Resilience, the capacity to adapt positively in adversity, is a key protective factor for adolescent well-being, particularly for depression and anxiety, which are highly prevalent among adolescents in Nepal. Accurate measurement across cultural contexts is essential to identify at-risk adolescents and understand protective mechanisms. This study culturally adapted and evaluated the psychometric properties of the Child and Youth Resilience Measure-Revised (CYRM-R) and Rugged Resilience Measure (RRM) in Nepal to ensure cultural relevance, reliability, and validity. This mixed-method study focused on poverty-affected adolescents in Kathmandu, using focus group discussions, cognitive interviews, pilot assessments, and a cross-sectional survey. The findings indicated Nepali versions of CYRM-R and RRM were acceptable, comprehensible, and relevant based on qualitative feedback. Most items showed item-total correlations between 0.2 and 0.5, indicating good discrimination, and internal consistency was satisfactory (α and ω > 0.7). Exploratory and confirmatory factor analyses supported a unidimensional structure, with an alternative two-factor solution explored for CYRM-R. Test-retest reliability was moderate overall, with some subscales less consistent. Both tools demonstrated strong psychometric properties, including face, content, convergent, and known-groups validity. The Nepali CYRM-R and RRM provide culturally robust tools for assessing adolescent resilience, supporting researchers, educators, and policymakers in designing targeted interventions.

Panic disorder (PD) is a debilitating anxiety disorder consisting of episodes of intense fear that may emerge in childhood and adolescence; however, the factors leading to the emergence of PD in youth remain poorly understood. The risk of experiencing panic symptoms may increase due to changes in developmental capabilities in late childhood and adolescence. In particular, two constructs have frequently been examined as likely candidates: increased anxiety sensitivity (AS) and emotion regulation (ER) difficulties associated with socioemotional and cognitive changes that arise in childhood and adolescence. AS has been consistently identified as a precursor and maintaining factor of panic; meanwhile, fewer studies have examined the role of ER difficulties in the development and maintenance of panic symptoms in youth. This systematic review utilized a developmental perspective to identify and summarize the (1) phenomenology of panic symptoms in children and adolescents, (2) the association between AS and panic symptoms, (3) the relationship between ER and panic symptoms, and (4) the interaction of AS and ER in the etiology of panic symptoms. A total of 47 articles were included in this review. Youth (e.g., negative affectivity) and parental factors (e.g., parental modeling) were associated with AS and panic, while only youth factors (e.g., gender, puberty status, stressors, and baseline anxiety) were associated with ER difficulties and panic. Overall findings suggest AS and ER difficulties are independent correlates of panic symptoms in children and adolescents. Due to the lack of studies examining the interactive effects of AS and ER difficulty on panic symptoms in youth, future research is needed to clarify these relations.

Children of mentally ill parents are at a higher risk of developing mental health disorders and experiencing maltreatment. Identifying predictors of maltreatment in this risk group may help provide support at an earlier stage. A random forest classifier was applied to a sample of psychiatric inpatients (n = 330, 59.70% female, M  = 41.15 years, SD  = 7.12) and their children (n = 95, 60.00% female, M  = 15.03 years, SD  = 2.14) to examine whether child maltreatment could be predicted based on reports from both parents and children. Maltreatment symptoms were assessed using a cut-off score from the Childhood Trauma Questionnaire Short-Form. Model 1, which predicted children's trauma scores as estimated by the parents, achieved 76.62% accuracy with an area under the curve (AUC) of .85. Model 2, which used only parental data to predict children's self-assessed maltreatment scores, showed a slightly lower accuracy of 68.42% and an AUC of .69. Model 3, which predicted children's maltreatment scores based solely on children's self-reports, showed an accuracy of 73.68% and an AUC of .84. These findings indicate moderate-to-good predictability of children's maltreatment scores and provide initial insights into the risk-assessment of children's maltreatment in families with a mentally ill parent.This study was preregistered as a clinical trial (28.04.2017, DRKS00011533) at the Deutsches Register Klinischer Studien (DRKS).

