Recent Advances in Child and Adolescent Psychiatry

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neurology & Neurodevelopmental Disorders".

Deadline for manuscript submissions: closed (5 June 2022) | Viewed by 70146

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Guest Editor
1. Developmental Psychopathology Research Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
2. Child Neuropsychiatry Unit, ASST Pavia, 27100 Pavia, Italy
Interests: child and adolescent neuropsychiatry; neurodevelopmental disorders; psychodynamic psychotherapy; treatments and outcomes
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Special Issue Information

Dear Colleagues,

Psychiatric disorders in children and adolescents are relevant both in terms of their prevalence (they are roughly estimated to affect about 20% of school-aged children and adolescents) and of their impact on the quality of life of the child/adolescent and their family, but also on the society as a whole.

Disorders affecting children and adolescents are increasingly seen as having highly specific features, and, therefore, require an equally specific approach despite the coexisting need to integrate contributions from other professions (e.g., pediatricians, psychiatrists, psychologists, and therapists of different sorts). However, the available data are still insufficient, especially for treatment options and too often therapeutic choices are still made based on studies conducted in adults. Even more important, the existence itself of some disorders is questioned especially outside the scientific field (e.g., ADHD).

This Special Issue will provide cutting edge data on all aspects of child and adolescent psychiatry, including etiopatogenesis, clinical characteristics and diagnosis, medical and neurological comorbidities (and psychiatric comorbidities of medical and neurological disorders), impact on patients/families/society (including school and other social groups), prognosis, and treatment options of the different disorders.

Dr. Matteo Alessio Chiappedi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Autism spectrum disorders 
  • ADHD 
  • Eating disorders 
  • Anxiety 
  • Mood disorders 
  • Psychotic disorders 
  • Psychosomatic disorders 
  • Post-traumatic stress disorder

Published Papers (22 papers)

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Editorial

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3 pages, 164 KiB  
Editorial
Conclusive Thoughts for a New Beginning
by Matteo Chiappedi
Children 2023, 10(1), 60; https://doi.org/10.3390/children10010060 - 27 Dec 2022
Viewed by 839
Abstract
When I was asked to name this Special Issue, I was both honored and worried, as being appointed the Guest Editor was a significant achievement and honor [...] Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
2 pages, 170 KiB  
Editorial
Recent Advances in Child and Adolescent Psychiatry
by Matteo Chiappedi and Martina Maria Mensi
Children 2022, 9(4), 489; https://doi.org/10.3390/children9040489 - 1 Apr 2022
Cited by 1 | Viewed by 1548
Abstract
The field of child and adolescent psychiatry is receiving growing attention, although a number of local differences still exist in terms of academic curricula, board certifications and even definitions of what is to be considered part of this field or not [...] Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)

