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Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article, we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit nonclinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (eg, well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom-including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall health care of the population.

To examine the association between supportive environments and adolescent suicidal behavior, especially among marginalized minority groups. Participants included 12,196 middle and 16,981 high school students who completed the 2019 Vermont Youth Risk Behavior Survey. Multiple logistic regression models were used to assess the association between three protective factors that were part of a supportive environment (feeling like they matter to people in their community, usually eating dinner at home, having a trusted adult) and suicidality (plan or attempt), controlling for key demographics (sex, sexual orientation, gender identity, and race/ethnicity). Moderating effects of demographics were also explored. All supportive environment variables were protective of making a suicide plan and making a suicide attempt (ORs < 0.75, p-values < 0.005). Students of minority identities were significantly more likely to make a suicide plan (middle school ORs: 1.34–3.51, p-values < 0.0005; high school ORs: 1.19–3.38, p-values < 0.02) and attempt suicide (middle school ORs: 1.42–3.72, p-values < 0.006; high school ORs: 1.38–3.25, p-values < 0.0005) compared to students with majority demographic characteristics. Generally, the associations between having a supportive environment and suicidality did not vary within sexual orientation, gender identify, or race/ethnicity subgroups, suggesting that these supportive environment factors were more universally protective. However, a few associations were stronger among students in the majority demographic groups. These data suggest that having a supportive environment is protective of suicidality for adolescents from both majority and minority demographic groups. A supportive environment is protective of adolescent suicide plan and attempt. Minority sexual, gender, and racial identities are risk factors for suicidality. Minority and majority students are protected by supportive environments. [ABSTRACT FROM AUTHOR]

Background: Social withdrawal is a core neuropsychiatric phenomenon in developmental psychopathology. Its presence predicts psychopathology across many domains, including depression, psychosis, autism, anxiety, and suicide. Withdrawn behavior is highly heritable, persistent, and characteristically worsens without intervention. To date, few studies have successfully identified genetic associations with withdrawn behavior, despite the abundance of evidence of its heritability. This may be due to reliance of categorical over dimensional measures of the behaviorally inhibited phenotype. The aim of this study is to identify associations between known psychiatric candidate genes and a dimensionally derived measure of withdrawn behavior. Methods: Genetic information was collected on 20 single-nucleotide polymorphisms (SNPs) from a custom-designed SNP chip and TAQMAN arrays of 4 variable number of tandem repeat (VNTR) genes for 551 individuals from 187 families. Linear mixed modeling was employed to examine the relationship between genotypes of interest and Child Behavior Checklist (CBCL) Withdrawn Behavior Subscale Score (WBS) while controlling for gender and age through multiple linear regressions. Results: Withdrawn behavior was highly associated with polymorphism "rs6314" of the serotonin receptor 2A ("HTR2A") [p = 0.009, estimate = 0.310 (bootstrap 95% CI 0.155-0.448), bootstrap p = 0.001] and "rs1800544" of the alpha 2-adrenergic ("ADRA2A") [ p = 0.001, estimate = -0.310 (bootstrap 95% CI -0.479 to -0.126), bootstrap p = 0.001] genes after correction for gender and age. The association between withdrawn behavior and "ADRA2A" was stronger for younger children. Conclusions: "HTR2A" and "ADRA2A" genes are associated with withdrawn behavior. This reinforces the role of catecholaminergic genes in the heritability of withdrawn behavior.

Objective: Using a general population sample, the adult outcomes of children who presented with severe problems with self-regulation defined as being concurrently rated highly on attention problems, aggressive behavior, and anxious-depression on the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) were examined. Method: Two thousand seventy-six children from 13 birth cohorts 4 to 16 years of age were drawn from Dutch birth registries in 1983. CBCLs were completed by parents at baseline when children from the different cohorts were 4 to 16 years of age and sampled every 2 years for the next 14 years. At year 14 the CBCL and DSM interview data were collected. Logistic regression was used to compare and contrast outcomes for children with and without dysregulation, as measured by the latent-class-defined CBCL-DP. Sex and age were covaried and concurrent DSM diagnoses were included in regression models. Results: Presence of childhood CBCL-DP at wave 1 was associated with increased rates of adult anxiety disorders, mood disorders, disruptive behavior disorders, and drug abuse 14 years later. After controlling for co-occurring disorders in adulthood, associations with anxiety and disruptive behavior disorders with the CBCL-DP remained, whereas the others were not significant. Conclusions: A child reported to be in the CBCL-DP class is at increased risk for problems with regulating affect, behavior, and cognition in adulthood. (Contains 1 figure and 5 tables.)

