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The COVID-19 outbreak forced widespread changes in minors' daily life with a risk of compromising well-being. So far, little is known about how health-related quality of life (HRQoL) of young refugees has developed during this time, although they belong to a vulnerable group. In a cross-sectional analysis during the first year of the pandemic, minors aged 8 to 16 years with and without refugee experience (n each = 156) were surveyed, using self-report questionnaires on HRQoL and perceived COVID-related stress. In a longitudinal analysis with refugee minors aged 8 to 18 years (n = 91) HRQoL and possible relevant predictors (gender, age, duration of stay, mental health) were assessed in 2019 (pre-pandemic). HRQoL was reassessed in 2020 (peri-pandemic). No difference was detected between minors with and without refugee experience in terms of peri-pandemic HRQoL. A proportion of 36% (refugee minors) and 44% (non-refugee minors) reported low peri-pandemic HRQoL. However, refugee minors reported more COVID-related stress (difficulties in following school). Longitudinally, HRQoL of refugee minors increased from pre- to peri-pandemic times. Older age, lower pre-pandemic HRQoL, and pre-pandemic externalizing problem behavior predicted worse peri-pandemic HRQoL. The findings suggest a certain resilience of refugee minors but also show a continued vulnerability. Therefore, minors at risk should be identified and their psychosocial needs addressed. [ABSTRACT FROM AUTHOR]

Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys. [ABSTRACT FROM AUTHOR]

Emergency inpatient admissions of children and adolescents are more difficult if the patient is admitted involuntarily and/or the caregivers or custodians of institutional care are absent. The present study aimed to clinically characterize involuntary versus voluntary admissions by examining the reasons for presentation and associated factors. We retrospectively analyzed patients who presented to the emergency department of a hospital for child and adolescent psychiatry in Bavaria, Germany, and were admitted as inpatients for crisis intervention in the 4th quarter of 2014–2018. Reasons for presentation, clinical and sociodemographic characteristics, and type of admission (voluntary versus involuntary) were analyzed for 431 emergency inpatient admissions. A total of 106 (24.6%) patients were involuntarily admitted. In a binominal logistic regression, presentation due to alcohol consumption, deviant social behavior, and psychosocial burden was positively associated, whereas difficulties at school and depression were negatively associated, with the likelihood of involuntary admission. 58.5% of the 123 unaccompanied patients were admitted involuntarily. Reasons for the presentation of unaccompanied and voluntary inpatient admissions were suicidal thoughts, psychosocial burden, and externalized aggression. A substantial number of child and adolescent psychiatric admissions represent emergency admissions. Involuntarily admitted patients and unaccompanied children/adolescents represent a non-negligible proportion of clinical routine and the clinical and legal background factors need to be further clarified in future studies. This study is registered in the German Clinical Trials Register (24 September 2019, DRKS00017689). [ABSTRACT FROM AUTHOR]

Although within- and between-family bidirectional associations between parental knowledge and children's externalizing behavior have been theoretically proposed, studies that unravel these associations simultaneously remain scarce. This study examined these bidirectional associations within and between German families. 3611 families participated across one-year intervals between children ages 8 to 15 (50.6% boys, 34.5% fathers, 89.0% German-born, Mwaves = 3.63, SDwaves = 2.00). Random intercept cross-lagged panel models (RI-CLPM) with linear slopes revealed negative between-family associations between parental knowledge and children's externalizing behavior, and a negative association between the random linear slopes. Generally, no within-family cross-lagged effects were found, but there were some correlated slopes across families. When teasing apart paternal and maternal knowledge, father-driven but not mother-driven lagged effects of increased knowledge predicting decreased externalizing behavior were found. The findings illustrate the importance of fathers' knowledge and new directions for within-family studies of parent-child interactions. [ABSTRACT FROM AUTHOR]

