Children's and youths' self-injurious thoughts and behaviors (SITBs) significantly impact their parents, often causing elevated stress and distress. In addition to managing the emotional toll, parents need to actively participate in their child's recovery, adding a second layer of caregiving burden. Despite the clinical relevance of this issue, few quantitative studies have examined parental stress during their child's suicidal crisis, and the nature of this association remains insufficiently understood. To address this, we conducted a scoping review to identify, summarize, and synthesize quantitative studies linking children's and youths' SITBs with parental stress and/ or distress. We systematically searched three databases for research published on or before May 2023. Studies were eligible if they provided data on the association or impact of children's and youths' SITBs on parental stress and/ or distress levels, including intervention studies that reported outcomes related to parental distress. The findings of this review highlight three key insights: (1) Descriptive data suggest that parental stress and/ or distress is significant among parents of children and youths exhibiting SITBs, even when not reaching the clinical threshold for psychopathology; (2) Parents of children and youths with SITBs report significantly higher levels of stress and distress compared to parents in control groups; (3) Parents benefit from various therapeutic interventions. This scoping review underscores the importance of investigating the nature and magnitude of the association between children's and youths' SITBs and parental stress and distress, as well as the outcomes of targeted interventions.

Anxiety and depression affect about 6.5% and 2.6% of young people and often occur together, worsening over time. Exercise increases mood-boosting chemicals like dopamine and endorphins, and research shows it can relieve these symptoms. However, most studies focus on ages 6-18 and test only one type of exercise, overlooking older adolescents (up to 24) and comparisons among different activities. This study addresses these gaps by examining 10-24-year-olds and using a network meta-analysis to compare various exercise programs-such as aerobic, resistance, mind-body, and mixed routines-to determine which best reduces anxiety and depression in this age group.

Early intervention of personality disorders (PD) in adolescents is crucial due to their long-term developmental impact. Dimensional models, like the DSM-5 Alternative Model for Personality Disorders (AMPD), may facilitate early detection and intervention, although their applicability in adolescent clinical populations is under-researched. This longitudinal study examines changes in PD diagnosis and impairments in personality functioning according to the AMPD and explores potential predictors in a clinical adolescent cohort. 227 adolescents (M age = 15.25, 85.02% female) from an outpatient clinic for early PD intervention were assessed at baseline, one year, and two years. Personality functioning was measured using the Semi-Structured Interview for Personality Functioning, psychiatric diagnoses with the Mini International Neuropsychological Interview, and psychosocial functioning with the Social and Occupational Functioning Assessment Scale. Mixed regression models were applied for analysis. The probability of a PD diagnosis significantly decreased over two years (OR = 0.54, p = .011). Significant improvements were observed in identity (β = -0.191, p < .001), self-direction (β = -0.243, p < .001), empathy (β = -0.147, p < .001) and intimacy (β = -0.136, p < .001). Age, sex, psychiatric comorbidity, psychosocial functioning at baseline, treatment setting (inpatient versus outpatient) and dose did not influence PD diagnosis remission or changes in personality functioning, but higher baseline psychosocial functioning was linked to less improvement in self-direction (β = 0.008, p = .033). Personality functioning improved over time, supporting the notion that PD pathology in adolescents is amenable to change. Further research is needed to examine individual trajectories of personality functioning and refine targeted intervention strategies.

