Machine Learning for Mental Health: Applications, Challenges, and the Clinician's Role.

Purpose Of Review: This review aims to evaluate the current psychiatric applications and limitations of machine learning (ML), defined as techniques used to train algorithms to improve performance at a task based on data. The review emphasizes the clinician's role in ensuring equitable and effective patient care and seeks to inform mental health providers about the importance of clinician involvement in these technologies.

Recent Findings: ML in psychiatry has advanced through electronic health record integration, disease phenotyping, and remote monitoring through mobile applications.

Implementation and evaluation of a proactive consultation-liaison model on an inpatient obstetric unit.

Objective: Perinatal mental and anxiety disorders (PMADs) contribute to adverse health outcomes, though they are underrecognized and undertreated. Inpatient obstetric settings represent a unique opportunity for behavioral health engagement, including screening, brief treatment, and referrals for outpatient care. The proactive consultation-liaison (CL) model has proven effective in general hospital settings but is not well-studied in obstetric settings.

Technology-Based Approaches for Supporting Perinatal Mental Health.

Purpose Of Review: This review explores advances in the utilization of technology to address perinatal mood and anxiety disorders (PMADs). Specifically, we sought to assess the range of technologies available, their application to PMADs, and evidence supporting use.

Recent Findings: We identified a variety of technologies with promising capacity for direct intervention, prevention, and augmentation of clinical care for PMADs.

Cortisol awakening response and developmental outcomes at 6-7 years in children born extremely preterm.

Background: Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening response would be associated with developmental and behavioral problems at school age in EPT children.

Adaptation of infant mental health services to preterm infants and their families receiving neonatal intensive care unit services during the COVID-19 pandemic.

Multiple changes and stressors at the family, hospital, and societal levels have resulted from the COVID-19 pandemic that impact the early social environment of infants in Neonatal Intensive Care Unit (NICU) settings. This manuscript reviews these pandemic-related adversities, including hospital-wide visitor restrictions, mask requirements that interfere with caregiver facial expressions, parental anxiety about virus transmission, and reduced support services. We will further describe adaptations to mental health service delivery and approaches to care in the NICU to mitigate increased risk associated with pandemic-related adversities.

Adaptive Behavior Profiles of Intellectually Gifted Children with Autism Spectrum Disorder.

Objective: The purpose of this study is to identify whether the well-described pattern of declining adaptive functioning across age among children with autism spectrum disorder (ASD) also exists among intellectually gifted children with ASD because their cognitive abilities might serve as a protective factor.

Methods: Data from the Simons Simplex Collection were used to identify 51 participants with full-scale intelligence (IQ) scores of 130 or above with this group labeled as the intellectually gifted range (IGR). Two comparison samples of children with IQs in the intellectual disability range (IDR; < 70 Standard Score [SS]) and average range (AR; 85-115 SS) were created based on matching of age (±2 years), maternal education level, and sex.

Primary contributors to gastrostomy tube placement in infants with Congenital Diaphragmatic Hernia.

Objective: To identify factors associated with gastrostomy tube (GT) placement in infants with congenital diaphragmatic hernia (CDH).

Methods: Retrospective cohort study of 114 surviving infants with CDH at a single tertiary care neonatal intensive care unit from 2010-2019. Prenatal, perinatal and postnatal characteristics were compared between patients who were discharged home with and without a GT.

Variations in Criteria for Eligibility Determination for Early Intervention Services with a Focus on Eligibility for Children with Neonatal Complications.

Objective: The purpose of this policy review is to describe data on eligibility determination practices for early intervention (EI) services across the United States as they particularly relate to eligibility determination for children seen in neonatal follow-up clinics.

Method: Policy information was gathered from posted information on state EI websites and confirmed through follow-up phone calls. Information collected included definition of delay, approved measures for developmental assessment, and inclusion criteria for medically at-risk status based on birth weight, prematurity, and/or neonatal abstinence syndrome/prenatal exposure.

Developmental and medical factors associated with parenting stress in mothers of toddlers born very preterm in a neonatal follow-up clinic.

The purpose of this exploratory, cross-sectional study was to identify child-related factors associated with maternal parenting stress in toddlers born very preterm and followed in a neonatal follow-up (NFU) clinic. The study aimed to describe the associations of current medical complications and presence of developmental delays with total parenting stress. Participants were 53 mother-child dyads presenting in a NFU clinic.

Editorial: Mental Health in Pregnancy and Child Development: Implications for Mental Health Service Delivery.

Perinatal mood and anxiety disorders (PMADs) are a significant and prevalent group of mental health concerns, and there are growing expectations for them to be identified and addressed in both obstetric and pediatric primary care settings. Adversity during pregnancy, including maternal stress, depression, and/or anxiety, has been shown to be associated with adverse outcomes for the child, including emotional and behavioral functioning and changes in brain development such as cortical thickening and white matter structural differences. There are multiple potential mechanisms to explain these associations, including ontogenetic vulnerabilities (ie, developmental changes in the fetal period) resulting from physiological effects of PMADs in pregnancy, as well as disruption of the early parent-child bonding relationship that often occurs with PMAD symptoms.

Addressing Perinatal Mental Health Risk within a Fetal Care Center.

Diagnosis of a fetal anomaly in pregnancy increases the risk for perinatal mental health difficulties, including anxiety, depression, and traumatic stress among expectant parents. Common emotional challenges include uncertainty about the diagnosis/prognosis, anticipated neonatal course, fears of fetal or neonatal demise, loss of a typical, uncomplicated pregnancy and postpartum course, and disruption of family roles due to medical care-related activities and restrictions. Psychologists in multidisciplinary fetal care centers are uniquely positioned to assess mental health risks and address the needs of expectant parents.