Bullying in school and cyberbullying are highly relevant issues. Students with special educational needs in emotional–social development and learning show individual characteristics that could be risk factors for bullying perpetration and victimization (e.g., externalizing behavior problems or poor social skills). Therefore, the present study was carried out to explore differences in school bullying and cyberbullying between adolescents without and with the aforementioned special educational needs. A cross‐sectional questionnaire study was carried out with N = 649 (Mage = 13.66, SD = 2.17, 61% boys and 39% girls) participants from Lower Saxony (Germany). Analyses of covariance only revealed differences regarding school bullying. Adolescents with special educational needs in emotional–social development were significantly more often bullying perpetrators. For the victim role, there are no differences between the groups without and with special educational needs in emotional–social development and in learning. The externalizing behavior problems of adolescents were considered to be the main predictor of bullying behavior and victim experiences. To imply targeted bullying interventions and preventions further research is needed focusing on characteristics, risk, and protective factors of special educational needs in emotional–social development. Highlights: Adolescents with special educational needs in emotional–social development were significantly more often bullying perpetrators in school than adolescents without or with special educational needs in learning.For cyberbullying and the victim role, there were no differences between the groups without and with special educational needs in emotional–social development and in learning.Externalizing behavior problems were considered to be the main predictor of bullying behavior and victim experiences. [ABSTRACT FROM AUTHOR]

Abstract Problematic school absenteeism is defined as absence from school occurring with a clinical-level mental disorder. It represents a higher-order term for school refusal, school truancy, and the combination thereof and is associated with an increased risk for school dropout, prolonged mental disorders, and unemployment. This article describes the manualized modular treatment of problematic school absenteeism (MT) by a multiprofessional team. The manual was developed to target a broad spectrum of mental disorders characterized by internalizing but also externalizing behavior. The therapeutic focus is on the reintegration into school and on the cognitive behavioral treatment of the mental disorder. The MT is based on a multilevel model of problematic school absenteeism. The treatment is informed by an extensive case-conceptualization and addresses motivational aspects by offering a low-threshold therapeutic design and motivational interviewing. Core interventions are represented in four modules: cognitive behavioral therapy, family counseling, school counseling, and a psychoeducational physical exercise program. A case vignette provides an illustration of the treatment and the specific graduated approach for school reintegration. The current modular approach is discussed in relation to other cognitive-behavioral manuals targeting a broad spectrum of mental disorders or school refusal. Highlights • A modular treatment for problematic school absenteeism is described. • The main treatment module is based on cognitive behavioral therapy. • Additional modules cover family counselling, school counselling, and psychoeducational sports. • Motivational interviewing supports treatment motivation and engagement. • The effectiveness of the modular treatment for different types of school absenteeism is discussed. [ABSTRACT FROM AUTHOR]

Background: Systematic screening is a powerful means by which children and adolescents with posttraumatic stress symptoms (PTSS) can be detected. Reliable and valid measures based on current diagnostic criteria are needed.Aim: To investigate the internal consistency and construct validity of the Child and Adolescent Trauma Screen (CATS) in three samples of trauma-exposed children in the US (self-reports: n=249; caregiver reports: n=267; pre-school n=190), in Germany (self-reports: n=117; caregiver reports: n=95) and in Norway (self-reports: n=109; caregiver reports: n=62).Method: Internal consistency was calculated using Cronbach's α. Convergent-discriminant validity was investigated using bivariate correlation coefficients with measures of depression, anxiety and externalizing symptoms. CFA was used to investigate the DSM-5 factor structure.Results: In all three language samples the 20 item symptom score of the self-report and the caregiver report proved good to excellent reliability with α ranging between .88 and .94. The convergent-discriminant validity pattern showed medium to strong correlations with measures of depression (r =.62-.82) and anxiety (r =.40-.77) and low to medium correlations with externalizing symptoms (r =-.15-.43) within informants in all language versions. Using CFA the underlying DSM-5 factor structure with four symptom clusters (re-experiencing, avoidance, negative alterations in mood and cognitions, hyperarousal) was supported (n =475 for self-report; n =424 for caregiver reports).Limitations: The external validation of the CATS with a DSM-5 based semi-structured clinical interview and corresponding determination of cut-points is pending.Conclusion: The CATS has satisfactory psychometric properties. Clinicians may consider the CATS as a screening tool and for symptom monitoring. [ABSTRACT FROM AUTHOR]

