Search

A variety of instruments are available for assessing parental and child behaviour in the context of interaction observation. This study investigated whether the Laboratory Parenting Assessment Battery (Lab-PAB) can be used to make predictive statements about the therapeutic success of child psychiatric treatment. The success of therapy was measured through pre- and post-intervention assessments using the Child Behavior Checklist (CBCL) and the Parent-Infant Relationship Global Assessment Scale (PIR-GAS). A particular focus was placed on discriminating between externalizing and internalizing problems of the child. It was observed that positive items of the interaction offer a greater resource for the therapeutic success of children with externalizing problems than stopping negative behaviour of the parents. In the case of internalizing problems, the elimination of negative interaction items seems to be essential for a good therapy success.Zusammenfassung Zur Einschätzung von elterlichem und kindlichem Verhalten im Rahmen einer Interaktionsbeobachtung stehen vielfältige Messinstrumente zur Verfügung. In dieser Studie wurde untersucht, ob sich mithilfe der Laboratory Parenting Assessment Battery (Lab-PAB) prädiktive Aussagen zum Therapieerfolg einer kinderpsychiatrischen Behandlung treffen lassen. Gemessen wurde derTherapieerfolg mithilfe prä- und postinterventioneller Erhebungen durch die Child Behavior Checklist (CBCL) und die Parent-Infant Relationship Global Assessment Scale (PIR-GAS). Dabei wurde ein Fokus auf die Differenzierung zwischen externalisierenden und internalisierenden Auffälligkeiten des Kindes gelegt. Beobachtet werden konnte, dass positive Items der Interaktion eine größere Ressource für denTherapieerfolg von Kindern mit externalisierenden Auffälligkeiten bieten als die Vermeidung negativer Verhaltensweisen der Eltern. Bei internalisierenden Auffälligkeiten scheint das Unterbinden negativer Items der Interaktion essenziell für einen gutenTherapiererfolg zu sein.

Zusammenfassung Ein verbreitetes frei verfügbares Instrument zum Screening psychischer Probleme ist der Strengths and Difficulties Questionnaire (SDQ). Für den Einsatz in der klinischen Praxis sind Informationen zu seiner differentiellen Validität und zum Nutzen für Verlaufsmessungen relevant, liegen bislang jedoch kaum vor. Für die Fremd- und Selbstauskunft des SDQ wurde daher geprüft, ob die von den Beurteilungsquellen wiederholt abgegebenen Verhaltensauskünfte differentielle Stabilität besitzen. Da die Wahrnehmung von Symptomen auch durch den sozialen Kontext beeinflusst wird, wurde zusätzlich exploriert, inwiefern sich die Urteile der Selbst- und Fremdauskunft im Längsschnitt wechselseitig beeinflussen und ob Kinder mit und ohne Lernstörung sowie Jungen und Mädchen als unterschiedlich stark belastet eingeschätzt werden. Dazu wurden 60 Fünft- und Sechstklässler mit und ohne Lernstörung sowie ihre Eltern und Klassenlehrkräfte zu drei Messzeitpunkten auf der weiterführenden Schule befragt. Cross-Lagged-Panel-Analysen zeigten über nahezu alle Skalen hinweg substanzielle Stabilitäten, was dafür spricht, dass Eltern, Kinder und Lehrkräfte in der Lage sind, mit Hilfe des SDQ die stabilen Anteile eines Problemverhaltens von seinen situativen Variationen zu trennen. Interrater-Dependenzen zwischen den abgegebenen Urteilen zeigten sich vor allem von den Erwachsenen zu den Kindern, was den Einfluss der nahen Bezugspersonen auf die Symptomwahrnehmung der Kinder belegt. Unterschiede in Bezug auf Lernstörungen wurden nur für die Skala Hyperaktivität gefunden: Während Eltern von Kindern mit Lernstörung mehr hyperaktive Symptome berichteten, gaben die Kinder bei sich selbst weniger hyperaktive Verhaltensweisen an im Vergleich zu Kindern ohne Lernstörung. Mädchen sahen bei sich mehr emotionale Probleme und Jungen mehr Verhaltensprobleme und weniger prosoziales Verhalten, während im Fremdurteil kaum Geschlechtseffekte gefunden wurden. Die Ergebnisse belegen den Nutzen des SDQ für die Verlaufsmessung in der klinischen Praxis.

To determinate behavioral problems of children of parents with mental illness. Conclusions for prevention.Inpatients from a psychiatric hospital (N = 399) with children (4-18 yrs.) evaluated their children's behavior with the Child Behavior Checklist (CBCL).Children of mentally ill parents showed significantly more behavioral problems than children of healthy parents. They had overall fewer behavioral problems compared to children with mental illness, however, behavioral problems were similar with respect to "social problems" (4-11 year-old boys, 12-18 year-old girls) and "somatic complaints" (12-18 year-old boys and girls).Results indicate a selective, partly indicated, need for prevention. The data point towards certain areas of behavioral problems that should be particularly targeted when planning such programs.Erfassung von Verhaltensauffälligkeiten von Kindern psychisch erkrankter Eltern (KpK), Schlussfolgerungen für Prävention.Patienten in stationärer psychiatrischer Behandlung (N = 399) mit Kindern (4–18 Jahre) schätzten das Verhalten der Kinder mit der Child Behavior Checklist (CBCL) ein.Verhaltensauffälligkeiten der KpK waren in allen Syndrombereichen signifikant stärker ausgeprägt als in der Normstichprobe Gesunder. Im Vergleich zu einer Klinikstichprobe der Kinder-/Jugendpsychiatrie zeigten sich insgesamt zwar weniger Auffälligkeiten, vergleichbar ausgeprägte Auffälligkeiten wurden jedoch in den Bereichen „sozialer Rückzug“ (4–11-jährige Jungen, 12–18-jährige Mädchen) und „körperliche Beschwerden“ (12–18-jährige Jungen und Mädchen) gefunden.Deutliche Hinweise auf selektiven, teils indizierten Präventionsbedarf bei KpK sowie auf Syndrombereiche, die in der Prävention besonders berücksichtigt werden sollten.

