Faculty Bibliography

Dennis Haseley and Claudia Lament, the editors of this special section of The Psychoanalytic Study of the Child titled, A Crisis Hidden in Plain Sight: Climate Anxiety in Our Youth, summarize in their introduction the contributions made by American and European activists, psychoanalysts, and researchers: Bill McKibben, Sally Weintrobe, Caroline Hickman, Panu Pihkala, Kathrin Horter, Ines Schelhas and Martina Gast, Christine Bauriedl-Schmidt. In their introduction, the editors emphasize the emotional catastrophe, stemming from climate change, that is being visited on the next generations. They find the current culture of "uncare" implicated, as it gives permission to our worst instincts to both exploit the planet and deny the consequences. Remedies include psychological understanding, clinical work, and community support. Finally, they echo the call by the German author, Kathrin Horter, for psychoanalysts themselves to use their tools to take action and find ways to intervene, not just on an individual clinical basis, but in the field of society as a whole.

The increasing administrative prevalence of Attention-Deficit Hyperactivity Disorder (ADHD) over recent years has correspondingly escalated the prescriptions of pharmacological treatments for ADHD, particularly methylphenidate (MPH), which remains the most extensively prescribed medication for this condition. In light of this trend, evaluating the long-term risks associated with using MPH is important. This article aims to present findings from studies concerning the long-term use of MPH, derived from a literature review of the past decade, primarily focusing on data sourced from PubMed to assess these risks. Our review has drawn on a diverse range of studies, including cohort studies, meta-analyses, and database reviews from various global regions, reflecting a comprehensive international perspective on the long-term safety of MPH. Our review highlights several key aspects. Initial worries about the adverse psychiatric effects of MPH did not find strong support in subsequent studies. Rather, the current body of literature suggests that MPH may have a protective effect against depression and substance use disorders. We found no significant increase in the likelihood of suicide or psychotic disorders among long-term users of MPH. In fact, studies indicate that MPH treatment might reduce the incidence of depression. Moreover, contrary to concerns that stimulant treatment might predispose individuals to SUDs, recent longitudinal studies have generally shown no increased risk of substance misuse. Some studies have even suggested a lower incidence of substance misuse among patients treated with MPH. The review also delved into cardiovascular risks, which have been a notable concern with long-term MPH usage. While short-term studies typically showed minimal cardiovascular risks, results on longer-term effects suggest potential increases in hypertension and other arterial diseases for a higher dosage, highlighting the necessity for careful cardiovascular monitoring in patients undergoing long-term treatment. No elevated risk was described concerning other cardiovascular diseases. Results regarding the impact on growth have been mixed. Some studies suggest a temporary reduction in growth velocity that normalizes over time. This pattern suggests a delayed, rather than permanently stunted, growth trajectory in children treated with MPH over the long term. Lastly, our review did not find any risk of testicular dysfunction in patients treated with MPH. The collective findings from the reviewed studies offer reassurance regarding several of the initial concerns about the long-term use of MPH. While there are concerns about potential hypertension and arterial disease risks and uncertainties regarding growth, it is important to regularly monitoring for patients using MPH. These findings should be communicated transparently to patients and their families, helping to inform shared decision-making about the initiation and continuation of MPH therapy for ADHD. As research continues to evolve, it is imperative to keep updating our understanding of the safety of MPH safety profile to optimize treatment strategies and ensure that patients receive the most effective and safe care possible.

Background: The Summer Treatment Program (STP) for youth with attention-deficit/hyperactivity disorder (ADHD) includes a Daily Report Card (DRC) intervention administered by staff to provide feedback and contingencies for child behavior. The DRC has also been implemented by teachers in school settings, but less is known about parent implementation. Objective: Given the importance of supporting parenting efficacy and child behavior in the home setting, this study evaluated a parent-implemented DRC concurrent to STP participation to examine predictors and associated changes for parenting efficacy and child in home behavior. Method: Forty-three youth (and their caregivers) participated in dynamically adjusted home-based DRC during their participation in a traditional STP during the day. Results: Home DRC contingencies significantly predicted parenting efficacy scores, including when home goals were both emphasized and removed. Parenting efficacy also differed by targeted behavior problem. Conclusion: These findings replicate and extend previous work on leveraging DRCs to support generalization of skills in the STP to home.

Although efforts have been made to improve teacher professional development and ongoing supports, limited research has examined how early childhood education (ECE) teachers support each other informally. The present study describes how one type of informal support, collegial support (e.g. instrumental and expressive), enabled ECE teachers to cope with the first full school year during the COVID-19 pandemic. Through qualitative interviews, 14 kindergarten teachers shared the various ways they received and perceived collegial supports, and the system-level resources that enabled them to leverage their colleague"™s expertise and assistance. ECE teachers expressed how they cared for their own well-being and shared the desire to continue doing so in the future. Implications for low-cost and nimble teacher supports and professional development are discussed.

