While the link between aggression and internalizing concerns is well-established, additional work is needed to understand when these links are most pronounced, particularly by evaluating the intersection of how and why one aggresses. Variables that might buffer such associations, such as peer and family belonging, also warrant investigation. Data from 243 middle school students (Mage = 12.22; 46.5% female) were collected to evaluate the unique and interactive influences of the various forms and functions of aggression and family and peer belonging on symptoms of anxiety and depression. Results indicated that the link between aggression and internalizing concerns varies based on the form and function of aggression. Specifically, reactive overt aggression and peer belonging were uniquely linked to symptoms of both depression and anxiety. Family belonging was uniquely associated with depression. Proactive functions of aggression were not significantly associated with internalizing symptoms. Both family and peer belonging moderated reactive aggression-anxiety links, but not depression. In general, low levels of belonging were associated with high levels of anxiety regardless of levels of reactive aggression. The lowest levels of anxiety were evident at low levels of aggression and high levels of belonging. However, high levels of belonging did not buffer the links between aggression and anxiety. Findings underscore the importance of examining aggression using a more differentiated approach; they also highlight the relevance of belonging in understanding reactive aggression-anxiety links among middle school youth.

Anxiety disorders are common in children and adolescents, but constrained resources limit access to cognitive-behavioral therapy (CBT). Stepped and stratified care models offer different ways to organize care. Stepped care starts with lower-resource CBT and escalates when needed, whereas stratified care matches CBT format to patient complexity from the outset. Economic evidence comparing these models remains scarce. We conducted a pilot economic evaluation alongside an RCT of 51 youths with anxiety disorders to examine the feasibility of health-economic evaluation and generate preliminary cost-effectiveness estimates. Participants were randomized to stepped care (guided internet-delivered CBT [iCBT] with escalation to in-person CBT if needed, n = 25) or stratified care (baseline allocation to guided iCBT or in-person CBT with escalation to in-person CBT if needed, n = 26). Health outcomes and costs from the healthcare and societal perspectives were collected over 6 months, with the base case analysis estimating the change in utility scores. Incremental cost-effectiveness ratios (ICERs) were estimated using non-parametric bootstrapping. Stratified care yielded greater, though not statistically significant, health gains than stepped care and was dominant from the societal perspective. From the healthcare perspective, the AUC-derived quality-adjusted life years (QALY) sensitivity analysis yielded an ICER of USD 6,878 per QALY gained, although estimates remained uncertain given the small pilot sample. Subgroup analyses by age, sex, and treatment response generally supported these patterns while highlighting heterogeneity. These findings support the feasibility of conducting economic evaluations of care models in routine youth mental health care, but larger trials are needed to provide more precise cost-effectiveness estimates and inform service-delivery policy.

The aim of this study was to gather participant feedback to enhance the Lights Out Online Program, a 4-session, self-directed, web-based parent intervention targeting behavioural sleep problems in preschool-aged children using evidence-based strategies. Specifically, we sought to (1) understand parents' experiences with the program itself, including their level of satisfaction and their implementation of program strategies, and (2) gain feedback from parents regarding possible program improvements, to inform improvements and adjustments to the program. Data were collected using session satisfaction surveys at the end of each session, complemented by videoconference interviews with a subset of participants to understand implementation of program strategies following program completion. Twenty-four parents of children aged 3-6 years with sleep problems participated in the program, six of whom also participated in a semi-structured interview. Deductive organisation of survey responses revealed that the program was practical, and that the strategies were easy to implement; however, parents found sessions most helpful when the content related to their child's specific problem. Using a reflexive thematic analysis, four main themes were captured in the interviews: (1) the cascade of positive changes following program completion, (2) the gradual process required for successful implementation and change, (3) the invitation for all parents to be on the same page, and (4) the need for flexibility in delivery. The areas for improvement suggested by parents were incorporated into the revised online program. This revised version of Lights Out Online has the potential to increase acceptability, engagement, and long-term adoption of the program.

Little research has analysed the relation between childcare and positive psychological wellbeing, e.g., self-esteem and life satisfaction. Using data from the UK Millennium Cohort Study, this paper investigates the association of the age of starting and intensity of formal childcare with self-esteem trajectories between 11 and 17 years and life satisfaction at 11 and 14 years (N = 5,484). Proportional odds for having greater psychological wellbeing and odds ratios for having good compared to poor psychological wellbeing (lowest 25% scores) were estimated. After controlling for children's socio-economic position, childcare was not associated with self-esteem or life satisfaction. Changes in estimates after adjustment show that children from a lower socio-economic position attended less childcare and had lower odds of later psychological wellbeing.

Psychologists' evaluation reports communicate diagnoses, findings, and recommendations that guide educational and health decisions for children and adolescents. Research has long shown that many of these reports are technical, test-focused, and hard for families, educators, and clinicians to use. This systematic review and meta-analysis pooled experiments in which readers compared accessible and traditional versions of the same, or closely matched, evaluation information. It included 14 experiments (N = 1,283 readers) across educational and clinical settings. Accessible reports used plain language, clearer organization, concrete examples, and reduced technical terminology, whereas traditional reports used technical language and conventional test-by-test organization. Accessible reports improved reader outcomes, with a moderate-to-large benefit (Hedges' g = 0.83, 95% confidence interval [0.60, 1.06]). Every experiment favored the accessible version. Accessible report writing is an evidence-supported communication practice for psychological evaluation reports.