Research

Jump to: Editorial, Other

17 pages, 705 KiB  
Article
The Trap of the COVID-19 Pandemic: Italian Adolescents Fare Well at First, Maybe Thanks to Protective Trait Expression
by Anna Malerba, Sara Iannattone, Giorgia Casano, Marco Lauriola and Gioia Bottesi
Children 2022, 9(11), 1631; https://doi.org/10.3390/children9111631 - 26 Oct 2022
Cited by 5 | Viewed by 1716
Abstract
Abundant research indicates that the COVID-19 pandemic has been negatively affecting mental health in adolescence. Few works, however, benefit from data from the same sample before and after the onset of the pandemic. The present longitudinal study involved a non-clinical group of 136 [...] Read more.
Abundant research indicates that the COVID-19 pandemic has been negatively affecting mental health in adolescence. Few works, however, benefit from data from the same sample before and after the onset of the pandemic. The present longitudinal study involved a non-clinical group of 136 Italian adolescents (Mage = 16.3 years ± 1.08, 67% girls) to investigate their psychological response to the first lockdown and explore the role of a protective trait (i.e., Positivity) in moderating the effect of Intolerance of Uncertainty (IU) on internalizing symptoms before and during the COVID-19 outbreak. Participants completed self-report questionnaires assessing psychopathological symptoms, psychological well-being, IU, and Positivity on three separate occasions: October 2019 (T1), January 2020 (T2), and April 2020 (T3). The results showed that internalizing and externalizing symptoms as well as psychological well-being did not vary significantly over time. Positivity was found to significantly moderate the relationship between IU and internalizing symptoms at T3 (i.e., during the COVID-19 lockdown) only. Overall, our findings suggest that the teenagers’ good adjustment to the initial phase of the pandemic might have been associated with the enhanced weight of the Positivity trait, which may have encouraged a positive attitude towards self, life, and the future. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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12 pages, 971 KiB  
Article
Depressive Anxiety Symptoms in Hospitalized Children with Chronic Illness during the First Italian COVID-19 Lockdown
by Cinzia Correale, Chiara Falamesca, Ilaria Tondo, Marta Borgi, Francesca Cirulli, Mauro Truglio, Oriana Papa, Laura Vagnoli, Cinzia Arzilli, Cristina Venturino, Michele Pellegrini, Valentina Manfredi, Rossella Sterpone, Teresa Grimaldi Capitello, Simonetta Gentile and Simona Cappelletti
Children 2022, 9(8), 1156; https://doi.org/10.3390/children9081156 - 2 Aug 2022
Cited by 5 | Viewed by 2217
Abstract
COVID-19 is continuing to spread around the world, having a direct impact on people’s daily lives and health. Although the knowledge of the impact of the COVID-19 pandemic on mental health in the general population is now well established, there is less information [...] Read more.
COVID-19 is continuing to spread around the world, having a direct impact on people’s daily lives and health. Although the knowledge of the impact of the COVID-19 pandemic on mental health in the general population is now well established, there is less information on its effect on specific and vulnerable populations, such as children with chronic illness (CI). We conducted a multi-centered cross-sectional study among pediatric patients in six public children’s hospitals in Italy during the first lockdown, with the aim of assessing the proportion of children with CI presenting anxiety and depressive symptoms, and the clinical and demographic characteristics affecting such symptomatology. We included children with at least one chronic condition, with no cognitive delay, aged between 11 and 18 years. Brief standardized questionnaires were administered during medical scheduled visits to screen anxiety and depressive symptoms. We found a very high proportion of children showing mild to severe depressive and anxiety symptomatology (approximately 68% and 63%, respectively). Our results highlight the need of ensuring tailored psychological interventions to protect children with CI from the effect of the pandemic (and related restrictive measures such as quarantine and social distancing), with the final aim of promoting mental health and psychological well-being in this vulnerable population. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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12 pages, 304 KiB  
Article
A Comprehensive Analysis of the Relationship between Play Performance and Psychosocial Problems in School-Aged Children
by Raúl Vigil-Dopico, Laura Delgado-Lobete, Rebeca Montes-Montes and José Antonio Prieto-Saborit
Children 2022, 9(8), 1110; https://doi.org/10.3390/children9081110 - 24 Jul 2022
Cited by 1 | Viewed by 2333
Abstract
During childhood, play contributes to the physical, emotional, cognitive and social development of infants and children and may enhance future mental health. The aim of this study was to examine the relationship between play performance factors and psychosocial problems in school-aged children. A [...] Read more.
During childhood, play contributes to the physical, emotional, cognitive and social development of infants and children and may enhance future mental health. The aim of this study was to examine the relationship between play performance factors and psychosocial problems in school-aged children. A total of 142 typical Spanish children aged 5 to 9 years were included. Play performance was measured with the My Child’s Play questionnaire, while the Strengths and Difficulties Questionnaire was used to evaluate internalizing and externalizing problems. The findings showed that personal, environmental and activity factors of play performance were associated with psychosocial problems and prosocial behavior in children. Moreover, children with high psychosocial difficulties reported significantly poorer play performance. As executive functioning during play was the factor that was most strongly associated with internalizing and externalizing psychosocial difficulties, it is possible that executive functions have a decisive role on both social cognition and self-regulation during play performance. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
10 pages, 1723 KiB  
Article
Family Dysfunctional Interactive Patterns and Alexithymia in Adolescent Patients with Restrictive Eating Disorders
by Chiara Coci, Livio Provenzi, Valentina De Giorgis, Renato Borgatti, Matteo Chiappedi, Martina Maria Mensi and on behalf of the Mondino Foundation Eating Disorders Clinical and Research Group