Adolescents with attention-deficit/hyperactivity disorder (ADHD) exhibit heightened vulnerability to school bullying, with sex-specific patterns. This study analyzed data from the 2021 Korean National Survey on Mental Health of Youth, comprising 6,689 adolescents (ages 12-18; 50.9% male). After inverse probability of treatment weighting (IPTW) adjustment, the effective sample comprised 3,1789 adolescents at risk of ADHD and 3,511 controls. Logistic regression analyses revealed pronounced sex differences. Female adolescents with ADHD symptoms showed significantly elevated odds of overall victimization, teasing/verbal provocation, and bullying perpetration, particularly verbal abuse. Conversely, male adolescents with ADHD symptoms demonstrated reduced odds of social exclusion and sexual harassment victimization, but an increased risk of verbal abuse perpetration. These findings underscore the critical role of sex in shaping the dynamics of ADHD-related bullying behaviors. They highlight the need for tailored, sex-sensitive interventions targeting emotional regulation and social skills deficits in adolescents with ADHD.

Obsessive-compulsive disorder (OCD) is a common mental health concern in young people, as it is often severe and can become chronic without adequate psychotherapeutic intervention. As a first-line treatment, cognitive behavioral therapy (CBT) has been extensively studied in both face-to-face and online trials. However, low remission rates may indicate that not all young patients benefit from treatment. To further improve the effectiveness of digital CBT, treatment moderators should be investigated thoroughly. We analyzed data from n = 12 children and adolescents with OCD who received 14 weeks of digital sensor-assisted CBT via videoconferences (vCBT). We assessed patients' self-ratings of OCD symptom course, affect, and arousal and examined the effects of potential moderating variables (e.g., treatment satisfaction, technical usability, self-regulation, self-control, and self-efficacy) on treatment outcomes. The results revealed a significant improvement in obsessive thoughts and compulsive behavior during online CBT. Higher treatment satisfaction and perceived usability of technical devices was associated with greater decreases in obsessive thoughts and compulsive behavior. A significant moderating effect on self-rated decreases in symptoms was also found for patients with higher levels of self-efficacy, self-regulation, and self-control. Our results highlight that digital sensor-assisted CBT led to a subjective decrease in symptoms. The moderating effects of patient satisfaction and usability on symptom improvement emphasize the need for participative design approaches in the development of digital mental health interventions. The different constructs of mastery and volition appear to be moderators of decreases in OCD symptoms and should be further investigated in future trials with larger patient samples.Clinical trial registration: [ www.ClinicalTrials.gov ], identifier [NCT05291611], first submission: 2021-12-10.

Attachment insecurity is associated with callous-unemotionality (CU), but few studies have considered whether specific dimensions of insecurity are differentially associated with CU. The first aim of this preregistered study was to test whether attachment avoidance and anxiety were differentially associated with CU. The second aim was to examine whether specific emotion regulation strategies explain these associations. The third aim was to evaluate the moderating effect of trauma exposure. Participants included 316 justice-involved adolescents (M = 16 years, 20% female, 39% White/non-Hispanic) who self-reported attachment avoidance and anxiety, emotion regulation strategies, trauma exposure, and CU. As predicted, CU was positively associated with attachment avoidance and negatively associated with attachment anxiety. There was limited evidence that these associations were accounted for by emotion regulation strategies or moderated by trauma exposure. These findings align with the proposition that specific forms of attachment insecurity are differentially associated with CU among high-risk youth.

Early identification of suicide risk in pediatric outpatient settings is crucial for preventive interventions. This multicenter study aimed to develop a machine learning model to predict self-reported suicidal ideation among children and adolescents aged 7-17 years visiting pediatric outpatient settings. Least Absolute Shrinkage and Selection Operator and logistic regression analysis were used for model development and feature selection. Of 855 patients recruited, 329 were included in the analysis (mean age 11.0 years, 61.7% males). Frequent suicidal ideation (defined as always thinking life is not worth living during the past week) was reported by 20 (6.1%) patients. Based on six items assessing child-rated psychosocial functioning and physical and psychological symptoms, the selected model achieved an Area Under the Curve (AUC) of 0.81 (95% CI: 0.70-0.92). This brief six-item model can help identify children at risk of suicide in pediatric outpatient settings, potentially facilitating timely intervention.

