Emotional abuse mediated by negative automatic thoughts impacts functional connectivity during adolescence.

Background: Emotional abuse during childhood and adolescence is thought to be associated with the brain; however, the neural mechanism underlying the cognitive process remains unknown. Therefore, we aimed to investigate the mediating effect of negative automatic thoughts on the relationship between emotional abuse and resting-state functional connectivity (rsFC) during adolescence. Method: Our community sample included 54 adolescents aged 13-17 years in the statistical analysis. Resting-state functional and structural magnetic resonance imaging (MRI) was performed, while emotional abuse and negative automatic thoughts were assessed using self-reported scales. A mediation analysis was used to assess the contributions of early traumatic events and negative automatic thoughts to resting functional connectivity. Result: Higher negative automatic thoughts were associated with lower connectivity in the context of greater emotional abuse (i.e., suppression effect). Thus, the relationships between emotional abuse and connectivity in the precuneus (pCun)-medial prefrontal cortex, parahippocampal cortex-extrastriate cortex, and temporal cortex-temporal pole were decreased by negative automatic thoughts. In contrast, functional connections in the pCun-pCun, pCun-precuneus/posterior cingulate cortex, and nucleus accumbens-somatomotor areas were strongly mediated when emotionally abused adolescents reported a high tendency for negative automatic thoughts. Conclusion: Negative automatic thoughts strengthened the relationship between emotional abuse and rsFC. These findings highlight the underlying cognitive processing of the traumatic event-neural system, supporting the use of cognitive therapy for post-traumatic symptoms.

Case Report: Intellectual disability and borderline intellectual functioning in two sisters with a 12p11.22 loss.

Multiple genome sequencing studies have identified genetic abnormalities as major causes of severe intellectual disability (ID). However, many children affected by mild ID and borderline intellectual functioning (BIF) lack a genetic diagnosis because known causative ID genetic mutations have not been identified or the role of genetic variants in mild cases is less understood. Genetic variant testing in mild cases is necessary to provide information on prognosis and risk of occurrence. In this study, we report two sibling patients who were 5 years 9 months old and 3 years 3 months old and presented to the hospital due to developmental delay. Clinical assessment and chromosomal microarray analysis were performed. The patients were diagnosed with mild intellectual disability (ID) and borderline intellectual functioning (BIF). Genetic analysis identified a loss of 12p11.22, including the OVCH1-AS1, OVCH1, and TMTC1 genes, which was the only variant that occurred in both sisters. Identical variants were found in their father with probable BIF. Neither patient presented any brain structural abnormalities or dysmorphism, and no exogenous factors or parenting problems were reported. Thus, loss of 12p11.22 may be associated with our patients' cognitive impairment. The OVCH1, OVCH1-AS1 and TMTC1 variants identified in this study are the most likely disease-causing genes in the sisters. Our findings may expand as yet limited knowledge on mild ID and BIF causative variants, which would further support the diagnosis even if the severity is mild.

A Survey on the Journal of the Korean Academy of Child and Adolescent Psychiatry: Implications for Growth and Development.

Objectives: This study aimed to assess the status of the Journal of the Korean Academy of Child and Adolescent Psychiatry (JKACAP) and propose measures for its growth and development. Methods: The study was conducted using a questionnaire survey targeting members of the Korean Academy of Child and Adolescent Psychiatry. The six key elements analyzed were Access to the journal, Convenience following conversion to English, Recognition as an international journal and institutional achievements, Author perspectives on manuscript submission,Transition to an online-only journal, and Content and identity of the journal. Results: The survey revealed that email notification was highly effective for Journal Accessibility, with the website and search engines also frequently being used by members. Conversion to English in 2018 initially impacted readability and submission rates, but these concerns have decreased over time. However, the Recognition of JKACAP as an international academic journal was still not on par with SCIE journals, highlighting the need for further efforts towards SCIE inclusion. Despite these challenges and limited research opportunities, there was an active intention among members to submit manuscripts. Respondents showed a notable preference for the Transition to an online-only journal. Regarding content and identity of the JKACAP, members predominantly favored review articles and perceived the journal as a research and communication platform for Korean child and adolescent psychiatrists. Conclusion: The results indicate the need for JKACAP to enhance its digital accessibility, provide more support for domestic and international authors, and actively seek SCIE indexing. Addressing the varied content preferences of its members, improving the submission process, and transitioning to an online-only format could further its growth and solidify its position as an internationally recognized academic journal in the field of child and adolescent psychiatry.

