Global Mental Health in Our Own Backyard: An Unaccompanied Immigrant Child's Migration From El Salvador to New York City.

There has been a recent surge in the number of children migrating to the United States without a parent. Despite their vulnerability to extreme adversity at every stage of their migration process, little is known about the psychosocial context and mental health needs of unaccompanied children. This article presents a case study of a 16-year-old Salvadoran boy who participated in a larger, mixed-methods study on the psychosocial context, psychological presentation, and mental health service utilization of unaccompanied children living in New York pending their immigration cases. After the presentation of the case, different models for understanding the experiences and needs of unaccompanied children are discussed.

Teleological Perspectives in Child and Adolescent Development.

The way adults think about children is of enormous consequence. Around the world, adults are "in charge" of children, claiming responsibility for their safety and lives. This may seem natural and intuitive, but adult concepts of youth, including in the sciences of development, can lead to a worldview in which the adult is seen as better, more important, more complex, and more valuable than the child.1.

Editors' Best of 2022.

There is, in the content of the Journal, an embarrassment of riches, and picking a "best" seems to demand a certain qualification: is the "best" the most interesting, most surprising, most educational, most important, most provocative, most enjoyable? How to choose? We are hardly unbiased and can admit to a special affection for the ones that we and the authors worked hardest on, hammering version after version into shape. Acknowledging these biases, here are the 2022 articles that we think deserve your attention or at least a second read.

Editors' Note: Second Annual Report Regarding JAACAP's Antiracist Journey.

In 2020, we wrote to you of our dedication and vision for this Journal "to be antiracist at every level," outlining the following 6 initiatives "to reshape the Journal to pursue this vision:" (1) Issuing a Call for Papers on racism and its impacts on child development and children's mental health; (2) updating our Guide for Authors to emphasize that we will evaluate articles submitted to the Journal on whether their study designs are inclusive and their discussions consider and address human diversity and structural determinants of health in the context of their research questions and hypotheses; (3) assembling a special collection of Journal articles on bias, bigotry, discrimination, racism, and mental health inequities; (4) accelerating our efforts to make our Editorial Board inclusive and representative of our community of scientists and practitioners as well as the communities we serve; (5) engaging in continuing education and dialogue as an Editorial Board that will include antiracism training and praxis; and (6) critically examining "our editorial and peer review process to ensure it is antiracist."1 In this Editors' Note, we write to update you on our progress, including a new initiative we started in the past year: (7) a new option for authors to add a statement to their manuscripts regarding the inclusion and diversity initiatives and practices they employed in pursuing their work. With the launch this year of JAACAP Open, the Academy's new open access publication and the newest member of the JAACAP family of journals, we have expanded opportunities to pursue these efforts, and look forward to sharing more about JAACAP Open in future updates.

Editors' Best of 2021.

There is, in the content of the Journal, an embarrassment of riches, and picking a "best" seems to demand a certain qualification: is the "best" the most interesting, most surprising, most educational, most important, most provocative, most enjoyable? How to choose? We are hardly unbiased and can admit to a special affection for the ones that we and the authors worked hardest on, hammering version after version into shape. Acknowledging these biases, here are the 2021 articles that we think deserve your attention or at least a second read.

Psychiatry and terrorism.

Terrorism has dominated the domestic and international landscape since 9/11. Like other fields, psychiatry was not well prepared. With the 10th anniversary of the 9/11 attack approaching, it is timely to consider what can be done to prepare before the next event. Much has been learned to provide knowledge and resources. The roles of psychiatrists are challenged by what is known of the causes of, consequences of, and responses to terrorism. Reflecting on knowledge from before and since 9/11 introduces concepts, how individuals become terrorists, how to evaluate the psychiatric and behavioral effects of terrorism, and how to expand treatments, behavioral health interventions, public policy initiatives, and other responses for its victims. New research, clinical approaches, and policy perspectives inform strategies to reduce fear and cope with the aftermath. This article identifies the psychiatric training, skills and services, and ethical considerations necessary to prevent or reduce terrorism and its tragic consequences and to enhance resilience.

Editors' Note: First Annual Report Regarding JAACAP's Antiracist Journey.

Last year, we wrote to you of our dedication and vision for this journal "to be antiracist at every level," outlining the following 6 initiatives "to reshape the Journal to pursue this vision:" (1) Issuing a Call for Papers "on racism and its impacts on child development and children's mental health;" (2) updating our Guide for Authors "to emphasize that we will evaluate articles submitted to the Journal on whether their study designs and discussions consider and address human diversity in the context of their research questions and hypotheses; (3) assembling a special collection of "Journal articles on bias, bigotry, racism, and mental health disparities;" (4) accelerating "our efforts to make our editorial board inclusive and representative of our community of scientists and practitioners as well as the communities we all serve;" (5) engaging in "continuing education and dialogue as an Editorial Board that will include antiracism training;" and (6) critically examining "our editorial and peer review process to ensure it is antiracist.1 In this Editors' Note, we write to update you on our progress.

