Reviewing manuscripts is hard work. We wish to express our heartfelt appreciation to the 436 hard workers listed below, who so diligently served their Journal between July 1, 2024, and June 30, 2025. Our additional gratitude goes to our 9 colleagues (David Cochran, Paul Croarkin, Kathryn Regan Cullen, Mary Margaret Gleason, Benjamin I. Goldstein, Meng-Chuan Lai, Mirko Uljarevic, Eric A. Youngstrom, and Bonnie Zima) who served as ad hoc and guest editors and helped ensure that all manuscripts, our own included, were treated under the same editorial standards. We also would like to acknowledge the colleagues who are completing their terms on our Editorial Board: Kathryn Regan Cullen, Stefan Ehrlich, Ryan J. Herringa, and Emily Simonoff; International Editors-at-Large Andrea Danese and Benjamin I. Goldstein; AACAP Emerging Leaders Fellow Nina R. Bihani; and John F. McDermott, MD, Assistant Editor-in-Residence David C. Saunders.

In keeping with the Journal's policies, we provide a listing of disclosures for all members of the editorial masthead and the ad hoc and guest editors (marked with an asterisk) as of September 15, 2025. This list, based on annually updated signed statements on file in the editorial office, includes all biomedical financial interests and potential conflicts of interest disclosed for the previous 36 months and the foreseeable future.

Autistic social traits (ASTs), evident in the general population, are associated with mental health challenges. ASTs have not been evaluated in youth born extremely preterm (EP), despite their increased prevalence of autism. The current research evaluates AST change from 10-17 years in a well-characterized sample of EP youth, including sex differences and associations with health and quality of life.

Children with attention-deficit/hyperactivity disorder (ADHD) have difficulties filtering irrelevant information, particularly when faced with competing inputs. These challenges may affect auditory distraction processing, especially under varying demands on visual attention. This study investigated the neural mechanisms underlying auditory distraction processing under these conditions in ADHD.

Parent-Child Interaction Therapy (PCIT) was developed for externalizing disorders in school-aged children and was influenced both by social learning theory and attachment theory. Taking a 2-step approach, it aims to develop parental management skills such as clear communication and limit setting to reduce behavior problems, and relationship skills to enhance nurturance. PCIT has been adapted for various internalizing disorders and for preschool-aged children. Joan Luby and her colleagues developed PCIT-ED, which condensed the original 8-session PCIT program to 6 sessions and added an 8-session Emotion Development (ED) module targeting the child's emotional awareness and regulation. Consistent with the tenets of PCIT, this program equips parents with tools to support the emotional development of their children. Earlier investigations of the same cohort demonstrated higher remission rates and reduced depression symptoms compared to waitlist controls, as well as decreased parenting stress and parental depression at the end of treatment compared to waitlist controls. Treatment gains were sustained in many areas at 3-month follow-up..

To estimate effects of initiating and subsequently adhering to different antidepressant medications on average BMI-z changes among youth by emulating a target trial.

Depression is a growing public health crisis, affecting millions worldwide. Recent data indicate that 13% of individuals aged 12 and older experience depression, with the prevalence highest in adolescents aged 12 to 19 years. Its marked heterogeneity-spanning symptoms, clinical courses, and biological mechanisms-drives variability in treatment response. Addressing this challenge requires identifying precise phenotypes or biologically informed subtypes. The Research Domain Criteria (RDoC) framework, developed by the National Institute of Mental Health, offers a strategy to define such subtypes, revealing distinct biological signatures and differential treatment responses and advancing the promise of precision psychiatry..

Autism spectrum disorder (ASD) is a neurodevelopmental condition with early-life origins. Maternal health conditions during pregnancy have been linked to autism risk, but most studies focus on single populations, limiting generalizability. We examined whether associations previously reported in a Danish registry-based study hold in a U.S.

To assess the predictive validity (PV) of Psychache, the Interpersonal Theory of Suicide (IPTS), and Reasons for Living (RFL) regarding future suicide attempts (SA) in youth.

Parental emotion socialization is theorized to influence adolescent emotion regulation. However, the causal nature of this relationship and the underlying neural mechanism has not been investigated.

