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The ability to regulate one's emotions (emotion regulation, ER) with regard to individual short- and long-term goals presents one of the most central human skills. A disrupted development of ER skills is associated with psychopathological outcomes. Non-suicidal self-injury (NSSI) presents a frequent and impairing phenomenon among young individuals. Disruptions regarding various aspects of ER are involved in the development and maintenance of NSSI. In the present study, we examined ER from a multidimensional perspective, including a sample of female adolescents meeting DSM-5 criteria for NSSI disorder (N = 30) and a psychologically healthy control group (N = 30). In line with results from previous studies, female adolescents with NSSI exhibited considerable difficulties regarding all aspects of ER investigated. Furthermore, various aspects of ER were distinctly linked with depressive and BPD symptomatology. Differences in NSSI frequency between participants largely went back to difficulties regarding specific aspects of ER, in combination with the self-rated severity of exposure to early life maltreatment. With regard to clinical practice, the use of interventions to improve particular aspects of ER, under simultaneous consideration of the individual developmental history and psychopathological impairment, might provide an efficient approach to mediate long-lasting change in the treatment of deliberate self-harm.

Indicated Stress Prevention for Adolescents in the Group Setting - A manual based on Acceptance- and Commitment-Therapy Stress in adolescence has become a topic of interest in recent years. Long-term exposure to stress can play a significant role in the development and maintenance of mental disorders. Previous studies have shown that especially the more severely stressed adolescents benefit from targeted interventions. However, evidence-based treatment concepts targeting this group are scarce. In this article we introduce the first German-language treatment manual for indicated stress prevention, addressing adolescents based on Acceptance and Commitment Therapy (ACT). ACT is part of the third wave of behavioral therapies, designed for treatment across disorders, which makes it suitable for the treatment of chronic stress symptoms. Previous studies show good efficacy of the ACT-approach in the treatment of adult stress and first promising successes in treatment of adolescents in non-German-speaking countries. The focus of our training lies in practical exercises based on ACT which are conveyed by the use of metaphors, art therapy techniques, role plays and group discussions. The concept is complemented by psychoeducation on stress, mindfulness exercises and training in problem solving. Worksheets and tasks for the week facilitate the transfer into everyday life. Alongside the presentation of the treatment manual, first experiences in the implementation of the program are discussed.

The Association Between Illicit Drug Use, Borderline Personality Disorder and Depression in a Help-Seeking Sample of Adolescents Risk-taking behavior is a common phenomenon in adolescence. Even prevalence rates for illicit drug use are considerably high in youth and associated with a range of psychiatric disorders, especially depression and Borderline Personality Disorder (BPD). However, there is a lack of data investigating differences in psychopathology between different substance user groups. Therefore, aim of the study was to investigate occurrence of depression and BPD symptoms in different drug risk groups (no use vs. occasional use vs. frequent use). Further aim of the study was to examine risk profiles regarding single BPD criteria. Data of n = 347 adolescents (81.7 % female, mean age 14.95, SD = 1.50) presenting at the specialized outpatient clinic for risk-taking and self-harming behavior (AtR!Sk) in Heidelberg were analyzed. Results show that BPD is clearly associated with illicit drug use in adolescence. There is no difference between occasional and frequent users in terms of mean number of BPD criteria. However, frequent users differ from occasional users regarding greater number of impulsivity and anger criteria. After adjusting for sociodemographic variables there was no association between drug use and depression. Since even single events of illicit drug use are associated with higher levels of BPD, clinicians should rapidly target to stop consumption. Further, psychotherapeutic interventions for BPD in high-risk consumers should especially focus on facilitating adaptive emotion regulation skills in regards to impulsivity and anger.

Development of an Online Intervention for Adolescents and Young Adults Engaging in Nonsuicidal Self-injury Nonsuicidal self-injury (NSSI) is a prevalent phenomenon in adolescence. Despite the existence of effective psychotherapeutic interventions, the majority of affected adolescents and young adults do not receive any treatment. Structural (e. g., no specific interventions, limited resources, limited accessibility) as well as individual factors (e. g., low help-seeking behavior) impede access to adequate clinical care for adolescent NSSI. Online interventions offer the possibility to provide specific interventions independent of one's location or local healthcare structures. Because of its high confidentiality and accessibility, the Internet also reaches adolescents with low help-seeking behavior. There is already evidence for online interventions concerning different mental health issues, like depression and anxiety. However, regarding NSSI, there are no effective, online interventions. Thus, we developed an online intervention based on an already evaluated short term program specific for adolescents and young adults with NSSI within the German STAR consortium (STAR: Self-Injury - Treatment, Assessment, Recovery). Within a randomised controlled trial, the intervention will be evaluated regarding its efficacy.