Disorders of self-regulatory behavior are common reasons for referral to child and adolescent clinicians. Here, the authors sought to compare 2 methods of empirically based assessment of children with problems in self-regulatory behavior. Using parental reports on 2,028 children (53% boys) from a U.S. national probability sample of the Child Behavior Checklist (CBCL; T. M. Achenbach & L. A. Rescorla, 2001), the receiver operating characteristic curve analysis was applied to compare scores on the Posttraumatic Stress Problems Scale (PTSP) of the CBCL with the CBCL Dysregulation Profile (DP), identified using latent class analysis of the Attention Problems, Aggressive Behavior, and Anxious/Depressed scales of the CBCL. The CBCL-PTSP score demonstrated an area under the curve of between 0.88 and 0.91 for predicting membership in the CBCL-DP profile for boys and for girls. These findings suggest that the CBCL-PTSP, which others have shown does not uniquely identify children who have been traumatized, does identify the same profile of behavior as the CBCL-DP. Therefore, the authors recommend renaming the CBCL-PTSP the Dysregulation Short Scale and provide some guidelines for the use of the CBCL-DP scale and the CBCL-PTSP in clinical practice. (Contains 2 figures and 3 tables.)

Objective: To test the association between the catechol-O-methyltransferase (COMT) Val158Met polymorphism and both aggressive behavior and attention problems in youth. We hypothesized that youth carrying a Met allele would have greater average aggressive behavior scores, and that youth exhibiting Val-homozygosity would have greater average attention problems scores. Method: Complete data on maternally rated Child Behavior Checklist (CBCL) measures of aggressive behavior (AGG) and attention problems (AP), COMT polymorphism data, demographics, and maternal parenting quality were available for 149 youth (6 to 18 years old). Multivariable linear regression models were used to test the degree to which youth COMT Val158Met genotype was associated with AGG and AP while statistically controlling for age, gender, parental socioeconomic status (SES), and maternal parenting quality from the Alabama Parenting Questionnaire. Results: Mothers of Met-carriers rated their children higher on average AGG scores when compared with mothers of Val-homozygotes (p = 0.016). Further analyses revealed that this association was even more robust for maternal ratings of direct aggression (p = 0.007). The hypothesized association between Val-homozygosity and higher average AP scores relative to average AP scores of Met-carriers did not quite reach statistical significance (p = 0.062). Conclusions: After controlling for demographics, SES, and maternal parenting quality as confounders, there remains a strong association between youth carrying a Met allele and higher average AGG scores relative to Val-homozygotes. (Contains 2 tables.)

Objective: The authors assess changes in knowledge and feeling connected to the field of child and adolescent psychiatry (CAP) after participation in a brief mentoring program held at two CAP conferences. Methods: Similar mentorship programs were implemented at two CAP conferences, one national (N=119 participants), one international (N=53). The 4-day programs were part of larger travel awards, and included daily small group meetings consisting of a mode of two mentors and six participants. The authors created a survey with 40 quantitative questions designed to measure the change in participants' perceptions related to the conference and mentoring program, and provided additional fields for narrative comments. Results: Mean participant ratings were positive for all questions on the survey. Changes in connectedness were rated higher than those in knowledge. The highest mean ratings were related to feeling more connected to the host organization, to CAP, and to other program participants. Outcomes were similar between the two conferences, except for knowledge gained on research, which was higher among participants in the international meeting. Outcomes were similar across demographic variables, except for internationally trained participants rating higher on research knowledge, connectedness, and overall knowledge. Over 75% of participants felt they made a connection with their mentor, bonded as a group, and learned new things about CAP and the host organization. A qualitative review of comments revealed several themes, including heightened importance of networking, increased awareness of the field, improved connectedness, a desire for trainee-focused events, and mixed feelings about how much structure to provide within the mentorship experience. Conclusion: A brief group-style mentoring program is logistically feasible within large conferences, and can result in broad positive impact for trainees. Future studies are warranted to determine if these programs have lasting effects on connectedness, career choice, and career development.