Analysis of the Status and Future Direction for Digital Therapeutics in Children and Adolescent Psychiatry.

Digital therapeutics based on software, such as artificial intelligence, virtual reality, games, and smartphone applications, are in the spotlight as new therapeutic alternatives in child and adolescent psychiatry. It draws attention to overcoming conventional therapeutics' limitations, such as toxicity, cost, and accessibility, and encourages patients to participate in the treatment attractively. The growth potential of the digital therapeutics market for psychiatric disorders in children and adolescents in Korea and abroad has been highlighted. Clinical studies and Food and Drug Administration approvals for digital therapeutics have increased, and cases approved by the Ministry of Food and Drug Safety have emerged in Korea. As seen above, digital transformation in child and adolescent psychiatry will change treatment paradigms significantly. Therefore, as this new field has just begun to emerge, it is necessary to verify the effectiveness and scope of the application of digital therapeutics and consider preparing a compensation system and institutional arrangements. Accordingly, this study analyzed the development trends and application status of digital therapeutics in children and adolescents and presented limitations and development directions from the perspective of application in healthcare. Further, the study is expected to identify the utility and limitations of digital therapeutics for children and adolescents and establish effective application measures.

Old Age, Female Sex, and Psychotropic Medications Predict Hyposalivation But Not Heart Rate Variability.

OBJECTIVE: To explore risk factors for dry mouth and examine the clinical utility of the heart rate variability (HRV) test in the prediction of dry mouth. METHODS: Every outpatient, who underwent tests for both unstimulated salivary flow and HRV, was retrospectively reviewed. After excluding seven subjects, the demographics and clinical factors in 70 total patients were collected. Based on objective salivary flow rates, patients were classified into normal (≥0.2 mL/min) or hyposalivation groups (<0.2 mL/min), and inter-group comparisons were performed with a two-tailed statistical significance of 0.05. RESULTS: Patients with subjective dry mouth were significantly more likely to show hyposalivation. Advanced age, female sex, and current use of psychotropic medications were identified as risk factors for dry mouth. However, dry mouth was not associated with any HRV parameters. CONCLUSION: HRV test did not demonstrate a clinical utility in predicting dry mouth. Because subjective dry mouth is significantly associated with objective hyposalivation, a simple probing question would be useful for early recognition of dry mouth. Clinical attention is required for patients meeting criteria of older age, female, and/or using psychotropic prescriptions. Prompt management of hyposalivation may improve quality of life and clinical outcome by enhanced treatment adherence.

Game-based digital therapeutics for children and adolescents: Their therapeutic effects on mental health problems, the sustainability of the therapeutic effects and the transfer of cognitive functions.

Mental health problems in childhood and adolescence (e. g., attention deficits, problems in emotional understanding and subclinical levels of anxiety) are reported to develop further in adulthood and/or to increase the risk of developing mental health disorders in adulthood. Although it is important to provide treatment or prevention interventions for children and adolescents in order to reduce the risk of the further development of mental health problems, the pharmacological and behavioral treatments for this age group have limitations (e.g., limited access, unsustainable treatment effects and the lack of engagement in intervention). In order to overcome the limitations of conventional treatments, the use of digital technology, especially video games for this age group, is suggested. In order to be accepted as clinical interventions, objective evidence for the therapeutic effects of digital therapeutic that used video games to treat or prevent targeted mental health problems are required. Thus, this review aims to explore whether game-based digital therapeutics (DTx) for children and adolescents showed therapeutic effects on targeted mental health problems. As game-based DTx are suggested to show sustained therapeutic effects and the transfer of cognitive functions, it also reviews the maintenance of the therapeutic effects of DTx and the extent of the transfer of cognitive functions. Game-based DTx that are developed to treat or prevent mental health problems (e.g., attention deficit, depression) in children and adolescents are found to show therapeutic effects on targeted mental health problems despite the limitations (e.g., small sample size, limited investigation of the sustainability). This review would contribute to the understanding of whether there is objective evidence of the therapeutic effects of digital therapeutics using video games that deliver treatment or prevention interventions for mental health problems in children and adolescents.