Early Life Stress Stress and daily hassles are a normal part of day-to day-life. The amount of control that is experienced strongly contributes to resilience and coping. Children very frequently do not experience control over the stressors within their lives. Starting from pregnancy, they are subjected - via the maternal endocrine system - to a variety of stressors ranging from normal stress regarding the transition to parenthood to maternal abuse or torture. This article collects research of the last two decades regarding the influence of stress on the developing brain. Both, animal and human studies will shed light on the effect of pre- and postnatal stress demonstrating an influence of early life stressors reaching far into adulthood. A direct influence of stress on multiple developmental characteristics has been postulated and shown. The results of this review will underline the necessity of early life programs focusing stress reduction and resilience in children and their parents. Also, a need for programs targeting stress reduction in pregnancy will be demonstrated and emphasized.

Relationship Between (Pathological) Internet Use and Sleep Problems in a Longitudinal Study Excessive or pathological Internet use has already been associated with sleep disorders, but the direction of the connection remains still uncertain. The relationship between (pathological) Internet use and sleep problems in adolescence was investigated by a representative longitudinal survey of data from a sample of 1,060 students from Heidelberg and the surrounding area (SEYLE study). The students, on average 15 years old, responded at a baseline and after one year to a survey on sleep and Internet use. In addition to the number of hours of Internet use, pathological Internet use was assessed using the Young Diagnostic Questionnaire (YDQ). Sleep duration and sleep problems were surveyed by self-assessment. The prevalence of adolescents with pathological Internet use was 3.71 % in the follow-up survey. Furthermore, 20.48 % of adolescents reported sleep problems. Pathological and excessive Internet use were predictors of sleep problems over the course of one year. Adolescents who met the criteria for Internet addiction to the baseline had a 3.6 times greater risk of developing sleep problems in the course of one year. Whereas sleep problems to the baseline increased the YDQ symptoms only by 0.22. Sleep problems often occur as a result of pathological Internet use and could have an addiction-enhancing effect as well as mediating further psychiatric comorbidities. Thus, sleep problems should be targeted for early intervention and therapeutic measures.

Identity - An Illusion? Self Development in Adolescence With support from their social environment, five out of six young people progress through adolescent development relatively well, while approximately 15 % are at risk of developing psychological problems (Kaess, Ghinea, Fischer-Waldschmidt, Resch, 2017). Those who cannot cope with the challenges of society and who do not have a safe space in the family or among friends to deal with worries and adjustment issues may attempt to stabilize their identity and self-esteem through risk-taking behavior (Kaess et al., 2017). Addictive behavior, e. g. substance abuse or extreme media consumption, may be an expression of adolescents' desire to assert and define their own identity - and not only to anesthetize themselves and forget their troubles. The "Who am I?" question in addictive behavior appears to be closely connected with consumption. The issue of identity will play a very important role for future generations of youth. The following overview, based on scientific findings, examines identity development in adolescence, the connection between identity and risk-taking behavior, and the connection between identity and zeitgeist.

The Outpatient Clinic for Adolescent Risk-taking and Self-harm behaviors (AtR!Sk) - A Pioneering Approach of Outpatient Early Detection and Intervention of Borderline Personality Disorder Self-harm and risk-taking behaviors are frequently occurring problems in adolescents' everyday life and commonly challenge the present child and adolescent health-care system. Those behaviors are typical features of borderline-personality disorder (BPD), a severe mental disorder that is associated with immense psychological strain, increased risk of mortality and poor psychosocial functioning. Despite controversy in the past, recent evidence shows that BPD is a valid and reliable diagnosis in adolescence. Consequently, specified and effective intervention programs for this age group are necessary. Instead, present health-care services for children and adolescents in Germany are usually characterized by long waiting periods for specialized outpatient treatments and unnecessary expanses of unnecessary long inpatient stays. Alternatively, and in order to prevent serious long-term consequences, new concepts - integrated in an ambulatory setting and close to patients' daily routines - should focus on early detection and treatment of adolescents at-risk presenting with borderline personality features. The specialist outpatient clinic AtR!Sk at the University Hospital Heidelberg ensures a low-threshold initial contact service, comprehensive and accurate diagnosis of BPD features, and rapidly "tailored" therapy for young people presenting with any types of risk-taking and self-harm behavior. AtR!Sk - as a pioneering approach in south Germany - provides evidence-based early detection and intervention for adolescent BPD.

