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According to Cloninger’s model, personality is conceptualized in temperament and character traits contributing to a child’s psychosocial development. Additionally, parent–child interaction is important for the child’s socio-emotional development. To date, the relationship between attachment and temperament and character for child mental health development and its effects on parents remains mostly unclear. The aim of the present study was thus to examine the relationship of attachment, temperament and character, parental stress, and mental health problems among 125 children (mean age = 7.14 years) in Switzerland. Temperament and character, attachment disorder (symptoms), parental stress, and mental health problems were assessed with psychometric questionnaires; attachment was assessed with an additional observational measure. Descriptive characters of the sample were presented, and group differences and correlations were computed. For temperament traits, results revealed significant group differences for novelty seeking and persistence and attachment disorder types. For character traits, the findings showed significant group differences for self-directedness and cooperativeness and attachment disorder types. Moderate effect sizes for groups differences were found. Further, the mixed-type (inhibited and disinhibited) and inhibited attachment disorder type were the most burdened groups. The present findings suggest that temperament and character traits, as well as parental stress and mental health problems are associated with the occurrence of attachment disorders among children. Future longitudinal studies with larger samples are needed to examine the causal relationships of temperament and character with attachment, including person-related and environmental factors among children.

Zusammenfassung. Ziel dieser Studie ist die Interrater-Reliabilität, Validität und Akzeptanz des Strukturierten Interviews für das Vorschulalter (SIVA: 0 – 6) zu ermitteln. Es wurden 117 Interviews mit Eltern durchgeführt. Die Akzeptanz wurde mit einem Fragebogen erfasst. Die Interrater-Reliabilität wurde durch zwei unabhängige Diagnostiker für die Klassifikationssysteme DC: 0 – 3R/DC: 0 – 5, ICD-10 und DSM-5 bestimmt. Mit prozentualer Übereinstimmung, Cohen’s Kappa und Yule’s Y wurde die Übereinstimmung der Diagnostiker berechnet. Die Validität des SIVA: 0 – 6 wurde mittels der Konstruktvalidität mit Fragebögen und der Kriteriumsvalidität überprüft. Das SIVA: 0 – 6 hat eine hohe Akzeptanz. Die Interraterreliabilität für externalisierende (κ > .82, > 91.9 %), internalisierende Diagnosen (κ > .72, 93.5 %) sowie den Ausschluss von Diagnosen (> 97 %) war gut bis sehr gut. Die Validität zeigte sich in der Unterscheidung von Kindern mit und ohne eine Diagnose sowie internalisierenden Störungen. Die Ergebnisse sprechen für eine gute Akzeptanz, Validität und Reliabilität des SIVA: 0 – 6 in Praxis und Forschung.

Zusammenfassung. Um psychische Störungen bei jungen Kindern zu erfassen, wurde das Klassifikationssystem DC: 0 – 5 entwickelt. Das Ziel dieser Studie war es, Diagnosen nach DC: 0 – 5 und ICD-10 zu vergleichen. Bei 176 konsekutiv vorgestellten Kindern (70,5 % Jungen) mit einem mittleren Alter von 3,96 Jahren wurden Diagnosen nach ICD-10 und DC: 0 – 5 vergeben. 78,4 % der Kinder hatten eine Diagnose nach ICD-10, 88,1 % der Kinder nach DC: 0 – 5. Die häufigste ICD-10 Diagnose war Störung des Sozialverhaltens mit oppositionellem Verhalten (ODD; 28,4 %), gefolgt von Schlafstörungen (21,0 %), ADHS (14,8 %) und Angststörungen (6,8 %). Die häufigsten DC: 0 – 5 Diagnosen waren ADHS (30,7 %) und die Dysregulierte Ärger- und Aggressionsstörung (31,3 %), gefolgt von Schlaf-‍, Angst-‍, Ess- und Traumafolgestörungen. Zusammengefasst ist die DC: 0 – 5 das spezifischste Klassifikationssystem zur Diagnose psychischer Störungen bei jungen Kindern. Es hat sich in Kombination mit der ICD-10 in der klinischen Praxis bewährt. Wünschenswert wäre die weitere Verwendung und Überprüfung der DC: 0 – 5 in klinischen Studien.

