rss_2.0Scandinavian Journal of Child and Adolescent Psychiatry and Psychology FeedSciendo RSS Feed for Scandinavian Journal of Child and Adolescent Psychiatry and Psychology Journal of Child and Adolescent Psychiatry and Psychology Feed Stress Prevalence Among Adolescents in Scandinavia Change from 2000 to 2019? A literature review<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Prolonged stress is a risk factor for developing mental illness and stress-related diseases. As there has been an increase in self-reported psychological symptoms and diagnosis of mental illness among Scandinavian adolescents, more knowledge of stress prevalence in this age group is needed.</p> </sec> <sec> <title style='display:none'>Aim</title> <p>This literature review will investigate a possible increase in stress prevalence among Scandinavian adolescents, aged 13-18, between the years 2000 and 2019.</p> </sec> <sec> <title style='display:none'>Methods</title> <p>A systematic literature search was conducted in the PubMed and PsycInfo databases. In addition, a grey literature search was conducted to find relevant surveys and reports. Altogether, nine papers and nine surveys, and reports containing relevant data were identified, assessed for risk of bias, and included in the analysis.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The results show higher stress scores among the older participants in the age group 13-18 years and a gender difference, where girls score higher than boys. The literature neither supports nor rejects the hypothesis that stress levels have increased among adolescents in Scandinavia, from year 2000 to 2019. Only two of the included studies used a validated stress questionnaire and there was a substantial risk of non-response bias. Therefore, the existing literature is considered insufficient to determine if there has been an increase in stress over time. A majority of the papers, surveys, and reports had moderate risk of bias.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Further research using validated stress questionnaires in representative populations is needed to investigate changes in stress prevalence among Scandinavian adolescents. Also, the age and gender difference in stress prevalence among 13-18-year-olds may be of relevance for planning preventive interventions to reduce stress.</p> </sec> </abstract>ARTICLEtrue years with Scandinavian Journal of Child and Adolescent Psychiatry and Psychology Violence against Children with Disabilities: A Danish National Birth Cohort Prospective Study<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Children with disabilities are at heightened risk of sexual violence compared to non-disabled peers.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>We aimed to examine the associations between ten childhood disabilities and sexual victimization.</p> </sec> <sec> <title style='display:none'>Methods</title> <p>Data were drawn from the Danish Psychiatric Case Register, the Criminal Register, and other population-based registers. Children born between 1994 and 2001 (n=570,351) were followed until 18 years of age. Using logistic regression, the association between the disabilities and risk of sexual victimisation was estimated.</p> </sec> <sec> <title style='display:none'>Results</title> <p>We identified 8,860 cases of sexual victimization towards children and adolescents. In the fully adjusted models, children with a diagnosis of ADHD, speech disability and intellectual disability were at highest risk of sexual victimization. Children with comorbid disabilities were particularly vulnerable to sexual victimization.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>We found that children with certain types of disability have a higher risk of sexual victimization. Our findings indicate that educational institutions and health care professionals should be aware of and have specialized training in, recognizing and assessing sexual victimization among children with disabilities.</p> </sec> </abstract>ARTICLEtrue in three perspectives: Associations with depression and suicidal ideation in a clinical adolescent sample<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Adolescence is a critical period for mental development where the consequences of psychopathologies can be exceedingly harmful, and compassion has been identified as a protective factor for adolescents’ mental well-being.</p> </sec> <sec> <title style='display:none'>Aim</title> <p>The aim of this study was to explore three perspectives of compassion – Self-compassion, Compassion for others, and Compassion from others – and their relationship with depression and suicidal ideation in adolescents.</p> </sec> <sec> <title style='display:none'>Method</title> <p>This Swedish cross-sectional study included 259 psychiatric patients (ages 16–22). Participants completed a survey including the self-assessment scales “Reynolds Adolescent Depression Scale – Second Edition” (RADS-2), “Suicidal Ideation Questionnaire – Junior Version” (SIQ-JR), and “Compassion Engagement and Action Scale – Youth” (CEAS-Y). Linear regression analyses were used to determine whether participants’ levels of compassion predicted depression and suicidal ideation.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Self-compassion and Compassion from others significantly predicted both depression and suicidal ideation. Girls, on average, reported higher levels of depressive symptoms and suicidal ideation and lower levels of self-compassion compared to boys. The correlation between compassion and depressive symptoms, however, appeared to be stronger in boys. There was also a positive correlation between Compassion for others and suicidal ideation.