Psychotic-like experiences (PLEs) are common among children and adolescents and are associated with adverse outcomes. The aim of this meta-analysis was to synthesize evidence on their prevalence and associated risk factors. From inception to June 21, 2025, we searched the following four databases for relevant articles: EMBASE, PubMed, Web of Science and PsycINFO. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Risk factors were categorized into demographic, lifestyle, psychological, and behavioural domains. Heterogeneity was explored by subgroup analysis (including age, region, etc.) and sensitivity analysis. Publication bias was assessed by funnel plots, Egger's test, and the trim and fill method. This research pooled 45 studies with a total of 353,350 participants. The overall prevalence of PLEs among children and adolescents was 20.9% (95% CI: 18.9-23.0). The prevalence was higher among children (9-12 years: 27.4%) than among adolescents (13-18 years: 19.5%) and varied by region (Europe: 29.2%; Africa: 10.0%). Twelve significant risk factors were identified. The strongest associations were for traumatic events (OR = 1.95, 95% CI: 1.53-2.49), marijuana use (OR = 1.83, 95% CI: 1.16-2.89), and alcohol consumption (OR = 1.74, 95% CI: 1.19-2.55). Other factors included female sex, urban residence, family history of mental disorders, smoking, single-child family, left-behind children, sleep disorders, depression, and anxiety. PLEs are prevalent among young people. Screening and early intervention targeting modifiable risk factors, such as substance use and sleep disorders, may help reduce the long-term burden of PLEs.

Social support from family, friends, and teachers is critical in preventing adolescents' internalizing and externalizing problems. However, longitudinal research on how different combinations of social support influence these problems remains limited. To address this gap, this study employed Parallel Process Latent Class Growth Modeling (PP-LCGM) to examine the joint developmental trajectories of support from family, friends, and teachers, and their associations with the developmental trajectories of internalizing problems (i.e., depressive symptoms and non-suicidal self-injury) and externalizing problems (i.e., proactive and reactive aggression). A total of 1437 adolescents (56.9% male, M=13.48, SD = 0.70) participated in assessments conducted at three time points. The results identified one convergent trajectory of social support, represented by the high overall support class, along with four divergent trajectories, characterized as predominant family support, predominant friend support, predominant teacher support, and predominant family and friend support classes. Four trajectories of internalizing and externalizing problems were also identified: Congruent-increasing, congruent-decreasing, moderate with predominant depressive symptoms and reactive aggression, and congruent-low. Compared to those in the high overall support class, adolescents who benefited predominantly from family and/or friend support were more likely to fall into the moderate with predominant depressive symptoms and reactive aggression trajectory. Conversely, no significant differences were observed between four divergent support trajectories and the high overall support trajectory in terms of congruent-increasing or congruent-decreasing patterns of internalizing and externalizing problems. These findings suggest the key role of teacher support in protecting against depressive symptoms and reactive aggression, emphasizing the importance of equipping teachers to provide support to their students. Moreover, enhancing any single source of support, whether from family, friends, or teachers, can effectively curb the synchronous changes in internalizing and externalizing problems, offering valuable insights for resource-constrained interventions.

Balancing autonomy and safety for youth with severe and enduring mental health problems (SEMHP) is a major challenge in (residential) child and adolescent psychiatry (CAP). While autonomy supports engagement and recovery, high-risk behaviors such as suicidality often necessitate safety measures that restrict autonomy. These conflicting priorities lead to clinical dilemmas and inconsistencies in care. To provide a nuanced understanding and enhance clinical support for youth with SEMHP, this study explores how autonomy and safety are understood and negotiated in residential CAP from the perspectives of youth, caregivers, and practitioners. In this qualitative study, we conducted two focus groups and eleven semi-structured interviews, involving youth with SEMHP (n = 7), practitioners (n = 8), and caregivers (n = 6). A reflexive thematic analysis was applied, and perspectives were compared. Autonomy and safety emerged as deeply interrelated concepts. Three main categories were deducted: (1) Foundation for safety and autonomy, (2) Regulation of safety and autonomy, and (3) Tensions and risks. Youth highlighted the need for relational proximity, trust, and shared decision-making, while practitioners emphasized boundaries and procedures. Caregivers expressed varied views, often evolving over time. These differences can lead to tensions, particularly in high-risk situations, where autonomy and safety are difficult to uphold simultaneously. Balancing autonomy and safety requires staying connected to support gradual growth within a predictable and supportive care environment. Particularly in high-risk situations, maintaining a relationship-centered approach, involving youth and caregivers in decisions, and creating space to slow down are key to fostering safety and autonomy in residential CAP.