Zusammenfassung. Psychische Störungen sind bei jungen Kindern häufig und weisen eine entwicklungsbezogene Symptomatik auf. Die DC: 0 – 5 wurde als ein multiaxiales Klassifikationssystem psychischer Störungen für das Alter von 0 bis 5 Jahren entwickelt. Das Ziel dieser Übersicht ist es, den Aufbau und die Anwendung der DC: 0 – 5 darzustellen. Sie umfasst die fünf Achsen: klinische Störungen, Beziehungskontext, medizinische Diagnosen, psychosoziale Stressoren und Entwicklungskompetenzen. Die erste Achse ist die wichtigste und hat viele neue Störungsbilder definiert. Als neue Angststörung bezeichnet z. B. die Störung mit Inhibition gegenüber Neuem eine Furcht gegenüber neuen Stimuli. Ein Novum ist die Spezifische Beziehungsstörung der frühen Kindheit, die das Auftreten von einer kindlichen Symptomatik speziell in einer Beziehung definiert und eine akute Gefährdung des Kindes signalisiert. Die DC: 0 – 5 ist das derzeitig beste System zur Erfassung psychischer Störungen bei jungen Kindern. Eine weitere empirische Überprüfung und Validierung gerade der neuen Kategorien ist notwendig.

Zusammenfassung. Verhaltensauffälligkeiten bzw. psychische Störungen können bereits bei sehr jungen Kindern auftreten und sind häufig mit erheblichem Leiden bzw. Beeinträchtigungen für das Kind aber auch seine Eltern verbunden. Deshalb ist eine frühzeitige Erkennung sinnvoll, um langfristige Folgen oder eine Chronifizierung zu vermeiden. Ziel dieses Überblickartikels ist eine Bestandsaufnahme über die aktuell für das Vorschulalter verfügbaren diagnostischen Instrumente. Dabei wird neben Fragebögen, Entwicklungs- und Leistungstest auch ein neuartiges klinisches Interview zur strukturierten Diagnostik im Vorschulalter (0 – 6 Jahre), das SIVA 0 – 6 vorgestellt. Diagnostiker sollten bei der psychopathologischen Beurteilung von Symptomen in der frühen Kindheit Normvarianten von Normabweichungen abgrenzen. Psychische Auffälligkeiten müssen dabei immer im interaktionellen Kontext des Kindes mit seinen Eltern oder anderen wichtigen Personen gesehen werden.

Funktionelle Defäkationsstörungen sind in der kinderärztlichen Praxis ein häufiger Vorstellungsgrund. Unter diesem Sammelbegriff versteht man Beeinträchtigungen bei der Ausscheidung der Nahrung, welche nicht allein durch organische oder biochemische Ursachen erklärt werden können. Typische Beschwerden in diesem Spektrum sind chronische Obstipation, Defäkationsschmerzen, Perianalläsionen oder großkalibrige Stühle. Weiterhin kann es zu Appetitlosigkeit, rezidivierenden Bauchschmerzen, Stuhlschmieren, Einkoten oder zu Einnässen kommen. Sekundär treten bei Kindern mit funktionellen Defäkationsstörungen häufig Verhaltensauffälligkeiten mit oppositionellem oder reaktiv aggressivem Verhalten, aber auch ängstlich-depressivem Rückzugsverhalten auf.

Les troubles de la défécation sont une cause fréquente de consultation en pédiatrie. Par ce terme on entend toutes les difficultés à éliminer la nourriture ne pouvant être expliquées par des causes organiques ou biochimiques uniquement. Des troubles typiques de ce spectre sont la constipation chronique, les douleurs à la défécation, les lésions péri-anales ou des selles de gros calibre. Peuvent aussi se manifester une perte d’appétit, des douleurs abdominales récidivantes, une encoprésie ou énurésie. Chez les enfants avec des troubles fonctionnels de la défécation apparaissent souvent des symptômes secondaires sous forme de troubles du comportement tels un comportement oppositionnel ou agressif, mais aussi anxieux, dépressif ou de retrait relationnel.