Parental Monitoring and its Relation to Behaviour Problems and Risk Behaviour in an Adolescent School Sample Numerous research studies emphasize parental monitoring as a protective factor for adolescent problem behaviour. The purpose of the study presented was to use Stattin and Kerr's (2000) monitoring subscales for the first time in a German-speaking area and to explore the relations to behaviour problems in an adolescent school sample. The two active monitoring strategies "parental control" and "parental solicitation" as well as "parental knowledge" and "child disclosure" relating to behaviour problems and risk behaviour were examined. A sample of 494 pupils, grades 5, 7 and 9, of German secondary schools and their parents answered questions on "parental knowledge", "control", "solicitation" and "child disclosure". Adolescents also answered the German version of the Strengths and Difficulties Questionnaire (SDQ) and items about risk behaviour like frequency of violence, delinquency, substance abuse, self-injuring behaviour and school absenteeism. Behaviour problems in terms of the SDQ could be predicted sufficiently by "parental knowledge", but for the prediction of risk behaviour, the active parental monitoring strategies were of importance, too. More "parental knowledge", more "control" and less "solicitation" could predict less risk behaviour. Results confirm "parental knowledge" as a general protective factor for problem behaviour. However, they show the importance of "parental control" for adolescent risk behaviour.

Refuge in Digital Worlds - the Association of Critical Life Events with Pathological Internet Use in Adolescence The present study sought to clarify the potential relationship between critical life events and pathological internet use in adolescents. A cross-sectional survey was conducted within the framework of a European school-based study (SEYLE) which included a representative sample of 1,444 students from the Rhein-Neckar catchment area. The Young Diagnostic Questionnaire (YDQ) was used to assess pathological internet use, whereas a combination of the List of Threatening Experiences (LTE) and Life Events Checklist (LCE) was administered to assess critical life events over the period of the last six months. Statistical models were adjusted for the presence of psychopathological distress using the Strengths and Difficulties Questionnaire (SDQ). 4.8 % of the participating students reported pathological internet use, 14.5 % met criteria for risky Internet use. Overall, adolescents with risky or pathological internet use recalled more critical life events, particularly within the context of interpersonal relationships and academic performance. After adjusting for sociodemographic variables and psychopathological distress, results showed that an unexpected decrease in academic performance as well as the termination of a romantic relationship, both were significantly associated with pathological internet use. Adolescents with pathological internet use reported significantly more frequent interpersonal problems and an unexpected decrease of academic performance. Based on the cross-sectional nature of the investigation, causality of the association cannot be established. However, results point towards potential risk factors (academic performance, termination of relationships) which may guide the identification of adolescents with risky or pathological internet use in child- and adolescent psychiatry.

By the current state of knowledge adolescent personality disorders should be taken seriously due to their high prevalence and severe symptomatology. Personality disorders are characterized by a stable pattern of deviation concerning cognition, affectivity, impulse control, and interpersonal relationships and have negative repercussions in psychosocial functioning and subsequent development. There is emerging evidence that personality disorder diagnosis is reliable and valid during adolescence. It is essential to detect youth with personality pathology in order to refer them to specific psychotherapeutic interventions and consequently avoid further chronification and life-long functional impairment. This selective review will give an overview over personality disorders in adolescents as well as according psychotherapeutic interventions.