Effectiveness of Clonidine in Child and Adolescent Sleep Disorders.

OBJECTIVE: We aimed to investigate the improvement in sleep quantity and quality when clonidine was used in children and adolescents with insomnia. We also examined how sociodemographic characteristics such as age, sex, underlying psychological problems, and levels of depression and anxiety affected the effect of clonidine. METHODS: We retrospectively reviewed outpatients aged 6 to 24 who took clonidine due to insomnia from September 2019 to September 2021 at the Department of Psychiatry at Eunpyeong St. Mary's Hospital of Catholic University. We used the Pittsburgh Sleep Quality Index (PSQI), Children's Depression Inventory (CDI), and State-Trait Anxiety Inventory (STAI) for our study. RESULTS: A total of 62 participants were included in our study (34 females, mean age 13.94±4.94 years). After using clonidine, there was a significant decrease in PSQI components 1, 2, and 5, especially PSQI component 2. There was a greater decrease in sleep latency when clonidine was used in females, those aged between 13 and 24, those with mood/anxiety disorder or attention-deficit/hyperactivity disorder, those whose sleep latency exceeded 60 minutes at baseline, and those who used clonidine for more than 14 days. Those with higher STAI-Trait scores and CDI scores at baseline showed less improvement in total PSQI scores. CONCLUSION: Considering that there are currently no Food and Drug Administration-approved sleep drugs for children and adolescents and no apparent difference in efficacy and safety among sleep drugs, we demonstrated that treatment with clonidine might be a good approach to improve sleep quality and quantity for children and adolescents.

Cerebellar Gray Matter Volume and its Role in Executive Function, and Attention: Sex Differences by Age in Adolescents.

Objective: This research measures the regional GMV (rGMV) of the cerebellum, attention, Executive Function (EF) and we aimed to identify their correlation and sex differences in children and adolescents. Methods: Subjects comprised 114 children (male = 62, female = 52, 12.44 ± 2.99 years old) from South Korea. Participants were divided into three groups by age (age 6-9, 10-13, and 14-17). The Stroop Color and Word Test (SCWT), Wisconsin Card Sorting Test (WCST), and Advanced Test of Attention (ATA) were used to estimate executive function. Magnetic resonance imaging (MRI) images were analyzed with Regional Voxel-Based Morphometry Analysis. Results: The correlations between cerebellar rGMV and SCWT, WCST, and ATA subcategories showed difference by age and sex. In 6-9 age group, girls showed more overall correlations with cerebellar regions than boys, in WCST Categories Completed and ATA results. In age 10-13 group, more regions of cerebellum corresponded to SCWT subcategories in girls. Nevertheless, more correlation between cerebellar rGMV, WCST subcategories and some ATA subtests were observed in boys in the same age group. In the adolescent group, aged 14-17, boys showed more correlation with cerebellar rGMV, while girls showed little correlation. Conclusion: This study highlights that sex-different cerebellum maturation in adolescence might be correlated with EF and attention. These results provides evidence that cerebellum modulates higher cognitive functioning during child development.

A systematic review of the impact of COVID-19 on the game addiction of children and adolescents.

