Search

School absenteeism is a significant social and public health problem. However, existing prevalence rates are often not representative due to biased assessment processes at schools. The present study assessed school absenteeism in Germany using a nationwide online self-report survey. Although our definition of school absenteeism was more conservative than in previous studies, nearly 9 % of the 1359 high school students reported school absenteeism within the past 7 days. Absent students lived less often with both parents, were on average of lower socioeconomic status, and reported more emotional problems, behavioral problems and less prosocial behavior than attending students. Being an indicator of a wide variety of problems in children and adolescents, school absenteeism deserves much more attention. Future directions for research and implications for prevention and intervention programs are discussed.

Objective: Acute stress exposure leads to physiological, behavioral and emotional stress responses. While measurements of physiological stress responses in young children have improved, assessments of correlates of emotional responses to stress in children at preschool age are still limited to the coding of video-taped responses and their validity is questionable. Therefore, the aim of this study was to develop and investigate a method to assess correlates of emotional responses to stress by experienced emotional responses (Picture-Stress-Test, PST) and by facial expressed emotional responses. Method: A total of 295 children aged 2–6 years of the SPLASHY study were assessed during an age-adapted stress task by heart rate variability, by videotapes (coded for positive and negative facial expression) and by the assessment of experienced emotional states at baseline, during the stress task and after the stress task. For this purpose, children were asked to estimate their own emotional state and to choose one of five pictures of rabbits with different emotional states (positive (happy) or negative (angry, anxious, stressed and sad)) depending on the estimated subjective emotional state. Results: Both correlates of emotional responses and heart rate variability significantly changed under stress condition. Children showed lower levels of positive states in the PST and in the videotaped material during the stress task. Conclusion: Measures of experienced emotional responses and of facial expression responses might represent valuable methods that could be combined to catch the broad range of correlates of emotional responses to a stress task in preschool children.

Fragebogen, Ratingskalen und Tagebucher sind unverzichtbare Hilfsmittel der verhaltenstherapeutischen Praxis. Das vorliegende Kapitel gibt eine Einfuhrung in den Nutzen und die Notwendigkeit von Fragebogen, Ratingskalen und Tagebuchern fur die verhaltenstherapeutische Praxis. Es werden Fragebogen und Ratingskalen zur allgemeinen Psychopathologie, zu spezifischen psychischen Storungen und Fragebogen, die storungsubergreifende Aspekte psychischer Storungen erfassen, kurz vorgestellt. Der zweite Teil des Kapitels widmet sich storungsspezifischen Tagebuchern. Ein besonderes Augenmerk wird dabei auf den fur die therapeutische Praxis sinnvollen Einsatz dieser Verfahren gelegt. Schlieslich werden die Probleme und Grenzen von Fragebogen, Ratingskalen und Tagebuchern diskutiert.

Muss die Liebe gerettet werden? Wenn ja, warum? Wie steht es um die Liebe in einer Welt des Neoliberalismus, der Digitalisierung, der ›fluchtigen Moderne‹? Was bedroht die Liebe? Wie ist Liebe heute uberhaupt zu denken? Welche Zeit, welchen Raum hat die Liebe in der modernen westlichen Welt? Haben wir die Liebe verloren? Fallt die Liebe zunehmend der Konsumtion zum Opfer? Ist die Liebe lediglich eine Investition fur ein Lebensprojekt? Oder suchen wir nach wie vor die Verschmelzung im Sinne einer romantischen Liebe? Wollen wir Eins-Werden oder Zwei-Sein?

Angststörungen gehören sowohl im Kindes- und Jugendalter als auch im Erwachsenenalter zu den häufigsten psychischen Störungen. Als wirksamste Behandlungsform mit dem höchsten Evidenzgrad hat sich bei Angststörungen in allen Altersgruppen die Kognitive Verhaltenstherapie (KVT) erwiesen. Dabei scheint die Wirksamkeit der KVT im Wesentlichen auf das Therapieelement der Exposition zurückzuführen zu sein und die Exposition wiederum auf dem Lernprinzip der Extinktion (Inhibitionslernen) zu beruhen. Unter Berücksichtigung translationaler Studien arbeitet der vorliegende Artikel den aktuellen Forschungsstand zur Rolle der Exposition bei der Therapie von Angststörungen bei Kindern und Jugendlichen sowie Erwachsenen auf und gibt einen Überblick über empirisch fundierte Strategien zur Steigerung des Expositionserfolgs durch die gezielte Förderung des Extinktionslernens. Hierbei werden Methoden wie die massierte oder variierte Exposition berücksichtigt sowie Mechanismen wie die Kontextkonditionierung, die zu einem erhöhten Rückfallrisiko nach erfolgreicher Therapie führen kann. Ein weiterer Schwerpunkt liegt auf kognitiven Expositionsverstärkern wie D-Cycloserin oder Cortisol, die bei gezielter Einnahme vor oder nach der Exposition die neurologischen Prozesse des Extinktionslernens und der Gedächtniskonsolidierung unterstützen.

Thought-shape fusion (TSF) describes the experience of marked concerns about body weight/shape, feelings of fatness, the perception of weight gain, and the impression of moral wrongdoing after thinking about eating fattening/forbidden foods. This study sets out to evaluate the short version of the TSF trait questionnaire (TSF). The sample consists of 315 healthy control women, 244 women with clinical and subthreshold eating disorders, and 113 women with mixed mental disorders (mixed). The factor structure of the TSF questionnaire was examined using exploratory and subsequent confirmatory factor analyses. The questionnaire distinguishes between a Concept scale and a Clinical Impact scale. However, a lack of measurement invariances refers to significant differences between groups in terms of factor loadings, thresholds, and residuals, which questions cross-group validity. Results indicate that the concept is understood differently in the 3 groups and refers to the suitability of the questionnaire primarily for individuals presenting with symptoms of eating disorders.

The objective of this study was to investigate the satisfaction and acceptance of a structured diagnostic interview in clinical practice and in a research setting. Using the Structured Diagnostic Interview for Mental Disorders in Children and Adolescents (Kinder-DIPS), 28 certified interviewers conducted 202 interviews (115 with parents, 87 with children). After each interview, children, parents, and interviewers completed a questionnaire assessing the overall satisfaction (0 = not at all satisfied to 100 = totally satisfied) and acceptance (0 = completely disagree to 3 = completely agree) with the interview. Satisfaction ratings were highly positive, all means >82. The mean of the overall acceptance for children was 2.43 (standard deviation [SD] = 0.41), 2.54 (SD = 0.33) of the parents, 2.30 (SD = 0.43) of the children's interviewers, and 2.46 (SD = 0.32) of the parents' interviewers. Using separate univariate regression models, significant predictors for higher satisfaction and acceptance with the interview are higher children's Global Assessment of Functioning, fewer number of children's diagnoses, shorter duration of the interview, a research setting, female sex of the interviewer, and older age of the interviewer. Results indicate that structured diagnostic interviews are highly accepted by children, parents, and interviewers. Importantly, this is true for different treatment settings.