Recent studies have shown that the development of externalizing behavior in childhood and adolescence can be described through different developmental pathways. However, knowledge about differences between the sexes regarding the trajectories is limited. This study focused on potential differences by examining the trajectories of self-reported externalizing symptoms for girls and boys separately. In addition, the relationships of several familiar and child-specific variables with those developmental courses were assessed. The study was conducted on a large community sample of German youths ( N = 3,893; mean age 11.38 years; 50 % girls) over 4 years. Using growth mixture modeling, three different classes of trajectories were found for both sexes. The classes differed with regard to the level and the course of symptoms ('low', 'moderate', 'high-decreasing'). Girls were overrepresented in the 'low' class, whereas boys were predominant in the 'moderate' and 'high-decreasing' classes. The multiple group analysis revealed that the girls and boys differed significantly in their level and linear course of symptoms with regard to the 'high-decreasing' class. In contrast, no sex differences were found in the growth factors of the 'low' and 'moderate' classes. The regression analyses showed that the children's depressive symptoms, dysfunctional parenting style, and negative family climate were associated significantly with the level and course of symptoms as well as the class membership of girls and boys. Life events predicted class membership only for boys, whereas maternal depressive symptoms and family conflict did not demonstrate any significant relationship. The sizes of the predictive associations with the growth factors were similar for both sexes. The results are discussed with regard to existing developmental models and their possible implications for prevention and future research. [ABSTRACT FROM AUTHOR]

We investigated the differential effectiveness of a parent management training program for children with externalizing problem behavior. The parent management training was tested using a within-subject control group design. 270 families with children aged 3-10 years were included and assessments were made at 3 months before treatment, immediately before treatment, immediately after treatment, and at 12 months follow-up. We analyzed data using growth mixture modeling. For attention problems, we obtained a two-subgroup solution. One subgroup started with high initial values indicating more severe impairment, and the other subgroup had low initial values. The more impaired group showed stronger treatment effects. For disruptive behavior problems, our analyses revealed a three-subgroup solution. Two subgroups exhibited high initial levels of disruptive behavior problems and the third subgroup had low initial levels. One of the more impaired groups exhibited a strong decrease in problem behavior during treatment, while the other two groups only showed moderate decreases. For attention problems and disruptive behavior problems, some of the most impaired children gained the most from parent training. [ABSTRACT FROM AUTHOR]

Assessments of child psychopathology are often derived from parental and teacher reports, yet there is substantial disagreement. This study utilized data from 7 European countries to examine parent-teacher agreement and possible explanatory factors for parent-teacher disagreement such as child and family characteristics, parenting dimensions, and maternal distress were explored. Parent-teacher agreement of the Strengths and Difficulties Questionnaire were assessed using a cross-sectional survey of 4,894 school aged children 6-11 from the School Children Mental Health Europe Project. Parent-teacher agreement was low to moderate (Pearson correlation ranging from .24 (Prosocial) to .48 (Hyperactivity) for the 5 subscales across 7 countries); kappa coefficient ranged from .01 (Turkey) to .44 (Italy) for internalizing problems and .19(Romania) to .44(Italy) for externalizing problems. Child's gender and age, mother's employment status, single parent home, number of children in household, and selected parenting dimension were found to be explanatory of informant disagreement. This study not only serves to advance our understanding of parent-teacher agreement of the Strengths and Difficulties Questionnaire in 7 European countries but provides a novel approach to examining the factors that contribute to informant disagreement., (Copyright © 2017 John Wiley & Sons, Ltd.)