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>The results suggest that Self-compassion and Compassion from others may have a significant protective effect against depression and suicidal ideation, especially in boys. However, due to the relatively small sample of boys (n = 40), further research is needed before any solid conclusion can be drawn regarding possible gender differences. Additionally, the combination of low Self-compassion and higher levels of Compassion for others may be associated with suicidal ideation.</p> </sec> </abstract>ARTICLEtrue of a Modified-Release Dexamphetamine Sulfate Formulation Following Single and Multiple Dosing in Healthy Adults: Comparative Bioavailability with Immediate-Release Dexamphetamine Sulfate, between Strengths, Assessment of Food and Meal Composition Effects<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>A modified-release dexamphetamine sulfate formulation (DEX-MR) is under development for the treatment of attention-deficit/hyperactivity disorder.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>We investigated the bioequivalence of once-daily DEX-MR to twice-daily immediate-release dexamphetamine sulfate (DEX-IR) after single and multiple dosing and between strengths, and effects of food and meal types.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Three randomized, open-label, crossover studies in healthy males were conducted. In the single-dose study, participants received DEX-MR 20 mg, DEX-MR 10 mg (20 mg dose), and twice-daily DEX-IR 10 mg under fasted conditions and after a high-fat, high-calorie breakfast. In the breakfast study, participants received DEX-MR 20 mg and twice-daily DEX-IR 10 mg after a normocaloric and a high-fat, high-calorie breakfast. In the multiple-dose study, participants received DEX-MR 20 mg and twice-daily DEX-IR 10 mg for seven days each. In the run-in period (five days), participants consumed a normocaloric breakfast; on profile days, participants consumed a normocaloric breakfast (day 6) or a high-fat, high-calorie breakfast (day 7).</p> </sec> <sec> <title style='display:none'>Results</title> <p>Once-daily DEX-MR at a dose of 20 mg was bioequivalent to twice-daily DEX-IR 10 mg after single dosing under fasted and fed conditions and after multiple dosing under fed conditions. DEX-MR 10 mg and DEX-MR 20 mg were bioequivalent when administered as a single 20 mg dose. Food slightly reduced the rate and extent of absorption of DEX-MR and delayed the time to peak plasma concentration (<italic>t</italic><sub>max</sub>) by approximately two hours compared to the fasted state. Bioavailability of DEX-MR was comparable under different meal conditions (normocaloric vs. high-fat, high-calorie breakfast) both after single and multiple dosing.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Bioequivalence of once-daily DEX-MR and twice-daily DEX-IR was established. 1×2 DEX-MR 10 mg was bioequivalent to 1×1 DEX-MR 20 mg. DEX-MR should be administered with/after a meal to achieve the targeted pharmacokinetic profile (delayed <italic>t</italic><sub>max</sub>). Bioavailability of DEX-MR is not affected by meal composition (i.e., fat and caloric content).</p> </sec> </abstract>ARTICLEtrue Insecurity or Disorder: A dichotomy worth revising? Review of Environmental and Psychosocial Risk Factors associated with Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder in Children and Adolescents<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>In the majority of cases, attention deficit hyperactivity disorder (ADHD) is accompanied by one or more comorbid disorders, with the oppositional defiant disorder (ODD) being one of the most frequently diagnosed comorbid disorders. There is a lack of systematic reviews addressing the evidence for an association between the independent environmental and psychosocial risk factors associated with ADHD, ODD, and Conduct Disorder (CD).</p> </sec> <sec> <title style='display:none'>Objective</title> <p>This study aims to determine the link between ADHD and ODD/CD, specifically in terms of the most up-to-date environmental and psychosocial risk factors in the development of these illnesses.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Eleven studies were included in this systematic review. Among these, ten studies involved environmental risk factors, and only one involved socioeconomic risk factors as exposure. Of the ten studies highlighting the environmental risk factors, six studies reported perinatal risk factors, three reported Atopic diseases as exposure measures, and one involved exposure to energy and coffee drinks. We have found that the most common risk factors associated with ADHD, ODD and CD in Europe and North America were Perinatal risk factors. In contrast, the risk factors of Atopic diseases were more common in Asia.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Most of the studies included in our systematic review fall within the scope of environmental risk factors were perinatal risk factors and atopic diseases are the most common risk factors. However, only one article highlighted the association of socioeconomic risk factors as an exposure. Our review results suggest the need for more research focused on psychosocial risk factors for ADHD and comorbid ODD/CD. Further research is required with the primary objective of investigating this association in greater depth and examining the possible mechanisms at varying levels is needed.