Mitochondria have been implicated in the etiology of autism spectrum disorder (ASD), but evidence for attention-deficit/hyperactivity disorder (ADHD) remains limited. Given the early onset of both ASD and ADHD and high degree of comorbidity, this study sought to examine the prospective association of 20 acylcarnitines in cord blood-a group of metabolites involved in mitochondrial fatty acid metabolism-with childhood risk of ASD, ADHD, and other neurodevelopmental disorders (NDDs).

To explore the association between acetaminophen use during pregnancy and the risk of neurodevelopmental disorders (NDDs) in children.

Some of the greatest challenges in understanding and treating attention-deficit/hyperactivity disorder (ADHD) stem from its heterogeneity and high rates of comorbidity. In particular, disentangling ADHD from early symptoms of bipolar disorder has been a long-standing challenge for the field of child psychiatry. This issue is particularly thorny because of concerns about treatment-emergent mania when treating ADHD with psychostimulant medication in youth with comorbid bipolar disorder, and possibly even in those at familial risk for bipolar disorder. In this context, the field stands in need of reliable biomarkers to guide treatment selection. Advances in this area will require a better understanding of how neural circuits vary across different subtypes of clinical disorders and, in particular, how interventions might affect these circuits differently across subtypes. In this issue of the Journal, Lei and colleagues address this knowledge gap by comparing how the brain changes after psychostimulant treatment in ADHD youth with vs without familial risk for bipolar disorder.

In pursuit of improved health outcomes, health services researchers have long sought to monitor quality of care and drive continuous improvements in the health care system. As defined by Donabedian in 1966, quality of care may be thought of as "a reflection of values and goals current in the medical care system and in the larger society of which it is a part." Although pediatric behavioral health (PBH; ie, psychiatry, psychology, behavioral pediatrics, developmental pediatrics, addiction) quality improvement has advanced considerably in the past few decades, the PBH field lags far behind other specialties in terms of large-scale, coordinated efforts to monitor and improve quality of care. For example, US News and World Report (USNWR) has published indices of hospital quality for more than 30 years, but only collected PBH data for the first time in 2023.

Children often grow up believing their parents are invincible-superheroes who can see, know, and fix everything. But what happens when those roles shift, and children find themselves guiding the very people meant to guide them? Across cultures and families, caregiving sometimes flows in surprising directions, with roles shifting between generations and among siblings. Popular media sources capture these reversals with striking honesty, offering glimpses into the humor, tenderness, resentment, and resilience that can coexist in these relationships. This month's Media Forum highlights 2 powerful stories that invite us to reflect on how love and responsibility intertwine when children and adolescents step into caregiving roles earlier than expected.

Anxiety disorders often emerge early in life but are frequently overlooked and insufficiently treated, leading to significant academic, social, and psychiatric challenges that can persist throughout adulthood. Although selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are standard treatments for childhood anxiety, these interventions do not always provide adequate relief, underscoring the need for more personalized and effective interventions. Over the past 2 decades, Attention Bias Modification Training (ABMT) has been studied as a possible intervention for anxiety disorders. Interventions with ABMT use a computer-based adaptation of the dot-probe task. Some patients with anxiety disorders have an implicit tendency to focus on threatening or negative stimuli. With ABMT, patients view a pair of images or words-one threatening and one neutral. A dot or other symbol then replaces the neutral stimulus, thereby training the brain to shift attention away from the negative threatening stimulus.

Psychiatric disorders have modest to high heritability, implying an important role for inherited liability carried in DNA sequences present from conception. However, it may take years or decades before this liability manifests as behaviors and inner experiences that meet criteria for a psychiatric diagnosis. In between, developmental processes unfold under genetic influence and in dynamic interaction with environments, exposures, and experiences. As a result, early life development presents a landscape of changing neural structures, evolving cognitive, socio-emotional, and behavioral repertoires, and period-specific environments. Genetic liability to psychiatric disorder is not dormant within this landscape. Rather, genome-wide association studies (GWAS) for essentially all psychiatric disorders implicate early neurodevelopmental processes that may alter developmental trajectories. These findings emphasize the importance of a developmental perspective in psychiatric genetics. To understand the genetic etiology of psychiatric disorders and detect emerging psychopathology is to understand how genetic liability is expressed over the course of development..