War-related experiences in children often result in significant psychological stress, frequently requiring professional intervention. The Huggy-Puppy Intervention (HPI) has demonstrated effectiveness in alleviating stress symptoms, yet its delivery has thus far depended on healthcare professionals and the use of a single doll type. This study aimed to evaluate a parent-delivered adaptation of the intervention, and examine whether the type of doll moderates treatment efficacy. A total of 160 Israeli children aged 3-8 years (M = 5.1 ± 1.4; 57% girls) were randomized to receive one of five doll types as part of the HPI, delivered by parents during the 2023 Hamas-Israel war. Doll types included the original puppy doll, as well as monkey, teddy-bear, dog, and bunny dolls. Parents received instructional videos on how to implement the intervention. Stress symptoms were assessed using online parent-reports at baseline and three weeks post-intervention. Additional measures included child attachment to the doll, parental compliance, and satisfaction with the intervention. Linear mixed models yielded significant large reductions in stress symptoms from pre- to post-intervention across all doll types (Cohen's d = 0.94-0.97). Children exhibited lower attachment to the monkey dolls, and parents reported reduced satisfaction with these compared to other doll types. These findings support the efficacy of a parent-administered HPI in reducing war-related stress in children, with largely comparable outcomes across different doll types. This parent-delivered, adaptable approach enhances accessibility, offering a practical, cost-effective method for supporting children in crisis-affected areas where professional resources are limited.

The objective of this study was to understand how socio-economic disadvantages relate to mental health problems (MHP) among children with mild intellectual disability or borderline intellectual functioning (MID-BIF) in outpatient care by extending beyond traditional economic measures, incorporating cumulative risks, and analyzing variations across clinical subgroups. Using a population-based case-control design, data from Statistics Netherlands and mental health records were analyzed for 1,742 children with MID-BIF receiving mental health care (M = 9.6, 33.1% girls) and 8,710 age- and sex-matched controls aged 0-17. Logistic regression revealed that children with MID-BIF and MHP were significantly more likely than controls to come from families facing socio-economic disadvantages, such as single parenthood, lower parental education, reliance on social benefits, low income, and subsidized housing. Socio-economic risks were more likely to cluster in the case group, with 15.3% of children exposed to five risk categories and 6.7% to all six, compared to 6.7% and 3.6% in controls, respectively. Children in the internalizing and externalizing symptom-based groups faced more pronounced socio-economic disadvantages than those in the developmental group. Additionally, more extensive care was unexpectedly linked to more favorable socio-economic conditions, suggesting a complex interplay between care needs and socio-economic conditions. Taken together, this study showed that children with MID-BIF receiving outpatient care for their MHP often face greater and more clustered socio-economic disadvantages. Simultaneously, children from socio-economically disadvantaged backgrounds received less specialized mental health care. This underscores the importance of addressing barriers in mental health care and promoting family- and community-based care.

Suicide is a leading cause of death among adolescents, highlighting the importance of early intervention in school settings. Universal mental health awareness programs, aimed at improving mental health literacy and help-seeking behaviors, are a key preventive approach. This study examined whether changes in thwarted belongingness and perceived burdensomeness-two constructs from the Interpersonal Theory of Suicide (IPTS)-mediate the effects of school-based mental health interventions on suicidal ideation (SI). A total of 436 adolescents from central Israel (154 boys, 279 girls; M = 14.6, SD = 1.1) were randomly assigned to either a mental health awareness intervention (N = 256) or a minimal-intervention control group with attendance monitoring (N = 180). Belongingness, burdensomeness, and SI were assessed at baseline, 1-month, and 1-year post-intervention. Regression analyses showed that lower belongingness (β = -0.25, p < .001) and higher burdensomeness (β = 0.21, p < .01) predicted higher SI at 1-month, while only belongingness remained significant at 1-year (β = -0.19, p < .01). The mental health awareness intervention increased school-specific belongingness (β = 0.22, p < .001), whereas attendance monitoring intervention increased general belongingness (β = 0.18, p < .01). Mediation analysis indicated that the effects of the intervention type on SI were not significantly mediated by general and school belongingness. These findings suggest that promoting broader social connectedness beyond school environments may support reductions in adolescent suicide risk over time.