Zusammenfassung Kindergartenkinder mit psychischen Auffälligkeiten erhalten nur selten professionelle Hilfe. Die Problemerkennung und somit der subjektive Handlungsbedarf bilden einen Schlüsselfaktor für die Inanspruchnahme von Unterstützung in dieser Altersgruppe. In dieser Studie wurde untersucht, inwieweit Eltern und Fachkräfte in Bezug auf psychische Auffälligkeiten, psychosoziale Ressourcen und subjektiven Handlungsbedarf übereinstimmen. Es wurden 255 Kinder (3,0-6,6 Jahre) in 26 Kindertageseinrichtungen von Eltern und Fachkräften mit dem Instrument „Verhaltensskalen für das Kindergartenalter“ (VSK, Koglin u. Petermann, 2016) eingeschätzt und der jeweilige subjektive Handlungsbedarf erfragt. Bei 19.8 % der Kinder sahen die Fachkräfte einen Handlungsbedarf in Bezug auf Verhaltensprobleme des Kindes; die Eltern sahen diesen bei 17.3 % der Kinder. Dabei waren sie sich bei 18.9 % dieser Kinder einig, dass Handlungsbedarf besteht. Es besteht eine geringe Übereinstimmung in Bezug auf den subjektiven Handlungsbedarf (κ = .16). In Bezug auf die mit dem VSK erhobene psychische Auffälligkeit war die Übereinstimmung zwischen Eltern- und Fachkräfteurteil ebenfalls gering (Median ICC = 0.32), ebenso wie im Bereich erhöhter Auffälligkeiten (κ = .13). In Bezug auf die psychosozialen Ressourcen der Kinder zeigten sich auf keiner Ebene signifikante Übereinstimmungen. Die Ergebnisse weisen auf die Notwendigkeit systematischer Vernetzung von Kindertageseinrichtungen mit Institutionen wie z. B. Sozialpädiatrischen Zentren hin, um blinde Flecken beim Erkennen von psychischen Auffälligkeiten zu vermeiden.

The prevention of externalizing disturbances

Symptoms of Attachment Disorder, Behavioral Regulation and Physiological Stress in Institutionalized Children The aim of the study was to investigate the influence of attachment status (availability of a specific caregiver) and caregiving quality on behavioral and physiological adaptation and attachment disorder in institutionalized children. In a sample of children from a Georgian children's home, attachment disorder symptoms were assessed by interview and attachment and exploration behavior as well as self-regulatory behavior were assessed by observation in the natural group setting as well in structured dyadic situations. The child circadian cortisol level was determined to assess physiological adaption. Quality of caregiving was assessed in terms of sensitivity by observation. While attachment status affected the occurrence of attachment disorder symptoms and physiological stress, patterns of regulation in terms of attachment-exploration-balance and self-regulatory behavior were predicted by caregiver sensitivity.Zusammenfassung Ziel der Studie war es, bei Heimkindern den Einfluss des Bindungsstatus (Verfügbarkeit einer präferierten Bezugsperson) und der Qualität des Fürsorgeverhaltens auf die psychische und physiologische Regulation und das Auftreten von Bindungsstörungssymptomen zu untersuchen. In einer Stichprobe von Kindern aus einem Kinderheim in Georgien wurden Bindungsstörungssymptome erfasst und Bindungs- und Explorationsverhalten sowie selbstregulatives Verhalten im natürlichen Gruppenkontext und in strukturierten dyadischen Situationen beobachtet. Das ciradiane Cortisolniveau diente als Maß für physiologische Anpassung und die beobachtete Feinfühligkeit der Erzieherin als Maß für die Qualität des Fürsorgeverhaltens. Während Verhaltensregulationsmuster mit der Feinfühligkeit der Bezugserzieherin assoziiert waren, zeigten sich Effekte des Bindungsstatus vor allem in der physiologischen Belastung und im Auftreten von Bindungsstörungssymptomen.

The Multiperspective Parent-Child Relationship Questionnaire (M-PCR) Parent-child relationship quality may considerably impact child mental health. Yet many instruments apply effortful behavioral observation methods. In this paper we aim to develop a multiperspective questionnaire of parent-child relationships. Several experts in the field of parent-child interaction treatment generated 18 items to assess aspects of the parent-child relationship. Mothers, therapists and assistant therapists rated 129 mother-child dyads that were treated at the Child Psychiatric Family Day Hospital for preschool children in Münster, Germany at the beginning and again at the end of treatment. For validity purposes, a global measure of relationship quality (PIRGAS) and measures of maternal psychopathology (SCL-90-R) and child behavior problems (CBCL/1.5-5; C-TRF/1.5-5) completed the assessment.Six principal component analyses and subsequent oblique rotation revealed a stable patternof two interpretable factors labeled as "Affective Bond" and "Functional-Conflict" with highinternal consistency and retest-reliability. Validity of the MEK scales was supported by significant correlations with the global rating of relationship quality PIRGAS by experts (therapistsand assistant therapists) and measures of maternal and child psychopathology, particularlyexternalizing problems, and therapy outcome. The MEK appears as a valid, reliable and user-friendly instrument for assessing the quality of parent-child relationship in clinical contextsfrom different perspectives.Zusammenfassung Die Eltern-Kind-Beziehung, der in der Entstehung und Aufrechterhaltung von Psychopathologie im Kindesalter eine bedeutende Rolle zugeschrieben wird, wird häufig mit Beobachtungsverfahren eingeschätzt. In diesem Beitrag soll geklärt werden, ob eine perspektivübergreifende Erfassung eines oder mehrerer Aspekte der Eltern-Kind-Beziehung mittels Fragebogen möglich ist. Mehrere Experten generierten 18 positiv wie negativ formulierte Items zur Erfassung verschiedener Aspekte der Eltern-Kind-Beziehung. Je eine Eltern- und eine Expertenversion dieses Instruments wurde für 129 Mutter-Kind-Dyaden der Familientagesklinik für Vorschulkinder in Münster zu Beginn und zum Ende der Behandlung von drei verschiedenen Beurteilern (Therapeuten, Familienbetreuern und Müttern) ausgefüllt. Zu Validierungszwecken wurden die Globale Beziehungsqualität (PIRGAS) sowie Maße zur mütterlichen (SCL-90-R) und kindlichen (CBCL/1,5-5; C-TRF/1,5-5) Psychopathologie erhoben. Sechs getrennte Faktorenanalysen (je Urteiler zu zwei Messzeitpunkten) zeigten ein stabiles Item-Ladungsmuster für zwei korrelierte Faktoren („Emotionales Band“, „Funktional-Konflikt“) mit guten internen Konsistenzen und Retest-Reliabilitäten. Hinweise auf die Validität der MEK-Skalen ergaben sich aus signifikanten Korrelationen mit dem globalen Beziehungsmaß PIRGAS, Zusammenhängen zur mütterlichen und kindlichen Psychopathologie, insbesondere dem externalisierenden Verhalten, sowie in der Therapieevaluation. Der MEK erlaubt eine valide, reliable sowie multiperspektivische Einschätzung von zwei Aspekten der Eltern-Kind-Beziehung.

