Sleep problems in childhood and adolescence as comorbid disorders or risk factors for mental disorders

Schlarb A, Imort S, Zschoche M. Sleep problems in childhood and adolescence as comorbid disorders or risk factors for mental disorders. Sleep Medicine. 2017;40(Suppl. 1):E295-E296

Anger regulation in children: Effects of contextual factors

Otterpohl N, Imort S, Lohaus A, Heinrichs N. Kindliche Regulation von Wut: Effekte familiärer Kontextfaktoren. Kindheit und Entwicklung. 2012;21(1):47-56.The present study examined a conceptual model of the impact of the family on children's emotion regulation ( ER) regarding anger. Questionnaire and interview data were collected from N = 135 parents and their children ( three to eleven years). Path analysis results revealed specific parental reactions to their children's anger as well as the global parenting practices to be significantly related to children's use of adaptive and maladaptive ER strategies. The relationship between parental psychological symptoms and children's ER was completely mediated by specific parental reactions and global parenting practices, respectively. Effects were independent of children's age and gender. Our results mainly support the model assumptions and stress the potential of parent trainings for reducing the negative impact of parental psychological symptoms on children's ER

Behavioral and Nondirective Guided Self-Help for Parents of Children with Externalizing Behavior: Mediating Mechanisms in a Head-To-Head Comparison

Parent training (PT) delivered as a guided self-help intervention may be a cost- and time-effective intervention in the treatment of children with externalizing disorders. In face-to-face PT, parenting strategies have repeatedly been identified as mediating mechanisms for the decrease of children's problem behavior. Few studies have examined possible mediating effects in guided self-help interventions for parents. The present study aimed to investigate possible mediating variables of a behaviorally oriented guided self-help program for parents of children with externalizing problems compared to a nondirective intervention in a clinical sample. A sample of 110 parents of children with externalizing disorders (80 % boys) were randomized to either a behaviorally oriented or a nondirective guided self-help program. Four putative mediating variables were examined simultaneously in a multiple mediation model using structural equation modelling. The outcomes were child symptoms of ADHD and ODD as well as child externalizing problems, assessed at posttreatment. Analyses showed a significant indirect effect for dysfunctional parental attributions in favor of the group receiving the behavioral program, and significant effects of the behavioral program on positive and negative parenting and parental self-efficacy, compared to the nondirective intervention. Our results indicate that a decrease of dysfunctional parental attributions leads to a decrease of child externalizing problems when parents take part in a behaviorally oriented guided self-help program. However, none of the putative mediating variables could explain the decrease in child externalizing behavior problems in the nondirective group. A change in dysfunctional parental attributions should be considered as a possible mediator in the context of PT

Dysfunktionale Attributionen von Eltern und ihre Bedeutung für ihr Erziehungsverhalten und für expansives Problemverhalten von Kindern

Katzmann J, Hautmann C, Greimel L, et al. Dysfunktionale Attributionen von Eltern und ihre Bedeutung für ihr Erziehungsverhalten und für expansives Problemverhalten von Kindern. Zeitschrift für Klinische Psychologie und Psychotherapie. 2015;44(4):266-274

Behavioral Versus Nonbehavioral Guided Self-Help for Parents of Children With Externalizing Disorders in a Randomized Controlled Trial

Self-help interventions for parents, which have a behavioral basis, are considered to be an effective treatment option for children with externalizing disorders. Nonbehavioral approaches are widely used but have little empirical evidence. The main objective of this trial was to compare the efficacy of a behavioral and a nonbehavioral guided self-help program for parents. Families of children (aged 4-11 years) diagnosed with attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) were randomized to either a behavioral or a nonbehavioral guided self-help program including 8 parenting booklets and 10 counseling telephone calls. The analyses considered the ratings of 5 informants: blinded clinician, therapist, participant, (her or his) partner, and teacher. Of the 149 families randomized to treatment (intention-to-treat sample [ITT]), 110 parents completed the intervention (per-protocol sample [PP]). For the 4 primary outcome measures (blinded clinician- and participant-rated ADHD and ODD) at post assessment, the analysis revealed a treatment advantage for the behavioral group in blinded clinician-rated ODD symptoms (ITT: d = 0.37; PP: d = 0.35). Further treatment differences, all in favor of the behavioral group (ITT and PP), were detected in therapist ratings (i.e., ODD) and participant ratings (e.g., parental self-efficacy [only PP], negative parenting behavior, parental stress). In both samples, no differences were found at post-assessment for ratings of the partner and the teacher, or at the 12-month follow-up (only participant ratings available). Behavioral guided self-help shows some treatment advantage in the short term. No superiority over nonbehavioral therapy was detected 12 months after treatment termination

KODAP Research Network: Pilot Data of a Project for Coordinating Research at University Outpatient Psychotherapy Clinics for Children and Adolescents in Germany