Background: During the COVID-19 pandemic, it is reported that children and adolescents who are socially isolated experience high levels of stress and various mental health problems. At present, little research has been done to collect previous studies that focused on game addiction in children and adolescents during the COVID-19 pandemic. In this research, we aimed to investigate the prevalence of gaming disorder during COVID-19 in children and adolescents and the various factors experienced by children and adolescents that affected gaming disorder. Methods: We searched PubMed, Embase, PsycINFO, and Cochrane on 5 May 2021 to identify relevant literature. We extracted the prevalence estimates of game addiction from the studies to measure the global prevalence of game addiction. Then, we found the answers to the questions raised and synthesized them into several themes. Results: We identified 2,609 articles. Among them, studies that were not related to the topic, duplicated, and that did not meet the selection criteria were excluded, and 18 studies were selected. We rated most of the studies as moderate, and a few were low, and high. A majority of studies found an increase in game usage time and game addiction score during the COVID-19 pandemic. Some children and adolescents in emotional pain play games to communicate with their peers. Regarding parenting, violent parenting and the absence of parental supervision increase levels of game addiction in children. Gaming disorder was caused by the impact of COVID-19 in a vulnerable group with predisposing factors such as depression, anxiety, and attention-deficit/hyperactivity disorder. Adolescents and males scored higher on a game addiction scale, although we could not find any quantitative correlations due to the heterogeneous scales used for gaming addiction. Conclusions: During the COVID-19 pandemic, isolated children and adolescents reported increased gaming hours as a result of coping with their psychological pain and avoiding social isolation. Their parents, who should provide proper supervision, also failed to provide appropriate support due to the stress caused by the pandemic. Mental health providers should educate children, adolescents, and their guardians on alternative ways to relieve stress and help parents effectively control their children's usage of games.

The Association Between Hippocampal Volume and Level of Attention in Children and Adolescents.

The hippocampus, which engages in the process of consolidating long-term memories and learning, shows active development during childhood and adolescence. The hippocampus also functionally influences attention. Based on the influence of hippocampal function on attention, it was expected that the volume of the hippocampus would be associated with the difference in attention during childhood and adolescence, in which the brain develops actively. Thus, this study examined the association between hippocampal volume and attention metrics measured by the continuous performance test (CPT) in 115 children and adolescents (mean age = 12.43 ± 3.0, 63 male and 52 female). In association studies with both auditory and visual attention, we found that the bilateral hippocampal volumes showed negative relationships with auditory omission errors. A smaller volume of the left hippocampus also led to a longer auditory response time. However, visual attention did not show any significant relationship with the hippocampal volume. These findings were consistent even after adjusting for the effects of the related covariates (e.g., age, insomnia, and depression). Taken together, this study suggested that the increase in hippocampal volume during childhood and adolescence was associated significantly with better auditory attention.

Association of Extensive Video Gaming and Cognitive Function Changes in Brain-Imaging Studies of Pro Gamers and Individuals With Gaming Disorder: Systematic Literature Review.

BACKGROUND: The World Health Organization announced the inclusion of gaming disorder (GD) in the International Classification of Diseases, 11th Revision, despite some concerns. However, video gaming has been associated with the enhancement of cognitive function. Moreover, despite comparable extensive video gaming, pro gamers have not shown any of the negative symptoms that individuals with GD have reported. It is important to understand the association between extensive video gaming and alterations in brain regions more objectively. OBJECTIVE: This study aimed to systematically explore the association between extensive video gaming and changes in cognitive function by focusing on pro gamers and individuals with GD. METHODS: Studies about pro gamers and individuals with GD were searched for in the PubMed and Web of Science databases using relevant search terms, for example, "pro-gamers" and "(Internet) gaming disorder." While studies for pro gamers were searched for without date restrictions, only studies published since 2013 about individuals with GD were included in search results. Article selection was conducted by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS: By following the PRISMA guidelines, 1903 records with unique titles were identified. Through the screening process of titles and abstracts, 86 full-text articles were accessed to determine their eligibility. A total of 18 studies were included in this systematic review. Among the included 18 studies, six studies included pro gamers as participants, one study included both pro gamers and individuals with GD, and 11 studies included individuals with GD. Pro gamers showed structural and functional alterations in brain regions (eg, the left cingulate cortex, the insula subregions, and the prefrontal regions). Cognitive function (eg, attention and sensorimotor function) and cognitive control improved in pro gamers. Individuals with GD showed structural and functional alterations in brain regions (eg, the striatum, the orbitofrontal cortex, and the amygdala) that were associated with impaired cognitive control and higher levels of craving video game playing. They also showed increased cortical thickness in the middle temporal cortex, which indicated the acquisition of better skills. Moreover, it was suggested that various factors (eg, gaming expertise, duration or severity of GD, and level of self-control) seemed to modulate the association of extensive video game playing with changes in cognitive function. CONCLUSIONS: Although a limited number of studies were identified that included pro gamers and/or individuals who reported showing symptoms of GD for more than 1 year, this review contributed to the objective understanding of the association between extensive video game playing and changes in cognitive function. Conducting studies with a longitudinal design or with various comparison groups in the future would be helpful in deepening the understanding of this association.