</p> </sec> </abstract>ARTICLEtrue properties of the Observing Mediational Interactions (OMI) coding system during mother-adolescent conflict discussions<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Observational assessments of parent-adolescent conflict can guide interventions to prevent and reduce conflict and mental health problems. The authors identified the Observing Mediational Interactions (OMI) as a particularly useful coding system for examining parent-adolescent conflict. The OMI is the observational measure used in the Mediational Intervention for Sensitizing Caregivers (MISC) and quantifies emotional (attachment-based) and cognitive (learning-based) behaviors during caregiver-child interactions.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>The overall aim of the current study was to tailor and evaluate the OMI specifically for observing conflict interactions.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Conflict discussions between 56 clinical youth aged 10-15 years and their mothers were coded using the OMI. Reliability, construct validity, and associations with affect following the conflict discussion were examined.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Analyses revealed that the OMI demonstrated adequate internal consistency, interrater reliability, and construct validity in terms of associations with an alternate observational measure and parent-reported family functioning and stress. Additionally, mothers who engaged in fewer negative parenting behaviors reported greater positive affect following the conflict discussion, controlling for baseline affect.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Taken together, findings support the use of the OMI in future studies. While further research should attempt to extend findings to other populations and settings and elaborate the coding instructions as needed, researchers can use the OMI to inform ongoing adaptations of MISC and identify targets for prevention and intervention more broadly.</p> </sec> </abstract>ARTICLEtrue effects of sexual abuse on female adolescent brain structures<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objective</title> <p>Sexual abuse (SA) is known for its effects on brain structures in adolescents. We aimed to explore if SA has any effect on limbic and prefrontal cortex (PFC) structures. We hypothesized that children with SA would have a thinner PFC with larger amygdala and hippocampus that lead to aberrations in threat detection, orientation and response circuit; that would be highly adaptive in a dangerous environment in the short term.</p> </sec> <sec> <title style='display:none'>Method</title> <p>We included 57 SA and 33 healthy control (HC) female participants. In addition to psychiatric evaluation, we acquired 3 T MR images from all participants. We compared prefrontal cortical thicknesses, hippocampus and amygdala volumes between groups.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The age and education levels of study groups were matched, however, IQ scores and socioeconomic status (SES) scores of the SA group were lower than the controls. Total CTQ scores of the SA group were higher than the HC. Nevertheless, the mean value of sexual abuse scores was above the cut-off scores only for the SA participants. SA participants had larger right and left hippocampus and right amygdala volumes than the controls. SA group had reduced inferior frontal gyrus cortical thickness (T=3.5, p&lt;0.01, cluster size=694 mm2, x=51 y=-30 z=6) than HC group. None of the structural findings were correlated with total or sexual abuse CTQ scores.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Children with SA history has structural abnormalities in threat detection, orientation and response circuit. SA victims with no psychiatric diagnosis have a high probability of psychiatric problems with a possible contribution of these aberrations. SA cases that do not have a diagnosis must not be overlooked as they may have structural changes in emotion related brain regions. Careful follow-up is needed for all of all SA cases.</p> </sec> </abstract>ARTICLEtrue Cortical Thicknesses of Adolescents with Bipolar Disorder and Relationship with Brain-derived Neurotrophic Factor<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Cortical thickness (CT) and brain-derived neurotrophic factor (BDNF) were widely investigated in bipolar disorder (BD). Previous studies focused on the association between the volume of subcortical regions and neurotrophic factor levels.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>In this study, we aimed to evaluate the association of the CT in youth with early-onset BD with BDNF levels as a potential peripheral marker of neuronal integrity.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Twenty-three euthymic patients having a clinical diagnosis of BD and 17 healthy subjects as an age-matched control group with neuroimaging and blood BDNF levels were found eligible for CT measurement. A structural magnetic resonance scan (MRI) and timely blood samples were drawn.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Youth with BD exhibited lower cortical thickness in caudal part of left (L) middle frontal gyrus, right (R) paracentral gyrus, triangular part of R inferior frontal gyrus, R pericalcarine region, R precentral gyrus, L precentral gyrus, R superior frontal gyrus and L superior frontal gyrus when compared to healthy controls. The effect sizes of these differences were moderate to large (d=0.67-0.98) There was a significant correlation between BDNF levels with caudal part of the R anterior cingulate gyrus (CPRACG) in adolescents with BD (r=0.49, p=0.023).