Adolescence is a vulnerable period which is associated with a heightened risk for the development of depressive disorders. Risk-behaviors like alcohol or illicit drug abuse, excessive use of media, school absenteeism and lack of sleep are also frequently occurring during this period; it is often suggested that such behaviors may be associated with mental health problems. This article includes a selective overview of literature to investigate the relation between depression and risk-behavior in adolescence; these results are compared with the results from a representative sample of German pupils who were examined in the context of the European school study SEYLE. Data from a school-based sample of 1,434 pupils with a mean age of 14.7 years (SD = 0.8) was used. Most risk-behaviors tend to be associated with increased likelihood for the development of depression and are correlated with the severity of depressive symptomatology. In this sample, alcohol abuse, smoking, media use, lack of physical activity, risky sexual behavior, school absenteeism, and sleeping problems showed an impact on the level of depression which was consistent with previous research. Illicit drug abuse showed no significant impact on depressive symptoms of young people. Further longitudinal studies are necessary to elucidate the directional relationship between depression and risk behavior in adolescence. The potential value of adolescent risk-behavior as a possible warning sign for early detection of depressive symptoms also warrants further investigation.

Data about the prevalence of school absenteeism and its correlation with emotional and behavioural problems in Germany is scarce, in particular regarding excused absenteeism. This study aims to close the gap by examining a sample of 2,679 pupils attending the different types of secondary school (Hauptschule, Realschule, Gymnasium), who participated in a clinical trial for the prevention of truancy (WE-STAY-Project). Pupils' mean age was 14 years (M = 13.94, SD = 0.85, Range = 11-19) and gender distribution was balanced (49.35% males, 50.65% females). Using a self-report questionnaire, pupils where asked on how many days they had missed school on average per month during the last school year (excused and unexcused). Emotional and behavioural problems were measured by using the "Strengths and Difficulties Questionnaire" (SDQ). 4.1% of the pupils reported to have missed school without a valid excuse on more than four days per month (unexcused absenteeism). 6.1% had missed school having an excuse on more than ten days per month (excused absenteeism). Both, unexcused and excused absenteeism, showed an increase of emotional and behavioural problems dependent on the intensity of absenteeism. In conclusion, these findings show the relevance of school absenteeism in Germany. In the future, more attention should be given to pupils with also excused absenteeism.

The Berkeley Puppet Interview (BPI) enables us to investigate psychological symptoms of children aged four to eight years under a multi-informant perspective by the means of self and parent report measures. 45 families with one parent suffering from cancer have been examined with regard to internalizing and externalizing symptoms of the children. Results have been compared to two different age-appropriate samples (Swiss preschool study of Basel and German KiGGS study). A small, highly selective sample of twelve children aged four to eight years could have been examined both from the self and parent perspective. Our results show, that four to eight year old children of cancer patients do not differ from other children of the same age in the way they express emotional symptoms in the BPI, but they are judged more emotionally burdened than other children by their parents (SDQ). Self and parent report do not significantly correlate. It seems as if parents in families struck by a cancer disease see their children's emotional symptoms more pronounced than the children themselves do express in the puppet interview. Implications for clinical and research practice will be discussed.

Maternal intuitive skills can be threatened as a result of severe deprivation or unresolved trauma in the own childhood and can even be inaccessible to the mother. A mother's own childhood experience of abuse maybe a risk factor for repeated child abuse. As a follow-up study to assess the emotional availability of abused mothers it was investigated how a physical or sexual abuse appears in the mother-child interaction and communication in the context of "cycle of abuse" and whether it could give effect to it. Interactions of mothers with abuse experience were compared with those of mothers without an abuse experience and evaluated five months postpartum with the Munich clinical communication scale (MKK). The results suggest that maltreatment experienced mothers show less emotion tuning to their child in a standardized interaction sequence.

So far there are contradictory findings concerning the degree of negative influence of attention deficit disorders, external or socio-emotional disorders on academic development of a child. Therefore the present epidemiologic study analyses the relationship between clinically relevant problems and academic achievement of fourth graders (measured by recommendation for secondary school: A-level, B-level or C-level). Children (N = 3910) were rated by their parents by anonymised questionnaires (Child Behavior Checklist CBCL) at the end of primary school. Especially in the field of attention deficit, somatic and anxiety/depression disorders, many children were in a clinically relevant range compared to German norm data. It became obvious that future C-level pupils are particularly strong, multiply problem troubled, with constantly higher problems at all subscales. Mainly attention deficit disorders proved to be relevant for academic achievement, but also delinquent behaviour and social problems, which enhance the relative risk of recommendation for B- or C-level considerably. Early applied preventive interventions supporting social and cognitive development seem therefore of central importance for the school career of primary school children.