Diagnostic labelling is a controversial issue, particularly when it comes to children. There are concerns about potential harmful effects of diagnosis, especially for Oppositional Defiant Disorder (ODD). There is a lack of research on parent perceptions of helpfulness of diagnosis, which is an important gap since parents of children with ODD are both the gatekeepers for treatment and the targets of parenting interventions. This study aimed to examine parent perceptions of the helpfulness of receiving a diagnosis of ODD for their child in families receiving an evidence-based parenting intervention, and to explore the reasons why it was considered helpful or unhelpful. Parents participating in parenting intervention for child ODD retrospectively completed questionnaires about receiving a diagnosis of ODD for their child on commencement of treatment. Of 244 parents completing questions at post-treatment, 134 parents (54.9%) reported that their psychologist diagnosed ODD for their child. Of those who reported receiving a diagnosis, 75.4% rated it extremely or somewhat helpful, 23.9% reported that it was neither helpful nor unhelpful, and just one parent (0.7%) rated it as somewhat unhelpful. The reasons for helpfulness were endorsed at high rates, with more than 90% reporting increased understanding of child behavior, understanding effective programs or strategies, and increased motivation to implement intervention strategies. No significant differences in perceptions of helpfulness emerged for parent gender, child exposure to adverse experiences, and previous ODD diagnosis. The findings appear to challenge concerns about the harmful effects of diagnostic labelling for children and point to a need for further research.

Views on autism shifted from a biomedical view to a neurodiversity-framework, with a parallel change in views on the nature of wellbeing. In this qualitative study the Capability Approach (CA), a theory of wellbeing, has been operationalized to identify (a) capabilities of young autistic adults in the Netherlands, as well as (b) important aspects in the process of converting resources on a personal, social and environmental level to realize valuable beings and doings. Fourteen young autistic adults with mental health problems and a self-chosen important other were interviewed twice using a semi-structured interview protocol driven by the central capability concepts. Thematic analysis revealed eight capability themes: autonomy, human connection, peace of mind, personal development, health, enjoyment, work and education, and meaning in life. Specific capabilities identified were to be free of sensory overload, participating in specific interests, to be understood by others, and access to autism-friendly care. Preconditions for capability realization related to the interaction between being autistic and social conditions (e.g. feeling misunderstood or bullied), but also to living conditions and resources (e.g. unsafety, poverty). The CA and identified capabilities offer a framework to discuss wellbeing, individual capabilities, and the conversion process with young autistic adults and their important others.

This study investigated the associations between perceived teacher support and academic anxiety among Chinese high school students, examining academic self-efficacy and social media use as potential mediating variables. Data were collected from 3,326 students (aged 14-19) across three regions in China using validated self-report measures. Path analysis identified three key relationships: (1) a negative association between perceived teacher support and academic anxiety; (2) academic self-efficacy and social media use as individual mediators in this relationship; and (3) these factors as sequential mediators in a chain pathway linking perceived teacher support with academic anxiety. These findings underscore the significant statistical association between teacher-student relationships and academic anxiety, and further illuminate the broader correlational dynamics among external support, psychological beliefs, digital behaviors, and emotional states. This research provides preliminary evidence with important implications for addressing academic anxiety in competitive educational environments.

Non-suicidal self-injury (NSSI) and suicidality in adolescents represent urgent public health concerns. Although distinct, these behaviors share several underlying mechanisms. To clarify their relationship and inform prevention strategies, it is crucial to identify the factors most strongly associated with NSSI and suicidality in early adolescence, as well as those that exert common influences on both. In this study, a survey of 625 Chinese early adolescents (M = 10.36 years, SD = 0.93 years) was conducted, and network analysis was used to examine the interconnections among NSSI, suicidal ideation, suicide attempts, and multiple influencing factors. Results showed that harsh parenting, interparental conflict, and perceived burdensomeness were central factors for the concurrent prevention and intervention of NSSI, suicidal ideation, and suicide attempts. Furthermore, meaning in life and deviant peer affiliation emerged as important factors influencing both NSSI and suicidal ideation. These findings provide a robust theoretical foundation and practical direction for the early identification and mitigation of adolescent NSSI and suicidality.

Siblings of children with neurodevelopmental disorders (NDD) are often exposed to challenging behaviors from their neurodivergent siblings, which may be associated with persistent negative feelings. While social support has been shown to buffer the effects of such challenges, limited research has examined emotional responses in these siblings. This study explored the association between discomfort caused by challenging behaviors and persistent negative feelings toward children with NDD, and investigated whether perceived social support moderates this association. A self-report questionnaire was completed by 127 siblings of children with NDD. Three scales were developed to assess discomfort with challenging behaviors, persistent negative feelings, and perceived social support from fathers, mothers, friends, and teachers. A significant correlation was found between discomfort and persistent negative feelings. Perceived social support moderated this association, such that higher levels of support were linked to lower levels of negative feelings-although the buffering effect was weaker when discomfort levels were high. These findings suggest that social support may play a protective role in the context of sibling emotional adjustment, particularly when discomfort is less intense.