Gray Matter Volume in the Developing Frontal Lobe and Its Relationship With Executive Function in Late Childhood and Adolescence: A Community-Based Study.

Background: During late childhood and adolescence, the frontal lobe undergoes critical developmental changes, affecting a wide range of executive functions significantly. Conversely, abnormality in the maturation of the frontal lobe during this period may result in a limited ability to effectively use various executive functions. However, at present, it is still unclear how the structural development of the frontal lobe is associated with different aspects of executive functions during this developmental period. To fill the gap in evidence, we aimed to elucidate gray matter volume (GMV) in the frontal lobe and its relationship with multiple aspects of executive functions in late childhood and adolescence. Methods: We recruited our participants aged between 6 and 17 years to assess GMV in the frontal lobe and its relationship with different domains of executive functions in late childhood and adolescence. We used the voxel-based morphometry-DARTEL procedure to measure GMVs in multiple frontal sub-regions and Stroop test and Advanced Test of Attention (ATA) to measure executive functions. We then conducted partial correlation analyses and performed multiple comparisons with different age and sex groups. Results: Overall, 123 participants took part in our study. We found that many regional GMVs in the frontal lobe were negatively correlated with ATA scores in participants in late childhood and positively correlated with ATA scores in participants in adolescence. Only a few correlations of the GMVs with Stroop test scores were significant in both age groups. Although most of our results did not survive false discovery rate (FDR) correction (i.e., FDR <0.2), considering their novelty, we discussed our results based on uncorrected p-values. Our findings indicate that the frontal sub-regions that were involved in attentional networks may significantly improve during late childhood and become stabilized later in adolescence. Moreover, our findings with the Stroop test may also present the possibility of the later maturation of higher-order executive functioning skills. Conclusion: Although our findings were based on uncorrected p-values, the novelty of our findings may provide better insights into elucidating the maturation of the frontal lobe and its relationship with the development of attention networks in late childhood and adolescence.

The Thirty-First Year Journey, the Journal of the Korean Academy of Child and Adolescent Psychiatry.

OBJECTIVES: The Journal of the Korean Academy of Child and Adolescent Psychiatry (JKACAP) has had a 31 year-long history, sharing research and reviews of children and adolescents' mental health to promote voluntary participation and communication of the members of this society. Here, we have reviewed the detailed history of the journal from the perspective of developmental progression of JKACAP and discussed the direction of further development. METHODS & RESULTS: We reviewed the journey of the journal by focusing on the effort it took to take the journal to a global standard, and discussed the future direction of progress of JKACAP, based on the opinions raised at the Editor-in-Chiefs' reunion. CONCLUSION: JKACAP has just stepped on the path to globalization by being indexed in Emerging Sources Citation Index, PubMed Central, and Scopus. It is time to progress to another dimension, by acknowledging and overcoming more complicated issues, such as augmenting impact of the journal, expanding domains of interdisciplinary collaboration, and more global cooperation.

The Matthew Effect in Recovery from Smartphone Addiction in a 6-Month Longitudinal Study of Children and Adolescents.

