CAPMH Corner (Updated Sep 2025)

Child and Adolescent Psychiatry and Mental Health (CAPMH) is the official IACAPAP Journal. The "CAPMH Corner" of the September 2025 issue of IACAPAP Bulletin summarizes the following three studies recently published in CAPMH – Changes in body dissatisfaction and dieting, and its association with mental health problems among Japanese eighth year adolescents: a 11-year time trend study (Hamada et al., 2025), Addressing international research challenges in child and adolescent mental health during global crises: experience and recommendations of the Co-SPACE international consortium (McMahon et al., 2025), and Personal growth through navigating the world as an artist: a qualitative study of the impact of creativity camp on adolescents with depression (Taniguchi et al., 2025).

Hamada et al., (2025) highlight the clinical importance of restrictive dieting and gender-based variations in body image and eating concerns in Japanese males to set a context for their study to explore the trends of body dissatisfaction and dieting among adolescents in 2011 and 2023 in Tokushima prefecture, Japan.  

The team includes 17 local junior high schools chosen from a pool of 96 institutions, with assistance from the local education board. They collect data in February and March 2011 and February and March 2023. They mention that in both the 2011 and 2023 surveys, students enrolled voluntarily and did not receive any reward for participation. In the 2011 survey, 1,865 out of 2010 students responded (92.8% response rate). However, only data of 1840 students (946 females and 894 males, average age 13.9 years) who specified their gender is used for analysis. In the 2023 survey, the data from 1155 students (533 females and 622 males, average age 13.9 years) is taken for analysis. The authors use a 9-item screening scale for assessing attitudes and behaviors involving dieting and body image and the Japanese version of Strength and Difficulties Questionnaire (SDQ) for gathering the data. They carry out the statistical analysis using analysis of variance (ANOVA), multiple liner regression analyses, and chi-squared tests. 

The authors report that no significant main effect was observed in the year surveyed, which means that the scores of body dissatisfaction and dieting behavior had not changed between 2011 (Female M = 16.2, SD = 4.09, SE = 0.13; Male M = 12.1, SD = 3.17, SE = 0.11) and 2023 (Female M = 16.3, SD = 4.54, SE = 0.20; Male M = 12.48, SD = 3.27; SE = 0.13) (F (1, 2940) = 2.85, n.s.). Furthermore, they report no significant interaction was observed between gender and years surveyed. The associated factors measured in the SDQ were similar in 2011 and 2023. However, they note that separate comparisons of the time-shifts of males and females on each behavior revealed that male adolescents reported more eating behavior and dieting problems in 2023, than those in 2011. Additionally, they note a difference in the prevalence of dieting and eating behaviors for females and males. Among females, the prevalence of “I have lost weight by not eating in a short period of time” (χ2(1) = 7.48, p < 0.001) (13.0% in 2011; 18.3% in 2023) increased and “I am not happy with my body” (χ2(1) = 13.57, p < 0.001) (85.2% in 2011; 77.6% in 2023) decreased, from 2011 to 2023. Among males, an increase from 2011 to 2023 was observed on three items: “I have been on a diet” (χ2(1) = 19.52, p < 0.001) (10.5% in 2011; 18.5% in 2023), “I am afraid of getting fat” (χ2(1) = 21.83, p < 0.001), (29.3% in 2011; 41.3% in 2023), and “I have lost weight by not eating in a short period of time” (χ2(1) = 5.69, p < 0.05) (5.9% in 2011; 9.2% in 2023). 

The authors acknowledge the study’s strengths as – it being the first study to examine body dissatisfaction and dieting among Japanese adolescents via a time-trend method; of having conducted two surveys, 11 years apart, in the same school districts; and of having used reliable scales to assess the problems of eating and dieting and emotional and conduct problems; and its limitations as – a survey conducted in only one location and among only eighth grade students; information on height or weight to calculate BMI was not obtained; using a scale for assessing body dissatisfaction and dieting behavior that was not validated in Japan; and inability to assess non-response bias due to non-availability of data related to non-responders; not considering socioeconomic status and school environment, such as academic pressures or school atmosphere. They conclude by suggesting future studies to include more comprehensive variables regarding with socioeconomic status and factors associated with schools. 