Editors' Best of 2020.

There is, in the content of the Journal, an embarrassment of riches, and picking a "best" seems to demand a certain qualification: is the "best" the most interesting, most surprising, most educational, most important, most provocative, most enjoyable? How to choose? We are hardly unbiased and can admit to a special affection for the ones that we and the authors worked hardest on, hammering version after version into shape. Acknowledging these biases, here are the 2020 articles that we think deserve your attention, or at least a second read.

Editorial: Analyzing Treatment and Prescribing in Large Administrative Datasets With a Lens on Equity.

In this issue of the Journal, Bushnell and colleagues1 present findings from their analysis of a commercial insurance administrative dataset, examining the ways that antipsychotics are used in young children (aged 2-7 years) in the United States. From 2009 to 2017, they find that the use of antipsychotics decreased and there was a shift toward use of medications in alignment with evidence-based standards. The most common conditions for use of antipsychotics included pervasive developmental disorders, externalizing disorders, and attention-deficit/hyperactivity disorder. More troubling were the findings that less than half of young children on antipsychotics had a visit with a psychiatrist, and only a third of children had evidence of a minimum dose of psychotherapy. These findings deserve attention and should be a cause for strengthening the use of existing treatment guidelines for preschool and younger children. They should also prompt enhanced advocacy to expand access to evidence-based mental health care for children that includes high-quality psychiatric assessment, treatment, and psychotherapy. The latter includes increasing the number of child and adolescent psychiatrists who focus on preschool-aged and younger children.

Editors' Note and Special Communication: Research Priorities in Child and Adolescent Mental Health Emerging From the COVID-19 Pandemic.

Over the last year, the coronavirus disease 2019 (COVID-19) pandemic has resulted in profound disruptions across the globe, with school closures, social isolation, job loss, illness, and death affecting the lives of children and families in myriad ways. In an Editors' Note in our June 2020 issue,1 our senior editorial team described this Journal's role in advancing knowledge in child and adolescent mental health during the pandemic and outlined areas we identified as important for science and practice in our field. Since then, the Journal has published articles on the impacts of the pandemic on child and adolescent mental health and service systems,2-5 which are available in a special collection accessible through the Journal's website.6 Alongside many opinion papers, the pace of publication of empirical research in this area is rapidly expanding, covering important issues such as increased frequency of mental health symptoms among children and adolescents3,5,7-10 and changes in patterns of clinical service use such as emergency department visits.11-14 As the Senior Editors prepared that Editors' Note, they were acutely aware that the priorities that they identified were broad and generated by only a small group of scientists and clinicians. Although this had the advantage of enabling us to get this information out to readers quickly, we decided that a more systematic approach to developing recommendations for research priorities would be of greater long-term value. We were particularly influenced by the efforts of the partnership between the UK Academy of Medical Scientists and a UK mental health research charity (MQ: Transforming Mental Health) to detail COVID-19-related research priorities for "Mental Health Science" that was published online by Holmes et al. in The Lancet Psychiatry in April 2020.15 Consistent with its focus on mental health research across the lifespan, several recommendations highlighted child development and children's mental health. However, a more detailed assessment of research priorities related to child and adolescent mental health was beyond the scope of that paper. Furthermore, the publication of that position paper preceded the death of George Floyd at the hands of Minneapolis police on May 25, 2020, which re-energized efforts to acknowledge and to address racism and healthcare disparities in the United States and many other countries. To build upon the JAACAP Editors' Note1 and the work of Holmes et al.,15 we conducted an international survey of professionals-practitioners and researchers-working on child and adolescent development and pediatric mental health to identify concerns about the impact of the pandemic on children, adolescents, and their families, as well as what is helping families navigate these impacts, and the specific research topics that are of greatest importance.

A Case of Clinical Scholarship.

