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The author offers insights about the "Journal of Child Psychology and Psychiatry (JCPP)." He believes that the influence of the journal may be increased further if authors consider the international impact of what they write. The "Journal of the American Academy of Child and Adolescent Psychiatry" is the leading child mental health journal in the U.S. and publishes less articles that come from Great Britain. On the other hand, JCPP published half of papers that come from Great Britain, and an equal number from the U.S.

Background: Causal explanations for the association of young motherhood with increased risk for child attention‐deficit hyperactivity disorder (ADHD) remain unclear. Methods: The ABCD Study recruited 11,878 youth from 22 sites across the United States between June 1, 2016 and October 15, 2018. This cross‐sectional analysis of 8,514 children aged 8–11 years excluded 2,260 twins/triplets, 265 adopted children, and 839 younger siblings. We examined associations of maternal age with ADHD clinical range diagnoses based on the Child Behavior Checklist and NIH Toolbox Flanker Attention Scores using mixed logistic and linear regression models, respectively. We conducted confounding and causal mediation analyses using genotype array, demographic, socioeconomic, and prenatal environment data to investigate which genetic and environmental variables may explain the association between young maternal age and child ADHD. Results: In crude models, each 10‐year increase in maternal age was associated with 32% decreased odds of ADHD clinical range diagnosis (OR = 0.68; 95% CI [0.59, 0.78]) and 1.09‐points increased NIH Flanker Attention Scores (β = 1.09; 95% CI [0.76, 1.41]), indicating better child visual selective attention. However, adjustment for confounders weakened these associations. The strongest confounders were family income, caregiver education, and ADHD polygenic risk score for ADHD clinical range diagnoses, and family income, caregiver education, and race/ethnicity for NIH Flanker Attention Scores. Breastfeeding duration, prenatal alcohol exposure, and prenatal tobacco exposure were responsible for up to 18%, 6%, and 4% mediation, respectively. Conclusions: Socioeconomic disadvantages were likely the primary explanation for the association of young maternal age with child ADHD, although genetics and modifiable environmental factors also played a role. Public policies aimed at reducing the burden of ADHD associated with young motherhood should target socioeconomic inequalities and support young pregnant women by advocating for reduced prenatal tobacco exposure and healthy breastfeeding practices after childbirth. [ABSTRACT FROM AUTHOR]

Background: Neurofeedback is considered a promising intervention for the treatment of attention‐deficit hyperactivity disorder (ADHD). NEWROFEED is a prospective, multicentre, randomized (3:2), reference drug‐controlled trial in children with ADHD aged between 7 and 13 years. The main objective of NEWROFEED was to demonstrate the noninferiority of personalized at‐home neurofeedback (NF) training versus methylphenidate in the treatment of children with ADHD. Methods: The NF group (n = 111) underwent eight visits and two treatment phases of 16 to 20 at‐home sessions with down‐training of the theta/beta ratio (TBR) for children with high TBR and enhancing the sensorimotor rhythm (SMR) for the others. The control group (n = 67) received optimally titrated long‐acting methylphenidate. The primary endpoint was the change between baseline and endpoint in the Clinician ADHD‐RS‐IV total score in the per‐protocol population (90 NF/59 controls). Trial registration: US National Institute of Health, ClinicalTrials.gov #NCT02778360. Results: Our study failed to demonstrate noninferiority of NF versus methylphenidate (mean between‐group difference 8.09 90% CI [8.09; 10.56]). However, both treatment groups showed significant pre–post improvements in core ADHD symptoms and in a broader range of problems. Reduction in the Clinician ADHD‐RS‐IV total score between baseline and final visit (D90) was 26.7% (SMD = 0.89) in the NF and 46.9% (SMD = 2.03) in the control group. NF effects increased whereas those of methylphenidate were stable between intermediate and final visit. Conclusions: Based on clinicians' reports, the effects of at‐home NF were inferior to those of methylphenidate as a stand‐alone treatment. [ABSTRACT FROM AUTHOR]