Abstract. Objective: Incontinence and functional gastrointestinal disorders are common in young children and are associated with higher rates of psychological symptoms and mental disorders. This article focuses on the mutual association between incontinence and related toilet refusal syndrome, parental stress, and children’s psychopathology especially in young children. Methods: Children’s psychological symptoms, mental disorders, and parental stress levels were assessed in 38 parent-child dyads involving children with incontinence and 42 dyads of typically developing (TD) children. Results: Compared to TD children, patients had higher internalizing and externalizing CBCL scores and higher rates of clinically relevant externalizing problems. However, the rates of clinically relevant internalizing problems and mental disorders did not differ. The parents of children with incontinence reported significantly higher stress levels regarding child-related stress factors (PSI-CD) than did parents of TD children. However, there were no clinically relevant parental stress scores on a group level, which remained below the clinical range (T-value < 60). When simultaneously analyzed, children’s (comorbid) mental disorders but not incontinence had a major impact on parental stress. Conclusions: Despite moderate stress levels, incontinence symptoms, urinary and fecal incontinence are highly prevalent in young children. However, stress among parents of young children was mainly elicited by any (comorbid) mental disorder.

Kinder, deren Bedürfnisse nach emotionaler Zuwendung, Schutz und Sicherheit hinreichend befriedigt werden, entwickeln normalerweise im Verlauf der ersten Lebensjahre eine sichere Bindung an ihre Bezugspersonen. Verschiedene Risikofaktoren aufseiten der Eltern und des Kindes können sich jedoch negativ auf die Bindungs- und Beziehungsentwicklung auswirken, in deren Folge es zu Störungen der Eltern-Kind-Bindung kommen kann. Der Ratgeber bietet verständliche Informationen zu Bindungsstörungen. Er liefert einen Überblick über die verschiedenen Erscheinungsformen und Symptome von Bindungs- und Beziehungsstörungen, die Ursachen, den Verlauf und die Behandlungsmöglichkeiten. Der Ratgeber richtet sich vor allem an Eltern sowie Pflege- und Adoptiveltern. Sie erhalten u. a. Empfehlungen zum Aufbau einer positiven Beziehung zu ihrem Kind und Tipps für eine gewaltfreie Erziehung. Zudem informiert der Ratgeber über weitere Möglichkeiten der Unterstützung, wie z. B. Erziehungsberatung oder sozialpädagogische Familienhilfe.

Das Konstrukt der Bindungsstörungen umfasst laut den gängigen Klassifikationssystemen eine heterogene Gruppe von Auffälligkeiten der sozialen Funktionen und des Beziehungsverhaltens bei Kindern. Diese entwickeln sich als Folge länger anhaltender vernachlässigender Umgebungsbedingungen, zu denen u.a. Vernachlässigung, Misshandlung oder auch ein häufiger Wechsel der Bezugspersonen gehört. Damit unterscheiden sich die Bindungsstörungen insofern von anderen Störungen, dass bereits in der klassifikatorischen Definition ein ätiologischer Faktor enthalten ist. Der Leitfaden stellt praxisorientiert das diagnostische und therapeutische Vorgehen bei Bindungsstörungen im Kindesalter dar. Aufbauend auf dem aktuellen Stand der Forschung werden Leitlinien zur Diagnostik, Verlaufskontrolle, Behandlungsindikation und Therapie dieser Störungen formuliert und ihre Umsetzung in die klinische Praxis dargestellt. Durch die Bereitstellung zahlreicher Materialien für den diagnostischen und therapeutischen Prozess, inkl. der Arbeit mit Eltern, sowie unterschiedlicher Fallbeispiele soll die Umsetzung der Leitlinien im klinischen Alltag erleichtert werden.