This meta-analysis aims to identify intervention parameters (e.g., intensity, session time, frequency, and intervention duration) of targeted physical activity (PA) to improve inhibition control (IC) in children and adolescents with ADHD. The systematic search was conducted across PubMed, Web of Science, Embase, and Cochrane Library. In this meta-analysis we assessed the overall effect of PA interventions and then conducted subgroup meta-analyses and meta-regression to explore potential sources of heterogeneity. Finally, we checked publication biases and performed sensitivity analyses. Sixteen studies (591 participants aged 7-17 years) were included. The result showed that targeted PA interventions improved IC with high heterogeneity (SMD = 0.71, 95% CI [0.30, 1.11], I = 83.11%). Long-term interventions improved IC (SMD = 0.84, 95% CI [0.36, 1.31], p < 0.01), whereas acute interventions did not. Although no statistically significant group difference in long-term interventions was found (p > 0.05), examination of individual studies suggested greater improvements with session time around 60 min (SMD = 1.43), 2-3 times/week (SMD = 1.04), and intervention duration of at least 8 weeks (≥8 weeks: SMD = 0.49; ≥12 weeks: SMD = 1.19). Meta-regression revealed an inverted U-shaped relationship between frequency and intervention effects (β = 2.15; β = -0.57). Targeted PA interventions could improve IC in children and adolescents with ADHD, particularly designed with a moderate frequency. Although session time and intervention duration in long-term interventions showed no statistical significance in this meta-analysis, examination of individual studies revealed their promising results. Further investigations are therefore recommended.

This study investigates parental factors as predictors of the outcome of an internet-based and telephone-assisted parent training intervention targeting child disruptive behavior, when it was implemented nationwide in Finland. 2,900 families with children who met screening criteria at their 4-year-old health checkup received the 11-week intervention. Potential predictors included parents' age and educational attainment, family structure, enrollment year, parenting skills, and parental mental health. The outcome was the Child Behavior Checklist 1.5-5 externalizing score, collected at baseline, 6-, 12-, and 24-month follow-ups. Hierarchical linear models were used to examine changes in the outcome over time. At 6 months, parents of children whose mothers had a college or university degree reported smaller reductions in child externalizing problems compared to those with lower maternal education (β= 0.87, 95% CI [0.28, 1.45], p= .004). At 24 months, greater reductions in externalizing problems were observed in children whose parents had a high parental over-reactivity score at baseline (β= -1.23, 95% CI [-1.97, -0.49], p= .001), as well as a medium or high baseline parental Depression, Anxiety and Stress Scale total score (Medium: β= -1.01, 95% CI [-1.65, -0.36], p= .002; High: β= -1.05, 95% CI [-1.82, -0.28], p= .007). There were greater changes in the outcome over time among disadvantaged populations, particularly families with lower education, poorer parenting skills, or more severe parental mental health problems. Future research is needed to examine the consistency of these effects across diverse sociodemographic groups and settings.