Children 2022, 9(7), 1038; https://doi.org/10.3390/children9071038 - 12 Jul 2022
Cited by 3 | Viewed by 2139
Abstract
Adolescents diagnosed with Restrictive Eating Disorders (REDs) are at risk for alexithymia. REDs patients’ families show dysfunctional interactive patterns, and childhood family environment influences alexithymia development. We aimed to assess the relationship between family dysfunctional interactive patterns and patients’ alexithymia in a sample [...] Read more.
Adolescents diagnosed with Restrictive Eating Disorders (REDs) are at risk for alexithymia. REDs patients’ families show dysfunctional interactive patterns, and childhood family environment influences alexithymia development. We aimed to assess the relationship between family dysfunctional interactive patterns and patients’ alexithymia in a sample of adolescents diagnosed with REDs. Forty-five patients and their parents were enrolled. They participated in the clinical version of the Lausanne Triadic Play (LTPc), a standardized observational procedure to assess family functioning. We used the self-report questionnaire Toronto Alexithymia Scale (TAS-20) to assess patients’ alexithymia. The TAS-20 provides a multi-factorial measure of patients’ alexithymia: Difficulty in Identifying Feelings, DIF; Difficulty in Describing Feelings, DDF; Externally-oriented Thinking, EOT) and a total (TOT) score. DDF and EOT scores were significantly higher than DIF score. Patients’ families showed dysfunctional interactive patterns, with a predominance of collusive alliance. Patients from families characterized by collusive alliance had higher TOT scores compared to counterparts from families exhibiting a different interactive dysfunctional pattern. In families characterized by a collusive triadic alliance, the dysfunctional interactive pattern was linked with the risk of alexithymia in patients with REDs. Assessment of family relationships should be included in the routine consultation with adolescent patients affected by REDs. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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14 pages, 260 KiB  
Article
Factors Affecting Psychological and Health-Related Quality-of-Life Status in Children and Adolescents with Congenital Heart Diseases
by Hao-Chuan Liu, Chung-Hsien Chaou, Chiao-Wei Lo, Hung-Tao Chung and Mao-Sheng Hwang
Children 2022, 9(4), 578; https://doi.org/10.3390/children9040578 - 18 Apr 2022
Cited by 6 | Viewed by 2611
Abstract
Congenital heart disease (CHD), a severe cardiac defect in children, has unclear influences on young patients. We aimed to find the impacts of differently structure heart defects and various treatments on psychology and health-related quality of life (HRQoL) in CHD children and adolescents. [...] Read more.
Congenital heart disease (CHD), a severe cardiac defect in children, has unclear influences on young patients. We aimed to find the impacts of differently structure heart defects and various treatments on psychology and health-related quality of life (HRQoL) in CHD children and adolescents. CHD patients aged between 6 and 18 years old visited our hospital from 1 May 2018 to 31 September 2018, and their principal caregivers were asked to participate. We used two validated questionnaires, Children Depression Inventory-TW (CDI-TW) and Child Health Questionnaire—Parent Form 50 (CHQ-PF 50), to evaluate CHD patients’ psychological and HRQoL conditions. Participants were grouped based on their cardiac defects and previous treatments. We analyzed the results via summary independent-samples t-test with post hoc Bonferroni correction and multivariant analysis. Two hundred and seventy-seven children and their principal caregivers were involved. There was no apparent depressive condition in any group. Single cardiac defect patients exhibited similar HRQoL to controls; simultaneously, those with cyanotic heart disease (CyHD), most multiple/complex CHDs children and adolescents, and those who received invasive treatments had poorer HRQoL. CyHD impacted the most on patients’ psychological and HRQoL status. Patients with sole cardiac defect could live near-normal lifes; on the other hand, CyHD had the worst effects on patients’ psychology and HRQoL. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
12 pages, 702 KiB  
Article
The Psychometric Properties and Cutoff Score of the Child and Adolescent Mindfulness Measure (CAMM) in Chinese Primary School Students
by Xin Chen, Kaixin Liang, Liuyue Huang, Wenlong Mu, Wenjing Dong, Shiyun Chen, Sitong Chen and Xinli Chi
Children 2022, 9(4), 499; https://doi.org/10.3390/children9040499 - 2 Apr 2022
Cited by 7 | Viewed by 2619
Abstract
To date, the Child and Adolescent Mindfulness Measure (CAMM) has been translated into several languages, including Chinese. This study aimed to explore the reliability and validity of the Chinese version of the CAMM and to identify the appropriate cutoff score among Chinese primary [...] Read more.
To date, the Child and Adolescent Mindfulness Measure (CAMM) has been translated into several languages, including Chinese. This study aimed to explore the reliability and validity of the Chinese version of the CAMM and to identify the appropriate cutoff score among Chinese primary school students. A total of 1283 participants (52.2% males; 11.52 ± 0.78 years of age) completed a series of questionnaires to evaluate their mental health, including mindfulness, subjective well-being, positive youth development (PYD), depression, and anxiety. Item analysis, Confirmatory Factor Analysis (CFA), Exploratory Structural Equation Modeling (ESEM), criterion-related validity analysis, Receiver Operating Characteristic (ROC) analysis, and reliability analysis were performed. The results show that the Chinese version of the CAMM had acceptable item–scale correlation (r = 0.405–0.775, p < 0.001) and was the best fit for the two-factor ESEM model (χ2 = 168.251, p < 0.001, df = 26, TLI = 0.910, CFI = 0.948, RMSEA = 0.065, SRMR = 0.033) among Chinese primary school students. Additionally, the total score of the Chinese version of the CAMM was significantly associated with subjective well-being and PYD (r = 0.287–0.381, p < 0.001), and negatively associated with depression, and anxiety (r = −0.612–−0.542, p < 0.001). Moreover, a cutoff score of 22 or higher revealed a significant predictive power for all the included criteria. Finally, the Chinese version of the CAMM had good internal consistency (Cronbach’s α = 0.826, McDonald’s ω = 0.826). Altogether, the Chinese version of the CAMM had satisfactory psychometric properties, and it can be applied to Chinese children. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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14 pages, 412 KiB  