Essential Knowledge and Competencies for Psychologists Working in Neonatal Intensive Care Units.

A training and competencies workgroup was created with the goal of identifying guidelines for essential knowledge and skills of psychologists working in neonatal intensive care unit (NICU) settings. This manuscript reviews the aspirational model of the knowledge and skills of psychologists working in NICUs across six clusters: Science, Systems, Professionalism, Relationships, Application, and Education. The purpose of these guidelines is to identify key competencies that direct the practice of neonatal psychologists, with the goal of informing the training of future neonatal psychologists.

Neuroimaging and Bayley-III correlates of early hand function in extremely preterm children.

Objective(s): Investigate associations between 18 and 22-month corrected age hand function, adverse findings on serial cranial ultrasound (CUS) and near-term brain MRI (ntMRI), and Bayley-III scores in extremely preterm (EPT) toddlers.

Study Design: Cohort analysis of Neonatal Research Network SUPPORT NEURO data. Associations between brain abnormalities, hand function, and Bayley-III scores were examined using chi-square and generalized linear mixed effect model analyses.

Differences in Performance on Developmental Tasks in Young Children Across Digital and Paper-Based Modalities: A Feasibility Trial.

Objective: To determine whether use of digital-based screening is a feasible approach to monitoring child development, it is necessary to assess young children's abilities to interface with touch screen technology. The primary objectives of this exploratory feasibility study with a randomized experimental design were to determine (1) whether young children respond differently to developmental tasks on paper versus tablet device and (2) whether responses to items presented digitally differed according to hours of weekly exposure to touch screen technology in the home.

Methods: Eighty children attending 18-, 24-, 36-, or 48-month pediatrician well-child checks were randomly assigned to complete a series of 70 examiner-facilitated, developmental tasks across 7 domains (receptive language, expressive language, early literacy, early numeracy, social emotional, cognition, and fine motor) presented either digitally or on paper.

Associations Between Family Member BMI and Obesity Status of Children with Autism Spectrum Disorder.

Objective: To determine whether there is an association between parent and sibling obesity status and obesity status in children with autism spectrum disorder (ASD).

Methods: We examined predictors of obesity in children with ASD with body mass index data for the proband, 1 sibling, and 2 parents using data from the multisite Simons Simplex Collection.

Results: In a stepwise logistic regression model, proband obesity status was associated with obesity status of the sibling (odds ratio [OR] 2.

Parental report of vaccine receipt in children with autism spectrum disorder: Do rates differ by pattern of ASD onset?

A contentious theory espoused by some parents is that regressive-onset of autism spectrum disorder (ASD) is triggered by vaccines. If this were true, then vaccine receipt should be higher in children with regressive-onset ASD compared with other patterns of onset. Parental report of rate of receipt for six vaccines (DPT/DTaP, HepB, Hib, polio, MMR, varicella) was examined in children with ASD (N=2755) who were categorized by pattern of ASD onset (early onset, plateau, delay-plus-regression, regression).

Brief Report: Further Examination of Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders.

Self-injurious behaviors (SIB) are problematic for many children with autism spectrum disorders (ASD). Existing models to explain factors contributing to SIB fail to account for a large proportion of variance in SIB. This study attempted to explain a greater proportion of variance in SIB by addressing methodological/theoretical limitations in previous research using a sample of 2341 youth with ASD.

Developmental Screening Among Children Born Preterm in a High-Risk Follow-Up Clinic.

Objective: The psychometric properties of two formats of developmental screening tools that may be used in follow-up clinics providing primary care to children born preterm are presented.

Methods: 28 children born extremely preterm (<27 weeks) attending a high-risk clinic at the time of their 18-24 month visit were administered the Child Development Review, Brigance Early Head Start Screen II, and Bayley Scales of Infant and Toddler Development-Third Edition.

Results: Both screeners identified the majority of the sample as at-risk.

Emergence of autism spectrum disorder in children from simplex families: relations to parental perceptions of etiology.

Current research describes a four-category scheme of Autism Spectrum Disorder (ASD) onset: early, regressive, plateau, delay + regression. To replicate prevalence of different onset types, ASD onset (per the Autism Diagnostic Interview--Revised) was examined in a large North American sample; for a subset, parents' causal beliefs were ascertained via the Revised Illness Perception Questionnaire to examine potential associations with ASD-onset types. Onset rates were similar across samples, with a slightly higher proportion of children in the subsample categorized with regression.

Patterns of disclosure among youth who are HIV-positive: a multisite study.

Purpose: Disclosure of serostatus is critical in preventing the transmission of HIV among youth. The purpose of this exploratory study was to describe serostatus disclosure in a multisite study of youth living with HIV.

Methods: This study investigated serostatus disclosure and its relationship to unprotected sex among 146 youth participating in a multisite study of young people living with HIV who were sexually active within the past 3 months.

Emotional and behavioral adjustment in typically developing siblings of children with autism spectrum disorders.

Research findings describing the emotional and behavioral functioning of typically developing (TD) siblings of children with autism spectrum disorders (ASD) are contradictory. Methodological issues, such as small study sample sizes and reliance on parent report, may contribute to inconsistent findings. The purpose of this study was to use parent and teacher report to describe presence of internalizing and externalizing behaviors among a large sample (n = 486) of TD siblings of children with ASD.