Introduction: Attachment disorder (AD), including reactive AD and disinhibited social engagement disorder, is a prevalent, yet underdiagnosed disorder in severely maltreated children. Because the condition is associated with significant psychiatric morbidity over the entire lifespan, a valid and economic screening tool to identify children with clinical symptoms of AD is needed to avoid unspecific or ineffective treatment. The present study aimed to assess the effectiveness and efficiency of the German version of the Relationship Problems Questionnaire (RPQ). Methods: With a total of 135 children (mean age = 7.17 years, SD = 1.40, 63% male) from both general (34 children) and high-risk populations (69 in- and outpatients, 32 foster children), we investigated the sensitivity and specificity of the RPQ. AD was diagnosed using a standardized clinical interview (K-DIPS). 35 out of 135 children fulfilled the criteria for AD. Results: The RPQ identified 74% of the children who fulfilled the criteria for AD in the standardized clinical interview. The optimal cut-off score of the RPQ for identifying AD was 4.5 with a moderate sensitivity of 0.74 and specificity of 0.68. Conclusions: The German version of the RPQ proved useful as a diagnostic indicator of clinical symptoms of AD. The tool is economic and suitable for the screening of AD in the general population as well as high-risk populations. We recommend the use of the RPQ in clinical and research settings, adding multi-method approaches after a positive screening.

Background: The emotional climate between mothers and their children is known to be a significant indicator for the development of childhood psychopathology. One index that allows measuring family-emotional climate is the expressed emotion measure (EE). Maternal mental strain is known to affect maternal EE, as it can shape the way a mother thinks about, and interacts with her child.

Psychische Storungen im Sauglings- und Kleinkindalter, also im Alter zwischen 0 und 3 Jahren, stehen im engen Zusammenhang mit dem Erreichen wichtiger Entwicklungsmeilensteine. Im Kontext der Bewaltigung zentraler Entwicklungsaufgaben kann es zu Anpassungsschwierigkeiten kommen, welche schlieslich zu den drei haufigsten Storungen in dieser Phase, dem exzessiven Schreien, den Schlaf- und den Futterstorungen, fuhren konnen. Diese Verhaltensauffalligkeiten konnen bereits in den ersten Lebenswochen auftreten und gehen meist mit einer erheblichen Belastung der Eltern einher. Haufig kommt es zu Fehlkommunikationsprozessen zwischen den Eltern und ihrem Kind, worauf wiederum kognitiv-verhaltenstherapeutische Interventionen fokussieren. Fruhe verhaltens- und interaktionsbasierte Interventionen zeigen sowohl bei Sauglingen und Kleinkindern als auch bei Vorschulkindern eine hohe Wirksamkeit u. a. auf das Schlafverhalten, die Bindungssicherheit, die Emotionsregulation sowie auf depressive Symptome der Eltern.