As psychiatrists, we listen to both what is said and what is unsaid. We must look at the patient both in the context of their individuality and as part of their family unit. The identity of our patients is shaped by their parents. However, conflict often arises when there is discordance between a parent's and a child's expectations, which can precipitate tragedy. In this month's Media Forum, we feature 2 works that are tied together by parental expectations: Everything I Never Told You, a novel by Celeste Ng, and Hospital Playlist, a Korean drama. The 2 pieces may appear dissimilar, as one is a literary tragedy and the other is a medical drama. However, both illustrate how family and culture shape identity, affording us clinical pearls to use in our health care practice.

Environmental factors have long been shown to influence brain structure and adolescent psychopathology. However, almost no research has included environmental factors spanning micro-to-macro-systems, brain structure, and psychopathology in an integrated framework. Here, we assessed the ways and degree to which multisystem environmental factors during late childhood are associated with subcortical volume and psychopathology during early adolescence.

Findings on the presence and direction of a sex/gender difference in internalizing problems for autistic children and young people (CYP) are inconsistent. This systematic review investigated whether autistic boys and girls differ in internalizing problem severity.

In recent years, there has been a marked increase in legislation across United States aimed at restricting the rights and visibility of lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals, with a focus on youth. These laws include prohibitions on discussing LGBTQ+ topics in educational settings, bans on gender-affirming care, and restrictions on participation in activities aligned with an individual's gender identity. Since the beginning of the second Trump administration in January 2025, a wave of federal executive actions has further threatened the health and rights of LGBTQ+ populations. These actions include efforts to reduce or eliminate federal funding for gender-affirming care, including coverage through the Affordable Care Act, and to eliminate recognition of gender identity across federal agencies and programs. As of this writing, several of these actions are facing legal challenges and are held up in court. The cumulative effect of these state and federal policies poses significant and immediate threats to the mental health and well-being of LGBTQ+ youth and their families.

We aimed to systematically review and meta-analyze evidence on the associations between prenatal exposure to SARS-CoV-2 infection or COVID-19 vaccination and child neurodevelopmental outcomes.

Obsessive-compulsive disorder (OCD), affecting ∼1% of the population, is characterized by intrusive thoughts and compulsive behaviors that cause significant distress and impairment. Following an evidence-based assessment to identify OCD and to differentiate co-occurring conditions, the front-line treatment is outpatient cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP), with or without serotonin reuptake inhibitors (SRIs). In severe cases, augmentation with neuroleptics is often used. Although standard outpatient treatment reduces OCD symptoms, many youth do not fully respond and require more intensive care, such as intensively delivered ERP. This article aims to guide clinicians in referring patients with severe and/or treatment-refractory OCD-defined as a failure of 2 SRI trials of adequate dose and duration and an adequate ERP trial-to appropriate intensive psychotherapeutic treatment.

Parent satisfaction is a desired outcome of care provided to pediatric patients in medical settings and has been associated with reductions in parent stress and child problematic behavior, significant improvements in child functional impairment, and willingness to seek future care. Inpatient psychiatric settings inherently pose barriers to satisfaction, as patients may not voluntarily agree to hospitalization, treatment options can be associated with stigma, and improvement in symptoms may take prolonged amounts of time. These challenges are intensified in pediatric psychiatric settings, as caregiver perceptions can influence facilitation of care and treatment outcomes..

It is well documented that autistic people are at an increased risk for co-occurring mental health challenges and suicide. There is also a robust and ever-growing body of literature delineating the challenges of meeting the varied mental health needs of autistic children, adolescents, and adults-most notably, access to efficacious treatments. For those who are able to access services, there are concerns about ableism and the failure of clinicians to understand how autistic characteristics may interact with mental health presentation and treatment response. Access difficulties are exacerbated by the general lack of disability- and autism-related content in curricula of preprofessional programs, resulting in a workforce who report being ill prepared to work with this population. It is imperative to have evidence-based mental health treatments. Equally important is the method by which such treatments are developed, studied, and disseminated. The autism community has identified key considerations for researchers who study treatment development, implementation, and dissemination. Most notable is the inclusion of and collaboration with autistic people, from all stages of research, treatment conceptualization through dissemination, and examining outcomes that matter to them. The emergence of rigorous randomized controlled trials (RCTs) such as those by White et al. are a strong step forward in addressing issues about efficacious treatment, as well as inclusion of the autistic community. As such, the White et al. study can serve as a model for others. Furthermore, the research community needs to diversify the composition of study participants, and as a field we need to turn more focus toward dissemination and training, both of which are imperative for improving access.