Family relations and behavioral-emotional problems in adolescents - an analysis with the adolescent version of the Family Relations Test for Children and Adolescents Abstract.So far hardly any instruments are available for the German-speaking countries, covering family relations from the perspective of young people reliably. Moreover, the relationship between family relations from the perspective of young people and behavioral problems has been rarely investigated.Based on the Family Relations Test, which has been developed originally for children, the Family Relations Test for Children and Adolescents was developed in order to assess the family relations from the perspective of adolescents (94 items, 44 % newly developed). A clinical sample (n = 152) and a field sample (n = 132) was tested with this instrument and additionally behavioural problems of the adolescents were rated by the parents and the adolescents.The two-factor solution of the principal component analysis resulted in a clear distinction between two factors describing positive and negative family relations. The internal consistencies (Cronbach's Alpha) of the scales describing positive and negative relations are between .91 and .93. On these total scores young people from the clinic sample describe overall stronger negative relations in their families compared to young people in the field sample. Within the clinic sample moderate correlations between the extent of mental problems of young people rated by themselves and their parents could be found.Positive and negative relationships of young people to the individual family members and to all members of the family as a whole can be assessed reliably and factorially valid. As expected, significant correlations between negative family relations and mental problems could be found. The adolescent version of the Family Relations Test for Children and Adolescents proves to be a useful tool, to assess family relationships from the perspective of young people and thus to identify possible factors maintaining mental disorders of young people.Zusammenfassung. Fragestellung: Bislang liegen für den deutschen Sprachraum kaum Instrumente vor, die familiäre Beziehungen aus der Perspektive von Jugendlichen reliabel erfassen, und der Zusammenhang zwischen familiären Beziehungen aus der Sicht von Jugendlichen und Verhaltensauffälligkeiten von Jugendlichen ist auch international bisher nur wenig untersucht worden. Methodik: Auf der Basis des Family Relations Test, der ursprünglich nur für Kinder entwickelt worden ist, wird mit dem Family Relations Test für Kinder und Jugendliche ein familiendiagnostisches Verfahren entwickelt, das Familienbeziehungen aus der Perspektive von Jugendlichen erhebt (94 Items davon 44 % neu formuliert). Dieser Test wurde in einer klinischen Stichprobe (n = 152) und einer Feldstichprobe (n = 132) durchgeführt. In der klinischen Stichprobe wurden zusätzlich Verhaltensauffälligkeiten der Jugendlichen im Selbst- und im Elternurteil erhoben. Ergebnisse: In der zweifaktoriellen Lösung der Hauptkomponentenanalyse ergeben sich eindeutige Ladungen der Items, die positive bzw. negative Beziehungsanteile auf jeweils einem Faktor beschreiben. Die internen Konsistenzen (Cronbachs Alpha) der Gesamtskalen, die positive und negative Beziehungen erfassen, liegen zwischen .91 und .93. Jugendliche aus der Klinikstichprobe beschreiben auf diesen Gesamtskalen insgesamt in ihren Familien stärkere negative Beziehungen als Jugendliche in der Feldstichprobe. Innerhalb der Klinikstichprobe konnten zum Teil deutliche Korrelationen zwischen dem Ausmaß der psychischen Auffälligkeiten der Jugendlichen und den berichteten Familienbeziehungen festgestellt werden. Schlussfolgerungen: Positive und negative Beziehungen von Jugendlichen lassen sich aus der Perspektive der Jugendlichen reliabel und faktoriell valide erfassen. Hypothesengemäß werden signifikante Zusammenhänge von negativen Familienbeziehungen und psychischen Auffälligkeiten festgestellt. Die Jugendlichenversion des Family Relations Test erweist sich als ein nützliches Instrument, um familiäre Beziehungen aus der Perspektive von Jugendlichen zu erheben.

Attachment and Externalizing Behavior Problems in Primary School Children with ADHD When examining children with ADHD, attachment research does not usually differentiate between the different clinical pictures within the disorder. This study examines attachment and ADHD in children who display a simple or unspecified form of ADHD, in order to be able to draw specific conclusions about this particular group. Attachment, ADHD symptoms as well as externalizing behavior problems were assessed from 93 children aged five to nine years, 48 of whom had an ADHD diagnosis. The distributions of attachment representations between children with ADHD and those without ADHD differ greatly. In addition, externalizing behavior problems differ between attachment classifications. Attachment seems to be an important factor in the etiology of ADHD, however, ADHD as well as externalizing behavior problems as a global construct are too unspecific to determine the influence of attachment on the disorder. Subsequent studies should first focus on specific symptom patterns within the clinical picture whereas clinical practice should consider the parent-child relation an important factor in the development as well as the treatment of ADHD.

Prader-Willi Syndrome (PWS) is caused by the absence of paternal expression of imprinted genes in the region at 15q11–q13. With an estimated birth incidence of 1/15 000 – 1/30 000, PWS is one of the more frequent genetic syndromes among humans. Typical physical features include neonatal hypotonia and feeding problems, hypogonadism, hyperphagia in later childhood with consecutive obesity, and short stature. Most people with PWS show a mild to moderate intellectual disability. Furthermore, lability of mood, temper tantrums, skin-picking, and compulsive behaviors are quite typical for subjects with PWS. Psychotic disorders have also been found to be quite common in adulthood. This manuscript reviews current knowledge about the etiology, physical features, developmental aspects, behavioral phenotype, and psychiatric disorders that occur as well as existing psychopharmacological and psychotherapeutic interventions.

We report on the frequency and the correlations of behaviour problems among children with Down syndrome in preschool-age.As part of a longitudinal study 48 mothers of children with Down syndrome completed the German version of the “Strengths and Difficulties Questionnaire” (SDQ-D) and the Parenting Stress Inventory (PSI). The mothers were asked to fill out the questionnaires when the children had a mean age of five years. The results were compared to norms from children with typical development.Thirty per cent of the children with Down syndrome were rated as abnormal. Specifically, mean scores indicating problems with children of the same age and hyperactivity were elevated. A regression analysis predicting the total problem score of the SDQ-D revealed maternal educational level, optimistic attitude, and subjective parental stress at the age of one year and the degree of behavioural abnormalities at the age of three years as significant influential factors.Early intervention for Down syndrome children should include supporting parenting competence and coping skills in order to prevent behaviour problems.