Objective The vigilance-avoidance theory postulates a specific threat-related pattern of attention deployment, characterized by initial orientation towards fear-evoking stimuli and subsequent directing of attention away from them. The current eye-tracking study was the first to examine the applicability of the theory for patients with eating disorders, who perceive their own body as a highly aversive, threat-evoking stimulus. Method N = 56 female adolescents with anorexia nervosa (AN) and n = 43 healthy controls (HC) aged 13-18 viewed own-body pictures while their eye movements were recorded. Relative fixation times on self-defined unattractive body areas were compared between the groups by sequencing the overall presentation time of 6,000 ms into six intervals a 1,000 ms. Results Participants with AN showed a significantly stronger attentional bias for unattractive body areas than HC within the time intervals 1, 2, and 3. However, for intervals 4, 5, and 6, no significant group differences occurred. Within the AN group, the bias for unattractive body areas was significantly stronger in interval 1 compared to intervals 4, 5, and 6; whereas within the HC group, a stable pattern of attention deployment emerged. In AN, early attention deployment was positively correlated with the negative affect reported after photo presentation. Discussion The early vigilance in AN and the subsequent decrease in attention to unattractive body parts is in line with our assumptions. However, no indication of attentional avoidance was found. The current findings partially support the vigilance-avoidance theory for the exposure to one's own body in adolescents with AN.

Imitation is a common way of acquiring novel behaviors in toddlers. However, little is known about toddlers’ imitation of undesired actions. Here we investigated 18- and 24-month-olds’ (N = 110) imitation of undesired and allowed actions from televised peer and adult models. Permissiveness of the demonstrated actions was indicated by the experimenter’s response to their execution (angry or neutral). Analyses revealed that toddlers’ imitation scores were higher after demonstrations of allowed versus undesired actions, regardless of the age of the model. In agreement with prior research, these results suggest that third-party reactions to a model’s actions can be a powerful cue for toddlers to engage in or refrain from imitation. In the context of the present study, third-party reactions were more influential on imitation than the model’s age. Considering the relative influence of different social cues for imitation can help to gain a fuller understanding of early observational learning.

Access to psychological interventions during early stages of psychosis is essential for ameliorating outcomes and improving prognosis. However, reaching and engaging individuals at these stages of the illness can be very challenging for early intervention teams. Recent digital technological advances have emerged to overcome some of these challenges and to improve access to psychological interventions. The aim of the present literature review is to summarise main findings of relevant studies published during the last 10 years on the utilization of digital technologies (i.e., virtual reality, smartphone technology and web-based interventions) to enhance psychological treatment outcomes in early psychosis. A literature search from January 2009 to June 2019 was performed to identify relevant papers. Of 1,502 studies identified, nine met inclusion criteria for the review and only five presented results from finalised trials. Overall, these studies showed positive feasibility and acceptability results, along with preliminary evidence of improved therapy outcomes. The present review offers a state-of-the-art summary of the main features of these user-centered digital interventions for early stages of psychosis and a critical discussion about their future implementation in mental health services.

OBJECTIVES To prospectively evaluate the outcome of combined microwave-induced bladder wall hyperthermia and intravesical mitomycin C instillation (thermochemotherapy) in patients with recurrent non-muscle-invasive bladder cancer. METHODS Between 2003 and 2009, 21 patients (median age 70 years, range 35-95 years) with recurrent non-muscle-invasive bladder cancer (pTaG1-2 n = 9; pTaG3 n = 3; pT1 n = 9; concurrent pTis n = 8) were prospectively enrolled. Of 21 patients, 15 (71%) had received previous intravesical instillations with bacillus Calmette-Guerin, mitomycin C and/or farmorubicin. Thermochemotherapy using the Synergo system was carried out in 11 of 21 patients (52%) with curative intent, and in 10 of 21 patients (48%) as prophylaxis against recurrence. RESULTS The median number of thermochemotherapy cycles per patient was six (range 1-12). Adverse effects were frequent and severe: urinary urgency/frequency in 11 of 21 patients (52%), pain in eight of 21 patients (38%) and gross hematuria in five of 21 patients (24%). In eight of 21 patients (38%), thermochemotherapy had to be abandoned because of the severity of the adverse effects (pain in 3/8, severe bladder spasms in 2/8, allergic reaction in 2/8, urethral perforation in 1/8). Overall, six of 21 patients (29%) remained free of tumor after a median follow up of 50 months (range 1-120), six of 21 patients (29%) had to undergo cystectomy because of multifocal recurrences or cancer progression and seven of 21 patients (33%) died (2/7 of metastatic disease, 5/7 of non-cancer related causes). CONCLUSIONS Given the high rate of severe side-effects leading to treatment discontinuation, as well as the limited tumor response, thermochemotherapy should be offered only in highly selected cases of recurrent non-muscle-invasive bladder cancer.

Previous studies of traditional and modern value orientations in individuals found mediated predictive relationships of these values on particular mental disorders. The aim of this study with samples from three countries (Germany, Russia, and China) is to extend findings on mental health (MH) and value orientations to broader MH indicators and two types of mediators, i.e. social support and resilience in accordance to a theory of values and modernization/postmodernization. The multisite study was conducted in the three countries. A path-model with traditional values predicting MH mediated by social support, and modern values predicting MH mediated by resilience was tested in all three countries. As expected, value orientations were for the most part strongest in China, followed by Russia and Germany. Structural equation modeling supported the assumption of mediated prediction of MH by value orientations by and large. The traditional value benevolence predicts social support whereas the modern value self-direction predicts resilience. Value orientations are a sensitive tool to empirically describe cross-cultural differences. The findings indicate that personal value orientations are meaningful predictors of MH. The analysis of personal values shows promise in linking public health, cross-cultural and modernization issues.Estudios previos sobre orientaciones de valores tradicionales y modernos encontraron relaciones predictivas mediadas con trastornos mentales particulares. El objetivo de este estudio con muestras procedentes de tres países (Alemania, Rusia y China) es ampliar los resultados indicadores más amplios de salud mental (SM) y dos tipos de mediadores (apoyo social y resiliencia), de acuerdo a la teoría de los valores y la modernización/postmodernización. Se probó en los tres países un