A 32-year-old child and adolescent psychiatry resident with a history of presenting an abstract at a local psychiatric conference during residency and fourth authorship on an immunotherapy paper from a summer internship during medical school presents with a new-onset desire to write a case report. She has just come off her consultation liaison rotation, during which she consulted on a 12-year-old boy with attention-deficit/hyperactivity disorder, oppositional defiant disorder, disruptive mood dysregulation disorder, and low depressive state hospitalized for pseudoseizures, a new-onset inability to walk, and aggressive outbursts. He had a negative magnetic resonance imaging scan, negative computed tomography scan, negative laboratory test results, and an unremarkable lumbar puncture. Based on an equivocal electroencephalogram, a neurology resident decided to prescribe a mood stabilizer, obtained it himself from the pharmacy, and administered it to the patient intravenously, only then realizing that it was six times the intended loading dose. Before anybody could stop him, the resident erased all documentation about the medication and fled the city. Nevertheless, that afternoon, before the error and fraud were caught by a pharmacist and before the child and his family were notified, the child's symptoms appeared to resolve and the child walked comfortably for the first time in months. The child and adolescent psychiatry resident is tentatively titling the case report, "Resolution of Conversion Disorder With a Megadose of Unknown Mood Stabilizer."

Editors' Best of 2019.

There is, in the content of the Journal, an embarrassment of riches, and picking a "best" seems to demand a certain qualification: is the "best" the most interesting, most surprising, most educational, most important, most provocative, most enjoyable? How to choose? We are hardly unbiased and can admit to a special affection for the ones that we and the authors worked hardest on, hammering version after version into shape. Acknowledging these biases, here are the 2019 articles that we think deserve your attention or at least a second read.

Our Vision: An Antiracist Journal.

Our renewed vision for the Journal is to be antiracist at every level. To achieve this, we will go beyond our long-standing charge to advance the knowledge of child development, children's mental health, and prevention and treatment of mental illness to solicit and disseminate research that addresses the systemic presence of racism and its influence on the health and well-being of children of color and their families. We acknowledge that our efforts as a journal to address these inequities have been insufficient and that dismantling the threads of White supremacy requires us to take a more active role. We pledge to do the work to advance research that understands the individual, cultural, and societal factors that contribute to the persistent disparities we have previously noted but failed to correct.

JAACAP's Role in Advancing the Science of Pediatric Mental Health and Promoting the Care of Youth and Families During the COVID-19 Pandemic.

As we pen these words, the COVID-19 pandemic is having profound impacts on human society. Based on decades of research, we know that the accompanying illness,1 death,2 social isolation,3,4 and malnutrition5 will have deep and lasting impacts on our children and adolescents, their families, and the communities in which they develop. The pandemic is exposing, with terrible clarity, the disparities in human society-racism,6 poverty,7,8 domestic violence,9,10 and child maltreatment and neglect11-and tragically will likely amplify the negative impacts that each has on child development and mental health.

The psychology of suicide terrorism.

This paper reviews current understandings of the psychology of suicide terrorism for psychiatrists and other mental health professionals to help them better understand this terrifying phenomenon. After discussing key concepts and definitions, the paper reviews both group and individual models for explaining the development of suicide terrorists, with an emphasis on "collective identity." Stressing the importance of social psychology, it emphasizes the "normality" and absence of individual psychopathology of the suicide bombers. It will discuss the broad range of terrorisms, but will particularly emphasize terrorism associated with militant Islam. The article emphasizes that comprehending suicide terrorism requires a multidisciplinary approach that includes anthropological, economic, historical, and political factors as well as psychological ones. The paper concludes with a discussion of implications for research, policy, and prevention, reviewing the manner in which social psychiatric knowledge and understandings applied to this phenomenon in an interdisciplinary framework can assist in developing approaches to counter this deadly strategy.

What Is "High Risk" and What Are We Actually Supposed to Do About It?

Regulatory agencies are increasingly taking on the important issue of effective risk assessment, risk stratification, and treatment planning for youth with psychiatric illness.1 The Joint Commission mandates a suicide assessment for patients "who exhibit suicidal behavior or who have screened positive for suicidal ideation" followed by risk stratification: after "this assessment, patients should be classified as high, medium or low risk of suicide."2 We anticipate that just as screening for depression and suicidality was initially restricted to emergency departments and inpatient units before being rolled out across all care settings, so risk stratification requirements will roll out to these other settings as well.

Editors' Best of 2018.

There is, in the content of the Journal, an embarrassment of riches, and picking a "best" seems to demand a certain qualification: is the "best" the most interesting, most surprising, most educational, most important, most provocative, most enjoyable? How to choose? We are hardly unbiased and can admit to a special affection for the ones that we and the authors worked hardest on, hammering version after version into shape. Acknowledging these biases, here are the 2018 articles that we think deserve your attention or at least a second read.

Study Registration: Encouraging the Practice of Hypothetical-Deductive Research in the Journal.

Earlier this year, we shared with you our commitment to supporting the dissemination of research that is well designed, carefully conducted, and properly interpreted, and our belief that authors, reviewers, editors, publishers, and readers should jointly strive to ensure the integrity of the science that we publish.1 Toward this end, we are pleased to announce a new submission type beginning in 2019: Registered Reports.