Zusammenfassung. Theoretischer Hintergrund: Frühe Interaktionserfahrungen zwischen Eltern und ihren Kindern wirken sich langfristig auf deren psychische Entwicklung aus. Jedoch können verschiedenen psychosoziale Risikofaktoren, insbesondere mütterliche psychische Erkrankungen, die Qualität solcher Interaktionen verändern und sich damit ungünstig auf die psychische Gesundheit von Kindern auswirken. Fragestellung: In der vorliegenden Untersuchung wurde deshalb geprüft, ob sich psychische Probleme von Müttern auf ihr Interaktionsverhalten auswirken und ob dieses wiederum mit Verhaltensproblemen bei Vorschulkindern assoziiert ist. Methode: Es wurden insgesamt 63 Mutter-Kind-Paare untersucht. Die psychische Gesundheit der Mütter wurde mit Hilfe des Brief Symptom Inventory (BSI), Verhaltensprobleme der Kinder mittels der CBCL erfasst. Die Mutter-Kind-Interaktion wurde während einer standardisierten Verhaltensbeobachtung videographiert und von zwei blinden Ratern ausgewertet. Ergebnisse: Multiple Regressionsanalysen zeigen, dass die globale psychische Belastung von Müttern 13 % der Varianz externalisierender und 14.5 % der Varianz internalisierender Symptome bei Vorschulkindern aufklärt. Weiterhin wurde deutlich, dass nur bei den internalisierenden Störungen die Qualität der Mutter-Kind-Interaktion einen Effekt auf die Ausprägung kindlicher Symptome hatte. Außerdem fanden wir einen Mediatoreffekt für mütterliche Intrusivität. Diskussion: Die Befunde der vorliegenden Studie ermöglichen somit ein besseres Verständnis der Entstehung von Verhaltensauffälligkeiten im Vorschulalter, da sie spezifische Interaktionsmerkmale als Risikofaktoren für internalisierende Probleme identifizieren konnten und die Bedeutung der psychischen Gesundheit der Mutter unterstreichen. Daraus kann abgeleitet werden, dass bei einer psychotherapeutischen Behandlung von Vorschulkindern, neben der symptomorientierten Therapie, eine Entlastung der Mütter und eine Verbesserung der Mutter-Kind-Interaktion von großer Relevanz ist.

Abstract. The impact of the environment early in life on long-term outcomes is well known. Stressful experiences during pre- and postnatal development can modulate the genetic programming of specific brain circuits underlying emotional and cognitive aspects of behavioral adaptation to stressful experiences later in life. Furthermore, there is documented evidence for gene-environment interactions in the context of early-life stress. Identical gene variants can be associated with different phenotypes depending on environmental factors. DNA methylation, an enzymatically-catalyzed modification of the DNA, is the mechanism through which phenotypes are regulated. The dynamics and plasticity of epigenetic mechanisms can have short-term, long-term, or transgenerational consequences. In epigenetic research, rodent models have targeted several behavioral and emotional phenotypes. These models have contributed significantly to our understanding of the environmental regulation of the developmental brain in early life. This review will highlight studies with rats and mice on epigenetic processes in fetal programming of stress-related mental disorders.

Background We tested the hypothesis that objectively assessed sleep at kindergarten level predicts sleep and psychological functioning in adolescence. Method Thirty-seven adolescents aged 14 years (SD = 1.3), of 67 participants assessed as preschoolers, took part in a follow-up study nine years later. Participants completed a series of questionnaires related to sleep and psychological functioning. Sleep-EEG clusters of poor, normal and good sleepers assessed as children nine years earlier were used as predictors for subjective sleep and psychological functioning in adolescence. Results At the age of 14, those who were normal and good sleepers rather than poor sleepers at the age of five had more positive psychological functioning on dimensions including mental toughness, peer relationship, self-esteem, and perceived stress, but did not differ in current sleep patterns. Conclusions Objectively assessed sleep patterns at the age of five are predictive of aspects of psychological functioning during adolescence.

BACKGROUND A growing body of literature documents associations of maternal psychosocial stress during pregnancy with fetal, infant and child behaviour and development. However, findings across studies are often inconsistent, which may in part be due to differences in stress definitions and assessments. METHODS We systematically reviewed methods applied to assess maternal psychosocial stress during pregnancy in studies looking at associations with biobehavioural outcomes in the offspring. A systematic literature search was performed on Web of Science and PubMed for the time period between January 1999 and October 2009. Psychometric instruments assessing maternal psychosocial stress during pregnancy were identified and described if data on psychometric properties were available. RESULTS We identified 115 publications that assessed psychosocial stress during pregnancy with validated methods. These publications applied overall 43 different instruments assessing constructs falling under seven categories, ordered according to their frequency of use: anxiety, depression, daily hassles, aspects of psychological symptomatology (not reduced to anxiety or depression), life events, specific socio-environmental stressors and stress related to pregnancy and parenting. If available, we provide information on validity and reliability of the instruments for samples of pregnant women. CONCLUSIONS Within the 'prenatal stress' research, a broad range of instruments is applied to assess psychosocial stress during pregnancy. Prenatal stress research should take into consideration that the variety of methods in use might hamper the comparability of stress research results. In each category of stress constructs, one instrument with good psychometric properties in pregnant women is highlighted as the best currently available measure.