Fragestellung: Ziel der vorliegenden Studie ist, die Interrater-Reliabilität des Diagnostischen Interviews bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS; Schneider, Unnewehr & Margraf, 2009 ) anhand von Eltern- und Kinderinterviews für verschiedene Störungsklassen zu ermitteln. Zusätzlich wird geprüft, ob sich in Abhängigkeit des Alters oder des Geschlechtes des Kindes, Unterschiede hinsichtlich der Interrater-Reliabilität ergeben. Methodik: 264 Eltern- und 213 Kinderinterviews wurden von 48 geschulten Interviewern in kinder- und jugendpsychiatrischen und schulpsychologischen Einrichtungen sowie im Rahmen eines Forschungsprojektes durchgeführt. Ergebnisse: Die Übereinstimmungsmaße der Eltern- und Kinderinterviews zeigen eine gute bis sehr gute Interrater-Reliabilität der Oberklassen Expansive Störungen, Ticstörungen, Ausscheidungsstörungen, Affektive Störungen, Essstörungen, Schlafstörungen sowie einem Großteil der spezifischen Diagnosen und für den Ausschluss psychischer Störungen. Das Geschlecht und das Alter der interviewten Kinder hatten keinen Einfluss auf die Reliabilitätswerte. Schlussfolgerung: Die Ergebnisse zeigen, dass es sich beim Kinder-DIPS mit trainierten Interviewern für die Oberklassen psychischer Störungen um ein reliables Eltern- und Kinderinterview zur Diagnostik psychischer Störungen handelt.

Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years (M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder (k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder (k = 0.24–0.52; k = 0.19–0.43) and corresponding diagnostic criteria (k = 0.22–0.67; k = 0.24–0.41) were low to moderate with the highest agreement on separation anxiety disorder (k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family—especially maternal depression and low social support—lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement.

Objectives: Exposure-based cognitive behavioural therapy (eCBT) is an effective treatment for anxiety disorders. Response varies between individuals. Gene expression integrates genetic and environmental influences. We analysed the effect of gene expression and genetic markers separately and together on treatment response.\ud \ud Methods: Adult participants (n ≤ 181) diagnosed with panic disorder or a specific phobia underwent eCBT as part of standard care. Percentage decrease in the Clinical Global Impression severity rating was assessed across treatment, and between baseline and a 6-month follow-up. Associations with treatment response were assessed using expression data from 3,233 probes, and expression profiles clustered in a data- and literature-driven manner. A total of 3,343,497 genetic variants were used to predict treatment response alone and combined in polygenic risk scores. Genotype and expression data were combined in expression quantitative trait loci (eQTL) analyses.\ud \ud Results: Expression levels were not associated with either treatment phenotype in any analysis. A total of 1,492 eQTLs were identified with q

Stress-induction procedures designed to increase cortisol levels in infants have been ineffective in many studies. One reason might be that infants did not have sufficient time to settle into the laboratory environment prior to the start of the stress induction, and thus already had high baseline levels of cortisol. In this study we investigate whether an extended warm-up period reduces infants’ ( N = 22) cortisol levels. Fifteen-month-old infants’ saliva cortisol was measured upon arrival at the laboratory. Then, they were allowed to play with their parent. After 30 min, cortisol was measured again. There was a decrease in cortisol after 30 min of free play. Our study suggests that infants’ cortisol levels decrease when infants have the opportunity to acclimatize to the test environment. An extended warm-up phase prior to stress induction procedures might be necessary to reliably increase cortisol levels in infants.

Background: The differential susceptibly hypothesis suggests that certain genetic variants moderate the effects of both negative and positive environments on mental health and may therefore be important predictors of response to psychological treatments. Nevertheless, the identification of such variants has so far been limited to preselected candidate genes. In this study we extended the differential susceptibility hypothesis from a candidate gene to a genome-wide approach to test whether a polygenic score of environmental sensitivity predicted response to cognitive behavioural therapy (CBT) in children with anxiety disorders. Methods: We identified variants associated with environmental sensitivity using a novel method in which within-pair variability in emotional problems in 1,026 monozygotic twin pairs was examined as a function of the pairs' genotype. We created a polygenic score of environmental sensitivity based on the whole-genome findings and tested the score as a moderator of parenting on emotional problems in 1,406 children and response to individual, group and brief parent-led CBT in 973 children with anxiety disorders. Results: The polygenic score significantly moderated the effects of parenting on emotional problems and the effects of treatment. Individuals with a high score responded significantly better to individual CBT than group CBT or brief parent-led CBT (remission rates: 70.9, 55.5 and 41.6%, respectively). Conclusions: Pending successful replication, our results should be considered exploratory. Nevertheless, if replicated, they suggest that individuals with the greatest environmental sensitivity may be more likely to develop emotional problems in adverse environments but also benefit more from the most intensive types of treatment.

The present study compared learning processes associated with panic-related symptoms in families with and without panic disordered mothers. Using a multi-informant approach, 86 mothers [of whom 58 had a primary diagnosis of panic disorder (PD)], their partners and teenage children (mean age, 16.67 years) reported about parents' behavior (modeling and operant learning) in response to children's and parents' experience of panic-related symptoms. Both, maternal and child reports revealed that mothers with PD were more likely to show panic-maintaining behavior and to involve their children in their own experience of panic-related symptoms than mothers without PD. Mothers with PD reported more often to be punished by others for their experience of panic-related symptoms than mothers without PD. Conversely, parent and child reports did not reveal differences between parents' reactions to their children's experience of panic-related symptoms in families with and without a PD mother. Given that mothers with PD were reported to behave differently in relation to their own experience of panic-related symptoms but not in relation to their children's experience of panic-related symptoms, the present study offers preliminary evidence that modeling, rather than operant learning, might affect children's sensitivity to somatic symptoms.

Perceived intrafamilial “emotional connectedness” and “autonomy” were investigated within families with and without an anxious family member using a multiple informant approach. The sample consisted of 32 mothers with a current anxiety disorder and 56 controls, their partners, and their anxious and nonanxious teenage children. No differences were found with respect to the perceived family relationships of family members with versus without anxious mothers. However, compared with nonanxious adolescents, anxious adolescents perceived less autonomy in relation to both parents. Mothers of anxious adolescents also perceived their children to be less autonomous toward them and their partners, than mothers of nonanxious adolescents. In contrast with “autonomy,” “emotional connectedness” was not reported to be different between families with and without an anxious adolescent. Agreement among family members and the importance of perceived individual autonomy in the development of anxiety are discussed.