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by the abrupt onset of neuropsychiatric symptoms, including obsessive-compulsive disorder and/or restricted food intake, in response to infection or other triggers. This mixed methods systematic review synthesized evidence on the lived experience and psychosocial impacts of caring for a child with PANS. Seventeen publications of moderate to high quality met eligibility criteria. Four synthesized findings emerged from the qualitative meta-aggregation: (i) broad psychosocial impacts on caregivers and families; (ii) shock and ongoing uncertainty arising from the sudden, severe onset and unpredictable symptom flares; (iii) pervasive systemic barriers to timely diagnosis, treatment, and educational support; and (iv) caregivers' proactive responses to the challenges of navigating PANS. Narrative synthesis of quantitative findings highlighted increased caregiver burden, and elevated psychological distress and relationship dissatisfaction. Disease activity, diagnostic and treatment delays, and disruption to schooling and employment were associated with greater impact. Implications for improving clinical recognition and supporting caregiver and family wellbeing are discussed.

Poor reading ability is associated with internalising symptoms in children; however, little research has been done with adolescents. The current study used self- and parent-report data from two cohorts of the Longitudinal Study of Australian Children (LSAC;N = 2222 andN = 2213) to test the longitudinal andbidirectional relationships between reading ability and internalising symptoms across adolescence (10/11years, 12/13years,14/15years, 16/17years), andwhetheracademic self-concept mediated these relationships. Adapted cross-lagged panel models found no significant longitudinal relationships between reading ability and later internalising symptoms or between internalising symptoms and later reading ability. There was a significant relationship between reading ability at 12/13years and academic self-concept at 14/15years, but no significant relationship between academic self-concept at 14/15yearsand internalising symptoms at 16/17years. Poor reading ability does not appear to increase adolescents' risk of mental health problems either directly or indirectly.

Refugee and asylum-seeking parents face distinct challenges in supporting their children's mental health during resettlement. Although elevated child mental health risks and barriers to service access are well documented, less is known about how parents could best be supported to help their children. This study explored parent and stakeholder perspectives to inform family-centred support. Semi-structured interviews were conducted with 23 refugee parents (ENRICH) and 30 stakeholders across health, education, local authority and voluntary sectors (ESTEEM) in the UK. Data were analysed using Reflexive Template Analysis. Four levels of support were identified: basic stability; belonging through community, language and play; understanding and trust; and specialist psychological support. Three overarching system conditions shaped whether families could access and use support: coordination, communication and competence; responsiveness; and the right setting. Parents also identified specific specialist supports, including practical guidance, family-centred and joint parent-child approaches, and culturally responsive therapeutic spaces. Services were often described as reactive, fragmented and culturally mismatched, limiting engagement and reducing support effectiveness. Effective support for refugee parents to help their children requires attention not only to what is provided but how it is delivered. Coordinated systems, culturally and linguistically responsive practices, timely support, and delivery through trusted community settings are central to enabling parents to support their children's mental health. Together, these findings provide a practical framework to inform the development of family-centred approaches during resettlement.

Research and theory suggest that neuroendocrine functioning, such as diurnal cortisol rhythms, plays an important role in emotional development and expression, but that this functioning can be impacted under conditions of elevated stress. Although mindfulness-based interventions show promise for improving emotional functioning, their effects on cortisol regulation in children remain unclear despite a solid theoretical foundation. This study provides preliminary data from a sample of children (n = 57; mean age = 10 years) on changes in diurnal cortisol rhythms associated with exposure to the Pure Power curriculum which is designed to teach youth yoga techniques, mindfulness, and emotion regulation. A non-randomized comparison design examined outcomes and diurnal cortisol levels among participants from schools that completed the intervention (n = 27) and from students in comparison schools (n = 30) assessed at three time points approximately one year apart. Modeling of diurnal patterns indicated that youth in the intervention schools demonstrated a relative change in their cortisol levels at Time 2 towards a diurnal rhythm associated with less stress. The data provide initial evidence for an association between exposure to a yoga and mindfulness curriculum and neuroendocrine function. The conclusions are limited by the non-randomized design and small sample. Replication with randomized designs and larger samples is needed.

Depression is one of the most prevalent mental health problems in adolescence. Due to the covert nature of depressive symptoms, parents play an important role in recognizing distress and seeking intervention for their child. However, research often reports discrepancies between parent and adolescent reports of depressive symptoms, and integrating and interpreting these discrepancies remains a challenge. The present study used a trifactor model to isolate sources of variance stemming from shared and unique perspectives in a sample of 583 parent-adolescent dyads (59% male; Mage= 14.22, SD = 1.81). Consensus between parents and adolescents was characterized by feelings of sadness, whereas unique views of adolescent depressive symptoms highlighted somatic symptoms (e.g., overtiredness), with adolescents generally reporting more symptoms. Adolescents' attachment security and family affective responsiveness were associated with lower depressive symptoms reported by adolescents, whereas parents' reports of problem-solving skills were associated with lower depressive symptoms reported by parents. These findings emphasize the importance of considering the degree of parent-adolescent agreement regarding adolescent mental health and educating parents to raise awareness of their adolescents' mental health, which could facilitate early detection and intervention. Furthermore, prevention and intervention efforts should target promoting family functioning through open and affective communication.