors influencing young adults' well-being in Malaysia through an explorative lens. Future research could delve deeper into the specific sentiments of young adults and explore these threats and uncertainties from more focused perspectives.
ObjectiveFood neophobia and picky eating in young children are important barriers to developing healthy eating patterns. Given the crucial role that families, especially parents, play in shaping children's eating behavior, we aimed to examine emotional undereating underlying children's food neophobia and picky eating within the family context.MethodParents (N = 170) of children aged 3–8 years (M = 5.45, SD = 1.69; 51.8% boys) reported on their child's food neophobia, picky eating, and emotional undereating. Parents also reported on their own food refusal behavior (modeling), pressure to eat (feeding practices), and emotional acceptance of the child (parenting style).ResultsMediation analyses showed that emotional undereating mediated the association between parental acceptance of the child and both food neophobia and picky eating. In contrast, parents' own food refusal behaviors and pressure to eat were directly associated with children's food refusal behavior. These associations were not mediated by emotional undereating.DiscussionThe findings underscore the role of the parent-child relationship quality and emotion regulation in explaining children's food refusal behavior. Longitudinal research is needed to replicate and extend these results and further examine how family context variables and emotion regulation strategies contribute to the development and maintenance of children's food avoidance.
Background/objectiveBorderline personality disorder (BPD) is a severe mental health condition typically identified in adolescence. Insecure attachment has been linked to BPD, with adult studies suggesting that reflective functioning might represent a mechanism linking attachment patterns to BPD. However, this interplay remains insufficiently explored in early adolescence—a developmental phase associated with reorganization of attachment and social cognitive function. The aim of this study is to explore the association between attachment styles and borderline personality traits (BPTs) in early adolescence and to test whether reflective functioning explains the association between attachment and borderline traits.MethodsA total of 112 adolescents aged 11–14 years attending a community outpatient child and adolescent mental health service completed the Attachment Questionnaire for Children (AQC), the Reflective Functioning Questionnaire (RFQ) and the Greek modified Borderline Personality Features Scale – Children (BPFS-C). Mediation analysis was conducted using secure attachment as the reference category.ResultsInsecure attachment styles were significantly associated with higher odds of elevated BPTs. Reflective functioning significantly explained a significant amount of variance in the association between ambivalent attachment and high BPTs [OR = 2.92, 95% BCa CI (1.14, 10.17)], whereas avoidant attachment demonstrated a smaller but marginally statistically significant indirect effect through reflective functioning [OR = 1.77, 95% BCa CI (1.00, 3.95)] alongside a strong direct effect [OR = 4.34, 95% BCa CI (1.36, 12.53)].ConclusionsAvoidant and ambivalent attachment appear to be strongly linked to BPTs in early adolescence through partially distinct pathways, highlighting the need for early targeted interventions.
IntroductionRetracing the theme of what can legitimately be considered “evidence” in psychotherapy, the present work shows the application of an ad hoc, rule-based text mining program specifically designed to analyze therapy session transcripts. Developed within a systemic-relational framework, and grounded in Semantic Polarities Theory, the program works through a hybrid human-in-the-loop approach and provides data for subsequent descriptive and inferential analyses on meaning transformation starting from consultation sessions.ParticipantsThe present study examines the clinical case of an adolescent girl with untreated past non-suicidal self-injury (NSSI) and suicidal ideation. Before moving to the joint family work phase, family therapy consultation was conducted in separate sessions within an alternating parent-adolescent format.MethodsOverall semantic activity was compared across events with Wilcoxon rank-sum tests. In categorical comparisons, data were analyzed using chi-square tests, with df-scaled Cramer's V to measure effect sizes and Monte Carlo p-values. Initial subjects' positioning profile across Family Semantic Grids (FSGs) was described using semantic heatmaps and main polarities use. Linear Mixed-Effects (LME) models were implemented to track longitudinal changes in the subjects' positioning, specifically investigating the therapist's influence.ResultsResults indicated that the therapist introduced a significantly lower proportion of new meanings across all comparisons during the consultation phase. LME models showed significant intensity shifts toward positive-valued meanings, supported by ICC, Rm2 and Rc2 values, and inform on the significant specific use of Narrated Semantic Polarities (NSP) and Interactive Semantic Polarities (ISP) across participants.DiscussionOverall, the study supports the feasibility of a semi-automated process for coding and for subsequent analyses of family semantic polarities. In fact, performed analyses demonstrate how therapist positioning and meaning management through re-expression and semantic shifts significantly influenced family members' change in positioning, an effect especially evident for the identified patient. In conclusion, rule-based text mining can yield process indicators that remain clinically legible. Read as “semantography,” results provide a compact, data-grounded map of coupling and early change while staying parsimonious on case disclosure. Limits and future directions of the present pilot study are discussed.