Objective:Unresolved questions exist concerning diagnosis of ADHD. First, some studies suggest a potential overdiagnosis. Second, compared with the male‐female ratio in the general population (3:1), many more boys receive ADHD treatment compared with girls (6‐9:1). We hypothesized that this occurs because therapists do not adhere toDiagnostic and Statistical Manual of Mental Disorders(4th ed.; DSM‐IV) and International Classification of Diseases (10th rev.; ICD‐10) criteria. Instead, we hypothesized that, in accordance with the representativeness heuristic, therapists might diagnose attentiondeficit/hyperactivity disorder (ADHD) if a patient resembles their concept of a prototypical ADHD child, leading therapists to overlook certain exclusion criteria. This may result in overdiagnosis. Furthermore, as ADHD is more frequent in males, a boy might be seen as a more prototypical ADHD child and might therefore receive an ADHD diagnosis more readily than a girl would.Method:We sent a case vignette to 1,000 child psychologists, psychiatrists, and social workers and asked them to give a diagnosis. Four versions of the vignette existed: Vignette 1 (ADHD) fulfilled allDSM‐IV/ICD‐10 criteria of ADHD. Vignettes 2‐4 (non-ADHD) included several ADHD symptoms but stated other ADHD criteria were nonfulfilled. Therefore, an ADHD diagnosis could not be given. Furthermore, boy and girl versions of each vignette were created.Results:In Vignettes 2‐4 (non-ADHD), 16.7% of therapists diagnosed ADHD. In the boy version of these vignettes, therapists diagnosed ADHD around 2 times more than they did with the girl vignettes.Conclusions:Therapists do not adhere strictly to diagnostic manuals. Our study suggests that overdiagnosis of ADHD occurs in clinical routine and that the patient’s gender influences diagnosis considerably. Thorough diagnostic training might help therapists to avoid these biases.

This study extends prior research on the Picture Anxiety Test (PAT; Dubi & Schneider, 2009 ) in clinical samples, by examining psychometric properties and acceptance in a community sample of 153 4–8-year-old children. Children completed the PAT and the RCMAS, a well-established questionnaire measuring anxiety. Parents and teachers completed questionnaires on anxiety and externalizing behavior. In addition, a panel of psychologists and psychiatrists evaluated the PAT for quality and utility. Results indicated high internal consistencies for the subscales and composite scale, very high interrater reliability, and moderate to high test-retest reliability. Substantial correlations between the PAT and the RCMAS indicated good convergent validity. Sex and age differences were found for some subscales. Agreement between children and their parents and teachers was generally low. Children reported high acceptance of the PAT, and the panel of psychologists and psychiatrists rated the PAT as high in both quality and utility. Results were consistent with prior research on the PAT in clinical samples and indicate reliability and validity for assessing anxiety in a subclinical community sample.

Die Trennungsangst ist eine der häufigsten Angsterkrankungen im Kindesalter. Für die Behandlung dieses Störungsbildes liegt bislang nur ein überprüftes kognitiv verhaltenstherapeutisches Behandlungsmanual vor, das Trennungsangstprogramm für Familien (TAFF). Der erste Teil des Behandlungsmanual umfasst jeweils vier Kind- und vier Elternsitzungen. Diese vorbereitenden Sitzungen beinhalten Psychoedukation mit Eltern und Kind. Informationen bzgl. Angst werden erarbeitet, dysfunktionale Gedanken identifiziert und modifiziert, Bewältigungsstrategien gesammelt und das Konfrontationsrational vorgestellt. Im zweiten Teil, der aus acht Familiensitzung mit einem kurzen, sich anschließenden Elternteil besteht, werden Konfrontationsübungen vorbereitet und umgesetzt. Mit den Eltern werden separat eigene dysfunktionale Gedanken bearbeitet, hilfreiches unterstützendes Verhalten eingeübt und Erziehungskompetenzen ausgebaut. Eine vorliegende Therapiestudie mit Warteliste weist auf die Wirksamkeit dieses Therapiemanuals für junge Kinder hin. Schlagwörter Trennungsangst – kognitive Verhaltenstherapie – familienbasiert – Kinder, Separation Anxiety Disorder is one oft the most frequent mental disorders in children. The SAFT treatment manual is an evidence-based cognitive behavioral therapy program for children with separation anxiety. Its first part consists of four weekly sessions with the child and four weekly sessions with the parents. Children and parents receive psychoeducation about anxiety, learn to recognize and reframe irrational beliefs about separation situations, expand their repertoire of coping strategies, and are introduced to the rationale for exposure. The second part of treatment consists of eight weekly family sessions followed by a short parent-only session. During the family sessions, exposure in vivo is planned and practiced. The parent-only portions of the family sessions involve reframing parental irrational beliefs about separation, parenting strategies and practicing parental behavior during exposure. Evaluation data shows that disorder-specific family-based therapy (SAFT) results in improvement compared with waiting list controls. Keywords separation anxiety – children – cognitive behavioral therapy – family based

Resume Le trouble lie a l’anxiete de separation est l’un des troubles mentaux les plus frequents chez les enfants. Le manuel de therapie « programme familial contre l’anxiete de separation » (PFAS) est le seul manuel de therapie cognitivo-comportementale existant destine aux enfants souffrant d’anxiete de separation. La premiere partie se compose de quatre seances hebdomadaires avec l’enfant et de quatre seances hebdomadaires avec les parents. Enfants et parents apprennent a comprendre ce qu’est l’anxiete, apprennent a reconnaitre et recadrer leurs pensees irrationnelles dans des situations de separation, developpent des strategies de gestion de la peur et sont prepares a des situations de confrontation de la peur. La deuxieme partie du traitement comporte huit seances familiales hebdomadaires, suivies d’une breve seance finale avec les parents. Durant les seances familiales, des situations d’exposition in vivo sont planifiees et mises en pratique. La partie des seances familiales reservee exclusivement aux parents vise a recadrer leurs pensees irrationnelles concernant la separation, a developper des strategies parentales et a mettre en pratique le comportement parental dans des situations de confrontation. Une etude demontre l’efficacite du PFAS compare a une liste d’attente.