OBJECTIVE:It is unclear how the functional brain hierarchy is organized in preschool-aged children, and whether alterations in the brain organization are linked to mental health in this age group. Here, we assessed whether preschool-aged children exhibit a brain organizational structure similar to that of older children, how this structure might change over time, and whether it might reflect mental health. METHOD/METHODS:This study derived functional gradients using diffusion embedding from resting state functional magnetic resonance imaging data of 4.5-year-old children (N = 100, 42 male participants) and 6.0-year-old children (N = 133, 62 male participants) from the longitudinal Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. We then conducted partial least-squares correlation analyses to identify the association between the impairment ratings of different mental disorders and network gradient values. RESULTS:The main organizing axis of functional connectivity (ie, principal gradient) separated the visual and somatomotor regions (ie, unimodal) in preschool-aged children, whereas the second axis delineated the unimodal-transmodal gradient. This pattern of organization was stable from 4.5 to 6 years of age. The second gradient separating the high- and low-order networks exhibited a diverging pattern across mental health severity, differentiating dimensions related to attention-deficit/hyperactivity disorder and phobic disorders. CONCLUSION/CONCLUSIONS:This study characterized, for the first time, the functional brain hierarchy in preschool-aged children. A divergence in functional gradient pattern across different disease dimensions was found, highlighting how perturbations in functional brain organization can relate to the severity of different mental health disorders.

PURPOSE/OBJECTIVE:This systematic literature review explores the evidence base related to the diagnosis and clinical management of eating disorders among transgender and gender nonbinary (TGNB) youth. Through an exploration of the literature, this review highlights key considerations for providers working with this population, including the complex relationship between body image and gender, the assessment of subthreshold eating disorder symptoms, the impact of gender-affirming care on eating disorder treatment outcomes, and available evidence-based metrics, with attention to factors impacting treatment, including family support, psychiatric comorbidities, and community safety. METHODS:We conducted a search of the databases PubMed and Ovid MEDLINE for articles pertaining to eating disorders and TGNB youth, with forward citation chaining conducted via Google Scholar to provide a review of recent publications. Twenty-six articles published from 2017 to 2022 met the criteria for full-text review. RESULTS:The selected articles primarily explored data from the United States and varied widely in methodology, including a systematic literature review (n = 1), narrative literature reviews (n = 3), case series (n = 4), case studies (n = 2), cross-sectional population surveys (n = 7), cross-sectional patient surveys (n = 3), other cross-sectional studies (n = 3), retrospective chart reviews (n = 2), and a retrospective longitudinal cohort study (n = 1). Most commonly, researchers sampled patients within the setting of gender clinics. Researchers used a range of validated measures in clinical settings, with the Eating Disorder Examination Questionnaire most frequently reported. The literature highlights several considerations unique to transgender populations, including the complex relationship between gender dysphoria, body dissatisfaction, disordered eating behavior, and gender-affirming care. DISCUSSION/CONCLUSIONS:In clinical settings with TGNB youth, providers may consider implementing validated screening measures to assess for eating disorders. Future research should emphasize a nuanced understanding of the heterogeneity among TGNB patient populations and the impact of gender identity on treatment of eating disorders.

BACKGROUND:Evidence that autism often manifests differently between males and females is growing, particularly in terms of social interaction and communication, but it is unclear if there are sex differences in restricted and repetitive behaviours and interests (RRBIs) when rigorously focusing on the narrow construct level (i.e., stereotyped behaviour, restricted interests, insistence on sameness, and/or sensory experiences). METHODS:We conducted a systematic review and four random effects meta-analyses investigating sex differences in narrow construct measures of RRBIs in autistic children, adolescents, and adults (Prospero registration ID: CRD42021254221). Study quality was appraised using the Newcastle-Ottawa Quality Assessment Scale. RESULTS:Forty-six studies were narratively synthesised and 25 of these were included in four random effects meta-analyses. Results found that autistic males had significantly higher levels of stereotyped behaviours (SMD = 0.21, 95% confidence interval (CI) [0.09, 0.33], p < .001) and restricted interests (SMD = 0.18, 95% CI [0.07, 0.29], p < .001) compared to autistic females. In contrast, there were no significant sex differences for sensory experiences (SMD = -0.09, 95% CI [-0.27, 0.09], p = .32) and insistence on sameness (SMD = 0.01, 95% CI [-0.03, 0.05], p = .68). The findings from the narrative synthesis were generally consistent with those from the meta-analyses and also found qualitative sex differences in the way RRBIs manifest. CONCLUSIONS:Our findings show significant differences in narrowly defined RRBIs in males and females. Practitioners need to be aware of such differences, which could be contributing to the under-recognition of autism in females and may not be captured by current diagnostic instruments.

PURPOSE/OBJECTIVE:Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings. METHODS:We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention shown to be efficacious on a small scale expanded under real-world conditions to reach a greater proportion of eligible population. Study characteristics, including EBIs, implementation strategies, and outcomes used, were summarized using frameworks from the field of implementation science. RESULTS:This search yielded 3,076 abstracts, with 24 studies eligible for inclusion. Included studies focused on a number of cancer sites including cervical (67%), breast (13%), breast and cervical (13%), liver (4%), and colon (4%). Commonly reported scale-up strategies included developing stakeholder inter-relationships, training and education, and changing infrastructure. Barriers to scale-up were reported at individual, health facility, and community levels. Few studies reported applying conceptual frameworks to guide strategy selection and evaluation. CONCLUSION/CONCLUSIONS:Although there were relatively few published reports, this scoping review offers insight into the approaches used by LMICs to scale up cancer EBIs, including common strategies and barriers. More importantly, it illustrates the urgent need to fill gaps in research to guide best practices for bringing the implementation of cancer EBIs to scale in LMICs.