Clinical Validation of the Caregiver-Child Socioemotional and Relationship Rating Scale (SIRS) for Child Behavior in a Preschool-Age Sample The description of child behavior in mother-child-interaction is important in early detection and treatment of psychiatric disorders in preschool children. The Caregiver-Child Socioemotional and Relationship Rating Scale (SIRS) may serve this diagnostic purpose. We aim to examine interrater-reliability of SIRS and concurrent, convergent, and discriminant validity to maternal behavior by Play-PAB, and a measure of mother-child-relationsship by Parent-Infant-Global-Assessment-Scale (PIRGAS). Five raters assessed 47 ten-minute video sequences of parent-child-interaction recorded at the Family Day Hospital for Preschool Children with SIRS, Play-PAB, and PIRGAS. We report psychometric properties of SIRS, and present the association with Play-PAB and PIRGAS. SIRS shows a satisfying interrater-reliability for all items. Positive child behavior e. g. the SIRS' "child responsiveness" shows negative correlation to Play-PAB-scales' parental "hostility" and "intrusiveness", but independence of parental "involvement", "positive emotionality", and "discipline". Child and parental behavior show expected associations with the global relationship measure PIRGAS. The assessment of child behavior in parent-child-interaction with SIRS can be quickly learned and reliably applied without extensive training. SIRS shows meaningful relations to parental behavior and a clinical global measure of the caregiver-child-relationship. We recommend SIRS for clinical diagnostics to describe child behavior in mother-child-interaction.

Besides typical physical and hormonal changes during pregnancy, this life period is often associated with an increased emotional and mental stress for women. For the child, the time in utero is regarded as a critical developmental period since adverse stimuli during pregnancy can have lasting consequences for the fetal and postnatal health and development. Thus, prenatal depression, anxiety and stress are considered as risk factors for developmental delay, emotional and behavioral problems. Epigenetic modifications, especially modifications in DNA methylation, are discussed as a possible biological mechanism that could explain the association between prenatal emotional stress and altered developmental and health outcomes of the child. This review summarizes evidence for DNA methylation changes related to prenatal emotional stress from studies with a candidate-gene approach as well as epigenome-wide association studies. Problematic issues are discussed and recommendations for future research are presented.

Disruptive behaviour disorders comprise the diagnosis conduct disorder (CD) and in adults the diagnosis antisocial personality disorder (APD). CD is seen as a difficult-to-treat disorder with a high risk for persistent behavioral problems. In addition, CD is seen as the precursor to antisocial personality disorder (Kretschmer et al., 2014). Dialectical behavior therapy (DBT) was originally developed by Marsha Linehan (1991) for the treatment of borderline personality disorder, but because of the core deficits in emotion regulation in disruptive behavior disorders, DBT is also increasingly being recommended for the treatment of CD and APD. This review presents DBT adaptions for the forensic setting and for the treatment of CD/APD. Clinical implications are discussed.

The Federal Initiative for Early Prevention (funded by German ministry BMFSFJ), through the development of specific assistance programmes, supports families that suffer from psychosocial burden. As nationally representative data are missing, the National Centre for Early Prevention carried out a national survey on the psychosocial burden experienced by families with children aged 0-3 years.Ascertainment of the connections between family-related psychosocial burden and knowledge and use of different assistance programmes.Via paediatricians, 8063 parents were recruited to complete a questionnaire on objective burden, subjective experience of burden as well as knowledge and use of assistance programmes. Differences in knowledge and use between educational groups were tested by means of chi-squared tests. Very good knowledge of available assistance programmes and the offer and acceptance of aid by family midwives were subjected to regression analyses.Clear differences in knowledge and use of individual assistance programmes between educational groups were observed. Many programmes are predominantly used by better educated families, although there are exceptions, for example in the case of family midwives. Despite generally small group differences, less-educated families are the proportionally largest user group of family midwives. Furthermore we present average predicted percentages of knowledge and use for specific groups of psychosocially burdened parents as derived from the regression analyses.The results are discussed in the context of barriers to access for individual assistance programmes as well as their match with families' needs in the practice of early prevention.

Information from parents is regularly used in the diagnostic process of children and adolescents with psychiatric symptoms. But the reliability of this information is debatable, because the parents’ own stress can distort their perceptions of the child’s symptoms.For each of N = 68 children and adolescents (11–18 years) who were using mental health services for the first time, we evaluated the ratings of a parent and a professional clinician (internalizing, externalizing symptoms, total-problem score). In addition, parenting stress was scored on the Eltern-Belastungs-Inventars (EBI, Tröster, 2011), which measures both child-related stress and parent-related stress as well as total stress.Highly stressed parent ratings differed more from the clinicians’ ratings than the ratings of less stressed parents. Additionally, correlations showed that higher parenting stress resulted in larger differences between the parent’s and the clinician’s assessments. Multiple regressions proved the predictive value of child-caused parenting stress for these differences. These results apply for internalizing symptoms, externalizing symptoms, and total-problem score.Parenting stress should be evaluated systematically in order to carefully assess the value of the information from parents and to determine how it should be included in diagnostic and therapeutical decisions.

The development of reading disorders is complicated by frequently occurring comorbid behavioral disorders. Studies have shown this relation between behavior problems and learning disabilities but the causal relation is unclear so far. The present study investigates whether and in what way parents’ judgment (CBCL) of behavioral problems of children change from kindergarten to the end of second grade depending on children’s reading performance. Reading performance of 241 children was assessed every year from kindergarten to second grade. Parents judged children’s behavioral problems on CBCL. Variance analyses showed that poor readers are judged higher on the CBCL problem score and on externalizing behavior in first grade in comparison to kindergarten. In kindergarten, those children who were later classified as poor readers did not differ in externalizing and internalizing symptoms from good readers, but they had more attention problems. In first and second grade poor readers showed overall more behavior problems than good readers. Also the proportion of children with clinical relevant behavior disorders increased in the group of weak readers during first and second grade. The results indicate that the confrontation with performance requirements in school put a high burden on the children.

The paper highlights the essential pillars of schema therapy as well as outlining the basic concepts of early maladaptive schemas, domains, emotional core needs, and the mode model. We present an overview of the important features of the schema therapy and look at the special schematic therapeutic relationship work, thereby focusing on emotional processes, needs-oriented biography work, age-appropriate psycho-education, and schema coaching for parents. Clinical recommendations are given based on the recent evidence.

To date, the factors contributing to emergence of resilience in different stages of adolescence have yet to be sufficiently examined. This study looks at the influence of extracurricular activities on resilience.The sample consists of 413 adolescents (f = 14.8) reporting personal problems (mood, concentration problems, behavior). The effect of extracurricular activities on resilience (gathered by the RS25) was analyzed by linear regression models. Predictor variables in these models were extracurricular activities (sport, hobbies, club memberships, household duties) and the subscales of the SDQ (Strengths and Difficulties Questionnaire). Because of the lack of homoscedasticity, two different regression models (model A: Realschule and Grammar School. Model B: Hauptschule) were specified.The explained variance of both models (model A: R = .516; model B: R = .643) is satisfactory. In both models “prosocial behavior” (SDQ) turns out to be a significant positive predictor for resilience (model A: b = 2.815; model B; b = 3.577) and emotional symptoms (model A: b = -1.697; model B: b = -2.596) are significant negative predictors for resilience. In addition, model A presents significant positive influences of sport (b = 16,314) and significant negative influences of “hyperactivity” (SDQ). In contrast, in model B “club memberships” (b = 15.775) and” peer relationship problems” (b = 1.508) are additional positive predictors.The results of the study demonstrate the important role of prosocial behavior and emotional competence in the manifestation of resilience. The effect of extracurricular activities proves to depend on the social environment (type of school). Thus, these results could form the basis for further more specific developmental programs.