Background Excessive crying, sleeping or feeding problems are found in approximately 20% of infants and may predict behavioural problems in childhood. \ud \ud Methods A quantitative meta-analysis of 22 longitudinal studies from 1987 to 2006 that statistically tested the association between infant regulatory problems and childhood internalising, externalising and attention-deficit/hyperactivity disorder (ADHD) problems was carried out; 1935 children with regulatory problems were tested. Cohen's d was used to express the association between regulatory problems and behavioural problems. Heterogeneity of the effect sizes was assessed using the I 2 statistic and meta-analysis of variance and meta-regressions were conducted to assess the influence of moderators. Rosenthal's classic fail-safe N and correlation of sample sizes to effect sizes were used to assess publication bias. \ud \ud Results The weighted mean effect size for the main regulatory problems-behavioural problems association was 0.41 (95% CI 0.28 to 0.54), indicating that children with previous regulatory problems have more behavioural problems than controls. Externalising and ADHD problems were the strongest outcome of any regulatory problem, indicated by the highest fail-safe N and lowest correlation of sample size to effect size. Meta-analyses of variance revealed no significant moderating influences of regulatory problem comorbidity (I(2) = 44.0, p > 0.05), type (I(2) = 41.8, p > 0.05) or duration (I(2) = 44.0, p > 0.05). However, cumulative problems and clinical referral increased the risk of behavioural problems. \ud \ud Conclusions The meta-analyses suggest that children with previous regulatory problems have more behavioural problems than controls, particularly in multi-problem families. Further studies are required to assess the behavioural outcomes of previously sleep, feeding or multiply disturbed children.

Background: The present study examines frequency of DSM-IV symptom and diagnostic criteria for separation anxiety disorder (SAD) by informant, age, and sex. Methods: Children aged 4–15 years with a primary DSM-IV diagnosis of SAD (N= 106) were assessed using structured diagnostic interviews (Kinder-DIPS; DSM-IV-TR Version). Frequency of DSM-IV symptom and diagnostic criteria were examined as a function of informant and child characteristics, along with impairment and distress ratings. Results: The most frequently reported symptoms were separation-related distress, avoidance of being alone/without an adult and sleeping away from caregivers or from home, with nightmares the least frequently endorsed criterion. Child report did not yield any significant sex or age differences. However, parent report revealed greater reluctance or avoidance of school attendance for girls than boys, and for younger children (

Angststorungen gehoren zu den haufigsten psychischen Storungen im Kindes- und Jugendalter. Sie sind sowohl mit hohem Leidensdruck als auch langfristig ungunstiger Prognose verbunden und werden oft nicht erkannt. Um eine reliable und valide Diagnostik sowie Therapieevaluation zu gewahrleisten, werden Kind und Eltern zur Symptomatik des Kindes befragt. Standardisierte klinische Interviewverfahren zur kategorialen Diagnostik, erganzt um storungsspezifische Selbst- und Fremdbeurteilungsverfahren, sind dabei die Methoden der Wahl. Sekundaranalysen zeigen, dass nur kognitiv-verhaltenstherapeutische Interventionen als ausreichend evidenzbasiert betrachtet werden konnen. Keine Unterschiede finden sich, wenn die kognitive Verhaltenstherapie individuell oder in der Gruppe, mit dem Kind allein oder unter Einbezug der Eltern durchgefuhrt wurde. Der kurzfristige Erfolg psychopharmakologischer Behandlung („selective serotonin reuptake inhibitor“, SSRI) gilt heute als belegt. Zentrale empirisch validierte psychotherapeutische Interventionen sind die Psychoedukation, kognitive Bearbeitung dysfunktionaler Gedanken und systematische Konfrontation mit den angstauslosenden Situationen.

Ätiologiemodelle zur Entstehung von Angststörungen messen neben genetischen Faktoren Umwelterfahrungen eine besondere Bedeutung bei. Anhand eines Messwiederholungsdesigns wurde geprüft, ob die mütterliche Stimmung, die durch Videoausschnitte mit beängstigenden oder neutralem Charakter experimentell manipuliert wurde, das Verhalten des Kindes (8 – 13 Monate) in einer für das Kind ambivalenten Situation, der visuellen Klippe, beeinflusst. Es wurden 25 Mutter-Kind-Paare in die Studie einbezogen. Eine Regressionsanalyse zeigte, dass das Temperament des Kindes und habituelle Depression der Mutter signifikante Prädiktoren für das Verhalten des Kleinkindes in der visuellen Klippe waren. Darüber hinaus zeigte sich tendenziell die akute negative Befindlichkeit der Mutter als Prädiktor. Die Ergebnisse weisen auf die Bedeutung mütterlicher Befindlichkeit und Temperamentsmerkmalen für das Verhalten von Kleinkindern in ambivalenten und unvertrauten Situationen hin.

Fear of negative evaluation (FNE) is regarded as being the core feature of social anxiety. The present study examined how FNE is associated with physical activity (PA), body mass index (BMI) and perceived physical health (PPH) in children. Data were collected in a sample of 502 primary school children in first and fifth grades taking part in a randomized-controlled trial ('Kinder-Sportstudie KISS') aimed at increasing PA and health. PA was assessed by accelerometry over 7 days, PPH by the Child Health Questionnaire and FNE by the Social Anxiety Scale for Children - Revised. BMI z-scores were calculated based on Swiss norms. Cross-sectional analyses indicated that children high in FNE exercised less, reported lower levels of PPH and had higher BMI z-scores (P>0.01). Using mixed linear models, the school-based PA intervention did not manage to reduce FNE scores. Overweight children demonstrated a greater increase in FNE (P>0.05) indicating that enhanced weight may be a risk factor for FNE. In conclusion, the associations among high FNE, low PA and increased BMI should be considered when promoting an active lifestyle in children

This study examines the psychometric properties of a newly developed pictorial anxiety assessment, the Picture Anxiety Test (PAT), designed for young children. A sample of 71 5-7-year-old children (clinically anxious and healthy controls) participated in an assessment comparing the PAT to other, established anxiety measures. Children's ratings were also compared to parent ratings of internalizing and externalizing problems. The PAT demonstrated favorable psychometric properties in this sample, including moderate to high internal consistency, high convergent validity with related constructs, and high discriminant validity between diagnostic groups and across pre- and post-treatment. Initial findings suggest that the PAT is a psychometrically sound instrument for assessing child anxiety and avoidance in young children and a valuable addition to existing diagnostic instruments for clinicians working with anxious children.