To investigate associations between risky and pathologic internet use with depression, deliberate self-harm and suicidal behaviour among a representative sample of German adolescents. A total of 1,435 students (48% boys, 52% girls) from the area of Heidelberg/Germany were recruited during the SEYLE study, a European school-based intervention study and completed an assessment of different questionnaires, including the Young Diagnostic Questionnaire for the assessment of risky and pathological internet use, the Beck Depression Inventory, the Deliberate Self Harm Inventory, and the Paykel Suicide Scale. 80.7% of the students reported regular, 14.5% risky, and 4.8% pathological internet use. The risky and the pathological internet users showed significant higher rates of depression, deliberate self-harm and suicidal behaviour compared to students with regular internet use. Remarkably, there were no significant differences of levels of depression and suicidal behaviour between risky and pathological users. These results suggest that not only pathologic internet use but also risky internet use is associated with symptoms of depression, self-harm and suicidal behaviour. Therefore, more attention should be paid to adolescents with risky internet use for the early recognition of depression, self-harm and suicidality in adolescence.

By the current state of research, it cannot be answered clearly how adolescents experience anticipatory grief and if and to which extent this process differs from anticipatory grief of adults. The present study will fill this gap by providing both a quantitative and a qualitative description of anticipatory grief processes. Therefore, 74 adolescents and young adults (11-21 years), whose parents have suffered from cancer, completed an adapted version of the "Trauerfragebogen" (Weiser u. Ochsmann, 2002). Additionally a subsample of n = 38 took part in a qualitative guided interview. Based on these interviews, 16 categories were formed, that were assigned to two types of stressors. Beside communication and prioritization of family, different symptoms of grief were the central category in the loss-oriented type, where fears of loss, compassion and concern were of crucial importance. Also categories of the restoration-oriented type were strongly present. Thus, it seems that young people generally manage to accept their new role in the stressful family situation and they have a series of coping mechanisms available to do so. This was also reflected in the quantitative data, were the subscale "Inner Strength" reached the highest value. In the counselling of adolescents with cancer-diseased parents, both loss-oriented and restoration-oriented processes should equally be recognized and encouraged.

This study examines the question whether early childhood temperaments of children of mothers suffering from postnatal depression differs from children of non-depressed mothers. Children of clinically depressed mothers were assessed with regard to their temperament on two different dimensions and compared to a control group. The level of cortisol concentration in the children's saliva was the first variable. Saliva samples were gathered on three consecutive days to obtain a baseline, and before and after a mother-children interaction, which was interrupted by a still-face phase. As second variable the early childhood temperament was assessed with the Infant Behavior Questionnaire (IBQ). After the mother-children interaction the cortisol concentration levels of children of mothers suffering from postnatal depression were significantly lower. In the IBQ-Scales the children of depressed mothers showed significantly higher values on the scales Distress to Limitations and Activity. The significantly lower cortisol concentration in the saliva of children of mothers suffering from postpartum depression could be an indication that these children are already used to the fact that their mothers are not paying attention to them during the still-face phase. Overall, the results give rise to the assumption that postpartum depression does have an adverse impact on the development of affected children and that early intervention would be expedient to prevent the occurrence of pathological behavior characteristics and difficult mother-child relationships.

Parents information about behavior, problems and life situation of children before and after first year of school were analysed and compared with data from teacher reports. At the end of first grade 131 parents were asked about behavior problems of their children using the child behavior checklist (CBCL) and additional items about living condition of the familiy and child. Findings were compared with those of a large epidemiological study conducted one year before in the same area using the same instruments. Additional teacher-reported data about behavior problems and school achievement were included. Comparing data before and after first year of school, no significant change in average CBCL total score could be observed. From parents view oppositional behavior was the most prevalent problem. There was a decrease of social problems. Children became more independent having more contact with peers. More children have their own television and computer at the end of first grade. Prevalence of headache and perfectionism as well as symptoms of tension and irritation increased. The most important problems from teachers' view are lack of attention and concentration affecting 32% of the first graders. Compared to the parents, teachers report only few oppositional and aggressive behavior. Achievement at school and behavior problems are highly correlated. Especially attention problems go along with low achievement at school. Parents' and teachers' ratings show an average correlation of r = .28 with the highest accord for attention problems and school achievement. The results of the study contribute to the question how children deal and cope with the new situation coming to school. The findings of a high rate of attention problems at school and the close relationship between behavior problems and achievement lead to the conclusion that an early prevention of behavior problems is essential to promote school performance.