Article
Generalization Task for Developing Social Problem-Solving Skills among Young People with Autism Spectrum Disorder
by Saray Bonete, Clara Molinero and Adrián Garrido-Zurita
Children 2022, 9(2), 166; https://doi.org/10.3390/children9020166 - 28 Jan 2022
Cited by 1 | Viewed by 2991
Abstract
This study aims to examine the usefulness of an ad hoc worksheet for an Interpersonal Problem-Solving Skills Program (SCI-Labour) the effectiveness of which was tested by Bonete, Calero, and Fernández-Parra (2015). Data were taken from 44 adolescents and young adults with Autism Spectrum [...] Read more.
This study aims to examine the usefulness of an ad hoc worksheet for an Interpersonal Problem-Solving Skills Program (SCI-Labour) the effectiveness of which was tested by Bonete, Calero, and Fernández-Parra (2015). Data were taken from 44 adolescents and young adults with Autism Spectrum Disorder (ASD) (age M = 19.73; SD = 3.53; 39 men and 5 women; IQ M = 96.27, SD = 15.98), compared to a matched group (in age, sex, and nonverbal IQ) of 48 neurotypical participants. The task was conceived to promote the generalization of interpersonal problem-solving skills by thinking on different possible scenarios in the workplace after the training sessions. The results show lower scores in the worksheet delivered for homework (ESCI-Generalization Task) in the ASD Group compared to neurotypicals in total scores and all domains (Problem Definition, Quality of Causes, and Solution Suitability) prior to program participation. In addition, after treatment, improvement of the ASD Group was observed in the Total Score ESCI-Generalization Task and in the domains of Problem Definition, Quality of Causes, Number or Alternatives and Consequences, Time, and Solution Suitability. This is a valuable task in furthering learning within the SCI-Labour Program and may be a supplementary material in addressing the difficulties of interpersonal skills within this population, both in the workplace and in daily life. In conclusion, this task may provide useful information for identifying key difficulties among this population and could be implemented in a clinical setting as a complement to the SCI-Labour Program. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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13 pages, 535 KiB  
Article
Outcome Quality of Inpatient and Day-Clinic Treatment in Child and Adolescent Psychiatry—A Naturalistic Study
by Leonhard Thun-Hohenstein, Franka Weltjen, Beatrix Kunas, Roman Winkler and Corinna Fritz
Children 2021, 8(12), 1175; https://doi.org/10.3390/children8121175 - 11 Dec 2021
Cited by 2 | Viewed by 2579
Abstract
Background: Child and adolescent psychiatry has only recently been established as a separate specialty and is practiced in different settings. The epidemiology of psychological problems in childhood is high and varied, thus qualitative work is essential. Assessment of outcome as part of quality [...] Read more.
Background: Child and adolescent psychiatry has only recently been established as a separate specialty and is practiced in different settings. The epidemiology of psychological problems in childhood is high and varied, thus qualitative work is essential. Assessment of outcome as part of quality management is central to assure the service of psychiatric care to be effective. Method: Over a three-year period consecutively admitted patients from inpatient and day-clinic treatment were prospectively evaluated. A total of 200 from 442 patients (m = 80, f = 120; age 15.1 ± 2.8 y) agreed to participate. Patients, caregivers, and therapists answered a range of questionnaires to provide a multi-personnel rating. Questionnaires used for outcome assessment were Child Behavior Checklist (CBCL) and Youth-Self-Report (YSR) (at admission, discharge, and 6 weeks after discharge) and the problem score of the Inventory of Quality of Life for children (ILK), treatment satisfaction, and process quality by the Questionnaire for Treatment Satisfaction (FBB, at discharge) and as real-life outcome control assessment of quality of life (ILK) was added (admission, discharge, and 6 wks after discharge). Results: There was a significant reduction in psychopathologicalsymptoms (CBCL, YSR) and in the problem score. Furthermore, there was a significant increase in quality of life. QoL score and YSR/CBCL scores returned to normal levels. Treatment satisfaction was high and so was satisfaction with process quality. Factors significantly influencing outcome were severity of disease and the relationship to the therapist. No differences were found for gender and setting. Conclusion: The quality management analysis revealed significant improvements of symptom load, a significant increase in QoL and a high treatment satisfaction. Furthermore, process quality was scored highly by parents and therapists. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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13 pages, 272 KiB  
Article
Mental Imagery and Social Pain in Adolescents—Analysis of Imagery Characteristics and Perspective—A Pilot Study
by Susan Muriel Schwarz, Mersiha Feike and Ulrich Stangier
Children 2021, 8(12), 1160; https://doi.org/10.3390/children8121160 - 8 Dec 2021
Cited by 6 | Viewed by 2383
Abstract
Background: Mental imagery (MI) may play a key role in the development of various mental disorders in adolescents. Adolescence is known to be a fragile life period, in which acceptance by one’s favored peer group is extremely important, and social rejection is particularly [...] Read more.
Background: Mental imagery (MI) may play a key role in the development of various mental disorders in adolescents. Adolescence is known to be a fragile life period, in which acceptance by one’s favored peer group is extremely important, and social rejection is particularly painful. This is the first pilot study investigating MI and its relationship to social pain (SP). Method: A sample of 80 adolescents (14–20 years; 75.3% female) completed a web-based quasi-experimental design about the contents and characteristics of their spontaneous positive and negative MI and associated emotions, and were asked to complete the Social Pain Questionnaire, the Becks Depression Inventory and the Social Phobia Inventory. Results: A higher score of SP was significantly associated with increased fear, sadness, and feelings of guilt, and less control over negative MI. Characteristics of negative MI were more precisely predicted by SP scores than depression- and social anxiety scores. Adolescents with higher SP-scores more often reported negative images including social situations and were more likely to perceive negative images in a combination of field-and observer perspectives than adolescents with lower SP scores. Conclusion: SP-sensitivity seems to be linked to unique characteristics of negative MI, which reveals the strong emotional impact of social exclusion in youths. The results do not allow causal conclusions to be drawn, but raise questions about previous studies comparing each imagery perspective individually. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
