Unmet Needs and Classical Pitfalls in the Management of Adolescents With Behavioral Problems in Emergency
Bibliographic record
Abstract
While behavioral problems are the main reasons for adolescents to be referred to an emergency room for mental health problems, their clinical management remain usually heterogenous, poorly standardized, and associated with a low level of patient and family satisfaction. So far, most attention has been paid to the treatment of agitation, and few insights have been provided on the treatment plan of behavioral problems once the crisis is over and a psychiatric or medical condition ruled out. This perspective article represents an attempt to incorporate multiple theoretical approaches to provide a comprehensive and operational model for the management of adolescents with behavioral problems in an emergency department. Short hypothetical case vignettes illustrate the importance of considering several levels of analysis to understand the adolescent's problematic behavior which can be seen as a symptom of a medical/psychiatric condition (medical model), as a maladaptive strategy in a context of vulnerability (developmental model), and finally as a mode of communication in a context of ill-adapted relational patterns (systemic model). As behavioral problems in adolescence are a complex issue, frequently involving the intervention of professionals from various disciplines, being aware of such different levels of understanding could help to preclude any role confusion and to provide better targeted interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".