In spite of the high importance of subjective opinions as essential evaluation criteria there are hardly any studies available, dealing with the research of subjective judgements made by children and adolescent patients in relation to their inpatient treatment, and comparison with the evaluation of their parents. The evaluative study on an age-group random sample survey (n=95) of patients and parents at the Department of Child and Adolescent Psychiatry at the University of Heidelberg includes success of treatment, experience of treatment and satisfaction with treatment by means of specially constructed and parallelized questionnaires for patients, parents and therapists. Apart from the extent of subjectively experienced changes in precisely defined success variables, not only agreements and differences were studied, but also connections between success of treatment, experience of treatment and satisfaction with treatment as well as influences of success variables and experience variables on treatment satisfaction. Parents', patients' and therapists' evaluations of the treatment in regard of most success variables were all positive. At the end of treatment a perspective convergence was noticeable in some variables. The pressure on the parents requires special therapeutic attention. In the sense of therapy evaluation the change in the way the problem was viewed proved to be a worthwile success criterium. From the patients' and parents' point of view the change in the problem "as a whole" is mainly characterized by a positive change in emotional disposition. The therapeutic atmosphere and organisation of therapeutic relationships were highly appreciated by patients and parents. All in all patients, parents and therapists were highly satisfied with inpatient treatment. The correlations found between the grade of success, experience of treatment and satisfaction with treatment were clearly positive. On the patients' side treatment satisfaction was dictated more by their experiences during the treatment, whereas on the parents' side the success of treatment proved to be the stronger factor.

"Operationalised psychodynamic diagnostics in childhood and adolescence" (OPD-CA) has been completed in its first version after years of development. In a first interview with a 13-year-old boy, the diagnostic instruments of OPD-CA are presented by means of examples. The text passages of the transcribed first interview are evaluated in four sections by representatives of the respective working groups regarding the axes--relationships, conflict, structure and preconditions for treatment--and the diagnostic conclusions resulting from this are presented, thus providing a direct insight into the specific psychodynamic diagnostics of OPD-CA.

Behavioral and emotional problems based on parents information from the Child Behavior Checklist (CBCL) were investigated in a large epidemiological sample of 4363 six year old pre-school children from the area of Heidelberg and Rhein-Neckar county. An overview about symptom frequencies of boys and girls is given, taking age specific evaluations into account. Considering symptoms and syndromes, externalizing and attention problems show high prevalence, especially for boys. Family problems are the most important predictors of child global symptomatology, explaining about 10% of variance of the CBCL total score. Other factors like gender, chronical illness, adverse living conditions, family constellation or amount of TV consumption prove as additional independent predictors. An overall model explains about 20% of variance of child symptomatology. Results are discussed from the view of normal child development, developmental psychopathology, changing norms and altered socio-cultural conditions.

The norms of the spelling test R-T Form C "Moselfahrt" (Althoff et al. 1974) from the year 1968 and of the nonverbal intelligence test CFT 20 (form A/part 1) from the year 1977 (Weiss 1987) are evaluated for their actual validity. In 1995, both original tests were being administered to an epidemiological sample (N = 592) of adolescents and young adults in the age of 16 to 30 years having passed at least their obligatory amount of school years. These results are being compared to those of the original norm samples. Using the norms for the CFT 20 from 1977 adolescents and young adults achieve in the year 1995 a mean IQ of 110.8 points, equaling a yearly IQ-gain of 0.6 IQ-points. This exceeds the expected gain of 0.33 IQ-points annually according to the literature and indicates a distinct change of norms. There were no significant gender differences found. The distribution of mistakes in the spelling test R-T "Moselfahrt" compared to the original norm sample from 1968 changes considerably as well and requires revised test norms. With an increase from 9-11 mistakes (depending on the age norm) to 19.8 mistakes the mean amount of mistakes is almost being doubled. Extremely high numbers of mistakes occurred more frequent and could not be differentiated according to the old norms. Using the original norms from 1968 in the year of 1995 12.4% of the sample achieve with a T-score of 20 the lower limit of the measured value scale and the overall mean has decreased by 1.2 standard deviations to T-score = 38.48% of the sample reach a result that equates percentage 10 or less which is interpreted as insufficient school mark. Women's mean spelling achievement is significantly better than men's. Causes and implications of this scissors-like development of deteriorated spelling achievement and increased nonverbal intelligence are being discussed. Tables containing the new standardization scores are included in the appendix.