While sensory processing alterations in autism are well-documented, the neurophysiological correlates remain unclear. This meta-analysis examined differences in early event-related potentials (ERP) and event-related fields (ERF) between autistic and non-autistic individuals using electroencephalography and magnetoencephalography to identify neurophysiological alterations that may underlie variations in sensory perception, communication, and social interaction in autism. Following PRISMA guidelines, a database search was conducted for peer-reviewed studies published from January 1980 onwards. Random-effects meta-analyses were performed using the metafor package in R. Standardised mean-group differences in early ERP/ERF latencies and amplitudes were analysed with moderator analyses exploring demographic and methodological factors, including neurophysiological technique, sensory modality, age group, sex, and language impairment. 145 studies (3778 autistic, 3484 non-autistic participants) were included. Autistic individuals exhibited significantly longer latencies in P/M50 (SMD = 0.44; SE = 0.21; 95% CI 0.03-0.86; p = 0.04), P/M100 (SMD = 0.18; SE = 0.08; 95% CI 0.01-0.36; p = 0.03), N170 (SMD = 0.33; SE = 0.12; 95% CI 0.10-0.56; p = 0.01), and P/M200 (SMD = 0.30; SE = 0.09; 95% CI 0.12-0.48; p = 0.00) components. P/M50 showed the greatest latency alteration, with an effect-size nearing medium, especially in individuals with language impairment (Q(2) = 7.70, p = 0.02), followed by N170 most notable in autistic adolescents and adults (Q (3) = 12.30, p = 0.01). No significant amplitude alterations were found, and substantial heterogeneity was observed. Neurophysiological characteristics of sensory processing in autism implicate multiple mechanisms and stages given prolonged P/M50- and N170-latency (associated with sensory filtering challenges and social perception alterations, respectively). These component timings show potential as biomarkers, though heterogeneity and modest effect-sizes limit clinical application, highlighting the need for further research.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that often persists from childhood into adolescence and adulthood. Resting-state functional magnetic resonance imaging (rs-fMRI) provides valuable insights into the intrinsic neural activity associated with ADHD. However, despite increasing neuroimaging research, the developmental specificity of spontaneous alterations in brain activity in children and adolescents with ADHD remains poorly understood. A comprehensive activation likelihood estimation (ALE) meta-analysis was performed on rs-fMRI data to investigate alterations in spontaneous brain activity in children and adolescents with ADHD compared with healthy controls (HCs). A contrast analysis was conducted to assess potential overlap in altered brain regions between the child and adolescent ADHD groups. The robustness of the findings was evaluated using a jackknife sensitivity analysis. A systematic review of the literature identified 28 rs-fMRI studies (1019 ADHD patients and 943 HCs). In children with ADHD, ALE revealed decreased spontaneous neural activity in the left middle frontal gyrus, superior frontal gyrus, medial frontal gyrus, precentral gyrus, and subgyral region, with no regions showing increased activity. In adolescents with ADHD, increased activity was observed in the bilateral paracentral lobule, left postcentral gyrus, and medial frontal gyrus, whereas decreased activity was found in the cerebellar tonsil, uvula, declive, anterior lobe, and superior/medial frontal gyrus. No significant clusters were identified in the contrast analyses. The jackknife sensitivity analysis demonstrated robustness in 9 of 17 iterations for children and 4 of 5 iterations for adolescent-specific cerebellar findings. Spontaneous alterations in brain activity in children and adolescents with ADHD reflect developmentally distinct neural mechanisms and may guide future age-specific neuroimaging research.

Early relationships between a caregiver and their child set the foundations for many aspects of the child's development. Exposure to abuse or neglect can negatively impact the security and stability within these early relationships. The aim of this project was to characterise the association between carer-child relationship quality and child's mental health over a period of 2.5 years. We used data collected between 2011 and 2022 as part of the Best Services Trial (BeST). The sample consisted of 220 children entering foster/kinship care who were between 0.08 (0.96 months) and 5.58 years at first data collection visit. Relationship quality was assessed using Parent-Infant Relationship Global Assessment Scale (PIR-GAS), and child emotional and behavioural difficulties was assessed using the Strengths and Difficulties Questionnaire (SDQ) and The Infant Toddler Social Emotional Assessment (ITSEA). Data was examined from two time points, a few weeks after entering foster/kinship care and after 2.5 years. The quality of the carer-child relationship did not predict emotional and behavioural outcomes for the child at a later time point. Nonetheless, we found that overall, children had significantly better relationships with their carers at the 2.5 year follow up than at baseline. This highlights a need for specific tailored interventions for care-experienced children, to support their emotional and behavioural needs and improve long term outcomes.