The COVID-19 pandemic has significantly impacted the mental health of children and families. This study sought to further explore the relationship between the pandemic (accounting for age and sex) and children's mental health outcomes, parenting quality, and service complexity. Data consisted of interRAI Child and Youth Mental Health Assessments from 5,067 children and youth between the age of 4-18-years-old. Surprisingly, our findings revealed the pandemic was not a significant predictor of parenting quality and children's mental health. Significantly lower levels of service complexity during the first few months of the pandemic were observed. Compared to younger males, older female children were more likely to experience internalizing symptoms and less likely to display externalizing symptoms. Older children (vs. younger children) were more likely to receive low parenting quality and experience service complexity. Clinical implications, limitations, and future directions are discussed.

This study aimed to develop and validate a new questionnaire, the Parental Burnout in ADHD (PBA) scale, to address this gap in the literature. Drawing on existing research on parental burnout, ADHD, and related constructs such as parenting stress and self-efficacy, the PBA scale was developed through a rigorous process involving item generation, expert review, and pilot testing. The final version of the PBA scale comprised 36 items, covering five dimensions: Parental stress, Parental self-efficacy, Parental guilt, Social support for parents, Parental burnout and Parental coping strategies. The psychometric properties of the PBA scale were examined in a sample of 118 parents of children with ADHD. Confirmatory factor analysis supported the five-factor structure of the scale, with good model fit indices. In conclusion, the Parental Burnout in ADHD (PBA) scale is a reliable and valid instrument for assessing parental burnout in parents of children with ADHD.

A cross-sectional survey with 399 parents of 1-5-year-old children aimed to investigate the extent to which parents make sex-based attributions for children's behaviours, and the association of parents' own gender and social role attitudes with those attributions. Overall, parents were more likely to attribute child behaviour to children's individual characteristics, age, and lack of socialisation than to sex. However, parents were more likely to make sex-based attributions for scenarios featuring boys compared to girls. In this sample, sex-based attributions were associated with attitudes towards social roles, but not with demographics, self-ascribed masculinity-femininity, and attitudes towards marital roles and child-rearing.

Voices and experiences of youth aged 12-15 years are rarely heard and prioritized. Understanding their perspectives is essential for tailoring effective mental health interventions and supports. As such, this qualitative study, co-designed with a youth advisory committee (n=7), interviewed 19 youth (aged 12-15 years) to explore their understanding of good mental health. Interviews were analyzed thematically following a reflexive thematic analysis approach. Three overarching themes were identified: 1) Everything is OK, describing a state of being able to manage the challenges of life, 2) Building Personal Strength and Resources, needed to maintain good mental health as an adolescent, and 3) Seeking Acceptance and Community, emphasizing the profound influence of social connections. Addressing adolescent mental health effectively requires a nuanced understanding of their perspectives to develop responsive and impactful mental health interventions and their active involvement in all facets of service design, research, and policymaking. PLAIN LANGUAGE TITLE: "My day is already planned out before I even get to choose it": Understanding what matters to youth aged 12-15 years and the implications for mental health services Youth aged 12-15 years are at a key developmental age and actively seek mental health services, yet their perspectives on these mental health services are rarely heard. Understanding what good mental health means to them is essential for creating support systems that meet their needs. This study explored how youth define good mental health. We worked with a youth advisory committee (n=7, aged 12-15 years) to co-design the research. Then, we interviewed 19 youth (aged 12-15 years, median age 14) from British Columbia, Canada, to learn about their views. Using an analysis approach that identifies patterns or themes in a way that reflects on the authors own perspectives and the process of analysis, we identified three key themes: 1. Everything is OK - Youth described good mental health as balancing their emotions to be able to handle life's challenges, including school and family pressures. 2. Building Personal Strength and Resources - Youth emphasized the importance of developing coping skills, confidence, and self-awareness to support their mental well-being. 3.Seeking Acceptance and Community - Youth highlighted the role of supportive relationships in having good mental health. These findings show that youth mental health is deeply connected to youths' environment, social connections, and ability to navigate challenges. To support them effectively, we must listen to their perspectives and include them in shaping mental health services, research, and policies. By prioritizing their voices, we can create meaningful and accessible mental health resources that align with their needs.