Maternal stress during pregnancy has been repeatedly associated with problematic child development. According to the fetal programming hypothesis adverse experiences during pregnancy increase maternal cortisol, which is then assumed to exert a negative effect on fetal development. Recent studies in non-pregnant women report significant associations between positive emotionality and low cortisol levels. We tested in a sample of 60 pregnant women whether both negative and positive life events independently predicted third-trimester baseline awakening cortisol levels. While the effect of negative life events proved unrelated positive life events significantly predicted lower cortisol levels. These findings suggest that positive experiences are of relevance regarding maternal morning cortisol levels in pregnancy reflecting a resource with potentially beneficial effects for the mother and the developing fetus. It might be promising for psychological intervention programs to focus on increasing positive experiences of the expecting mother rather than exclusively trying to reduce maternal stress during pregnancy.

To determine whether prenatal stress is associated with behavioral and emotional regulation problems (crying/fussing) in infants, after controlling for confounding factors. Furthermore, the study investigated the stress-buffering effect of maternal self-efficacy.Data were collected in 120 pregnant women (29 ± 3.2 weeks gestation) and their infants at 6 weeks of age. Expecting mothers completed a structured interview and self-report questionnaires on prenatal stress and self-efficacy. Crying/fussing data were obtained with a validated parental diary.After controlling for confounding variables, multiple regression analyses show that prenatal stress and self-efficacy accounted for 20% of the variance of infant's fussing and crying behavior. Results suggest a mediating role of self-efficacy. Babies of mothers reporting high levels of prenatal stress cried less when their mother had high levels of self-efficacy compared with mothers with low self-efficacy. In addition, mothers of infants with excessive crying reported more symptoms of stress, depression, and anxiety in pregnancy.To foster the development of well-adapted parent-infant relationships and potentially to reduce infant crying in the early postpartum phase, health care professionals need special education about the effects of prenatal stress and interventions that promote self-efficacy.

Postpartum depression (PPD) affects up to 19% of all women after parturition. The non-apeptide oxytocin (OXT) is involved in adjustment to pregnancy, maternal behavior, and bonding. Our aim was to examine the possible association between plasma OXT during pregnancy and the development of PPD symptoms. A total of 74 healthy, pregnant women were included in this prospective study. During the third trimester of pregnancy and within 2 weeks after parturition, PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Blood samples for plasma OXT assessment were collected in the third trimester. Following the literature, participants with postpartum EPDS scores of 10 or more were regarded as being at risk for PPD development (rPPD group). In a logistic regression analysis, plasma OXT was included as a potential predictor for being at risk for PPD. Results were controlled for prepartal EPDS score, sociodemographic and birth-outcome variables. Plasma OXT concentration in mid-pregnancy significantly predicted PPD symptoms at 2 weeks postpartum. Compared with the no-risk-for-PPD group, the rPPD group was characterized by lower plasma OXT concentrations. To our knowledge, this is the first study to show an association between prepartal plasma OXT concentration and postpartal symptoms of PPD in humans. Assuming a causal relationship, enhancing OXT release during pregnancy could serve as a potential target in prepartum PPD prevention, and help to minimize adverse effects of PPD on the mother-child relationship.

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.

