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In This Issue of JAMA Psychiatry
June 2019


JAMA Psychiatry. 2019;76(6):561. doi:10.1001/jamapsychiatry.2018.2985


Public mental health clinics treat many children with autism spectrum disorder, but therapist training is lacking to serve this population. Brookman-Frazee and colleagues conducted a randomized clinical trial in 29 public mental health clinics and found significant improvements in challenging behaviors among children whose community therapists were trained in an individualized mental health intervention for autism spectrum disorder. These findings support the effectiveness of training therapists to deliver individualized interventions in publicly funded mental health services.

Continuing Medical Education

Childhood maltreatment is a major public health issue, and prospective and retrospective measures are both used to study it. Baldwin and colleagues conducted a meta-analysis of 16 studies using prospective and retrospective methods and found that agreement between the 2 kinds of measures was poor regardless of type of prospective measure used or age at retrospective report. These results indicate that prospective and retrospective measures of childhood maltreatment identify different groups of individuals. In an Editorial, Widom discusses implications for research in this area.


Evidence indicates developmental insults play a role in the origins of psychiatric disorders, but this phenomenon has not been studied systematically. al-Haddad and colleagues used a Swedish population-based registry to study 1 791 520 children over 4 decades and found that fetal exposure to any maternal infection increased the risk of diagnosis of autism or depression but not bipolar disorder or psychosis. These findings suggest that fetal exposure to a maternal infection raises the risk of subsequent psychiatric disorders and highlights reducing prenatal infections as a potential preventative mechanism.

Urbanicity is an established risk factor for psychosis, but air pollution specifically has not been examined in this context. Newbury and colleagues used data from 2232 children followed up from birth through age 18 years and found that air pollution levels, particularly NO2 and NOx, estimated for the children’s home addresses were significantly associated with psychotic experiences. These findings indicate that air pollution exposure partly explained the association between urban residency and adolescent psychotic experiences. In an Editorial, Kioumourtzoglou discusses the implications for the field.


Author Audio Interview

Anhedonia in children has detrimental clinical outcomes, but its neural correlates are not well understood. Pornpattananangkul and colleagues used functional magnetic resonance imaging data from 2878 children in the Adolescent Brain Cognitive Development study and found that anhedonia, but not low mood, anxiety, or attention-deficit/hyperactivity disorder, was associated with hypoconnectivity among multiple large-scale networks at rest and in reward-related regions. Thus, the neural correlates of anhedonia map onto lack of intrinsic reward-arousal integration during rest and reduced extrinsic reward-arousal during a task. In an Editorial, Auerbach et al review the implications.