12 pages, 452 KiB  
Article
Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Scale in a Sample of Italian Students
by Pietro Muratori, Carlo Buonanno, Anna Gallani, Giuseppe Grossi, Valentina Levantini, Annarita Milone, Simone Pisano, Randall T. Salekin, Gianluca Sesso, Gabriele Masi and Annalaura Nocentini
Children 2021, 8(11), 1020; https://doi.org/10.3390/children8111020 - 6 Nov 2021
Cited by 12 | Viewed by 2630
Abstract
This study aimed to further validate the self-reported version of the Proposed Specifiers Conduct Disorder (PSCD) scale, testing the associations between the PSCD with a scale that measures emotional/behavioral difficulties and prosocial behaviors (Strength and Difficulties Questionnaire, SDQ). A total of 536 Italian [...] Read more.
This study aimed to further validate the self-reported version of the Proposed Specifiers Conduct Disorder (PSCD) scale, testing the associations between the PSCD with a scale that measures emotional/behavioral difficulties and prosocial behaviors (Strength and Difficulties Questionnaire, SDQ). A total of 536 Italian students (47.76% male; 11–14 years) completed the PSCD, while their caregivers and teachers completed the SDQ. A series of confirmatory factor analyses to test the best fitting model were run. The internal consistency of the PSCD was evaluated, and the correlations between the PSCD self-reported scores and SDQ Parent and Teacher report scores were examined. A bi-factor model was fitted with a refined 19-item version of the scale, which showed adequate fit indices. The PSCD total score was strongly associated with higher parent- and teacher-rated conduct problems, hyperactivity, and lower prosocial behavioral symptoms. In conclusion, this study indicated that the self-report PSCD shows preliminary promise as a reliable, easy-to-use tool, for measuring psychopathic traits in Italian children and young adolescents. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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12 pages, 569 KiB  
Article
Evaluation of an Early Intervention Model for Child and Adolescent Victims of Interpersonal Violence
by Claudia Calvano, Elena Murray, Lea Bentz, Sascha Bos, Kathrin Reiter, Loretta Ihme and Sibylle M. Winter
Children 2021, 8(10), 941; https://doi.org/10.3390/children8100941 - 19 Oct 2021
Cited by 1 | Viewed by 2223
Abstract
Only the minority of youth exposed to traumatic events receive mental health care, as trauma-informed clinical services are lacking or are poorly accessible. In order to bridge this gap, the Outpatient Trauma Clinic (OTC) was founded, an easily accessible early, short-time intervention, with [...] Read more.
Only the minority of youth exposed to traumatic events receive mental health care, as trauma-informed clinical services are lacking or are poorly accessible. In order to bridge this gap, the Outpatient Trauma Clinic (OTC) was founded, an easily accessible early, short-time intervention, with onward referral to follow-up treatment. This report presents the OTC’s interventional approach and first outcome data. Using a retrospective naturalistic design, we analyzed trauma- and intervention-related data of the sample (n = 377, 55.4% female, mean age 10.95, SD = 4.69). Following drop-out analyses, predictors for treatment outcome were identified by logistic regression. The majority (81.9%) was suffering from posttraumatic stress disorder (PTSD) or adjustment disorders. Around one forth dropped out of treatment; these cases showed higher avoidance symptoms at presentation. In 91%, psychological symptoms improved. Experience of multiple traumatic events was the strongest predictor for poor treatment outcome (B = −0.823, SE = 0.313, OR = 0.439, 95% CI 0.238–0.811). Around two thirds were connected to follow-up treatment. The OTC realized a high retention rate, initial improvement of symptoms and referral to subsequent longer-term psychotherapeutic treatment in the majority. Further dissemination of comparable early intervention models is needed, in order to improve mental health care for this vulnerable group. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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14 pages, 301 KiB  
Article
Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy
by Barbara Forresi, Marcella Caputi, Simona Scaini, Ernesto Caffo, Gabriella Aggazzotti and Elena Righi
Children 2021, 8(10), 930; https://doi.org/10.3390/children8100930 - 17 Oct 2021
Cited by 7 | Viewed by 2264
Abstract
Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to [...] Read more.
Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to predict PTSD in offspring, also testing the reverse pattern. Two years after the 2012 earthquake in Italy, 843 children and adolescents (9–15 years) living in two differently affected areas were administered a questionnaire on traumatic exposure and the UCLA PTSD Reaction Index. Anxiety, depression, and somatization were assessed in 1162 parents through the SCL-90-R. General linear model showed that, for offspring in the high-impact area, predictors of PTSD were earthquake exposure, past trauma, and parental internalizing symptoms, taken individually. An interaction between earthquake exposure and parental depression or anxiety (not somatization) was also found. In the low-impact area, youth PTSD was only predicted by earthquake exposure. The reverse pattern was significant, with parental psychopathology explained by offspring PTSD. Overall, findings support the association between parental and offspring psychopathology after natural disasters, emphasizing the importance of environmental factors in this relationship. Although further research is needed, these results should be carefully considered when developing mental health interventions. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