McMahon et al. (2025) underscore the importance of international longitudinal research during global public health emergencies to better understand mental health trajectories, inform the development of mental health support, and shape global research priority setting and policies. They describe the challenges faced to combine individual study data across countries and provide suggestions to navigate the challenges. 

The team summarises their experiences from 14 independent sites across 10 countries that formed the Co-SPACE (COVID-19 Supporting Parents, Adolescents, and Children during Epidemics) International Consortium. The Co-SPACE study was launched by researchers at the University of Oxford on the 30th of March 2020, a week after the first UK national lockdown was announced. Ten sites spanning eight countries began to conduct similar studies. Another four sites had already started to collect overlapping data independently and joined the Consortium later, introducing two additional countries They mention that all the fourteen sites from the Consortium collected parent-reported data and seven sites collected additional child-reported data. While, 12 sites collected information about child mental health symptoms primarily through the Strengths and Difficulties Questionnaire (SDQ), 11 sites also collected information on parent mental health from the Depression, Anxiety and Stress Scale (DASS-21) and ten sites collected COVID-specific information, for example, using the Pandemic Anxiety Scale (PAS). The ample sizes ranged from 138 to > 30,000 across the sites with an average sample size of 4490 participants.  

The authors report current findings based several stages of expert discussion and review within the Consortium. These stages include (1) Lorentz workshop to discuss the issues (2) develop recommendations, (3) review stage. Additionally, they note that a small working group was formed to bring these discussions together and formulate the associated recommendations to share it with rest of the members of the Consortium Observations and amendments for their comments to develop the final statement. 

The authors report that following key areas of challenges –  funding inequalities leading to insufficient focus on mental health research; lack of focus on international research wherein many funders prioritised national over international research; issues with timely initiation of studies due to problems arising in the ethics review process; data sharing issues due to variations in data governance procedures and changes in data governance procedures during the pandemic; cultural and local contextual issues impacting interpretation such as variations in country; lack of cross-culturally comparable or meaningful standardised measures; issues pertaining to contextual metrics that allow more accurate and acceptable assessment within each country but complicated efforts to gather consistent and reliable data; research design issues impacting data collection; concerns due to varying recruitment procedures; and dissemination challenges arising from different publishing norms and practices across countries. 

They suggest the following recommendations to enhance collaborative international research taking place during future crises to – prepare in advance by establishing research networks; increase dedicated funding for international mental health research; improve data sharing and governance procedures; improve access to validated and culturally sensi-tive measures; develop inclusive and robust recruitment strategies and minimum data synchronicity; and plan ahead for dissemination. They conclude that the unprecedented global crisis of the COVID-19 pandemic provided a critical learning opportunity for valuable insights into the challenges and shortcomings of existing systems and response mechanisms and that given the likelihood of further global crises arising in the future, it is imperative to integrate these lessons into policy development, research initiatives, and institutional preparedness to ensure a more effective, coordinated global research response. 

Taniguchi et al., (2025) discuss the use of creative arts-based therapies in addressing the mental health needs of young people. They allude to their novel arts-based intervention, Creativity Camp, that was designed and facilitated by artists to improve mental health and well-being in adolescents with depression (Cullen et al., 2024). Their two-week curriculum offered across eight weekdays (4 h per day) incorporates multiple art modalities and facilitates self-inquiry across the different art projects. 

They conduct this qualitative research with an aim to construct an overarching theory to understand how the Creativity Camp intervention benefitted the adolescents. This is part of the same study that was done to develop the intervention (Cullen et al., 2024), wherein 12–17 year old adolescents with depression symptoms were recruited through clinical referrals, social media and other community postings, and community engagement events, their parents completed the Child Depression Rating Scale - Revised questionnaire and adolescents with scores ≥ 12 were invited to move forward in the study. It was conducted by an interdisciplinary team including mental health professionals and professional artists in university spaces with spacious areas suitable for supporting structured day camp activities by enrolling three cohorts in the Summer of 2022 and three in the Summer of 2023.  

