Reflecting on our experiences-whether they stem from clinical practice, a moment of connection with a patient, or an event that shifted our perspective-offers us the opportunity to create something lasting that reaches beyond the moment. The JAACAP Reflections section provides a space for sharing these moments, allowing us to weave together stories that inform, challenge, and ultimately shape our understanding

OBJECTIVE Most children and adolescents with mental disorders do not access appropriate help, facilitating a lifetime of entrenched difficulties. School-based, universal, mental health screening has been used as one method to increase pediatric service use and subsequently reduce mental health problems. Despite its popularity, there are no randomized trials that demonstrate the efficacy of this method

OBJECTIVE No previous studies have evaluated the efficacy of internet-based cognitive behavioral therapy (ICBT) among children below age 13 screened at the population level. This study was an open two parallel-group RCT, stratified by sex, that compared ICBT with telephone coaching to an educational control. METHOD Altogether 465 children (mean age 11.5, SD 1.0, 71.4% girls) were randomly allocated

Despite decades of suicide prevention research and advances in clinical practice, suicide rates among youth-especially youth from minoritized racial, ethnic, and sexual identity groups, and living in rural populations-have rapidly increased since 2010.1,2 Because of the rising suicide rates in the United States, the US Surgeon General called mental health the "defining health crisis of our time."3

Disruptive child behaviors, such as aggression and oppositional behaviors, are the most common problems for which parents seek professional intervention. Historically, mental health professionals primarily addressed problematic behaviors through child therapy, adolescent institutionalization, or juvenile adjudication, all focused exclusively on changing the child's undesirable behaviors. Since the

Antipsychotics and α-2 agonists are evidence-based medications for Tourette's Disorder (TD). Tic severity, functional impairment, and risk-benefit trade-offs guide treatment planning.1 However, much like other clinical disorders in child and adolescent psychiatry, treatment that definitively improves symptoms without also causing untoward side effects remains an unmet clinical need. This editorial

Farid and Dunham's 1939 classic psychiatric epidemiologic study of schizophrenia and psychosis in Chicago found that overall White individuals generally had lower psychiatric admission rates for psychosis than Black individuals; however, that was not the case for primarily Black areas in the city.1 In these areas, White individuals had remarkably high admission rates and Black individuals had unusually

Emotional dysregulation (ED) presents a persistent and multifaceted challenge for autistic children, their families, clinicians, and educators, affecting emotional, social, and academic aspects of daily life.1 Characterized by intense emotional responses, frequent irritability, and reactive aggression, ED can disrupt social, academic, and daily functioning, impacting the child's life and placing immense

In this issue of the Journal, Reed and colleagues1 explore the intersection of 2 important public health problems: overweight/obesity and attention-deficit/ hyperactivity disorder (ADHD), both having a high population prevalence and tending to start in childhood. They analyzed data cross-sectionally and longitudinally from a UK birth cohort of 7,908 youth, including 442 with ADHD by either actual diagnosis

OBJECTIVE Self-harm is common in adolescents and a major public health concern. Evidence for effective interventions that stop repetition is lacking. This individual-participant-data (IPD) meta-analysis of randomised controlled trials (RCTs) aimed to provide robust estimates of therapeutic intervention effects and explore which treatments are best suited to different subgroups. METHOD We searched databases

OBJECTIVE Adolescents' exposure to racism in online contexts is related to adverse outcomes, including poor mental health. This study aims to expand existing research by examining the unique relation between adolescents' online exposure to race-based violence and substance use, beyond experiences of racism in offline contexts, and by exploring racial differences. METHOD Data are from an observational

For children navigating complex psychological and emotional challenges, the concept of community extends far beyond the walls of their home. Storytelling can be a powerful tool to foster a broader "village" of support, drawing on the rich network of extended family, neighbors, teachers, and cultural traditions that shape a child's world. Through sharing and listening to stories, children not only find

OBJECTIVE Exposure to extreme temperatures has been linked to acute mental-health events in young populations, but the underlying neural mechanisms are not well understood. Resting-state functional magnetic resonance imaging allows for the assessment of connectivity patterns in brain functional networks, which have been associated with mental-health disorders. We investigated the short-term effects