At the age of 9 weeks a girl was presented by her mother because of intolerable hysterical attacks' triggering maternal impulses of abuse. Maternal perception of her infant was distorted to the extent that the mother was reexperiencing encounters with her own intrusive and traumatizing mother in the face of her screaming child. She also perceived the infant's motor impulses as physical transgressions against herself and expressed intense anxieties about her daughter's future aggressive potential. The infant was viewed by her mother as extraordinarily and dangerously greedy. Even neutral infantile vocalizations were perceived as manipulating and sadistic. She tried to ward off these anxieties by employing a rigid scheme of rules and obsessively controlling the father's and grandmother's interaction with the child. The mother feared to be overwhelmed by the infant's needs if she'd yield to them in a flexible way. A background of early neglect and trauma experienced by the mother is illustrated considering recent literature about early intergenerational transmission of traumatic experiences in order to demonstrate treatment modalities in view of protective and risk factors.

Apart from the structural differentiation of the body and its functions, the enlargement of the child's repertoire of possibilities to make experiences and to act is a manifestation of the development of the child's psychic structure which, advancing in years, may be considered as a treasure of all the experiences one has made with oneself, with the world and with the others. Structure will develop along with the interactional experiences with the world around us and becomes manifest in one's behaviour which may be witnessed and observed. The description of the psychic structure comprises three dimensions (perception of the self and of the objects, control, communication and bonding) which will be described by certain capabilities and will be assessed with the help of an anchoring example typical for each age which serves the purpose of clinical illustration. The adaptational achievement may then be assessed on the basis of a structural standard independent of age and may be ranged on a structural level. It appears that the exemplary description of different scopes of tasks typically to be performed at certain ages which serves as a basis for the assessment of the adaptational competence during childhood and adolescence seems to be a good policy. The purpose of our studies is the development of a valid instrument which is easy to handle in practice and which has a high interrater-reliability.

An attempt to define "psychic structure" leads to the conclusion, that "structure" provides adaptive behavioral strategies for the interaction of the person with a physical and social world by representing experiences of earlier interactions in memory processes. Compatibility of different definitions of "structure" in psychopathology and psychoanalysis is being discussed. Developmental aspects of a "theory of mind" in children and of different modes of representation have to be addressed. A "multiple code theory" of W. Bucci is introduced. Conclusions for diagnosis and therapy in psychodynamic approaches will be drawn. It has to be faced, that children represent optimal structures in each level of psychic development, noting the importance of age-relevant normative measures.

Adopting a therapeutic view on diagnosis in child and adolescent psychiatry a psychodynamic diagnostic manual seems to be necessary, that may provide reliability in the assessment of intrapsychic processes. Multiaxial diagnosis of children's and adolescent's psychiatric disturbances may thus be completed with additional psychodynamic assessment procedures. In adults an operationalized procedure of psychodynamic assessment (OPD) already exists. In child and adolescent psychiatry a working group for psychodynamic diagnostic (OPD-KJ) has been founded. In 4 areas (subjective experiences of disturbances, relationships, intrapsychic conflicts and psychic structure) diagnostic manuals are being worked out. Fundamental questions of developmental psychopathology and diagnostic procedures have to be addressed. The basic proposition takes into account that children should not be psychodynamically compared with adults, but normally have a basic capacity to adapt to environment on a high level of psychic organisation in all developmental stages. Reports of the ongoing work are being given.

The sense of shame seems to vanish for more than a decade now, manifested e.g. by an increasing tolerance toward the naked female body. However, it is supposed that shame has still its significance especially during female puberty. Psychological considerations referring to shame and to the puberty of girls are reported and the significance of feeling ashamed in this salient segment of female development is delineated. Finally a concept is proposed within which the feeling of shame is understood as a possibility to create accordance between the positive aspects of being ashamed and the tendency of going beyond the borders of shame usually guaranteed by social rules.