The mental health of children and adolescents is a critical concern, as a significant proportion of internalizing disorders emerge early in life, highlighting the importance of timely identification and intervention. However, recent data on the prevalence and comorbidity of these disorders among Spanish youth remain scarce. This study aims to examine the estimated rates and comorbidity patterns of internalizing symptoms -including depression, generalized (GAD) and social anxiety, somatic complaints, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and eating behavior problems- in a nationwide sample of Spanish children and adolescents. A total of 5,450 participants aged 9 to 16 completed the Sistema de Evaluación de Niños y Adolescentes. Results show that 10.4% of children and 14% of adolescents exhibited clinically significant symptoms of at least one disorder. In children, the most common were depression (4.7%), social anxiety (3.6%), and GAD (3.4%); while in adolescents, OCD (4.5%), eating behavior problems (4.3%), and depression (4.0%) prevailed, indicating that, while the estimated rate of certain clinically significant symptoms has increased compared to pre-pandemic data, rates remain lower than what observed during COVID-19. However, some symptoms still require attention due to their potential impact on well-being. Comorbidity patterns reveal a strong presence of clinically significant depressive symptoms with other internalizing disorders, such as GAD, PTSD, and somatic complaints. Moreover, across several domains, the presence of clinically significant symptoms of one disorder increases the risk of also presenting another. These findings emphasize the need for strengthening mental health services, promoting early detection strategies and implementing targeted interventions within public health and educational settings.

To evaluate the feasibility and acceptability of a therapist-guided, mobile app-assisted behavioural treatment for children and adolescents with chronic tic disorders, compared to videoconference-delivered behaviour therapy for tics. Pilot, single-blind, two-arm randomised controlled trial (RCT). A specialist tic disorder clinic for children and adolescents in Denmark. 30 participants with Tourette syndrome or chronic tic disorder aged 9 to 17 years (inclusive) and their parents. Participants were randomised to 8 sessions of either mobile app-assisted behavioural therapy (n = 14) or videoconference-delivered behaviour therapy (n = 16) for tics. The primary outcomes were measures of feasibility, acceptability, adherence and safety. Secondary measures of tic severity (Yale Global Tic Severity Scale; YGTSS) were administered at baseline, post-treatment and 2-month follow-up. Both interventions were deemed feasible and acceptable by the families. Both groups experienced meaningful tic severity reductions on the Total Tic Severity Score of the YGTSS (app group: -9.25 (-13.10 to -5.41; Cohen d = 1.17); videoconference group: -7.43 (-10.93 to -3.93; Cohen d = 0.94). Participants in both groups experienced further tic severity improvements during the 2-month follow-up (app group: -5.75 (-9.16 to - 2.34; Cohen d = 0.96); videoconference group: -5.00 (-8.16 to -1.84; Cohen d = 0.64). A therapist-guided mobile app-assisted behavioural intervention was found to be acceptable and potentially efficacious in the treatment of tics in a naturalistic clinical setting. The findings are promising but preliminary, given the limited sample size. The efficacy should be evaluated in a larger RCT.

Internalizing and externalizing problems often co-exist throughout an individual's development, shaped by a shared set of early environmental risks. However, most existing studies focused on discrete developmental periods, limiting understanding of how the negative impact of early-life adversity on mental health varies with age. Using data from 7,377 participants across seven waves of the UK Millennium Cohort Study (MCS), the current study investigated the bidirectional associations between internalizing and externalizing problems from ages 5 to 17, as well as the long-term impact of early environmental risks (i.e., prenatal influences, neonatal factors, maternal mental health, harsh parenting, and socioeconomic status) on the two symptom domains across time. Random-intercept cross-lagged panel analyses indicated that individuals with higher internalizing symptoms tended to report higher externalizing symptoms, with both symptom domains showing high stability over time. A significant positive bidirectional relationship between internalizing and externalizing problems was found from childhood to early adolescence. However, this pattern diverged in late adolescence: internalizing problems at age 14 no longer predict externalizing problems at age 17, whereas externalizing problems negatively predict subsequent internalizing symptoms. Early environmental risk factors significantly predicted both internalizing and externalizing problems from ages 5 to 14, with the effects generally decreasing with age, except for an increase at age 11. Gender differences were also observed in both the bidirectional relationships between the symptom domains and the long-term impact of early environmental risks. Findings underscore the enduring impact of early adversity on adolescent mental health and highlight the complex, evolving interaction between internalizing and externalizing problems. The study offers critical insights for early, sustained interventions that address multiple risks and adapt to adolescents' changing mental health needs over time.