The team takes participatory observation notes during and after each session to document their observations of the adolescents’ behaviors and interactions; carry out adolescent interviews about their artwork and overall experience to gain insight into adolescents’ experiences of creating artwork and the meaning behind their creations; and also conduct parent interviews. Overall, they collect data over multiple time-points. They employ a Constructivist Grounded Theory (CGT) methodology for analysis, which recognizes that data and analysis are co-constructed through interactions between researchers and participants. A team of “intervention-naive raters”, 20 undergraduate students (who had not been a part of the Creativity Camp intervention or data collection) conduct the initial coding. They employ triangulation process to integrate findings from adolescent-focused data (observation notes and interviews) and parent interviews to inform theory construction.  

The authors constructed a theory that explains the benefits of Creativity Camp on adolescent well-being: “Personal growth by navigating the world as an artist” by triangulating the data from both adolescent and parent sources. They report several key processes in the adolescents’ experiences during and after camp: internal negotiation between novelty and discomfort, exploring playfulness and responsibility, discovering the uniqueness of self and others, flexible approach toward life, and an expanded view of creativity. From parent interviews, they noted that adolescents expanded personal boundaries and enthusiasm through deep engagement, empowered perspective, and sustained enthusiasm. 

The authors acknowledge strengths of their study – the convergent methodology from different sources adopted for data collection and large quantity of data analyzed using the CGT method; and limitations – lack of generalizability due to overrepresentation of White and non-Hispanic youth (63%) and sample represented metropolitan population; possible information bias as some individual responses warranted further exploration; the qualitative methods were not optimized for longitudinal analysis precluding direct examination of change over time, and that the research team’s epistemologies may have influenced the study’s interpretation and findings, despite ongoing reflection on their perspectives and positionality. Additionally, they note that the influence of the Arts in Health scholar— who emphasized bringing the artist’s perspective was carefully considered throughout to ensure that this per¬spective did not predetermine the way the data was analyzed; this potential limitation was also deliberately countered by the research team members’ varied disciplinary and sociocultural experiences. They conclude that Creativity Camp’s multifaceted approach, which integrated creative exploration and encouraged “thinking as an artist,” fostered significant personal growth among adolescents. The authors suggest that this may be useful in future work geared towards refining and tailoring arts interventions for adolescents with depression. 

REFERENCES:  

• Cullen, K. R., DiMaggio-Potter, M. E., Klimes-Dougan, B. et al. (2024). The Impact of a Creativity Camp Intervention on Depression and Well-Being in Adolescents. Child psychiatry and human development, 10.1007/s10578-024-01766-3. Advance online publication. https://doi.org/10.1007/s10578-024-01766-3.
• Hamada, S., Kaneko, H., Ogura, M. et al. Changes in body dissatisfaction and dieting, and its association with mental health problems among Japanese eighth year adolescents: a 11-year time trend study. Child Adolesc Psychiatry Ment Health 19, 69 (2025). https://doi.org/10.1186/s13034-025-00934-0.
• McMahon, J., March, S., Oakes, M. et al. Addressing international research challenges in child and adolescent mental health during global crises: experience and recommendations of the Co-SPACE international consortium. Child Adolesc Psychiatry Ment Health 19, 62 (2025). https://doi.org/10.1186/s13034-025-00918-0.
• Taniguchi, Y., Costa, O., Ortega, A. et al. Personal growth through navigating the world as an artist: a qualitative study of the impact of creativity camp on adolescents with depression. Child Adolesc Psychiatry Ment Health 19, 38 (2025). https://doi.org/10.1186/s13034-025-00893-6.  

IACAPAP Bulletin, Issue 79