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch), The aim of this study was to investigate whether maternal adversities and cortisol levels during pregnancy predict cord blood DNA methylation of the oxytocin receptor (OXTR). We collected cord blood of 39 babies born to mothers participating in a cross-sectional study (N = 100) conducted in Basel, Switzerland (2007-10). Mothers completed the Inventory of Life Events (second trimester: T2), the Edinburgh Postnatal Depression Scale (EPDS, third trimester: T3), the Trier Inventory of Chronic Stress (TICS-K, 1-3 weeks postpartum) and provided saliva samples (T2, T3) for maternal cortisol profiles, as computed by the area under the curve with respect to ground (AUCg) or increase (AUCi) for the cortisol awakening response (CAR) and for diurnal cortisol profiles (DAY). OXTR DNA methylation was quantified using Sequenom EpiTYPER. The number of stressful life events (P = 0.032), EPDS score (P = 0.007) and cortisol AUCgs at T2 (CAR: P = 0.020; DAY: P = 0.024) were negatively associated with OXTR DNA methylation. Our findings suggest that distinct prenatal adversities predict decreased DNA methylation in a gene that is relevant for childbirth, maternal behavior and wellbeing of mother and offspring. If a reduced OXTR methylation increases OXTR expression, our findings could suggest an epigenetic adaptation to an adverse early environment.

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.

A growing body of literature documents associations of maternal psychosocial stress during pregnancy with fetal, infant and child behaviour and development. However, findings across studies are often inconsistent, which may in part be due to differences in stress definitions and assessments.We systematically reviewed methods applied to assess maternal psychosocial stress during pregnancy in studies looking at associations with biobehavioural outcomes in the offspring. A systematic literature search was performed on Web of Science and PubMed for the time period between January 1999 and October 2009. Psychometric instruments assessing maternal psychosocial stress during pregnancy were identified and described if data on psychometric properties were available.We identified 115 publications that assessed psychosocial stress during pregnancy with validated methods. These publications applied overall 43 different instruments assessing constructs falling under seven categories, ordered according to their frequency of use: anxiety, depression, daily hassles, aspects of psychological symptomatology (not reduced to anxiety or depression), life events, specific socio-environmental stressors and stress related to pregnancy and parenting. If available, we provide information on validity and reliability of the instruments for samples of pregnant women.Within the 'prenatal stress' research, a broad range of instruments is applied to assess psychosocial stress during pregnancy. Prenatal stress research should take into consideration that the variety of methods in use might hamper the comparability of stress research results. In each category of stress constructs, one instrument with good psychometric properties in pregnant women is highlighted as the best currently available measure.

Infant mental health problems include difficulties to regulate emotions or attention, crying, sleeping or feeding problems as well as aggressive behavior. Early identifications of these problems help to change developmental trajectories and improve developmental outcomes. Psychiatric assessment and classification have to take into account the rapid processes of development as well as the inseparable linkage between symptoms of the infant, psychosocial risks in the family environment, and parent–child relations. The proposed DSM-5 classification system presents a systematic description of mental health disorders which are relevant for infant psychiatry. However, the proposal has provided rather limited attention to developmental differences and parent–infant relations. Therefore, additional classification systems, like the Zero-to-Three (DC: 0–3R), are strongly recommended. In terms of assessment and in accordance with the guidelines of the American Academy of Child and Adolescent Psychiatry, infant psychiatrists have to consider the close relation between somatic and mental health and the interplay between behaviors of the caregiver and the infant. Therefore, the assessment has to be multidisciplinary and relationship based. A standard assessment in infancy includes a clinical interview, behavior observations, caregiver questionnaires, and a pediatric screening. All assessments should pay attention to motor, cognitive, language, and social-emotional development. Because infant development is embedded in the family context, socio-economic factors, parents’ mental problems, including drug abuse, domestic violence, and trauma history should be assessed. The treatment has to be oriented toward symptoms and development and has to address underlying medical conditions. The focus should be on parent–child interactions. Evidence-based interventions are based on attachment theory, use social-learning perspectives, and behavioral approaches.

Impulsive and aggressive behaviour symptoms often are serious problems in children, even already at preschool age. Thus, effective treatment approaches are requested. In this comment pharmacotherapeutic treatment approaches, first of all risperidone, their limitations and alternative psychotherapeutic approaches are outlined.