The aim of this study was to investigate the impact of critical periods of maternal Generalized Anxiety Disorder (GAD) on mental health problems in preschoolers from a city in Southern Brazil. This cohort study included 328 pregnant adolescents and their children who were assessed in three stages (prepartum, postpartum, and at 4-5 years of age). The Mini International Neuropsychiatric Interview Plus (MINI PLUS) was used to assess maternal mental health, and the Strengths and Difficulties Questionnaire (SDQ) was used to assess child mental health. children of mothers with GAD only during pregnancy showed a higher risk of peer relationship problems (IRR: 3.57; p = 0.040) compared to children of mothers with no history of GAD. In turn, children of mothers with GAD only when the child was 4-5 years old had a higher risk of conduct problems (IRR: 2.77; p = 0.001), hyperactivity (IRR: 1.99; p < 0.028), and total problems (IRR: 3.26; p = 0.001) compared to children of mothers with no history of GAD. Maternal GAD at different periods was associated with different child mental health problems, highlighting the need for targeted preventive interventions.

Despite well-established evidence on the mental health consequences of child maltreatment, prior research is limited by the assumption that changes in maltreatment status have symmetrical impacts. This study investigated the association between child maltreatment and depressive symptoms, distinguishing transitions into and out of abuse and neglect. Potential gender differences were also examined. This study used six waves of longitudinal data from the nationally representative Korean Children and Youth Panel Survey 2010 (KCYPS 2010), which included students from three cohorts (Grades 1, 4, and 7). Based on transition variables measured as changes in exposure to maltreatment between survey waves, we employed a novel asymmetric fixed effects model to estimate the individual effects of transitioning into and out of maltreatment, accounting for time-invariant, unobserved individual-level heterogeneity. Gender-stratified and gender interaction models were employed to examine potential differences between boys and girls. The effect of transitions into abuse was larger in magnitude than that of transitions out of abuse but not statistically significant. Similarly, no significant asymmetry was observed for neglect. Gender analyses revealed that asymmetric effects of maltreatment were significant only for abuse among girls: the effect of transitions into abuse was greater in magnitude than that of transitions out of abuse. Moreover, the effect of transitions into abuse was more pronounced for girls compared to boys. The findings highlight the need for gender-specific interventions to address the mental health challenges associated with maltreatment. In addition to supporting victims of maltreatment, developing preventive measures-particularly tailored for girls-may prove highly effective.

Although youth with attention-deficit/hyperactivity disorder (ADHD) and a family history of bipolar I disorder (BD) are at increased risk for developing BD, the underlying neurobiological mechanisms remain poorly understood. Aberrant ventrolateral prefrontal cortex (VLPFC) and amygdala (AMY) functional connectivity (FC) have been implicated in the pathophysiology of BD. This study compared VLPFC-AMY FC in psychostimulant-free ADHD youth with (high-risk, HR) and without (low-risk, LR) a BD family history, and healthy controls (HCs). Subjects received a magnetic resonance scan while performing a continuous performance task with emotional and neutral distractors. Generalized psychophysiological interaction analysis was used to assess VLPFC-AMY FC in response to unpleasant emotional stimuli and attentional targets. A total of 144 adolescents (46 HC, 50 LR, and 48 HR) were included. In response to unpleasant emotional stimuli, FC between right VLPFC and left AMY differed among groups. HR youth exhibited lower right VLPFC-left AMY FC compared with both LR and HC, and LR youth exhibited lower right VLPFC-left AMY FC compared with HC. There were no group differences in right VLPFC-left AMY FC in response to attentional distractors. ADHD in conjunction with BD family history is associated with blunted emotion-generated right VLPFC-left AMY FC compared with ADHD youth without a BD family history and healthy youth, and may represent a neurobiological feature associated with genetic vulnerability to BD.