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ABSTRACT Introduction Prodromal symptoms of mania in children are predictive of the later development of bipolar disorder; yet, the neurostructural correlates of these early symptoms remain poorly understood. This study aimed to investigate the association between prodromal mania symptoms and brain structure in a large cohort of children. Methods We analyzed data from 10,662 nine‐ to 10‐year‐old children from the Adolescent Brain Cognitive Development (ABCD) Study, employing structural equation modeling to examine the concurrent and longitudinal associations between prodromal mania symptoms and cortical and subcortical gray matter volume. Results After adjusting for multiple comparisons and controlling for age, sex, scanner model, socioeconomic status, and medication use, we found that baseline mania symptoms were associated with reduced gray matter volume across both cortical and subcortical areas, suggesting a global effect. These findings were further supported by the loss of these effects when total intracranial volume was included as an additional covariate, suggesting that smaller overall brain size, rather than specific regional effects, is related to prodromal mania symptoms. Lastly, longitudinal analyses revealed that brain volume at baseline did not predict prodromal mania symptoms at the second‐year follow‐up. Conclusion Our results support the structural differences observed in adults with bipolar disorder in prior work and refine our understanding of the neurostructural correlates of prodromal mania symptoms in children. These findings could enhance early identification and intervention efforts for youth at risk of developing bipolar disorder. The current study examined the relationship between prodromal mania symptoms and brain structure in a large sample of children. We found that baseline mania symptoms were associated with smaller brain volumes in all cortical and subcortical regions, suggesting a global effect that is also supported by the loss of these effects when total intracranial volume was included as an additional covariate. These results help to refine our understanding of the neurostructural correlates of mania symptoms during the prodromal stage, which could be leveraged for improved identification and intervention.

Background Studies suggest that prosocial behavior, having high empathy and engaging in behaviors intended to benefit others, may predict mental health or vice versa; however, these findings have been mixed. The purpose of the current study was to examine the bidirectional relationships between prosocial behavior and dimensions of psychopathology in children. Methods The relationships between prosocial behavior and four dimensions of psychopathology (general psychopathology, internalizing symptoms, conduct problems, and attention‐deficit/hyperactivity disorder symptoms) were examined longitudinally in children 9–12 years of age from the Adolescent Brain Cognitive Development Study (N = 9122). We used a random intercept cross‐lagged panel model to distinguish between stable, trait‐like (between‐person) and time‐dependent (within‐person) fluctuations across a 24‐month period. Results Between‐person results revealed that prosocial behavior was negatively associated with general psychopathology and conduct problems while being positively associated with internalizing symptoms. Within‐person results demonstrated that, out of four possible directional paths tested, one was significant. This path showed that greater general psychopathology and conduct problems at the first‐year follow‐up predicted fewer prosocial behaviors at the second‐year follow‐up, although the effect size was small. In contrast, prosocial behavior did not predict psychopathology dimensions for any year. Conclusions The results of this study suggest that prosocial behaviors have stable associations with psychopathology across preadolescence; however, evidence of a directional association in which psychopathology predicts fewer prosocial behaviors in the future was only modest. Using a random intercept cross‐lagged panel model, we examined the bidirectional associations between prosocial behavior and youth psychopathology. General psychopathology and conduct problems unidirectionally predicted less future prosocial behavior, suggesting that only some forms of psychopathology are predictive of prosociality.

Childhood irritability and the experience of negative life events have independently been associated with the emergence and trajectory of internalizing symptoms. Here, we investigate how irritability and negative life events independently predict the course of internalizing symptoms, as well how their interaction may influence internalizing trajectories. Additionally, we examine the distinct outcomes of depressive versus anxious symptoms. Participants included 9- to 10-year-old children (N = 9,228) from the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Using linear mixed effects models, we examined the course of internalizing symptoms over three years as predicted by irritability, negative life events, and their interaction. The presence of both higher irritability and negative life events independently predicted a decrease in anxious symptoms, and an increase in depressive symptoms over time. We also found that youth with higher irritability and more negative life events showed a decrease in internalizing symptoms over the course of three years. Our findings suggest that irritability and negative life events interact to predict divergent trajectories of change in internalizing symptoms. In particular, high irritability in the presence of more negative life events may promote resilience in youth against the progression of internalizing symptoms. Future work is needed to examine the specific components of irritability that may be driving this complex interaction and the underlying behavioral mechanisms that may contribute to this effect.

Prior research has shown smaller cortical and subcortical gray matter volumes among individuals with attention-deficit/hyperactivity disorder (ADHD). However, neuroimaging studies often do not differentiate between inattention and hyperactivity/impulsivity, which are distinct core features of ADHD. The present study uses an approach to disentangle overlapping variance to examine the neurostructural heterogeneity of inattention and hyperactivity/impulsivity dimensions. We analyzed data from 10,692 9- to 10-year-old children from the Adolescent Brain Cognitive Development (ABCD) Study. Confirmatory factor analysis was used to derive factors representing inattentive and hyperactive/impulsive traits. We employed structural equation modeling to examine these factors' associations with gray matter volume while controlling for the shared variance between factors. Greater endorsement of inattentive traits was associated with smaller bilateral caudal anterior cingulate and left parahippocampal volumes. Greater endorsement of hyperactivity/impulsivity traits was associated with smaller bilateral caudate and left parahippocampal volumes. The results were similar when accounting for socioeconomic status, medication, and in-scanner motion. The magnitude of these findings increased when accounting for overall volume and intracranial volume, supporting a focal effect in our results. Inattentive and hyperactivity/impulsivity traits show common volume deficits in regions associated with visuospatial processing and memory while at the same time showing dissociable differences, with inattention showing differences in areas associated with attention and emotion regulation and hyperactivity/impulsivity associated with volume differences in motor activity regions. Uncovering such biological underpinnings within the broader disorder of ADHD allows us to refine our understanding of ADHD presentations.