The clinical course of problematic smartphone use (PSU) remains largely unknown due to a lack of longitudinal studies. We recruited 193 subjects with smartphone addiction problems for the present study. After providing informed consent, the subjects completed surveys and underwent comprehensive interviews regarding smartphone usage. A total of 56 subjects among the 193 initially recruited subjects were followed up for six months. We compared baseline characteristics between persistent addicted users and recovered users at the end of the 6-month follow-up. Persistent problematic smartphone users displayed higher baseline smartphone addiction severity and were more prone to develop mental health problems at the follow-up. However, baseline depressive or anxiety status did not significantly influence the course of PSU. PSU behaved more like an addictive disorder rather than a secondary psychiatric disorder. Harm avoidance, impulsivity, higher Internet use, and less conversation time with mothers were identified as poor prognostic factors in PSU. Lower quality of life, low perceived happiness, and goal instability also contributed to persistent PSU, while recovery increased these scores as well as measures of self-esteem. These findings suggest that the Matthew effect is found in the recovery of PSU with better premorbid psychosocial adjustment leading to a more successful recovery. Greater clinical resources are required for interventions in vulnerable populations to modify the course of this increasingly prevalent problematic behavior worldwide.

Structural Alterations in Large-scale Brain Networks and Their Relationship with Sleep Disturbances in the Adolescent Population.

Although sleep disturbances are highly prevalent in adolescents, neuroimaging evidence on the effects of sleep disturbances on their developing brains remains limited. Therefore, we explored gray matter volumes (GMVs) at the whole-brain level and investigated their relationship to sleep disturbances in a sample of Korean adolescents in the general population. We recruited participants from one middle school and high school. All participants and their legal guardians gave informed consent before participating in our study. We used component 5 of the Pittsburgh Sleep Quality Index to measure sleep disturbances and conducted a voxel-based morphometry-DARTEL procedure to measure GMVs. We performed partial correlation analyses to examine whether the GMVs were associated with sleep disturbances. A total of 56 adolescents participated in this study. Our results revealed that GMVs in multiple global regions were negatively correlated with sleep disturbances. Moreover, most of these identified regions belong to large-scale brain networks categorized by functional neuroimaging studies. We found an association between regional GMVs in multiple global regions involved in large-scale networks and the severity of sleep disturbances in the adolescent population. Based on this evidence and previous neuroimaging evidence, we suggest that structural alterations in the networks may be linked to sleep disturbances.

Commercial video games and cognitive functions: video game genres and modulating factors of cognitive enhancement.

BACKGROUND: Unlike the emphasis on negative results of video games such as the impulsive engagement in video games, cognitive training studies in individuals with cognitive deficits showed that characteristics of video game elements were helpful to train cognitive functions. Thus, this study aimed to have a more balanced view toward the video game playing by reviewing genres of commercial video games and the association of video games with cognitive functions and modulating factors. Literatures were searched with search terms (e.g. genres of video games, cognitive training) on database and Google scholar. RESULTS: video games, of which purpose is players' entertainment, were found to be positively associated with cognitive functions (e.g. attention, problem solving skills) despite some discrepancy between studies. However, the enhancement of cognitive functions through video gaming was limited to the task or performance requiring the same cognitive functions. Moreover, as several factors (e.g. age, gender) were identified to modulate cognitive enhancement, the individual difference in the association between video game playing and cognitive function was found. CONCLUSION: Commercial video games are suggested to have the potential for cognitive function enhancement. As understanding the association between video gaming and cognitive function in a more balanced view is essential to evaluate the potential outcomes of commercial video games that more people reported to engage, this review contributes to provide more objective evidence for commercial video gaming.

The difference in sleep, depression, anxiety, and Internet addiction between Korean adolescents with different circadian preference.

