We describe the implementation and evaluation of an online sexuality psychoeducation group program for parents of young people attending the transgender and gender diverse outpatient service of a ...pediatric hospital. The 10 participants completed semi-structured pre- and post-intervention questionnaires assessing: whether they had ever discussed with their children about aspects of sexuality, or had the intention of doing it in the future; the level of knowledge and comfort in speaking about these topics; the perceived level of helpfulness of the intervention; and, by using open-ended items, the topics they considered to be most relevant. After attending the program, parents reported they had started talking with their children about issues which previously had been little or not discussed, such as sexting, sexually transmitted diseases, pregnancy, fertility, abuse, and healthy relationships. Participants reported increased levels of knowledge and comfort in addressing these topics and highlighted the importance of being emotionally available to their children. We discuss implications for future intervention development.
Participants of the Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (ADHD) eight years earlier do not differ significantly in repeated measures or newly ...analyzed variables that include school grades and psychiatric hospitalization. The treatment of childhood ADHD does not predict functioning six to eight years later.
Some medical and nursing schools have graduated their seniors months ahead of schedule in order to meet the overwhelming demand for health care providers. Screening and quarantine conditions have ...been instituted for patients in urgent need of inpatient care, but universal testing is not yet available in most countries, further compounding the challenges to admit children into congregate care settings. School closures have led to distance-learning and home-schooling—not to mention challenges to food distribution: school is the place where many children around the globe get a consistent daily caloric intake. The uncertain duration of the quarantine measures, the need for families to simultaneously work (or manage the stressors of employment loss), to provide childcare and to support distance-learning efforts, as well as to manage the impact of disease and loss of life in their families and communities may lead to long-lasting effects, many of them related to mental health and psychopathology.
The clinical manifestations of attention-deficit/hyperactivity disorder (ADHD) often emerge before 6 years of age, and an early onset can portend a more marked and severe clinical course. Given that ...untreated ADHD can have a negative impact on educational attainment and social functioning, early treatment is indicated, as it might translate into better distal outcomes. For this age group, the current recommendation from clinical guidelines and ADHD experts is to administer behavioral therapy as first-line treatment. Because only limited information has been available on the possible safety implications of long-term pharmacological treatment at young ages, the use of methylphenidate is reserved for cases with impairing ADHD symptoms unresponsive to psychosocial intervention.
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An association between sensationalized media reporting and subsequent increase in suicidal behavior has been documented, and adolescents are especially vulnerable to imitative influences. The aims of ...this study were to examine the characteristics of the articles reporting adult and adolescent (under age 18) suicides in the Italian press and to assess adherence to the World Health Organization (WHO) guidelines for responsible reporting.
: The print versions of the three newspapers with the widest national distribution in Italy were searched for all the articles on incident suicides printed over a 7-month period (July 2022 to February 2023). Articles were examined for adherence to the WHO guidelines.
Overall, 213 articles were identified, reporting on 122 individual suicide cases (88.5% adults and 11.5% adolescents). Of the articles, 78.9% were on adults and 21.1% on adolescents, with a ratio articles/suicide cases of 1.6 for adults and 3.2 for adolescents (
< 0.0001). Adolescent suicide articles had more words (mean 612.5 ± SD 275.6) than adult ones (462.1 ± 267.7,
= 0.001). Potentially harmful reporting features were present in both the adult and adolescent articles (12-82%). Few articles (0-15%) included protective features. Articles on adolescents were more adherent to the WHO guidelines for omitting specific information of suicide method and location.
: Significant differences were found in the press reporting of adolescent versus adult suicides, with adolescent suicides receiving more attention in terms of the number of articles and article length. Suicide press reporting can be improved. A close collaboration between journalists and suicide prevention experts may be beneficial.
We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD).
Participants were 658 children with ASD ...(age 3–17 years; mean = 7.2 years) in one of six federally-funded multisite randomized clinical trials (RCT) between 1999 and 2014. All children were referred for hyperactivity or irritability. Study designs varied, but all used the Child and Adolescent Symptom Inventory or Early Childhood Inventory to assess Attention Deficit Hyperactivity Disorder (ADHD), Oppositional-Defiant Disorder (ODD), Conduct Disorder (CD), Anxiety Disorders, and Mood Disorders. In addition, several measures in common were used to assess demographic and clinical characteristics.
Of the 658 children, 73% were Caucasian and 59% had an IQ >70. The rates of concomitant disorders across studies were: ADHD 81%, ODD 46%, CD 12%, any anxiety disorder 42%, and any mood disorder 8%. Two or more psychiatric disorders were identified in 66% of the sample. Of those who met criteria for ADHD, 50% also met criteria for ODD and 46% for any anxiety disorder. Associations between types of concomitant disorders and a number of demographic and clinical characteristics are presented.