The study applies latent profiles analysis to a group of children and adolescents to test temperament phenotypes in order to examine their association to wellness and psychopathology. One of the results concluded that lifetime disorder was lower in the steady class as compared to moderate class.

The article discusses the possible adoption of positive psychiatry into routine practice involving children, adolescents, and families. Topics covered include positive psychiatry's promotion of well-being via assessments of factors of risk for developing mental illnesses, and the core principles of positive child and adolescent psychiatry, and its comparison with the approach of traditional psychiatry. Also noted are the two approaches' complementary relationship.

The study applies latent profiles analysis to a group of children and adolescents to test temperament phenotypes in order to examine their association to wellness and psychopathology. One of the results concluded that lifetime disorder was lower in the steady class as compared to moderate class.

Background: Personality traits are important factors with regard to the tendency to experience and response to stress. This study introduces and tests a new stress-related personality scale called the Virtual Inventory of Behavior and Emotions (VIBE). Methods: Two samples totaling 5512 individuals (with 66% between the ages of 18 and 34) completed the VIBE along with other measures of personality, stress, mood, and well-being. Results: Exploratory factor analyses revealed a four-factor structure for the instrument with dimensions labeled: 1) stressed; 2) energetic; 3) social; and 4) disciplined. Confirmatory factor analytic procedures on the final 23-item version showed good psychometric properties and data fit while machine learning analyses demonstrated the VIBE's ability to distinguish between groups with similar patterns of response. Strong convergent validity was suggested through robust correlations between the dimensions of the VIBE and other established rating scales. Conclusion: Overall, the data suggest that the VIBE is a promising tool to help advance understanding of the relations between stress, personality, and related constructs. [ABSTRACT FROM AUTHOR]

Recently, it seems like youth are presenting for their initial psychiatry appointment with a clear self-diagnosis in mind. For years, parents have come to appointments with hopes that I might rubber stamp their suspicions about a bipolar or attention-deficit/hyperactivity disorder diagnosis. The use of this approach from youth themselves is newer. [ABSTRACT FROM AUTHOR]

Children with Sydenham's chorea may develop psychological symptoms such as obsessive-compulsive disorder. Sydenham's chorea is a self-limited disorder of early life that is characterized by involuntary movements that gradually become severe. Eleven children between four and 12 years old with Sydenham's chorea were evaluated physically and psychologically. All of the children had different types of psychological symptoms. Nine had symptoms of obsessive-compulsive disorder, and four fit the diagnostic criteria for this disorder. The severity of psychological symptoms correlated with the severity of the children's motor impairment. Other psychological symptoms observed in the children included increased emotional instability, hyperactivity, irritability, distractibility and regressive behavior. Sydenham's chorea was called St. Vitus dance when it was first described in the 1600s., Eleven children with Sydenham&apos;s chorea (8 girls and 3 boys, mean age = 8.4 [+ or -] 2.2 [SD] years) underwent comprehensive physical, neuropsychologic, and psychiatric examination. The chorea was manifested as dysarthria, gait disturbances, and frequent adventitious movements of the face, neck, trunk, and extremities. Antineuronal antibodies were present in 10 of 11 children. All children exhibited concomitant psychologic dysfunction, specifically obsessive-compulsive symptomatology, increased emotional lability, motoric hyperactivity, irritability, distractibility, and age-regressed behavior. Obsessive-compulsive symptoms were observed in 9 (82%) children, 4 of whom met diagnostic criteria for obsessive-compulsive disorder. These behavioral symptoms began several days to weeks before the chorea was observed, and they waxed and waned in severity along with the motoric abnormalities. These results suggest that psychologic, particularly obsessive-compulsive, symptoms are accompanying manifestations of Sydenham&apos;s chorea which may require medical attention. Pediatrics 1993; 91:706-713; Sydenham&apos;s chorea, movement disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, neuropsychology.