Cognitive distortions refer to cognitive processes that are biased and therefore yield dysfunctional and maladaptive products (e.g., interpretation bias). Automatic aspects of information processing need to be considered and investigating these aspects requires forms of assessment other than self-report. Studies focussing on the specificity of cognitive biases across different types of anxiety disorders in childhood are rare. Thus, a forced choice reaction time paradigm with picture stimuli was used to assess the interpretation bias in anxious children online. The study investigated disorder-specific interpretation bias in 71 children with separation anxiety disorder (SAD), 31 children with social phobia, and 42 children without mental disorders, aged 5-13 years. Results indicated that children with SAD rated ambiguous separation pictures as significantly more unpleasant and more arousing than nonanxious children. However, no support was found that children with SAD and social phobia interpret ambiguous separation or social pictures in a more negative way than nonanxious children. Furthermore, no group differences were found in reaction times to all picture categories.

Zusammenfassung. Theoretischer Hintergrund: Bei dem KASI handelt es sich um die deutsche Ubersetzung des „Childhood Anxiety Sensitivity Index (CASI)” zur Erfassung von Angstsensitivitat bei Kindern und Jugendlichen. Fragestellung: Die psychometrischen Eigenschaften des „Kinder-Angstsensitivitatsindex (KASI)” wurden uberpruft. Methode: Insgesamt 1538 Kinder und Jugendliche fullten den Fragebogen aus. Ergebnisse: Die interne Konsistenz (Cronbachs Alpha) ist mit α ≥ .79 hoch. Die Datenanalysen zeigen signifikante Zusammenhange zwischen KASI und konstruktnahen Messinstrumenten (ACQ, BSQ) sowie Paniksymptomen, agoraphobischen Angsten und Trennungsangst. Erwartungsgemas geringer sind die Zusammenhange mit spezifischer und sozialer Phobie und Depression. Zudem konnten an einer Stichprobe von 1235 Schulern Normen fur das Testverfahren gewonnen werden. Schlussfolgerungen: Aufgrund der vorliegenden Befunde kann der KASI als ein reliables und valides Messinstrument bezeichnet werden.

In Europe, little is known about the prevalence of indoor tanning. The aims of this study were therefore to estimate the prevalence of sunbed use and to identify risk groups and motives in a population-based survey. The cross-sectional "SUN-Study 2008" ("Sunbed-Use: Needs for Action-Study 2008") was conducted in 2008. A total of 500 adults, aged 18-45 years, were randomly selected and asked about their indoor tanning practices, their motivation and risk perception, and the compliance of staff with international sunbed use recommendations. Forty-seven percent of subjects reported having visited an indoor tanning facility at least once in their lives. Prevalence of use was not reduced in risk groups for skin cancer. Risk awareness of users equalled that of non-users. The poor quality of services and advice provided by many solariums was alarming. It can be concluded that appropriate measures to change tanning habits need to be identified. Legal regulations could be one option.

The factor structure of the Childhood Anxiety Sensitivity Index (CASI) was investigated in four nonclinic German samples (N=1244, 225, 230, and 143) with participants aged 8-16-years-old. Factor solutions suggested for different CASI versions were tested using confirmatory factor analysis. The best goodness-of-fit indices were found for the 13-item CASI version with 4 factors (Disease Concerns, Unsteady Concerns, Mental Incapacitation Concerns, and Social Concerns). Testing for factorial invariance of this model with respect to age and gender revealed non-invariant factor loadings between children and adolescents as well as between boys and girls. The theoretical and clinical implications of these findings for anxiety sensitivity in children and adolescents are discussed.

Infants and toddlers are at high risk of neglect and maltreatment, as they are especially dependent on the care and the safeguard of their parents. Child protection can only succeed if early and preventive support for families at risk and their infants is provided. The project "A good start to life" helps to promote parental sensitive behaviour and care giving competence of parents in precarious life settings and in high risk situations and is aimed to prevent child neglect and abuse at an early age. A relevant prerequisite for child protection is interdisciplinary networking between the involved systems. The main focus of the project is the establishment of collaboration and network structures between the infant and youth welfare system and the health-care system and their services in eight communities in four states in Germany by using so-called round tables as communication platforms. Preliminary results of the round tables are reported in this article together with the results of the evaluation process.