Antenatal maternal stress is thought to negatively affect fetal development, birth outcomes, and infant’s development. Glucocorticoids are suggested to be a common link between prenatal stressors and infant’s health. However, data on these mechanisms are rare and sometimes conflicting. The objective of this study was to examine the effects of maternal distress during pregnancy on fetal development and birth weight in humans prospectively. This study focuses on cortisol as one mediating the mechanism of the association between maternal distress and birth outcomes. Pregnancy-related and general distress was measured in 81 women with uncomplicated, singleton pregnancies. The rise of salivary cortisol on awakening (CAR) was assessed in weeks 13–18 and 35–37 postmenstrual age of pregnancy. Mothers completed a structured interview, the perceived stress scale, a widely used psychological instrument that provided a global measure of perceived stress, as well as the Prenatal Distress Questionnaire, a self-report questionnaire designed to assess worries and anxiety in pregnancy. Pre-, peri-, and postnatal medical risk factors as well as birth characteristics were extracted from medical records routinely kept by the attending obstetricians. Hierarchical multiple regressions indicate that maternal cortisol levels explained 19.8% of the variance in birth weight and 9% of the variance in body length at birth, even after controlling for gestational age, parity, pre-pregnancy BMI, smoking, and infant’s sex. Newborns of mothers with higher cortisol levels in pregnancy had lower birth weights and were shorter at birth. An ANCOVA for repeated measures indicated that, after controlling for covariates, pregnancy-related as well as general distress in pregnancy did not influence cortisol levels after awakening (area under the curve). No significant associations between perceived stress and anthrometric measures at birth were found. In conclusion, maternal cortisol levels in pregnancy influence intrauterine growth and may be a better predictor for birth outcome than perceived stress.

Animal models suggest that stress-induced hormonal changes in the mother during pregnancy lead to enduring changes in the fetus and empirical links between prenatal maternal stress and negative child development have been discerned repeatedly in human studies. But the role of heritable personality traits has received little attention in the latter work. The goal of the current study was to investigate the relationship between maternal personality, psychological measures of maternal distress and maternal salivary cortisol during pregnancy. Maternal reports of personality (16 PF) and stress-related psychological measures (depression, pregnancy-related anxiety, perceived stress, negative life events) as well as salivary cortisol samples of 66 healthy pregnant women were collected in early and late pregnancy. Maternal trait anxiety proved related to all stress-related psychological measures and high anxiety predicted low baseline cortisol awakening levels in early pregnancy. Maternal trait anxiety is related to both psychological and biological stress measures during pregnancy.

Objective Hypothalamic-pituitary-adrenal (HPA) activation during pregnancy is linked to dysfunctional behavioral outcomes in the offspring. According to Belsky's differential susceptibility hypothesis, individuals vary regarding their developmental plasticity. Translating the differential susceptibility hypothesis to the field of fetal programming, we hypothesize that infants' temperament, as the constitutionally based reactivity to stimulation, moderates prenatal environmental effects on postnatal emotion regulation. Methods Maternal HPA axis activity and stress-reactivity during pregnancy was estimated, by measuring cortisol concentrations in saliva, collected at 0, 30, 45 and 60 min after awakening and in blood, collected during a laboratory stress test (Trier Social Stress Test), respectively. Newborns reactivity to stimulation was evaluated between postnatal day 10 and 14 using the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Infant's self-quieting-activities, as an indicator of emotion regulation, were evaluated at the age of six months during the still face paradigm. Results Maternal cortisol reactivity to stress during pregnancy was associated with infant's emotion regulation at the age of six months. Whereas cortisol levels after awakening in mid and late pregnancy were not associated with emotion regulation. Furthermore, regression analyses revealed that in interaction with neonatal reactivity, both, prenatal maternal HPA activity as well as prenatal maternal HPA reactivity to stress predicted emotion regulation. Conclusion The findings indicate that newborns' reactivity to stimulation is moderating the association between prenatal exposure to maternal glucocorticoids and emotion regulation in infancy. Data suggests that temperamental characteristics of the newborn are a relevant differential susceptibility factor with regard to prenatal effects on emotion regulation.