17 pages, 317 KiB  
Article
Assessment of Psychological Distress and Peer Relations among Trans Adolescents—An Examination of the Use of Gender Norms and Parent–Child Congruence of the YSR-R/CBCL-R among a Treatment-Seeking Sample
by Alexandra Brecht, Sascha Bos, Laura Ries, Sibylle M. Winter and Claudia Calvano
Children 2021, 8(10), 864; https://doi.org/10.3390/children8100864 - 28 Sep 2021
Cited by 9 | Viewed by 2553
Abstract
Among trans adolescents, increased psychological distress is reported in the literature. The goal of this study was to examine psychological distress, associated peer relations and parent report congruence among the treatment-seeking sample of the Gender Identity Special Consultation (GISC) for youth at the [...] Read more.
Among trans adolescents, increased psychological distress is reported in the literature. The goal of this study was to examine psychological distress, associated peer relations and parent report congruence among the treatment-seeking sample of the Gender Identity Special Consultation (GISC) for youth at the Charité Berlin. Further, differences between the instruments’ binary gender norms were investigated. Retrospectively, we analyzed clinical data derived from the GISC. By initial interviews and using the Youth Self-Report and Child Behavior Checklist, n = 50 trans adolescents aged 12–18 years (M = 15.5) were examined for psychological problems and peer relations. Congruence between self and parent report was analyzed by correlations. Half of the sample reported suicidality, self-harm and bullying. Trans adolescents showed significantly higher internalizing and total problems than the German norm population. The congruence between self and parent report proved to be moderate to high. The level of congruence and poor peer relations were identified as predictors of internalizing problems. Significant differences between the female vs. male gender norms emerged regarding mean scores and the number of clinically significant cases. Data provide valuable implications for intervention on a peer and family level. There are limitations to the suitability of questionnaires that use binary gender norms, and further research on adequate instruments and assessment is needed. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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13 pages, 586 KiB  
Article
Ten Years (2011–2021) of the Italian Lombardy ADHD Register for the Diagnosis and Treatment of Children and Adolescents with ADHD
by Maurizio Bonati, Francesca Scarpellini, Massimo Cartabia, Michele Zanetti and on behalf of the Lombardy ADHD Group
Children 2021, 8(7), 598; https://doi.org/10.3390/children8070598 - 15 Jul 2021
Cited by 8 | Viewed by 3131
Abstract
Background: The purpose of this article is to update the diagnostic assessment, therapeutic approach, and 12–18 month follow-up of patients added to the Italian Lombardy Attention Deficit Hyperactivity Disorder (ADHD) Register. Methods: Medical records of patients added to the Registry from 2011 to [...] Read more.
Background: The purpose of this article is to update the diagnostic assessment, therapeutic approach, and 12–18 month follow-up of patients added to the Italian Lombardy Attention Deficit Hyperactivity Disorder (ADHD) Register. Methods: Medical records of patients added to the Registry from 2011 to 2021 were analysed. Results: 4091 of 5934 patients met the criteria for a diagnosis of ADHD, and 20.3% of them presented a familiarity with the disorder. A total of 2879 children (70.4%) had at least one comorbidity disorder, in prevalence a learning disorder (39%). Nearly all (95.9%) received at least one psychological prescription, 17.9% of them almost one pharmacological treatment, and 15.6% a combination of both. Values of ≥5 of the Clinical Global Impression—Severity scale (CGI-S) are more commonly presented by patients with a pharmacological prescription than with a psychological treatment (p < 0.0001). A significant improvement was reported in half of the patients followed after 1 year, with Clinical Global Impression—Improvement scale (CGI-I) ≤ 3. In all, 233 of 4091 are 18-year-old patients. Conclusions: A ten-year systematic monitoring of models of care was a fruitful shared and collaborative initiative in order to promote significant improvement in clinical practice, providing effective and continuous quality of care. The unique experience reported here should spread. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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8 pages, 931 KiB  
Article
Reading Skills of Children with Dyslexia Improved Less Than Expected during the COVID-19 Lockdown in Italy
by Ilaria Maria Carlotta Baschenis, Laura Farinotti, Elena Zavani, Serena Grumi, Patrizia Bernasconi, Enrica Rosso, Livio Provenzi, Renato Borgatti, Cristiano Termine and Matteo Chiappedi
Children 2021, 8(7), 560; https://doi.org/10.3390/children8070560 - 29 Jun 2021
Cited by 18 | Viewed by 6119
Abstract
Following school closures due to the SARS-CoV-2 pandemic, for some months, children received only distance learning. The effects of this approach, however, are not clear for children with dyslexia. We conducted a cross-sectional comparison between children with and without dyslexia after the so-called [...] Read more.
Following school closures due to the SARS-CoV-2 pandemic, for some months, children received only distance learning. The effects of this approach, however, are not clear for children with dyslexia. We conducted a cross-sectional comparison between children with and without dyslexia after the so-called “lockdown” and a comparison between pre- and post-lockdown parameters in children with dyslexia. We recruited sixty-five children with dyslexia (dyslexia group, DG) from an outpatient facility in Pavia (Lombardy, Italy) and fifty-two children without specific learning disabilities as the control group (CG) from summer camps in the same province. We performed neuropsychological tests to explore reading skills and an ad hoc questionnaire to explore how parents and children had experienced the measures taken to reduce spreading of SARS-CoV-2 infection. Between 59 to 63% of children with dyslexia did not reach the average expected increase of reading skills. According to their parents, they also showed greater social isolation and fewer worries about the pandemic and the school’s closure. Our data indicate that children with dyslexia are at increased risk of consequences on their learning potential in case of school closure. They also seem to have a peculiar psychological experience of school closure. Specific interventions should therefore be provided to minimize the risk of negative effects on global development. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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10 pages, 1341 KiB  