In-Albon T, Christiansen H, Imort S, et al. Forschungsnetzwerk KODAP Pilotdaten zur Inanspruchnahmepopulation universitärer Psychotherapie-Ambulanzen für Kinder und Jugendliche. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE. 2019;48(1):40-50.Zusammenfassung. Theoretischer Hintergrund: Die Anzahl universitärer psychotherapeutischer Ambulanzen für Kinder und Jugendliche an psychologischen Instituten ist in nur wenigen Jahren deutlich angestiegen. Diese erfreuliche Entwicklung ist potentiell für die Versorgung von Kindern und Jugendlichen mit psychischen Störungen, die praxisnahe Lehre im Psychologiestudium, die qualifizierte Psychotherapieausbildung und die klinisch-psychologische Forschung äußerst relevant. Der Wissensstand bezüglich Diagnostik, Ätiologie und psychotherapeutischer Behandlung von psychischen Störungen im Kindes- und Jugendalter steht für viele Störungsbilder deutlich hinter dem umfangreichen Forschungs- und Wissensstand psychischer Störungen des Erwachsenenalters. Vor diesem Hintergrund ist die Initiative, Daten der universitären Psychotherapieambulanzen für Kinder und Jugendliche zusammenzuführen, ein wesentlicher Schritt, um der Altersgruppe der Kinder und Jugendlichen gleich gut begründete und evaluierte Behandlungsansätze zukommen zu lassen. KODAP – die Koordination der Datenerhebung und -auswertung an Forschungs-‍, Lehr- und Ausbildungsambulanzen für psychologische Psychotherapie – übernimmt dabei die Koordination dieses komplexen Vorhabens sowohl für den Kinder- und Jugend- als auch den Erwachsenenbereich. Fragestellung / Methode: Es werden die soziodemographischen und klinischen Daten der im Jahr 2016 behandelten Patient_innen, deren Eltern und jeweiligen Therapeut_innen von sieben Ambulanzen beschrieben. Hierzu werden die deskriptiven Angaben zu Diagnosehäufigkeiten, Altersstruktur, Anzahl komorbider Störungen der Patient_innen und eine soziodemographische Beschreibung der Therapeut_innen und Eltern vorgestellt und diskutiert. Ergebnisse: Für das Jahr 2016 stehen Daten von 568 Kindern und Jugendlichen zwischen 3 und 20 Jahren (Malter = 11.89, SD = 3.68; 46.6 % weiblich) zur Verfügung. Die häufigsten Diagnosen stellten die Angststörungen (F40, F41, F93) mit 317 Diagnosen (35.30 %), gefolgt von den hyperkinetischen Störungen und den Störungen des Sozialverhaltens (F90, F91, F92) mit 195 Diagnosen (21.71 %) dar. Bei 45.6 % der Patient_innen wurde mehr als eine Störungsdiagnose festgestellt. Des Weiteren lagen die Daten von 257 Müttern bzw. 228 Vätern und 126 Therapeut_innen, davon 83.1 % weiblich, vor. Schlussfolgerungen: Die Studie zeigt die Machbarkeit der Zusammenführung und Aufbereitung der Daten aus universitären Psychotherapieambulanzen für Kinder und Jugendliche. Zudem geben die Pilotdaten einen ersten Einblick in diese Inanspruchnahmepopulation. Schlüsselwörter:Hochschulambulanzen für Kinder und Jugendliche, Versorgungsforschung, PsychotherapieforschungBackground: In recent years, the number of university outpatient psychotherapy clinics for children and adolescents in Germany has substantially increased. This is of potential importance not only for the health care of young people affected by mental disorders but also for teaching and mental health research. Knowledge about certain disorders in children and adolescents, predictors of treatment success, and treatment trajectories is still in its early stages. Objective: Therefore, in 2013 an initiative was launched to aggregate data from university outpatient psychotherapy clinics for children and adolescents in order to create a German-wide research data platform. KODAP short for the coordination of data collection and evaluation at research and training outpatient clinics for psychotherapy - is responsible for the coordination of this complex project for children/adolescents and adults. Method: The patient population treated in seven university outpatient psychotherapy clinics for children and adolescents in 2016 is described. Descriptive data on the diagnoses as well as on the age, frequency of comorbid disorders of the patient population, their parents, and their therapists are presented. Results: For the year 2016, data of 568 children and adolescents between 3 and 20 years of age (M = 11.89, SD = 3.68; 46.6% female) were available. The most frequent diagnoses were anxiety disorders (F40, F41, F93; n = 317, 35.30%) followed by attention-deficit hyperactivity disorders and conduct disorders (F90, F91, F92; n = 195, 21.71 %). In 45.6% of the patients, there was at least one additional comorbid diagnosis. The data of 257 mothers, 228 fathers, and 126 therapists, of these 83.1 % female, are described. Conclusion: The present study indicates the feasibility of consolidating and evaluating research data across university outpatient psychotherapy clinics for children and adolescents. This KODAP pilot study provides the first description of this patient population