Zusammenfassung: Fragestellung: Zahlreiche Elternbefragungen belegen, dass ubergewichtige Kinder neben somatischen Folgen vielfaltigen psychosozialen Belastungen ausgesetzt sind. Standardisierte Interviews zur Erhebung klinischer Diagnosen nach DSM-IV an ubergewichtigen Kindern und direkte Kinderbefragungen fehlen bisher jedoch weitgehend. Methodik: Psychische Auffalligkeiten einer Inanspruchnahmepopulation ubergewichtiger 8‐12-jahriger Kinder (N = 59) wurden mittels eines strukturierten Interviews (Kinder-DIPS) im Kind- und Elternbericht untersucht. Weiter wurde mit den verfugbaren Daten (N = 55) der Child Behavior Checklist (CBCL) dieser klinischen Stichprobe ein Kontrollgruppenvergleich mit einer reprasentativen Stichprobe (n = 1080) vorgenommen. Schlieslich wurde bei der Untergruppe der 10‐12-jahrigen Kinder ein Vergleich zwischen der klinisch vorgestellten ubergewichtigen Sub-Stichprobe (N = 33) mit der Gruppe ubergewichtiger Kinder (N = 34) sowie der Gruppe normalgewichtiger Kinder einer geschlechtsparallelisierten reprasentativen Stichprobe (N = 386) durchgefuhrt. Ergebnisse: Bei 23 Kindern (39.0%) der klinischen Stichprobe wurde eine psychische Storung nach DSM-IV festgestellt. Ca. ein Drittel (N = 19, 34.5%) erfullte die Forschungskriterien fur eine Binge-Eating-Disorder (BED). Ubergewichtige 8‐12-jahrige Kinder der klinischen Stichprobe wiesen im Vergleich zur geschlechts- und altersparallelisierten Kontrollstichprobe in der Child Behavior Checklist (CBCL) signifikant hohere Werte in 6 der 8 Syndromskalen auf. Ferner waren die Werte fur internalisierende und externalisierende Probleme sowie der Gesamtwert im Vergleich signifikant erhoht. Die ubergewichtigen 10‐12-jahrigen Kinder der klinischen Stichprobe hatten im Vergleich zu den ubergewichtigen Gleichaltrigen der reprasentativen Stichprobe bei der CBCL-Primarskala «soziale Probleme» und beim CBCL-Gesamtwert signifikant hohere Werte; nach Korrektur fur BMI ergab sich keine Signifikanz mehr fur den Gesamtwert. Innerhalb der reprasentativen Stichprobe hatten die ubergewichtigen 10‐12-jahrigen Kinder bei den CBCL-Syndromskalen «soziale Probleme» und «dissoziales Verhalten» signifikant hohere Werte als ihre normalgewichtigen Gleichaltrigen. Schlussfolgerungen: Uber ein Drittel der klinischen Stichprobe ubergewichtiger Kindern weist psychische Storungen auf. Fur ubergewichtige Kinder aus der Normalbevolkerung ergeben sich Hinweise auf eine leicht erhohte Pravalenz psychischer Auffalligkeiten in der CBCL. Ubergewichtige Kinder, die sich fur eine Behandlung melden, stellen somit eine hoch belastete Patientengruppe dar, die mehrdimensional behandelt werden sollte. Dabei ist ein Umdenken in der Behandlung ubergewichtiger und adiposer Kinder von der prioritaren Umstellung von Ess- und Bewegungsverhalten hin zu einer umfassenden Pravention von Chronifizierung und Entstehung komorbider psychischer Storungen und deren Behandlung erforderlich. Schlusselworter: Ubergewicht, Adipositas, psychische Belastung, psychische Storungen, Verhaltensauffalligkeiten, Kinder Summary: The mental status of overweight children Objective: Numerous studies based on parent questionnaires reveal that obese children are subject to both physical and psychosocial strains. Children are not included as informants in the assessment procedure, and there is a lack of clinical interview studies assessing DSM-IV-based diagnoses in overweight children. Methods: Emotional and behavioural problems of treatment seeking obese children (N = 59; aged 8‐12-years) attending a mental health service were assessed by means of clinical interviews (Kinder-DIPS) that included child and parent reports. In addition, Child Behavior Checklist (CBCL) data (N = 55) available for this clinical sample were compared with data of a representative sample of normal-weight children (N = 1,080). Furthermore, CBCL data of the clinical subsample of 10‐12 year-old overweight children (N = 34) were compared with data of a subsample of 10‐12 year-old overweight children (N = 33) and of the subsample of normal-weight (N = 386) children from a representative population, both matched by sex. Results: 23 children (39%) met full criteria for a psychiatric disorder according to DSM-IV, and 19 (34.5%), nearly one third, suffered from Binge Eating Disorder (BED). The overweight clinical sample and their normal weight peers differed significantly on 6 of the 8 primary syndrome scales, on the internalizing and the externalizing scores, and on the total problem score of the CBCL. The overweight children in the clinical sample scored significantly higher than the overweight children in the representative sample on the subscale measuring social problems and

Hintergrund: Ziel dieser Studie ist die Uberprufung der Interrater- und Retest-Reliabilitat des an die DSM-IV-TR-Kriterien angepassten und erweiterten Diagnostischen Interviews bei Psychischen Storungen [DIPS fur DSM-IVTR; Schneider und Margraf, 2006]. Methode: 10 geschulte Interviewerinnen fuhrten 237 Interviews in klinischen ambulanten und stationaren Einrichtungen durch. Ergebnisse: Die Ergebnisse sprechen fur eine gute bis sehr gute Interrater-Reliabilitat der Oberklassen Angststorungen, affektive Storungen, somatoforme Storungen, Schlafstorungen, Essstorungen, Substanz- und Alkoholmissbrauch/-abhangigkeit sowie aller uberprufbarer Diag nosekategorien und fur den Ausschluss psychischer Storungen. Ein vergleichbares Bild ergab sich fur die Retest-Reliabilitaten: Lediglich die Storungsoberklasse Schlafstorungen sowie die Diagnoseklassen generalisierte Angststorung und dysthyme Storung zeigten eine nicht zufriedenstellende Reliabilitat. Die Reliabilitatswerte waren fur die verschiedenen klinischen Settings (ambulant vs. stationar) vergleichbar. Schlussfolgerung: Die Ergebnisse zeigen, dass auch das vollstandig uberarbeitete und erweiterte DIPS fur DSM-IV-TR ein reliables Interview zur Diagnostik psychischer Storungen darstellt und komorbide Storungsbilder, wie sie insbesondere im klinischen Alltag haufig anzutreffen sind, zuverlassig abbilden kann.

An important factor in cognitive theories of anxiety disorders is the way in which information is processed. Findings support the existence of a biased information-processing style in anxious children. So far, cognitive biases in children with anxiety disorders are typically assessed as a general phenomenon. Thus, there is a lack of studies in children focusing on anxiety-disorder-specific interpretation bias. A new forced choice paradigm using anxiety-disorder-specific material was developed. Pictures illustrating separation and social situations were carefully generated and evaluated in a pre-study. In a school sample of 265 children the paradigm was investigated. The pictures were able to trigger emotional response and the paradigm demonstrated good internal consistency, and construct validity. Results clearly indicate evidence for content-specificity of the materials. Furthermore, preliminary results suggest a disorder-specific interpretation bias.

Zusammenfassung. Theoretischer Hintergrund: Das “Diagnostische Interview bei psychischen Störungen“ (DIPS für DSM-IV-TR; Schneider & Margraf, 2006 ) ist ein strukturiertes Interview, welches erweitert und an die DSM-IV-TR Kriterien angepasst wurde. Fragestellung: Ziel dieser Studie ist die Validierung des DIPS für DSM-IV-TR. Methode: Die Validität der DIPS-Diagnosen wurde mit einer Fragebogenbatterie an einer Stichprobe von 194 Patienten aus unterschiedlichen klinischen Einrichtungen überprüft. Ergebnisse: Die Ergebnisse sprechen für eine gute Validität der Oberklassen Angststörungen, Affektive Störungen, Somatoforme Störungen, Essstörungen, Substanz- und Alkoholmissbrauch/-abhängigkeit sowie einzelner, überprüfbarer Störungskategorien und für den Ausschluss psychischer Störungen. Eine ungenügende Validität ergab sich für die Oberklasse Schlafstörungen und der Generalisierten Angststörung. Schlussfolgerungen: Das DIPS für DSM-IV-TR zeigt außer bei der Generalisierten Angststörung und den Schlafstörungen eine gute Validität bei Patienten ambulanter sowie stationärer psychiatrischer Einrichtungen.