Article
The Child Behavior Checklist as a Screening Instrument for PTSD in Refugee Children
by Ina Nehring, Heribert Sattel, Maesa Al-Hallak, Martin Sack, Peter Henningsen, Volker Mall and Sigrid Aberl
Children 2021, 8(6), 521; https://doi.org/10.3390/children8060521 - 18 Jun 2021
Cited by 7 | Viewed by 2973
Abstract
Thousands of refugees who have entered Europe experienced threatening conditions, potentially leading to post traumatic stress disorder (PTSD), which has to be detected and treated early to avoid chronic manifestation, especially in children. We aimed to evaluate and test suitable screening tools to [...] Read more.
Thousands of refugees who have entered Europe experienced threatening conditions, potentially leading to post traumatic stress disorder (PTSD), which has to be detected and treated early to avoid chronic manifestation, especially in children. We aimed to evaluate and test suitable screening tools to detect PTSD in children. Syrian refugee children aged 4–14 years were examined using the PTSD-semi-structured interview, the Kinder-DIPS, and the Child Behavior Checklist (CBCL). The latter was evaluated as a potential screening tool for PTSD using (i) the CBCL-PTSD subscale and (ii) an alternative subscale consisting of a psychometrically guided selection of items with an appropriate correlation to PTSD and a sufficient prevalence (presence in more than 20% of the cases with PTSD). For both tools we calculated sensitivity, specificity, and a receiver operating characteristic (ROC) curve. Depending on the sum score of the items, the 20-item CBCL-PTSD subscale as used in previous studies yielded a maximal sensitivity of 85% and specificity of 76%. The psychometrically guided item selection resulted in a sensitivity of 85% and a specificity of 83%. The areas under the ROC curves were the same for both tools (0.9). Both subscales may be suitable as screening instrument for PTSD in refugee children, as they reveal a high sensitivity and specificity. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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8 pages, 252 KiB  
Article
Online Videogames Use and Anxiety in Children during the COVID-19 Pandemic
by Concetta De Pasquale, Matteo Chiappedi, Federica Sciacca, Valentina Martinelli and Zira Hichy
Children 2021, 8(3), 205; https://doi.org/10.3390/children8030205 - 8 Mar 2021
Cited by 31 | Viewed by 11444
Abstract
Videogames use has constantly increased among children and adolescents, with uncertain consequences on their health. This study aimed to assess the prevalence of videogames use and addiction in a sample of Italian children during the COVID-19 pandemic and their association with anxiety symptoms. [...] Read more.
Videogames use has constantly increased among children and adolescents, with uncertain consequences on their health. This study aimed to assess the prevalence of videogames use and addiction in a sample of Italian children during the COVID-19 pandemic and their association with anxiety symptoms. One hundred and sixty-two children (M/F:78/84; age range: 8–10 years; average age 9.4 ± 0.7 years) completed the Videogame Addiction Scale for Children (VASC), the Test of Anxiety and Depression (TAD) and the Children’s Anxiety Meter—State (CAM-S). Demographic variables and data on the access to electronic tools and games preferences were also collected. Overall, 96.3% of the study participants stated to have access to one or more device. They reported a low risk of videogame addiction (VASC score (mean ± SD): 46.7 ± 15.4), a moderate level of trait anxiety (TAD score (mean ± SD): 135 ± 16.8) and a low state anxiety (CAM-S score (mean ± SD): 2.2 ± 2.1). Males reported to spend more time on videogames, to perceive higher self-control and to be more influenced by reinforcement mechanisms; females described higher levels of trait anxiety. In the regression analysis, state anxiety was a predictor of videogame use and addiction (p = 0.01). Further research is needed to confirm these data and to maximize the developmentally positive effects of videogames and preventing the negative consequences. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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14 pages, 308 KiB  
Article
The Role of Alexithymia in Social Withdrawal during Adolescence: A Case–Control Study
by Sara Iannattone, Marina Miscioscia, Alessia Raffagnato and Michela Gatta
Children 2021, 8(2), 165; https://doi.org/10.3390/children8020165 - 22 Feb 2021
Cited by 10 | Viewed by 2749
Abstract
Although social withdrawal is becoming increasingly common among adolescents, there is still no consensus on its definition from the diagnostic and psychopathological standpoints. So far, research has focused mainly on social withdrawal as a symptom of specific diagnostic categories, such as depression, social [...] Read more.
Although social withdrawal is becoming increasingly common among adolescents, there is still no consensus on its definition from the diagnostic and psychopathological standpoints. So far, research has focused mainly on social withdrawal as a symptom of specific diagnostic categories, such as depression, social phobia, or anxiety disorders, or in the setting of dependence or personality disorders. Few studies have dealt with social withdrawal in terms of its syndromic significance, also considering aspects of emotion control, such as alexithymia. The present case-control study aimed to further investigate the issue of social withdrawal, and try to clarify the part played by alexithymia in a sample of Italian adolescents diagnosed with psychological disorders (n = 80; Average Ageg = 15.2 years, SD = 1.49). Our patients with social withdrawal (cases) scored significantly higher than those without this type of behavior (controls) in every domain of alexithymia investigated, using the Toronto Alexithymia Scale (TAS-20) and with the scales in the Youth Self-Report (YSR) regarding internalizing problems, anxiety–depression, social problems, and total problems. Internalizing problems and total levels of alexithymia also emerged as predictors of social withdrawal. These variables may therefore precede and predispose adolescents to social withdrawal, while social problems may develop as a consequence of the latter. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)