Background: This study evaluated two risk pathways that may account for increases in child internalizing and externalizing problems during the COVID‐19 pandemic: one pathway operating through pre‐existing family vulnerability and a second pathway operating through disruption in family functioning occurring in response to the pandemic. We assessed family disruption and family functioning with measures of key family‐level and parenting dimensions, including family cohesion, conflict and routines, and parents' harsh discipline, lax discipline and warmth. In all models, pre‐pandemic parent emotional distress, financial strain and child maladjustment were included as covariates. Methods: The sample included 204 families, comprised of parents who had children (MAge = 4.17; 45.1% girls). Parents (MAge = 27.43) completed the first survey prior to COVID‐19 onset in the United States, a second survey after COVID‐19 onset in May 2020 and a third survey two weeks later. Results: Analyses were conducted in a model‐building fashion, first computing structural equation models for each family and parenting dimension separately, then advancing significant dimensions into one integrated model for the family‐level factors and a second model for parenting quality factors. Results provided more support for the family disruption hypothesis across all tests. In the family‐level domain, decreases in family cohesion and increases in family conflict each uniquely predicted subsequent child maladjustment. In the parenting domain, increases in harsh discipline and lax discipline each uniquely predicted subsequent child maladjustment. Family routines and parental warmth were not associated with child adjustment. However, parents' emotional distress prior to the pandemic exhibited a robust association with children's internalizing problems. Conclusions: These findings indicate that efforts to support families in adapting to unique conditions of the pandemic will yield the greatest effect for child adjustment. Specifically, interventions should include efforts to help families maintain cohesion and manage conflict, and help parents minimize increases in harsh and lax discipline. [ABSTRACT FROM AUTHOR]

Objective: Research has identified the United States (U.S.) as a global outlier in its firearm ownership rates, with a correspondingly higher risk of youth firearm violence compared to other countries. The relative extent of disparities in youth firearm violence within the U.S. has been less clear. Little is known about factors in the social ecology driving these disparities and whether current firearm violence prevention approaches sufficiently address them. Method: Applying a health disparities framework, we synthesized epidemiological, sociological, and prevention science literatures, emphasizing structural inequalities in youth sociocultural positionality in life course developmental context. We also highlighted findings from national injury data and other studies regarding the magnitude and impacts of youth firearm violence disparities. Results: The burden of firearm violence varied markedly at intersections of gender, race, place, developmental stage, and homicidal or suicidal intent. Firearm homicide among Black boys and young men (ages 15‐24) was at outlier levels ‐ many times greater than the rates of any other demographic group, developmental stage, or violence intent, particularly in urban settings. Recent research has operationalized structural racism and implicated historically racialized spaces as a root cause of this disparity. In contrast, elevated firearm suicide rates were found among Native and White boys and young men in rural settings; firearm‐related cultural attitudes and gender socialization were points of consideration to explain these disparities. We highlighted research‐based youth firearm violence preventive interventions, and emphasized gaps in efforts focused on structural and sociocultural factors. Conclusions: More explicit attention to reducing firearm homicide among Black boys and young men and firearm suicide among Native and rural White boys and young men is urgently needed and has potential to substantially lower overall rates of firearm violence in the U.S. [ABSTRACT FROM AUTHOR]

This research paper reports two small studies which form part of a series of exploratory investigations by the authors where the explicit aim has been to examine why some children respond differently to management techniques normally effective with most. A close association between scores on the Psychopathic Deviant Scale (Pd) of the Minnesota Multiphasic Personality Scale and teachers' assessments of refractory behavior suggest that such behavior could be considered as being on the same continuum as psychopathy and that the Pd Scale might prove a useful index of it. Early adverse experience was also found to be related to refractory behavior, as in psychopathy.

Currently, in the United States and worldwide, the vast majority of children and adolescents in need of mental health services receive no treatment. Although there are many barriers, a key barrier is the dominant model of delivering psychosocial interventions. That model includes one‐to‐one, in‐person treatment, with a trained mental health professional, provided in clinical setting (e.g., clinic, private practice office, health‐care facility). That model greatly limits the scale and reach of psychosocial interventions. The article discusses many novel models of delivering interventions that permit scaling treatment to encompass children and adolescents who are not likely to receive services. Special attention is accorded the use of social media, socially assistive robots, and social networks that not only convey the ability to scale interventions but also encompass interventions that depart from the usual forms of intervention that currently dominate psychosocial treatment research. Read the Commentary on this article at doi: 10.1111/jcpp.13034 [ABSTRACT FROM AUTHOR]