</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>As a special region for mood regulation, the CT of the caudal part of the R anterior cingulate gyrus had a positive correlation with BDNF. Regarding the key role of CPRACG for affective regulation skills, our results should be replicated in future follow-up studies, investigating a predictive neuroimaging biomarker for the early-onset BD.</p> </sec> </abstract>ARTICLEtrue Motor Skills in Children with Tourette Syndrome and their Unaffected First-degree Siblings<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>The exact etiology of Tourette Syndrome (TS) remains unclear, making the search for impaired neuropsychological functions possibly connected to the underlying cause of TS as important as it is challenging. One neuropsychological domain of interest is fine motor skills.</p> </sec> <sec> <title style='display:none'>Method</title> <p>This study compared fine motor skill performance on the Purdue Pegboard Task (PPT) in 18 children with TS, 24 unaffected first-degree siblings and 20 controls. A set of screening questionnaires was administered to determine comorbid psychiatric illness.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Children with TS, their siblings and controls did not differ significantly in fine motor skills as measured with the PPT. Performance on the PPT was not correlated with tic severity; however, we found an inverse correlation with severity of attention-deficit/hyperactivity disorder (ADHD) symptoms, as assessed by parent reported ADHD symptoms. Children with TS were found to have significantly higher parent reported ADHD symptoms compared to controls, yet only two out of the 18 participants had been diagnosed with ADHD.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>This study suggests that fine motor skill impairment in children with TS may be more strongly correlated with comorbid ADHD than to TS and tics.</p> </sec> </abstract>ARTICLEtrue and Acceptability of Using FirstPlay® to Enhance Mother–Child Interaction: A pilot study of mothers’ perspectives<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Although there is evidence that human touch facilitates mother–child bonding, mothers’ understanding of how to connect with and develop the emotional regulation of their babies remains unclear.</p> </sec> <sec> <title style='display:none'>Objectives</title> <p>This study used a Storytelling Massage program to investigate mothers’ experience of practicing reciprocal interactions with their children. Specifically, it explored the efficacy of multi-sensory activities for building healthy parent–child bonds.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Participants included 12 mothers with children between 8 and 23 months. These mothers participated in a 6-session program on FirstPlay Infant Storytelling-Massage Intervention (FirstPlay Therapy) and attended an individual semi-structured interview after the program. Data were analyzed using a phenomenological approach.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The FirstPlay program positively affected the participants’ self-efficacy in parent–child bonding and parenting beliefs. Five themes were identified: “bonding with the child—connect and engage,” “attending to the child’s uniqueness and needs,” “developing a structure and a daily routine,” “feeling calm and relaxed as a person,” and “gaining confidence as a mom.”</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>The results of this study further support the need for low-cost, high-impact programs that enhance parent–child interactions. Limitations of this study are discussed. Future research and practical implications are also suggested.</p> </sec> </abstract>ARTICLEtrue Evidence of an Association Between a Positive Child Behavior Checklist-Bipolar Profile and a Diagnosis of Pediatric Bipolar Disorder: A Meta-Analysis<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Previous research has found that a unique profile of the Child Behavior Checklist comprising of aggregate elevations of the Attention, Anxiety/Depression and Aggression scales (A-A-A profile, CBCL-Bipolar (BP) profile, CBCL-Dysregulation profile (DP); henceforth CBCL-BP/DP profile) is associated with a clinical diagnosis of pediatric bipolar (BP) disorder.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>The main aim of the study is to evaluate the strength of the association between the CBCL-BP/DP profile and the clinical diagnosis of pediatric BP disorder through a meta-analysis.</p> </sec> <sec> <title style='display:none'>Methods</title> <p>A literature search was performed to identify studies that examined the association between a positive CBCL-BP/DP profile and a clinical diagnosis of pediatric BP disorder. The meta-analyses first examined studies assessing the rates of a positive CBCL-BP/DP profile in youth with BP disorder versus those with 1) ADHD, anxiety/depression, or disruptive behavior disorders (DBDs), and 2) non-bipolar controls. The second analysis evaluated studies examining the rates of pediatric BP disorder in youth with and without a positive CBCL-BP/DP profile.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Eighteen articles met our inclusion and exclusion criteria, and fifteen articles had adequate data for meta-analysis. Results showed that BP youth were at significantly increased odds of having a positive CBCL-BP/DP profile compared to those with other psychiatric disorders (i.e., ADHD, anxiety/depression, or DBDs) (pooled OR=4.34, 95% CI=2.82, 8.27; p&lt;0.001) and healthy control groups (pooled OR=34.77, 95% CI=2.87, 420.95; p=0.005). Further, meta-analysis results showed that youth with a positive CBCL-BP/DP profile were at significantly increased odds of having a BP disorder diagnosis compared to those without (pooled OR=4.25, 95% CI=2.12, 8.52; p&lt;0.001).