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12 pages, 2559 KiB  
Case Report
Stimulus Control Procedure for Reducing Vocal Stereotypies in an Autistic Child
by Marco Esposito, Laura Pignotti, Federica Mondani, Martina D’Errico, Orlando Ricciardi, Paolo Mirizzi, Monica Mazza and Marco Valenti
Children 2021, 8(12), 1107; https://doi.org/10.3390/children8121107 - 1 Dec 2021
Cited by 1 | Viewed by 3831
Abstract
Stereotyped vocal behavior exhibited by a seven-year-old child diagnosed with autism spectrum disorder and maintained by automatic reinforcement was placed under stimulus control through discrimination training. The training consisted of matching a green card (SD) with free access to vocal stereotypy and a [...] Read more.
Stereotyped vocal behavior exhibited by a seven-year-old child diagnosed with autism spectrum disorder and maintained by automatic reinforcement was placed under stimulus control through discrimination training. The training consisted of matching a green card (SD) with free access to vocal stereotypy and a red card (SD-absent) with interruption of stereotypy and vocal redirection. At the same time, appropriate behaviors were reinforced. After discrimination training, the child rarely engaged in vocal stereotypy in the red card condition and, to a greater extent, in the green card condition, demonstrating the ability to discriminate between the two different situations. After the training, the intervention began. Once they reached the latency criterion in the red stimulus condition, the child could have free access to vocal stereotypy (green card condition). The latency criterion for engaging in stereotypy was gradually increased during the red card condition and progressively decreased during the green card condition. The intervention follows a changing criterion design. This study indicates that stimulus discrimination training is a useful intervention to reduce vocal stereotypy in an autistic child. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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11 pages, 694 KiB  
Case Report
Additional Evidence for Neuropsychiatric Manifestations in Mosaic Trisomy 20: A Case Report and Brief Review
by Marco Colizzi, Giulia Antolini, Laura Passarella, Valentina Rizzo, Elena Puttini and Leonardo Zoccante
Children 2021, 8(11), 1030; https://doi.org/10.3390/children8111030 - 10 Nov 2021
Cited by 1 | Viewed by 3330
Abstract
Mosaic trisomy 20 is a genetic condition in which three chromosomes 20 are found in some cells. Its clinical phenotype seems to be highly variable, with most features not reported across all individuals and not considered pathognomonic of the condition. Limited and recent [...] Read more.
Mosaic trisomy 20 is a genetic condition in which three chromosomes 20 are found in some cells. Its clinical phenotype seems to be highly variable, with most features not reported across all individuals and not considered pathognomonic of the condition. Limited and recent evidence indicates that neuropsychiatric manifestations may be more present in the context of trisomy 20 than was once thought. Here, we present a case of a 14-year-old female adolescent of White/Caucasian ethnicity with mosaic trisomy 20, who was admitted twice to an inpatient Child and Adolescent Neuropsychiatry Unit for persisting self-injury and suicidal ideation. A severe and complex neuropsychiatric presentation emerged at the cognitive, emotional, and behavioral levels, including mild neurodevelopmental issues, isolation, socio-relational difficulties, depressed mood, temper outbursts, irritability, low self-esteem, lack of interest, social anxiety, panic attacks, self-cutting, and low-average-range and heterogeneous intelligence quotient profile. Particularly, the patient was considered at high risk of causing harm, mainly to self, and appeared to be only partially responsive to medication, even when polypharmacy was attempted to improve clinical response. Except for school bullying, no other severe environmental risk factors were present in the patient’s history. The patient received a diagnosis of disruptive mood dysregulation disorder. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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