The first autism surveys were simple head counts of children already diagnosed with a severe autism phenotype and residing in small, circumscribed geographical areas. Prevalence was low, ranging from 0.4 to 2/1,000 in the 1960's and 1970's. Today, the methodology of surveys has become more complex; studies include large populations, multiple sites, stratified samples and rely on intricate sets of screening activities followed by some form of diagnostic confirmation procedures. Yet, and as surprising as it may be, there is no standardization of autism survey methodology. Each survey has unique design features that reflect the local educational and health services infrastructure and current social policies for children with disabilities, they include or not parents, teachers and subjects with Autism Spectrum Disorder (ASD), and rely on variable screening and diagnostic instruments and methods. As such, prevalence differences between studies are hazardous to evaluate and whether observed discrepancies are due to method factors or true differences in population parameters, cannot be determined. [ABSTRACT FROM AUTHOR]

Background The accuracy of any screening instrument designed to detect psychopathology among children is ideally assessed through rigorous comparison to 'gold standard' tests and interviews. Such comparisons typically yield estimates of what we refer to as 'standard indices of diagnostic accuracy', including sensitivity, specificity, positive predictive value ( PPV), and negative predictive value. However, whereas these statistics were originally designed to detect binary signals (e.g., diagnosis present or absent), screening questionnaires commonly used in psychology, psychiatry, and pediatrics typically result in ordinal scores. Thus, a threshold or 'cut score' must be applied to these ordinal scores before accuracy can be evaluated using such standard indices. To better understand the tradeoffs inherent in choosing a particular threshold, we discuss the concept of 'threshold probability'. In contrast to PPV, which reflects the probability that a child whose score falls at or above the screening threshold has the condition of interest, threshold probability refers specifically to the likelihood that a child whose score is equal to a particular screening threshold has the condition of interest. Method The diagnostic accuracy and threshold probability of two well-validated behavioral assessment instruments, the Child Behavior Checklist Total Problem Scale and the Strengths and Difficulties Questionnaire total scale were examined in relation to a structured psychiatric interview in three de-identified datasets. Results Although both screening measures were effective in identifying groups of children at elevated risk for psychopathology in all samples (odds ratios ranged from 5.2 to 9.7), children who scored at or near the clinical thresholds that optimized sensitivity and specificity were unlikely to meet criteria for psychopathology on gold standard interviews. Conclusions Our results are consistent with the view that screening instruments should be interpreted probabilistically, with attention to where along the continuum of positive scores an individual falls. [ABSTRACT FROM AUTHOR]

Background Oppositional defiant disorder ( ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior. Methods Latent class analysis was performed on the oppositional defiant problems scale of the Child Behavior Checklist in two samples, one in the US (the Achenbach Normative Sample, N = 2029) and one in the Netherlands (the Zuid-Holland Study, N = 2076). A third sample of American children (The Vermont Family Study, N = 399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid-Holland Study. Results Four classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults. Conclusions Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior. [ABSTRACT FROM AUTHOR]

There is little research on how specific borderline personality disorder (BPD) symptoms relate to suicide attempts or suicide and non-suicidal self-injury (NSSI) within adolescent populations, which is important to know given the recent proposal of an NSSI disorder. Even less well known is whether specific BPD symptoms distinguish NSSI from suicide attempts or differentiate single from repeated acts of either suicide or NSSI. Archival, de-identified outpatient clinical charts from 441 ethnically diverse (4.3% Caucasian; 70.9% female) adolescents (mean age = 14.9, SD = 1.61) were reviewed. Data pertaining to NSSI, suicide attempt history, BPD symptoms, and psychiatric diagnoses were obtained from self-report measures and semi-structured interviews administered at intake. MANOVA and logistic regression analyses revealed significant differences across groups, with the BPD symptoms of 'confusion about self' and 'unstable interpersonal relationships' significantly predicting NSSI and NSSI+Suicide group status. The number of BPD criteria met plus high levels of confusion about self significantly predicted single vs. repeat self-harm group membership. Two BPD symptoms exhibit distinct relationships to NSSI and suicide attempts, but there is not strong variation in their relationship to BPD. Treatment addressing BPD symptoms may be useful to reducing both NSSI and suicide in ethnically diverse adolescents. [ABSTRACT FROM AUTHOR]