Non-suicidal self-injury (NSSI) is prevalent among early adolescents. However, few studies have explored the complex psychosocial mechanisms underlying NSSI among this population. This study aimed to examine the roles of Internet gaming disorder (IGD) and peer victimization by linking emotional insecurity to NSSI during early adolescence. Data were collected from 886 adolescents across four primary schools at three time points, spaced six months apart, using multi-stage random sampling. All participants were of Han ethnicity, with a mean age of 10.17 years. Girls accounted for 47.4% of the sample. The results indicated that IGD served as a mediator in the relationship between emotional insecurity and adolescent NSSI. Furthermore, this indirect effect was significantly moderated by peer victimization, such that the mediating role of IGD was only significant among adolescents experiencing high levels of peer victimization. These findings emphasized the longitudinal pathways through which emotional insecurity contributes to NSSI and have important implications for prevention and intervention strategies targeting NSSI among early adolescents.

This study examines risk factors associated with bullying among U.S. adolescents including social determinants of health, parental determinants, and pre-existing health conditions to inform evidence-based strategies to prevent bullying. Data for 12-17-year-old adolescents from the 2022-2023 National Survey of Children's Health (NSCH) was analyzed. Summary statistics, chi-squared tests, and binary logistic regression analyses were performed to examine associations between bullying involvement and a variety of factors, including physical health conditions, mental and developmental health variables, caregiver influences, adverse childhood experiences, and social determinants. Bivariate analyses revealed significant associations between bullying or being bullied and caregiver mental health and social determinants. Logistic regressions highlighted that being overweight, having autoimmune disease, mental health conditions (anxiety, depression, ADHD), learning disabilities, and difficulty making friends significantly increased the odds of being bullied. These findings support the need for evidence-based, multi-level, culturally specific interventions to reduce bullying and improve adolescent well-being.

Preterm birth and very low birth weight (VLBW; <1500 g) are associated with a greater risk for later child psychopathology. However, longitudinal studies on influencing factors and developmental precursors for behavioral problems in VLBW children are still scarce. This study investigates whether difficult infant temperament moderates the association between VLBW and internalizing symptoms, while controlling for family contextual factors. Data from N = 146 families (n = 75 VLBW and n = 71 term birth) were derived from the longitudinal HaFEn cohort study in Hamburg, Germany. Mothers reported on infant temperament at 12 months of age, and internalizing problems at 2.0, 4.4, and 8.0 years. Parental depressive symptoms and socioeconomic status (SES) were assessed shortly after birth. The results showed no moderating effect of infant difficultness on the association between VLBW and internalizing problems. However, difficult temperament was associated with higher levels of internalizing problems in both groups. Our findings highlight the relevance of considering infant temperamental predisposition in relation to later behavioral problems in general. Future research should further examine specific factors influencing mental health outcomes in VLBW children, such as parenting or SES.

This study investigated the inter-rater agreement, test-retest reliability, and convergence validity of the Japanese-translated Anxiety Disorders Interview Schedule (ADIS) for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The ADIS was administered to 71 children and adolescents (53.52% females, M = 10.70 years, SD = 2.05) and their parents, with a two-month test-retest interval. Participants also completed questionnaires on anxiety and depression. Test-retest reliability was good for the presence or absence of a diagnosis and clinical significance ratings for all diagnoses. Inter-rater reliability was good to excellent. Strong convergent validity was observed for the separation anxiety disorder, generalized anxiety disorder, dysthymia, and depression domains in both the child- and parent-reported measures. However, correlations with parent-reported social phobia and specific phobia were not statistically significant. These results support moderate stability across time, consistent diagnostic results among independent diagnosticians, and convergent validity of the Japanese version of the ADIS for the DSM-IV.

Racial/ethnic discrimination is associated with elevated internalizing symptoms. However, the psychological processes through which discrimination affects internalizing symptoms in ethno-racially minoritized youth are less understood. The current study examined the role of emotion dysregulation in the association between racial/ethnic discrimination and internalizing symptoms. Participants were 5,693 ethno-racially minoritized youth (M = 9.89; 48% female; 42.3% Hispanic) enrolled in the Adolescent Brain Cognitive Development Study. Path analysis revealed that experiences of racial/ethnic discrimination were associated with greater emotion dysregulation in the following year, which was, in turn, associated with greater internalizing symptoms concurrently, covarying for sex assigned at birth and caregiver education level. Findings suggest emotion dysregulation may play a key role in the link between racial/ethnic discrimination and internalizing symptom development in minoritized youth. Targeting emotion dysregulation in clinical interventions to address internalizing symptoms related to racial/ethnic discrimination may improve well-being in this population.