</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Our systematic review and meta-analysis of the extant literature provides strong support for the association between the CBCL-BP/DP profile and pediatric BP disorder.</p> </sec> </abstract>ARTICLEtrue Book Review on Handbook of Positive Youth Development: Advancing Research, Policy, and Practice in Global Contexts. Radosveta Dimitrova and Nora Wiium (Eds.) (Cham, Switzerland: Springer), 2021, 754 pages, ISBN 978-3-030-70261-8 of the pandemic on the mental health of children and clinical practice in Turkey: a narrative review with recommendations effects of perceived discrimination, social support and ethnic identity on mental health of immigrant adolescents<abstract> <title style='display:none'>Abstract</title> <p> <bold>Background</bold>: The number of immigrants has been increasing. Immigrant adolescents experience an acculturation process that affects particularly their ethnic identity, perceived discrimination, and relationships with their peers, which would have significant impact on their mental health. The ethnic composition of social environments might affect this relationship.</p> <p> <bold>Objective:</bold> The main purpose of the current research is to examine the effect of peer attachment, social support, ethnic identity, and perceived discrimination on immigrant adolescents’ mental health.</p> <p> <bold>Method:</bold> The sample included 226 Syrian immigrants (X<sup>̄</sup> <sub>age</sub> = 13.31, SD=1.67, 70.8 % girls). Adolescents live in a homogenous social environment where proportion of Syrian is higher. Two hierarchical regression models were used to predict depression and emotional problems. In both models, the predictive roles of social and psychological factors were examined in separate steps.</p> <p> <bold>Results:</bold> The regression analysis results for depression emphasized peer attachment, social support, and ethnic identity did not affect the depression after controlling the effect of emotional problems. Similarly, regression analysis results for emotional problems showed that peer attachment, social support, and ethnic identity did not affect depression after controlling the effect of emotional problems. The results also revealed that perceived discrimination was a risk factor for both depression and emotional problems.</p> <p> <bold>Conclusions:</bold> The results underlined the importance of psychological variables on immigrant adolescents’ depression. Past research emphasized that ethnic identity and peer support had a buffering effect on mental health. The current study participants were living in a different area where they attended schools for only immigrants. The social environment was totally different from the host culture. These reasons may account for why social support from ethnic peers and ethnic identity development did not emerge as a protective factor in the present study. The results will further be discussed in terms of the importance of interaction between ethnic and host culture.</p> </abstract>ARTICLEtrue morbidity in children and adolescents with dermatological disorders<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Understanding the existence of a cycle, where psychological disturbances cause skin diseases and in turn, skin diseases cause psychological disorders, provides the basis for good dermatological practice.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>The aim of this case-control study is to examine the psychiatric morbidity of dermatological disorders in children and adolescents with no history of psychiatric disorders.</p> </sec> <sec> <title style='display:none'>Method:</title> <p>In this study, 502 participants (251 patients and 251 healthy individuals) were evaluated according to DSM-IV criteria. All participants were interviewed and evaluated using the Turkish version of the Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version (K-SADS-PL) and the State-Trait Anxiety Inventory for Children (STAI-1 and STAI-2), the Childhood Depression Inventory (CDI), adolescent and parent forms of the Strengths and Difficulties Questionnaire (SDQ-A and SDQ-P) and a questionnaire evaluating child’s level of school success.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Our results indicated that the rates of general psychiatric comorbidity, mood disorders, anxiety disorders, and adjustment disorders were significantly higher in the study group compared to the control group. The CDI, STAI-1, STAI-2, and SDQ (and subscales) scores were significantly higher in the study group. Moreover, psychiatric comorbidity was higher in inflammatory and allergic dermatoses compared to other dermatological subgroups. Having a dermatological disease restricts physical activity thus increasing the risk of psychiatric comorbidity.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Investigating the education, attitudes, and awareness of dermatologists about psychocutaneous disorders might contribute to the development of new educational strategies and elicit appropriate biopsychosocial approaches.