Background: Adolescent involvement in religious organizations has been hypothesized to protect against early age at first drink. However, the correlation between adolescent religiosity and later age at first drink may be confounded by environmental or genetic differences between families. This study tests whether, after controlling for shared environmental and genetic confounds using a behavior genetic design, the association between individual levels of religiosity and earlier age at first drink is still evident. Method: Twin and sibling pairs were drawn from the National Longitudinal Study of Adolescent Health, a nationally-representative sample of US adolescents. Age at first drink was measured as how old adolescents were when they first had a drink of beer, wine, or liquor. Religiosity was measured using four items concerning frequency of religious activities and importance of religious beliefs. Using twins and siblings who were discordant for religiosity, analyses tested whether religious adolescents had a later age at first drink than their non-religious co-twins/co-siblings. Results: Religious adolescents did not differ from their non-religious siblings in their mean age at first drink. Results from survival models indicate that environmental differences between families completely account for the correlation between religiosity and later age at first drink. Conclusions: Results suggest that individual religious involvement is a proxy variable for family or cultural environments that are salient for when adolescents initiate alcohol use. Future research is needed to identify specific protective environments in religious families. These results have implications for both public policy and etiological theory. [ABSTRACT FROM AUTHOR]

Background: Little is known about short-duration episodes of mania-like symptoms in youth. Here we determine the prevalence, morbid associations, and contribution to social impairment of a phenotype characterised by episodes during which symptom and impairment criteria for mania are met, but DSM-IV duration criteria are not (bipolar not otherwise specified; BP-NOS). Methods: A cross-sectional national survey of a sample ( N = 5,326) of 8–19-year-olds from the general population using information from parents and youth. Outcome measures were prevalence rates and morbid associations assessed by the Developmental and Well-Being Assessment, and social impairment assessed by the impact scale of the Strengths and Difficulties Questionnaire. Results: While only seven individuals (.1%) met definite or probable DSM-IV criteria for BPI or BPII, the prevalence of BP-NOS was 10-fold higher, 1.1% by parent report and 1.5% by youth report. Parent–youth agreement was very low: κ = .02, p > .05 for BP-NOS. Prevalence and episode duration for BP-NOS did not vary by age. BP-NOS showed strong associations with externalising disorders. After adjusting for a dimensional measure of general psychopathology, self-reported (but not parent-reported) BP-NOS remained associated with overall social impairment. Conclusions: BP meeting full DSM-IV criteria is rare in youth. BP-NOS, defined by episodes shorter than those required by DSM-IV, but during which DSM-IV symptom and impairment criteria are met, is commoner and may be associated with social impairment that is beyond what can be accounted for by other psychopathology. These findings support the importance of research into these short episodes during which manic symptoms are met in youth but they also call into question the extent to which BP-NOS in youth is a variant of DSM-IV BP – superficially similar symptoms may not necessarily imply deeper similarities in aetiology or treatment response. [ABSTRACT FROM AUTHOR]

Background: This study examines the cross-sectional and longitudinal associations among cognitive variables, depressive symptoms and suicidal ideation in Hong Kong Chinese and Caucasian American adolescents. Methods: Community adolescents ( n = 2,044) ages 14–18 years from Hong Kong and the United States provided information regarding their suicidal ideation, depressive symptoms, and cognitions (self-efficacy, cognitive errors and hopelessness), at two surveys, six months apart. Results: Self-efficacy was a weak unique predictor of suicidal ideation in both cultures. Hopelessness was the strongest of cognitive variables in concurrent associations with suicidal ideation in bivariate and multivariate models, in both cultures, and in both boys and girls. Hopelessness continued to offer unique prediction when depressive symptoms were controlled, both concurrently and prospectively. Conclusions: Our results support hopelessness theories of suicidal ideation and behavior in Hong Kong, and extend the cognitive theory of suicidality to a modernized Asian culture. [ABSTRACT FROM AUTHOR]