Suicide ranks third as a cause of death among teenagers and young adults aged 15 to 24 years. The number of suicide attempts is 40 to 220 times greater than that of successful suicides, however. Factors that increase the risk of suicide are classified into psychiatric disorders, personality traits, family influences, biological causes, and psychosocial conditions. Suicide attempts may be triggered by a stressful event such as the break-up of a relationship, humiliation, sexual abuse, or impending punishment. Teenagers who attempt suicide may perceive that their present life is chaotic, and that they are alone and without the support of family or friends. Many adolescents have similar experiences but do not attempt suicide, and thus certain risk factors may be more significant in predicting the likelihood that a teenager will attempt suicide. The contributions of psychiatric, familial, psychosocial, and environmental risk factors to adolescent suicide attempts were assessed. The study involved 21 adolescents who had attempted suicide, 34 normal adolescent control subjects, and 15 adolescents who had never attempted suicide but had the risk factors for attempted suicide. The subjects were interviewed and asked to fill out a questionnaire. Teenagers who had attempted suicide differed from control subjects with regard to substance abuse, depression, self-image, relationships with other people, ways of communicating, family support, and behavior difficulties. Teenagers who attempted suicide and high-risk teenagers differed on tests assessing sense of hopelessness and distress, as well as in experience with thinking about and planning suicide (suicidal ideation). Analysis of the results indicated that detection of hopelessness and suicidal ideation helped to identify 93 percent of subjects who actually attempted suicide. (Consumer Summary produced by Reliance Medical Information, Inc.)

Personality traits have been found to be related to a variety of health outcomes. The aim of this study was to examine how personality traits were associated with adjustment to the COVID pandemic in college students. The sample included 484 first-year university students (76% female) attending a northeastern university who completed the Big Five Inventory (BFI) personality assessment at the beginning of a semester that was disrupted by the COVID pandemic. Using a phone-based app, students completed daily ratings of mood, perceived stress levels, and engagement in a number of health promotion activities (exercise, mindfulness, adequate sleep, etc.) throughout the semester both before and after the onset of the pandemic (e.g., a within-person longitudinal design). Results, as expected, showed that mood and wellness indices generally declined during the COVID period, although stress levels actually decreased. Further, irrespective of COVID, improved mood, less perceived stress and greater participation in health promotion activities were significantly associated with a number of personality traits including neuroticism (lower), extraversion (higher), agreeableness (higher), and conscientiousness (higher). Of primary interest, mixed-effects models were used to test how major personality traits interacted with any changes in daily ratings from the pre-COVID to COVID period. Significant interactions terms were found suggesting differential impacts of the COVID epidemic for students with low versus high levels of particular traits. Higher levels of extraversion, for example, were found to be related to decreases in mood as the pandemic progressed in contrast to those with lower extraversion, for whom there was a slight increase in mood over time. These data support the conclusion that personality traits are related to mental health and can play a role in a person's ability to cope with major stressful events. Different traits may also be more adaptive to different types of stressors. [ABSTRACT FROM AUTHOR]

Attention-deficit hyperactivity disorder (ADHD) is associated with reduced school performance. To determine which ADHD symptoms and subtypes have the strongest association, we used type and frequency of symptoms on the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA) to create symptom scores for inattention and hyperactivity-impulsivity and define subtypes (ADHD-Inattentive [ADHD-I], ADHD-Hyperactive-Impulsive, ADHD-Combined [ADHD-C]). Regression methods were used to examine associations between symptoms and subtype and a composite measure of school performance. Children with ADHD-C and ADHD-I had higher adjusted odds of having reduced overall school performance (ADHD-C = 5.8, 95% confidence interval [CI] = 3.1-10.9; ADHD-I = 5.5, 95% CI = 3.1-10.1) compared with children without ADHD. All inattentive symptoms were significantly related to reduced school performance in reading, writing, and handwriting, while 6 of 9 symptoms were significantly associated in mathematics. Children with ADHD-I were significantly more likely than children with other ADHD subtypes to receive a school-based Individualized Education Program or 504 Plan. ADHD-I symptoms may be broadly linked to reduced school performance. [ABSTRACT FROM AUTHOR]