The article describes the programme „Kids’ Skills“ by the Finnish psychiatrist Ben Furman. „Kids’ Skills“ was developed to address behavioural issues in children. It is based on the assumption that children’s behavioural problems should not be pathologized, but can instead be corrected by learning a corresponding skill. The programme is characterised by its focus on strengths and its humorous and playful approach. The 15 steps of “Kids’ Skills” are intended to identify the specific skill, help generate a learning process and continue motivating the child. The authors describe the steps of the programme using a case study. They also address the limited number of existing studies, which have included a telephone and an online survey of practitioners using the programme, as well as case studies. The results of these studies are discussed with regard to their basis in evidence and practical relevance. Continuing research is recommended and possible implementations are suggested.

By means of the Child Behavior Checklist (CBCL) it was assessed how much children who are attended to a child guidance center suffer from behavior problems and emotional distress. Furthermore, the interaction between straining and supporting influences was examined. Results show that symptom severity lies in the range of clinical significance. Children of divorced parents show more internalizing as well as externalizing problems than children of nuclear families. High social integration is correlated with lower psychic symptomatic - yet, this finding was dependent on family situation: While frequency to meet friends in children from nuclear families was correlated with lower symptomatic, this effect could not be found in children of divorced parents.

Disturbances of attachment represent a clinically significant disorder and seriously impair social behavioural functioning. To date there has been little research and valid diagnostic methods are lacking. In the present study a German Version of the Disturbances of Attachment Interview developed by Smyke and Zeanah (1999) was used to assess disturbances of attachment in a sample of foster children and the validity of the translation is investigated. Furthermore, the Strengths and Difficulties Questionnaire (Goodman, 1997) was used to examine the discriminative validity. The results show a satisfying reliability and the scales of attachment disorders declare the main of the variance. There is a weak association between the disinhibited scale and hyperactivity in the SDQ. Overall the disinhibited disorder can be distinguished from other behaviour patterns. Regarding the inhibited scale there are associations with all SDQ scales and the inhibited category seems harder to distinguish from other deviant developmental issues. The method is evaluated as a qualified approach to the diagnosis of attachment disorders in the context of a multimethodical approach. Furthermore, the findings suggest further examination of the construct of attachment disturbances.

Children with language disorders are at increased risk of developing behavioural and emotional problems. The analysis focused on the question whether behavioural problems differ depending on the type of language deficit. The present study examines the behaviour of preschool children with different language impairments.The results of N=540 children aged between 4;0 and 5;11 years were analyzed. Language impairments were classified into phonetics/phonology (n=44), vocabulary (n=44), grammar (n=58), pragmatics (n=26) and multiple language impairments (n=171). In addition, a distinction was made between deficits in language production and comprehension. The children were compared with an unimpaired control group (n=197). The extent of emotional and behavioural problems were analyzed.The results indicate that emotional and behavioural problems differ depending on the type of language deficit already in preschoolers. Especially deficits in language comprehension, pragmatic impairments and multiple language impairments increase the risk of behavioural and emotional problems and hyperactivity.The relationship between language skills and emotional and behavioural problems should be emphasized in the developmental observation and documentation in preschool. In particular, the distinction between deficits in pragmatics and behavioural problems requires a differentiated examination to ensure an optimal intervention.

The present study has examined the relationship between school based effort avoidance tendencies and problem behavior in children aged 9 to 16 years. Effort avoidance tendencies were assessed in 367 children with and without child care. Teachers and social workers rated children on behavioral and emotional problems with the Strengths and Difficulties Questionnaire (SDQ). Results confirmed significant but low correlations between teacher ratings of behavior and emotional problems in children and selected subscales of self-reported effort avoidance in school, especially for children in child care institutions. For them "conduct problems" were significantly correlated with three of the four subscales and the total sum score of effort avoidance whereas "hyperactivity" was the only scale which was significantly associated with the fourth subscale. In the school sample only "hyperactivity" and "peer problems" were significantly correlated with one subscale of school-based effort avoidance. The findings suggest that more problem behavior is in relation to more school based effort avoidance tendencies.

With community samples, parent behavior can be assessed in standardized mother-child interaction situations with the observational instrument Lab-PAB by Wilson und Durbin (2012) with respect to five dimensions (Involvement, Positive Emotionality, Hostility, Intrusiveness and Discipline). We examined an adaptation of Lab-PAB for non-standardized free-play interaction situations (Play-PAB version) with a preschool psychiatric sample. We examined the internal consistency, interrater reliability and dimensional structure of the Play-PAB and its associations to the clinical relationship assessment scale PIR-GAS from DC:0-3R. Interaction sequences of 47 parent-child dyads who were treated in our Family Day Clinic were evaluated at admission with the Play-PAB, in addition to the PIR-GAS-rating. Each instrument was rated by two independent raters. We report means, standard deviations, internal consistencies and the interrater-reliability for each of the five Play-PAB scales. Furthermore we examine if the scale intercorrelations are reasonable in comparison to the original version. Finally, the associations to PIR-GAS are presented. The Play-PAB scales reflect sufficient variation of parenting, good internal consistencies and satisfactory interrater reliability. The adaptation shows psychometric properties that are comparable to the original version. The scale intercorrelations as well as the associations to PIR-GAS are reasonable. The Play-PAB is a promising instrument for assessing different aspects of parent behavior in a preschool psychiatric sample, with meaningful associations to parent-child-relationship quality.

The term inclusion (=admittance, involvement) is used almost synonymously for the concept of the joint schooling of children with and without intellectual disabilities, language disabilities, physical handicaps, or mental disorders. This article addresses the current state of inclusion in Germany as well as the international situation, such as the Salamanca Declaration of the UNESCO, the «Individuals with Disabilities Act» (IDEA) in the United States as well as European developments, particularly in Great Britain, Austria, and Russia. Even though, from a political perspective, the decision in favor of inclusion seems irreversible, there appears to be a lack an agreement on the modality and timeframe. Thus, the average percentage of students with special education needs in Germany amounts to only 28.2%. The reasons behind this situation are presently being analyzed and discussed. A question of key importance concerns the benefit for the persons concerned, since that should be the measure of the success of inclusion. This question will most likely be validly answered only for individual subgroups of disabilities. This field still requires extensive research.