Irritability, or an increased proneness to frustration and anger, is common in youth; however, few studies have examined neurostructural correlates of irritability in children. The purpose of the current study was to examine concurrent and longitudinal associations between brain structure and irritability in a large sample of 9–10-year-old children. Participants included 10,647 children from the Adolescent Brain Cognitive Development sm Study (ABCD Study ® ). We related a latent irritability factor to gray matter volume, cortical thickness, and surface area in 68 cortical regions and to gray matter volume in 19 subcortical regions using structural equation modeling. Multiple comparisons were adjusted for using the false discovery rate (FDR). After controlling for age, sex, race/ethnicity, scanner model, parent’s highest level of education, medication use, and total intracranial volume, irritability was associated with smaller volumes in primarily temporal and parietal regions at baseline. Longitudinal analyses showed that baseline gray matter volume did not predict irritability symptoms at the 3rd-year follow-up. No significant associations were found for cortical thickness or surface area. The current study demonstrates inverse associations between irritability and volume in regions implicated in emotional processing/social cognition, attention allocation, and movement/perception. We advance prior research by demonstrating that neurostructural differences associated with irritability are already apparent by age 9–10 years, extending this work to children and supporting theories positing socioemotional deficits as a key feature of irritability.

The COVID-19 pandemic is a chronically stressful event, particularly for youth. Here, we examine (i) changes in mood and anxiety symtpoms, (ii) pandemic-related stress as a mediator of change in symptoms, and (ii) threat processing biases as a predictor of increased anxiety during the pandemic. A clinically well-characterized sample of 81 youth ages 8–18 years (M = 13.8 years, SD = 2.65; 40.7% female) including youth with affective and/or behavioral psychiatric diagnoses and youth without psychopathology completed pre- and during pandemic assessments of anxiety and depression and COVID-related stress. Forty-six youth also completed a threat processing fMRI task pre-pandemic. Anxiety and depression significantly increased during the pandemic (all ps < 0.05). Significant symptom change was partially mediated by pandemic stress and worries. Increased prefrontal activity in response to neutral faces pre-pandemic was associated with more intense parent-reported anxiety during the pandemic (all Fs(1.95,81.86) > 14.44, ps < 0.001). The present work extends existing knowledge on the mediating role of psychological stress on symptoms of anxiety and depression in youth.

Adverse childhood experiences (ACEs) are known to contribute to long-term harmful effects on mental health in young adults. Research has demonstrated that having a chronic medical condition (CMC) can also be conceptualized as being a potentially traumatic experience, and that young adults with a CMC are also at risk for negative adjustment. Emotion dysregulation, or difficulty identifying and regulating one’s emotions, is common among individuals with ACEs, and is a predictor of young adult adjustment. Given the mediational link between ACEs, emotion dysregulation, and young adult adjustment, it is likely that emotion dysregulation may demonstrate a similar linkage to adjustment in individuals with a CMC. The current study compared the effects of ACEs and having a CMC on depressive and anxious symptoms, while also examining emotion dysregulation as a possible mediator for both ACEs and CMC on adjustment outcomes, specifically depressive and anxious symptoms. College students ( N  = 1911) completed online questionnaires that assessed history of ACEs, emotion regulation difficulties, adjustment, and chronic illness status. Path analyses demonstrated a significant correlation between ACEs and depressive and anxious symptoms, as well as having a CMC and depressive and anxious symptoms. Furthermore, emotion dysregulation demonstrated a significant mediation between ACEs and negative adjustment, as well as between having a CMC and negative adjustment. This study highlights the importance of emotion dysregulation in understanding outcomes for individuals with a CMC and/or ACEs.

Background Programme developers have the responsibility of ongoing programme renewal and evaluation to ensure that curricula remain responsive to rapidly changing educational and healthcare contexts. In reporting on programmes, significant emphasis is often placed on content and outcomes of Master’s in Health Professions Education (MHPE) programmes. However, less emphasis has been placed on meaningful evaluation of all aspects of these programmes, particularly from a student perspective including what worked and what needs to be enhanced, as well as any emergent or unplanned factors. As the number of established MHPE programmes increases, so does the need for evaluation models that consider programme complexity. In this article we consider a MHPE programme against a model that provided scope for going beyond ‘did it work?’ Our intention was to determine whether the renewed MPhil in HPE programme was implemented as planned, and to which extent it achieved the planned outcomes. Methods This programme evaluation was conducted in an interpretive paradigm. We collected qualitative data at two points. Firstly, at the start of students’ first-year with voluntary participation in focus groups and secondly, a year later with voluntary participation in individual interviews. Two members of the research team performed the initial thematic analysis of both the focus group interviews and the individual interviews. Thereafter, the full author team worked collaboratively discussing the themes until we reached consensus, looking specifically to identify any “emergent” factors. Results We identified three themes in the student data related to the process of implementing the new programme and the outcomes from it, including those aspects that could be regarded as emergent or unplanned: balancing work, personal lives and studies; managing the hybrid learning approach; and the scholarly journey. Conclusions While many of the outcomes of the renewed programme were met, not all manifested as had been planned. The experience of the programme differed from one student to the next such that at the end of the two years they were at different points in their scholarly journeys. We realised that although we sought to be pedagogically sound in the process of curriculum renewal, we did not take into account the complex matrix of influences that sit outside the formal curriculum. Future renewal activities should intentionally and sensitively consider those factors, both planned and emergent, that influence a student’s journey towards becoming a scholarly teacher and teaching scholar.