Sleep problems occur frequently in young children, possibly causing detrimental effects on their development. Parental marital difficulties are known to put a burden on children’s sleep and adjustment. However, research concerning the relation between the parental relationship quality and children’s sleep difficulties is rare for preschool-aged children. This study aims to fill in the gap. Initially, caregivers of 94 preschoolers (41 girls and 53 boys, aged 2–6 years) filled in questionnaires providing information on their children’s sleep and anxiety as well as on their own sleep and relationship quality. A path model approach was used to examine two competing theoretical models linking these factors. The conducted path analysis indicated that children’s separation anxiety, β = −.134, p = .017, as well as their anxiety in general, β = −.177, p = .024, partially mediated the relation between the parental relationship quality and children’s sleep problems. Parental sleep problems correlated with the relationship quality, r = −.371, p = .030, but had no significant influence on children’s sleep. The results of our study suggest that children growing up with parents who state a low relationship quality might thus be concerned about the stability of their family system. As a result children’s sleep quality might be compromised due to irritation and feelings of insecurity. The study highlights the importance of the parental relationship as an influence factor in children’s sleep quality.

Due to a technical error, a 21-item version of the Depression Anxiety and Stress Scales (DASS-42; Lovibond & Lovibond, 1995) which is not identical to the DASS-21 validated by Henry and Crawford (2005) was used in our study [1]. Ten items of the DASS version that was used in our study [1] were identical to the items of the original DASS-21, the remaining eleven items were part of the DASS-42, but not of the DASS-21 by Crawford and Henry (2005) [2]. In order to put the results of our paper into perspective, we have conducted an additional study that aimed to investigate the comparability of our 21-item version with the original DASS-21 that has been validated by Henry and Crawford (2005) [2]. A total of 1,031 individuals (47.9 % male) participated in a web-based survey, which included the DASS-42. Mean age of the participants was 48 years (SD = 15.26). Comparisons between the original DASS-21 and the version that was used in our study revealed that both scales were highly similar. Correlations between the original DASS-21 subscales and the subscales of the version that was used in our study were very high (r = .97, p

Representative data on the incidence of sports injuries and the risk groups involved is extremely rare. The data generated by the "First National Health Survey for the Federal Republic of Germany", conducted between October 1997 and March 1999, included information on the incidence of sports injuries requiring medical care and the associated sick leave, fitness indicators, and potential risk factors. The data was collected on the basis of a standardised cross-sectional questionnaire. The net sample comprised 6687 subjects aged 18 to 79. 3.1 % of adult Germans sustained a sports-related injury within the foregoing year. The annual incidence of injury among those actively engaging in sports is 5.6 %. 62 % of all sports injuries result in sick leave. The period off work was longer than 30 days in only one out of five cases. Three out of four injured recreational athletes are male. The incidence declines significantly in the more senior population. These differences apply even if the specific sporting profile is factored in. Analysis of incidence rates on their own is misleading for some population groups. For instance, although individuals of normal weight and a good fitness display more than twice the average incidence of sports injuries, our study shows that these figures do not reflect the actual risk of injury, as bivariate calculation of incidence does not take account of the specific extent of sporting activity. When specific participation rates and the intensity of training are taken into account, no significant differences in the risk of injury are apparent. Our representative data also shows that future injury prevention strategies should focus on the highest risk group of young male recreational athletes.

Background Regulatory problems such as excessive crying, sleeping–and feeding difficulties in infancy are some of the earliest precursors of later mental health difficulties emerging throughout the lifespan. In the present study, the inter-rater reliability and acceptance of a structured computer-assisted diagnostic interview for regulatory problems (Baby-DIPS) was investigated. Methods Using a community sample, 132 mothers of infants aged between 3 and 18 months (mean age = 10 months) were interviewed with the Baby-DIPS regarding current and former (combined = lifetime) regulatory problems. Severity of the symptoms was also rated. The interviews were conducted face-to-face at a psychology department at the university (51.5 %), the mother’s home (23.5 %), or via telephone (25.0 %). Inter-rater reliability was assessed with Cohen’s kappa (k). A sample of 48 mothers and their interviewers filled in acceptance questionnaires after the interview. Results Good to excellent inter-rater reliability on the levels of current and lifetime regulatory problems (k = 0.77–0.98) were found. High inter-rater agreement was also found for ratings of severity (ICC = 0.86–0.97). Participants and interviewers’ overall acceptance ratings of the computer-assisted interview were favourable. Acceptance scores did not differ between interviews that revealed one or more clinically relevant regulatory problem(s) compared to those that revealed no regulatory problems. Conclusions The Baby-DIPS was found to be a reliable instrument for the assessment of current and lifetime problems in crying and sleeping behaviours. The computer-assisted version of the Baby-DIPS was well accepted by interviewers and mothers. The Baby-DIPS appears to be well-suited for research and clinical use to identify infant regulatory problems. Electronic supplementary material The online version of this article (doi:10.1186/s13034-016-0107-6) contains supplementary material, which is available to authorized users.

Background\ud \ud \ud Hypothalamic–pituitary–adrenal (HPA) axis functioning has been implicated in the development of stress-related psychiatric diagnoses and response to adverse life experiences. This study aimed to investigate the association between genetic and epigenetics in HPA axis and response to cognitive behavior therapy (CBT).\ud \ud \ud Methods\ud \ud \ud Children with anxiety disorders were recruited into the Genes for Treatment project (GxT, N = 1,152). Polymorphisms of FKBP5 and GR were analyzed for association with response to CBT. Percentage DNA methylation at the FKBP5 and GR promoter regions was measured before and after CBT in a subset (n = 98). Linear mixed effect models were used to investigate the relationship between genotype, DNA methylation, and change in primary anxiety disorder severity (treatment response).\ud \ud \ud Results\ud \ud \ud Treatment response was not associated with FKBP5 and GR polymorphisms, or pretreatment percentage DNA methylation. However, change in FKBP5 DNA methylation was nominally significantly associated with treatment response. Participants who demonstrated the greatest reduction in severity decreased in percentage DNA methylation during treatment, whereas those with little/no reduction in severity increased in percentage DNA methylation. This effect was driven by those with one or more FKBP5 risk alleles, with no association seen in those with no FKBP5 risk alleles. No significant association was found between GR methylation and response.\ud \ud \ud Conclusions\ud \ud \ud Allele-specific change in FKBP5 methylation was associated with treatment response. This is the largest study to date investigating the role of HPA axis related genes in response to a psychological therapy. Furthermore, this is the first study to demonstrate that DNA methylation changes may be associated with response to psychological therapies in a genotype-dependent manner.