</p> </sec> </abstract>ARTICLEtrue to diagnostic investigation of a child with comorbid psychiatric conditions<abstract> <title style='display:none'>Abstract</title> <p>Presented here is the unique case of diagnostic investigation for a 16 year old male presenting in an acute state of apparent psychosis. The patient had a long history of previous specialist work-ups, tentative diagnoses, multiple emergency department admissions, and medication trials, all of which failed to produce significant lasting relief. While initial encounters diagnostically centered on autoimmune encephalitis, comprehensive work-ups always drove the differential towards a likely psychiatric disorder. Despite this consistent professional opinion, tentative diagnosis of schizophrenia with underlying Autism Spectrum Disorder was delayed for many years, due to a variety of complicating factors. Overall, this case highlights many different considerations that might assist in avoiding a protracted road to diagnosis, including navigating the obstacles that parental interaction with a complex healthcare system can pose during diagnostic evaluation and recommended treatment as well as, the role of re-interpreting past test results within the context of new literature, and the complexities of diagnosing comorbid psychiatric conditions.</p> </abstract>ARTICLEtrue mentalizing in adolescents with anorexia nervosa and borderline personality disorder: A comparative study of psychiatric inpatients and healthy controls<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Impaired mentalizing, i.e., difficulties in understanding oneself and others in terms of mental states, has been associated with the development of Anorexia Nervosa (AN), mainly among adults. However, few studies have addressed this question in clinical samples of adolescents with AN. Moreover, no study has explored mentalizing abilities among inpatient adolescents presenting with AN and Borderline Personality Disorder (BPD), despite their high comorbidity in a highly relevant age group.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>This study attempted, for the first time, to further examine differences in mentalizing abilities and to identify specific mentalizing impairments in different psychiatric inpatient groups and healthy adolescents.</p> </sec> <sec> <title style='display:none'>Methods:</title> <p>Using samples of female adolescents aged 12–17, comparison analyses were performed between psychiatric inpatient adolescents with AN (<italic>n</italic> = 44), BPD (<italic>n</italic> = 101), AN+BPD (<italic>n</italic> = 48), other psychopathology (<italic>n</italic> = 163) and healthy adolescents (<italic>n</italic> = 129). Structured and semi-structured clinical interviews, and two experimental tasks were administered to assess AN, BPD and mentalizing, respectively.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Comparison analyses showed that patients with BPD and other psychiatric disorders evidenced higher levels of hypermentalizing compared to healthy adolescents. Hypermentalizing was also reported among inpatients with AN+BPD, although to a lesser extent. BPD and AN scores were positively correlated with hypermentalizing responses.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Our results suggest that hypermentalizing is a specific mentalization impairment in inpatient adolescents, particularly with BPD and both AN+BPD. Further investigation into the efficacy of mentalization based treatments for adolescents with BPD and AN+BPD is recommended. Prospective studies are needed to assess mentalizing using experimental tasks among adolescents with AN, taking into account the potential influence of temporality and severity of the disorders’ symptoms.</p> </sec> </abstract>ARTICLEtrue trust in adolescents with psychiatric disorders and borderline pathology<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Adolescents with features of borderline personality disorder (BPD) may experience deficits in interpersonal trust; however, a simultaneous comparison of interpersonal trust among adolescents with BPD, other psychiatric disorders, and no psychiatric conditions (healthy controls) has never been conducted.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>The aims of this study were to 1) explore differences in interpersonal trust (emotional trust, honesty beliefs, and reliability beliefs) between these three groups, and 2) examine the incremental value of BPD features in association with interpersonal trust over and above internalizing and externalizing.</p> </sec> <sec> <title style='display:none'>Method:</title> <p>Adolescents (<italic>N</italic> = 445, 67.9% female, <italic>M</italic> <italic> <sub>age</sub> </italic> = 15.13) recruited from two psychiatric hospitals (psychiatric sample, n = 280) and community organizations (healthy sample, n = 165) completed measures of BPD features, interpersonal trust, and internalizing and externalizing psychopathology. Psychiatric adolescents also completed an interview assessing BPD (n = 83 BPD). ANCOVA and hierarchical linear regression were used for analyses.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Emotional trust differed significantly across all three groups, with the lowest level of emotional trust in adolescents with BPD. Reliability was also lower in the two psychiatric groups relative to healthy controls. BPD features were significantly, inversely associated with emotional trust and reliability beliefs when controlling for internalizing and externalizing pathology. Post-hoc analyses testing specificity of the three forms of trust found that lower emotional trust predicted BPD diagnosis over and above the other two forms of trust.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Findings highlight emotional trust as a correlate and important target of intervention for adolescents with BPD, and add to knowledge on interpersonal trust deficits for adolescents with psychiatric disorders more broadly.</p> </sec> </abstract>ARTICLEtrue