In this well-characterized sample of treatment-seeking children with ASD, rates of concomitant psychiatric disorders were high and the presence of two or more co-occurring disorders was common. Findings highlight the importance of improving diagnostic practice in ASD and understanding possible mechanisms of comorbidity.
•We observed a high frequency of multiple concomitant DSM-defined disorders.•50% of children who met criteria for ADHD also met criteria for ODD.•46% of children who met criteria for ADHD also met criteria for an anxiety disorder.•Findings highlight the importance of improving diagnostic practices in ASD.
About one-fifth of patients with anorexia nervosa (AN) engage in non-suicidal self-injury (NSSI). This study examined clinical and temperament profile of female adolescents with both disorders ...(AN+NSSI) as compared with peers with AN only.
A consecutive sample of 73 female adolescents with AN (mean age: 13.77 years), who had been admitted to inpatient or day-hospital services, received clinical, cognitive, and temperament/character evaluations. Of them, 32 met DSM-5 criteria also for NSSI. Assessments included demographics, standard nutrition parameters, Youth Self-Report (YSR), Wechsler Intelligence Scale for Children IV (WISC-IV), Temperament and Character Inventory (TCI), and Global Assessment of Functioning (GAF).
No differences were detected between AN+NSSI and AN in demographics, body mass index, or age at onset of AN. AN+NSSI had higher rate of binging and purging, higher YSR scores for both internalizing and externalizing psychopathology, lower total IQ, and lower Self-directedness and Cooperativeness scores.
These data suggest that adolescents with AN+NSSI have psychopathological, cognitive and overall character features that differ from patients with AN only. These characteristics may have implications for treatment and outcome.
•Adolescents with anorexia and NSSI displayed more psychopathology, binging/purging, and lower functioning than peers with AN.•Global intelligence scores were lower in AN+NSSI than in AN.•AN+NSSI showed character features with lower levels of self-directedness and cooperativeness than AN.
Gender diverse children (here defined as minors under 18) face greater risk for depression, anxiety and suicidality than their cisgender peers. This situation calls for research on protective factors ...of mental health in this population, and on appropriate therapeutic and supportive interventions. This systematic review aimed at (1) examining literature on the role of attachment, mentalization and reflective functioning in protecting mental health of gender diverse children and identifying the mental health outcomes that have been assessed; and (2) outlining interventions based on attachment, mentalization and reflective functioning that have been proposed. The work was conducted according to the PRISMA guidelines. Fifty-one studies were identified and 9 met the inclusion criteria. Results indicate that, besides a general protective role for mental health, attachment, mentalization and reflective functioning moderate and mediate, through different pathways, (1) the association between gender diversity and emotional/behavioural problems; and (2) the negative effects of minority stress. Mentalization seems to be an individual resilience factor; the capacity of the caregiver to serve as a secure base and validate the internal experience of incongruence of the child promote a healthy psychological development. Three levels of action for interventions were identified: individual, family and community.
The objective of this study was to examine psychopathology and its impact on adaptive functioning in a sample of patients affected by Noonan syndrome (NS), a genetically heterogeneous condition with ...systemic manifestations.
Forty-two subjects affected by NS (23 males and 19 females), aged 5 to 21 years (mean 12.6 ± SD 5.1), were assessed for nonverbal cognitive abilities, with dimensional measures of psychopathology, adaptive functioning, and family quality of life.
The nonverbal intelligence quotient (IQ) mean was 99.4 ± SD 22.2, with 3 subjects (8%, 95% confidence interval CI, 1.6%-20.9%) showing cognitive impairment (IQ<70). The Parent Child Behavior Checklist (CBCL) total psychopathology score was in the clinical range in 10% of sample and borderline in another 10%. On the Conners' Parent Rating Scales, scores suggestive of attention-deficit/hyperactivity disorder (ADHD) were in the clinical range in 20%. On the autism quotient, autism spectrum disorder symptoms were reported in 10%. Higher scores on the Adaptive Behavioral Assessment System-Second Edition and on the World Health Organization Quality of Life (26 items) were associated with lower problems on the CBCL (r = -0.63, 95% CI, -0.78 to -0.40 and r = -0.48, 95% CI, -0.69 to -0.20, respectively).
Psychopathology was common in patients with NS and negatively correlated with global functioning and family quality of life. Treatable psychopathology, such as ADHD, may constitute a treatment target for improving adaptive functioning.
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