The Convention on the Rights of Persons with Disabilities became legally binding in Germany in March 2009. “Inclusion” is the major concept–all people with any kind of handicap must have the same rights to full and effective participation and inclusion in society. Preceding inclusion come adjustments in society with regard to ethical, legislative, administrative, conceptual, structural, economical, and thus also to healthcare-political frameworks, in order to make disabilities are as far as possible no longer a handicap in an individual’s everyday life. This review first outlines the present social status influencing the development of children, a child’s welfare, and especially the healthcare of children and adolescents with psychiatric disorders and conditions indicating barriers to inclusion. It focuses on those articles of the UN convention which are relevant with regard to ethical attitude, epidemiology, healthcare framework, diagnostics, therapy, teaching, and research with respect to child and adolescent psychiatry. The analysis points to a significant backlog demand in child psychiatric healthcare, teaching, and research.

Indications for home treatment for specific diagnoses in child and adolescent psychiatry have not yet been evaluated.In a recent intervention study (primary outcome: length of stay), 92 patients aged 5 to 17 years were randomized into an intervention group (early discharge followed by home treatment in combination with inpatient treatment, where needed) and a control group (regular length inpatient treatment). The aim of this explorative analysis was to retrieve additional information on “what works for whom.” Outcome parameters were as follows: Children’s Global Assessment Scale (CGAS), Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), Strengths and Difficulties Questionnaire (SDQ) and Columbia Impairment Scale (CIS) at T1 (within 14 days after intake), T2 (end of treatment) and T3 (∅ 8.4-month follow-up). Multiple regression was used to investigate the association between diagnoses, treatment setting, age, sex, and improvement in both groups.In children externalizing disorders were predominant, whereas in adolescents internalizing disorders were prominent. Patients improved equally under both types of treatment. Home treatment, however, was rated by the patients to be significantly more effective in adolescents (SDQ p = .017), boys (CIS p = .009, SDQ p.001), and with externalizing disorders (SDQ p = .005).Home treatment may be considered an alternative to inpatient treatment, especially in boys with externalizing disorders.

The present study investigated five to six year old children's ability to regulate negative and positive emotions in relation to psychosocial problem behavior (N=53). It was explored, whether mothers' supportive and nonsupportive strategies of emotion socialization influence children's problem behavior by shaping their emotion regulation ability. Mothers reported on children's emotion regulation and internalizing and externalizing problem behavior via questionnaire, and were interviewed about their preferences for socialization strategies in response to children's expression of negative affect. Results showed that children with more adaptive expression of adequate positive emotions had less internalizing behavior problems. When children showed more control of inadequate negative emotions, children were less internalizing as well as externalizing in their behavior. Furthermore, results indicated indirect relations of mothers' socialization strategies with children's problem behavior. Control of inadequate negative emotions mediated the link between non-supportive strategies on externalizing problem behavior. Results suggest that emotion regulatory processes should be part of interventions to reduce the development of problematic behavior in young children. Parents should be trained in dealing with children's emotions in a constructive way.

Offsprings of psychiatric patients are burdened and they are at risk of developing a mental disorder themselves.All admissions in a psychiatric hospital within a period of 6 months were screened for parenthood of underaged children. They were given standardized questionnaires for child behavior (SDQ), parenting behavior and subjective need for help in parenting.21.5 % (N = 439) of the patients had underaged children, 194 patients participated in the study. They considered their children as having more psychological/behavioral problems than a control group (N = 97). Patients with personality or affective disorders and patients with a high level of psychiatric comorbidity rated their children most problematic. Although patients did not differ from controls in the evaluation of their parenting style, they expressed a higher need for help in parenting.Parenting and education issues need to be considered in the treatment of mentally ill patients. Effective support could be a relief for families and help to prevent mental disorders in offsprings.

The present study examines the relation between knowledge of emotion regulation strategies and social behavior in preschoolers. Knowledge of emotion regulation strategies of 210 children (mean age 55 months) was assessed. Teachers rated children's social behavior with SDQ. Linear regression analysis examined how knowledge of emotion regulation strategies influenced social behavior of children. Significant effects of gender on SDQ scales "prosocial behavior", "hyperactivity", "behavior problems", and SDQ total problem scale were identified. Age was a significant predictor of SDQ scales "prosocial behavior", "hyperactivity", "problems with peers" and SDQ total problem scale. Knowledge of emotion regulation strategies predicted SDQ total problem scores. Results suggest that deficits in knowledge of emotion regulation strategies are linked with increased problem behavior.

The attempts to differentiate, separate and draw lines between counseling, educational counseling and psychotherapy are fundamentally flawed. There are no clear distinctions between these areas with a view to the techniques, procedures and methods used. In the context of counseling psychotherapeutic interventions are also necessary to overcome the problems. This will be shown in three case studies on the grounds of the following principles of psychodynamic psychotherapy: unconscious conflicts - defence/resistance - transference/countertransference - clarification/confrontation/interpretation.

The article gives an insight into the practice of Integrated Family Counseling and identifies their interfaces with psychotherapeutic approaches. The example of the child-centered educational counseling shows how consultancy, systemic and psychotherapeutic interventions interact in order to meet the parents educational needs defined by the parents. The first part of the article explains the term of Integrated Family Counseling, differentiates the various substantive areas of work and outlines the systematic attitude. The second part describes the psychotherapy-systemic action in the child-centered educational counseling from the perspective of the practice. Main priorities in the course of counseling, including cause-related behavioral and developmental diagnostics, play therapy intervention and parental involvement are presented. Here the systemic approach, major methodological elements as well as their effects are pointed up. The third part is devoted to the reflection of the relationship between counseling and psychotherapy. It becomes clear that in particular the intended effectiveness of an intervention determines their methodological design to a large extent.

Recent work implicates the capacity to mentalize as a predictor of therapeutic success of psychodynamically oriented psychotherapy for adults. However, little, if any, research focuses on similar associations in childhood. In the current study, we investigated the role of maternal reflective functioning (RF) in the treatment of 25 children with clinically diagnosed anxiety disorders and a high level of externalizing comorbidity in an outpatient setting. Before and after treatment of their children with short-term Psychoanalytic Child Therapy (PaCT), we assessed maternal RF using the Parent Development Interview and requested parents to report on symptoms of their 4-10-year-old children using the Child Behavior Checklist (CBCL). RF proved highly stable and showed no significant change from pre- to post-treatment over an average treatment interval of 41 weeks. While remission in internalizing symptoms was unrelated to pretreatment maternal RF, children with high-RF mothers showed significant remission of externalizing comorbidity in comparison to children with low-RF mothers both immediately after treatment as well as at six-month follow-up. These preliminary results support parental RF as a valuable prognostic criterion for successful treatment of externalizing symptoms with PaCT. These findings call for replication in large-scale follow-up studies with children diagnosed with externalizing disorders.