The goal of this study is to construct a 16-week, 2-stage, adaptive intervention consisting of DTT (Discrete Trials Training, largely considered usual care for children with autism), JASP-EMT (a blended, naturalistic, developmental behavioral intervention involving JASPER [Joint Attention, Symbolic Play, Engagement and Regulation] and EMT [Enhanced Milieu Teaching]), and parent training (P) for improving

OBJECTIVE To estimate the longitudinal bidirectional association between parent-child conflict and child externalizing and internalizing symptoms from the preschool years through adolescence. METHOD A nationally representative longitudinal study recruited 11,134 children at birth and followed them from December 2010 through June 2022. Primary caregivers completed validated measures at each follow-up

Indigenous communities in the United States and Canada have endured generations of historical trauma. In the face of ongoing marginalization, Indigenous Peoples persist, resist, and thrive. Simultaneously, the consequences of historical trauma are vast and enduring. For instance, there is significant variation in how depression symptoms unfold over the life course. The aim of this study is to examine

The purpose of this study is to explore the intersection between trauma and discrimination among Black and Latino/a/x youth seeking treatment. Specifically, we examine the following: (1) the frequency of various everyday discrimination experiences, averaged across the sample and disaggregated by demographic characteristics; (2) unique associations between exposure to potentially traumatic events (PTEs)

Previous studies suggest that school ethnic density is associated with less internalizing problems in Black and Latine adolescents in high school. Here, we assessed associations between school ethnic density and internalizing, externalizing, and thought problems in Black, Latine, and White preadolescent children (mean age = 9.9 years) in elementary school. We additionally examined whether associations

Improving access to child mental health care is a national priority area. The US Department of Health and Human Services, through the Substance Abuse and Mental Health Services Administration (SAMHSA), recently awarded $68.5 million in grants that support behavioral health education, training and community programs to help address mental health and substance use conditions.1 One of the 4 guiding principles

OBJECTIVE Addressing the disproportionate use of school detentions and suspensions among Black youth is crucial for reducing educational and health disparities across the life span. Yet, few studies have explored external factors beyond school or individual characteristics as potential contributors to school discipline disparities, such as state-level racial bias and neighborhood opportunity. METHOD

To examine the association between newer generation antidepressants and insomnia as an adverse event (AE) in the treatment of children and adolescents with major depressive disorder (MDD).

OBJECTIVE Although extant research points to nonverbal learning disability (NVLD) as a distinct disorder, it is not included in the diagnostic nomenclatures, and there is heterogeneity in how it is defined. A working group was formed to gain consensus on a standard DSM-type definition for NVLD, a necessary first step for proposing its inclusion in future DSM editions, and the disorder was renamed to

Callous-unemotional traits (CU), characterized as a lack of guilt and empathy, and irritability, a tendency to show anger and frustration, are 2 risk factors for externalizing behavioral problems. Externalizing problems, CU, and irritability are all heritable. However, there is a dearth of studies examining the genetic and environmental associations between the 3 domains. The present study partitioned

This study tests the effectiveness of leader- and provider-level implementation strategies to implement evidence-based interventions (EBIs) in 2 of the service systems caring for autistic children. The TEAMS Leadership Institute (TLI) targets implementation leadership and climate, and TEAMS Individualized Provider Strategy (TIPS) targets provider motivation and engagement.

Selective serotonin reuptake inhibitors (SSRIs) are the first choice in pharmacotherapy for children and adolescents with obsessive-compulsive disorder (OCD). SSRI trials for pediatric OCD have not been investigated using individual participant data (IPD), which is crucial for detecting patient-level effect modifiers. This study performed an IPD meta-analysis of efficacy of SSRIs compared with placebo

The aim of this study was to determine whether advanced puberty at age 9 and 10 years, relative to that in same-aged peers, predicts current and/or new-onset self-injurious thoughts and behaviors (SITBs). New predictors of SITBs in preadolescence are urgently needed to address this escalating public health crisis of youth self-harm and suicidality.

High comorbidity in childhood emotional and behavioral disorders calls for transdiagnostic interventions that can address both internalizing and externalizing problems. Mentalization-Based Treatment for Children (MBT-C) is a transdiagnostic, time-limited individual child psychotherapy with parallel parent sessions that aims to promote mentalization and emotion regulation. This pragmatic randomized

Our study examined the association between state-level structural racism and past year rates of suicide ideation (SI) and suicide attempts (SA) among non-Hispanic Black, Hispanic, and non-Hispanic White adolescents.