OBJECTIVES: Compared to adults, adolescents tend to prefer evening times developmentally. The orientation toward evening times is associated with behavioral and emotional problems. Thus, this study examined the association of circadian preference with sleep-related variables, depression, anxiety, and Internet addiction in Korean adolescents. MATERIALS AND METHODS: Participants completed the questionnaires measuring sleep pattern, sleep problem, depression, anxiety, and Internet addiction. RESULTS: Among 765 students (age range: 13-17 years), 211 students (N male= 134) were allocated into morning types (MT) and 258 adolescents (N male= 147) were allocated into evening types (ET) based on scores of the Morningness-Eveningness Scale. Adolescents without circadian preference (N = 296) were defined as neither type (NT). ET, compared to MT and NT, woke up later in the weekend, showed delays in bedtimes, and spent shorter time sleeping. They also reported a higher level of daytime sleepiness, insomnia, and depression than NT. However, the group difference in wake time on school days was not significant, and adolescents showed mild insomnia regardless of their circadian preference. Although smartphone using time in the weekend was significantly different between groups, group difference in Internet addiction was significant only when gender was adjusted. CONCLUSION: Circadian preference was associated with sleep patterns and sleep problems in Korean adolescents. ET showed significantly different sleep patterns compared to MT and NT. ET not only reported a higher level of daytime sleepiness and insomnia but also more depressive symptoms compared to NT. These findings suggest that the uniqueness of adolescence and environmental factors seemed to influence the association of circadian preference with mental problem.

The Relationship between Adverse Childhood Experiences and Sleep Problems among Adolescent Students: Mediation by Depression or Anxiety.

Adverse childhood experiences (ACEs) are known to be closely related to depression, anxiety and sleep problems. However, it remains unclear whether adolescents with ACEs have sleep problems regardless of depression or anxiety or under a mediating effect from depression or anxiety. Therefore, our aim was to examine whether depression or anxiety mediates the relationship between ACEs and sleep problems in adolescents by using a community sample. The Early Trauma Inventory Self Report-Short Form (ETISR-SF) and List of Threatening Experiences Questionnaire (LTE-Q) were used to assess traumatic ACEs. Ultimately, data from 737 students (M = 448, F = 289, 15.1 ± 1.4 years old) were included in the statistical analysis. A total of 576 (78.1%) participants reported that they had experienced one or more ACEs. Adolescents with ACEs had higher levels of depression, anxiety and sleep problems than did adolescents without ACEs, and boys tended to experience more trauma than girls. Depression and anxiety partially mediated the relationship between ACEs and sleep problems. The results of this study suggest the need for depression and anxiety interventions for adolescents with ACEs to reduce the long-term consequences, including sleep problems and physical health problems.

The relationship between risk of obstructive sleep apnea and other sleep problems, depression, and anxiety in adolescents from a community sample.

Obstructive sleep apnea (OSA) is highly related to mental health problems, such as depression and anxiety. However, previous studies on OSA and depression and anxiety have mostly been conducted in the adult population. We aimed to (1) screen for risk of OSA in a sample of adolescents from the general population using self-report questionnaires and (2) examine whether there are differences between the high- and low-risk groups for OSA in depressive and anxiety symptoms, self-esteem, and sleep-related variables. The data of 793 students (age range: 12-17 years old) were analyzed. The participants were assigned to the high-risk (n = 202, 25.5%) or the low-risk group (n = 591, 74.5%) of OSA. The participants in the high-risk group had more severe anxiety symptoms, lower self-esteem, insomnia, excessive daytime sleepiness, and higher BMI compared those in the low-risk group. This study shows that it is possible to efficiently screen for risks of various problems associated with OSA in adolescents using an easy and simple screening tool.

Cerebellar Gray Matter Volume, Executive Function, and Insomnia: Gender Differences in Adolescents.

The cerebellum is an important region responsible for adolescent cognitive function and sleep, and their correlation is expected to show different patterns depending on age and gender. We examined the regional cerebellar gray matter volume (GMV), executive function (EF) and insomnia symptoms to identify their correlation and gender differences in adolescents. Data for a total of 55 subjects' (M = 31, F = 24, 14.80 ± 1.39 years old) were analyzed. The correlations between cerebellar regional GMV and Wisconsin card sorting test (WCST) subcategories showed that EF was better with larger GMV both in males and females. Far more overall correlations with cerebellar regions were observed in boys, with corresponding correlation strength being higher, and differences in localization were also observed in contrast to girls. Larger cerebellar GMV corresponded to better EF in adolescents. Insomnia did not influence the correlations between cerebellar regional GMV and EF, but more severe insomnia in boys correlated to smaller GMV in the right flocculonodular lobe. These results might implicate that the adolescent cerebellum is involved differently in EF dependent on gender.