Psychiatric treatment of children in preschool age (0-6 years) and their parents is an expanding field of research due to its high clinical significance. Specific family psychiatric treatment programs have been developed to meet the demands of this young age group, but are little known. A multiprofessional intermittent treatment approach sensitive to developmental and family context has been established in the Preschool Family Day Hospital for Infants, Toddlers and Preschoolers and their Families at Münster University Hospital, Germany. Group and individual therapeutic interventions for both children and parents, video-based parent-child-interaction therapy, psychiatric and psychotherapeutic treatments of parents and family therapeutic interventions integrating siblings are supporting and enhancing each other in an innovative and integrated family psychiatric program. First results of evaluation studies are reported that show that this treatment is effective.

Caregiver Stress in Foster and Adoptive Parents of Children with Fetal Alcohol Spectrum Disorders. Foster and adoptive parents of 71 children with fetal alcohol syndrome (FAS) report on developmental and behavioral characteristics, family stress, coping resources and their satisfaction with support. The data reveal an elevated rate of social and emotional problems in the children. In spite positive individual and social resources, the foster and adoptive parents feel a high level of caregiver stress. 30 % of them rate the support they receive from pediatric, therapeutic or educational services as lower than expected. Specifically, they miss early information on the diagnosis, professional knowledge and support for the special challenges of education and managing behavioral problems in their collaboration with social support agencies.

This study evaluates the Musical Concentration Training with Pepe ("MusiKo mit Pepe") for children aged 5 to 10 years with attention deficits.Using a pre-post-control design (N = 108), changes in attention capacity are measured by the Test of Attentional Performance for Children (KiTAP), whereas changes in the quality of life are assessed with the Children's Questionnaire (KINDL-R). Additionally, we utilized the Symptom Checklist for Attention Deficit Hyperactivity Disorders (FBB-ADHS) and for Conduct Disorder (FBB-SSV) of the Diagnostic System of Mental Disorders in Children and Adolescents II based on ICD-10 and DSM-IV as well as the Child Behavior Checklist and the Teacher's Report Form (CBCL, TRF).Significant pre-post effects were found in both attention and quality of life for children treated by the training compared to controls. Moreover, significant reductions were detected in ADHD symptomatology in parents' and teachers' ratings, and in internal problems in parents' ratings. The effectiveness of the intervention was not affected by age, sex, intelligence, or migration background.The music-based training "MusiKo mit Pepe" is an effective intervention for children with attention deficits, pending replication of these findings in future studies.Fragestellung: Die vorliegende Studie überprüft die Wirksamkeit des Musikalischen Konzentrationstrainings mit Pepe (MusiKo mit Pepe) für fünf- bis zehnjährige Kinder mit Aufmerksamkeitsproblemen. Methodik: In einem Prä-Post-Kontrollgruppendesign (N = 108) wurden Veränderungen der Aufmerksamkeitsleistung mittels der Testbatterie zur Aufmerksamkeitsprüfung für Kinder (KiTAP) sowie Veränderungen der kindlichen Lebensqualität mittels des Fragebogens für Kinder (KINDL-R) erfasst. Zusätzlich wurden Fremdbeurteilungsbögen zur Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (FBB-ADHS) sowie zur Störung des Sozialverhaltens (FBB-SSV) des Diagnostik-Systems für psychische Störungen nach ICD-10 und DSM-IV für Kinder und Jugendliche II und der Eltern- und der Lehrerfragebogen über das Verhalten von Kindern und Jugendlichen (CBCL, TRF) eingesetzt. Ergebnisse: Es zeigen sich für die am Training teilnehmenden Kinder im Vergleich zu der Kontrollgruppe über die Zeit signifikante Verbesserungen der Aufmerksamkeitsleistung sowie der Lebensqualität. Darüber hinaus ergibt sich eine signifikante Reduktion der ADHS-Symptomatik im Eltern- und Lehrerurteil sowie eine Verminderung der Internalisierenden Probleme im Elternurteil. Die Behandlungseffektivität ist unabhängig von Alter, Geschlecht, Intelligenz und Migrationshintergrund der teilnehmenden Kinder. Schlussfolgerung: Das musikbasierte Trainingsprogramm MusiKo mit Pepe stellt eine wirkungsvolle Maßnahme zur Behandlung von Aufmerksamkeitsproblemen dar, sollten sich diese Effekte in Replikationsstudien bestätigen.

Negative behavioral changes after anesthesia in children are common. The Post Hospitalization Behavior Questionnaire (PHBQ) was particularly developed and has been widely used in English-speaking countries to investigate such behavioral changes. The PHBQ consists of 27 questions related to behavioral features observed by parents after anesthesia or hospitalization, each involving comparison with their baseline status.A comparable diagnostic tool in German should be established.The PHBQ was translated into German using a well defined back-translation method. A 3-point Likert scale was used to categorize behavioral features as less than, equal to or more than baseline. Overall 600 questionnaires were given out at children's hospital discharge, following surgical or medical procedures or examinations with or without concurrent anesthesia or deep sedation. After questionnaires were returned, factor and item analysis was conducted. Cronbach's alpha was calculated to determine internal consistency as a measure of reliability.In total, 155 returned and completed questionnaires were assessed, with patients' age ranging from 1.1 to 15.9 (median 5.7) years and length of hospitalization between 1 to 15 (median 2.5) days. The German translation of the PHBQ has a factorial structure that is similar to the English version, and its psychometric properties are also similar. After analysis of the main components and consideration of the Scree plot, either 6 or 7 factors were indicated. Analogously to the original version, we chose 6 factors, which explain 58% of variance. Items were not identically assigned to factors as with the original version, and terms used to describe the factors were slightly adapted. Reliability was adequate, with Cronbach's alpha for the 6 factors being between 0.6 and 0.82 (for total scale: Cronbach's alpha = 0.89, compared to 0.82 for the original version). Children younger than 5 years showed more negative behavioral changes than older children. There were no gender differences.With the German translation of the PHBQ presented here an instrument is available to detect negative behavioral changes after anesthesia in children among German speaking populations. The translation is comparable to the English version with minor differences concerning its factorial structure, which may be due to the predominant role of anxiety in all items. Like the original, this questionnaire does not per se discriminate between anesthesia and hospitalization induced behavioral changes. However, the German translation of the PHBQ is a questionnaire that is feasible for clinical routine and scientific settings and can be easily and quickly completed by caregivers.

Parental stress is increased in clinical contexts (e.g., child psychiatry) and correlates with behavioral and emotional problems of children. In addition, parental stress can result in a biased parental perception of child's behavior and emotions. These interrelations were examined in a normal (N = 320) and a clinical (N = 75) sample. The "Eltern-Belastungs-Screening zur Kindeswohlgefährdung" (EBSK; Deegener, Spangler, KörnerBecker, 2009) was used for the assessment of parental stress. As expected, increased EBSK scores were overrepresented in the clinical sample. In both samples stressed parents reported having children with more behavioral and emotional problems. Children of stressed parents in turn reported significantly less problems than their parents did. The rating of independent third persons, e.g. teachers, was not available and should be added in future research. Restrictions in methodology and conclusions for practice are discussed.Elterliche Belastung ist zum einen in klinischen Settings (z. B. Kinder- und Jugendpsychiatrie) erhöht und geht mit mehr Erlebens- und Verhaltensproblemen beim Kind einher. Zum anderen kann elterliche Belastung aber auch mit einer negativ verzerrten Wahrnehmung der Eltern hinsichtlich kindlichen Problemverhaltens einhergehen. Die Zusammenhänge wurden an einer Normal- (N = 320) und einer klinischen (N = 75) Stichprobe unter Einsatz des Eltern-Belastungs-Screening zur Kindeswohlgefährdung (EBSK,citationReference rid="c7" id="cr7-4"Deegener, Spangler, KörnerBecker, 2009/citationReference) zur Erfassung der elterlichen Belastung untersucht. Entsprechend der Annahmen fiel die elterliche Belastung in der klinischen Stichprobe höher aus. In beiden Stichproben ging elterliche Belastung mit mehr von den Eltern berichteten Erlebens- und Verhaltensproblemen beim Kind einher. Waren die Eltern belastet, berichteten die Kinder deutlich weniger Probleme bei sich selbst als von den Eltern wahrgenommen. Die Meinung eines dritten Außenstehenden, z. B. Lehrer, wurde in der vorliegenden Studie nicht miteinbezogen und die Untersuchung steht noch aus. Methodische Einschränkungen und Ableitungen für die Anwendung wurden diskutiert.

Psychological disturbances play an increasingly important role in the pediatric practice. Since the efficacy of early interventions is well proven, screening instruments are of interest that could help pediatrists with the diagnostic procedure. The authors report on the prevalence of psychological disorders and/or somatoform symptoms with their effects on the psychological and health related quality of life in a consecutive representative pediatric population in a rural area. Altogether 511 children, juveniles and their parents participated in the study. The Strengths and Difficulties Questionnaire (SDQ), the Health Survey (SF-36) and the Children's Somatization Inventory (CSI) were administered. The results showed that a great percentage of the children and juveniles who did not primarily attend a pediatrist due to behavior problems did exhibit psychological and emotional disturbances. Among the 11- to 17-year-old children the boys were significantly more disturbed than the girls, based on parent ratings. Furthermore, 49% of the children and juveniles reported indications for somatoform disorders, in 7.2% the DSM-IV criteria for a somatization disorder were fulfilled. Girls met the criteria significantly more often than boys. The subjectively perceived quality of life of the children and juveniles was found to be reduced with the degree of the psychological problems and the degree of somatization.

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 number of scientific evaluations of early preventions programs has considerably increased since the foundation of the national center of early prevention in Germany. Early primary and secondary intervention programs are designed to address parents with little children (prenatal until three years) to improve the parent-child-relationship and parental educational competencies. This is thought to enhance child development and to avoid maltreatment in terms of neglect and abuse. During a systematic review, six data-bases were searched for publications on studies about the effectiveness of early prevention programs in Germany between 2003 and 2013. Eight studies were found to fulfill inclusion criteria and were included in a meta-analysis. In comparison to the control groups the early prevention programs had a small effect on maternal symptom burden (d = 0.28), however there was no effect on maternal competences (d = 0.10) and perceived social support (d = -0.06). In addition, there was no effect on psychic child development (d = 0.05) but no effect on the physical development of the children (d = 0.00). Results are discussed as preliminary due to a current lack of a sufficient amount of studies in Germany.

To analyse the administrative prevalence and regional differences in hyperkinetic disorder (HK) diagnoses in Germany.The administrative prevalence of HK (ICD-10 F90) was analysed for 3,6 million children, up to 18 years old and in the whole year 2009 insured by the AOK, using health insurance data. Additionally, administrative prevalence changes between 2006 and 2008 were investigated. The prevalence analyses were differenciated according to postal code areas and regions of the associations of statutory health insurance physicians (SHIP-regions).The analyses revealed a continous increase of the administrative HK-prevalence between 2006 (2,8 %) and 2009 (3,8 %). The administrative prevalence was notably lower in the city states Bremen, Hamburg and Berlin, but rather high in four of five SHIP-regions in the New Laender. 14 % of children with HK were diagnosed with HK and ICD-10 F98.8. In 47 % these different diagnoses had been coded by different physicians.Regional differences in administrative prevalence rates and discrepancies in diagnosis coding by different physicians may indicate uncertainties regarding HK-diagnosis in routine health care. Future studies should analyse these associations more detailed.

Attention Deficit-/Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence, often accompanied by comorbid disorders. A high standard of diagnostic assessment combined with a demand for valid diagnostic instruments is necessary. The K-SADS-PL is an established semi-structured interview, focusing on the categorical assessment of psychiatric disorders. The aim of the following study was to examine specific characteristics of ADHD symptomatology including functional and behavioral assessment. Therefore correlations between the result in a diagnostic interview (K-SADS-PL) and different ADHD-specific instruments were performed. Groups were formed (exposed vs. unexposed), based on the diagnostic finding in the K-SADS-PL. Group-specific test score differences were calculated and compared by multivariate analyses of covariance. Children with ADHD showed a significantly higher impact of conduct and emotional problems than the unexposed group. Health related quality of life was more impaired in children and families suffering from ADHD which refers to the relevance of family-oriented psychotherapy.

The aim of this study is to investigate behaviour problems and emotional regulation of children who's siblings are diagnosed with cancer. Participants were assessed with the Strengths and Difficulties Questionnaire (SDQ) and the MacArthur Story Stem Battery (MSSB). Both instruments were administered twice (shortly after diagnosis and at the end of treatment). Brothers and sisters of 14 children suffering from cancer were compared with 18 siblings of healthy individuals. In the SDQ no differences between the two groups were found. At time 1 the MSSB showed significant differences in number and quality of displayed contents, representation of parents and the way of performing the narrative. At time 2 narratives changed particularly in the treatment group, but some differences still remained. Overall siblings of children suffering from cancer showed more intrapsychic reaction to the disease than became obvious in their behaviour. This fosters the conclusion that there may be a need for specific support for siblings of children with cancer in order to prevent them from psychic disorders and pathological mourning reactions.