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De Ronda AC, Rice L, Zhao Y, Rosch KS, Mostofsky SH, Seymour KE. ADHD-related sex differences in emotional symptoms across development. Eur Child Adolesc Psychiatry 2024; 33:1419-1432. [PMID: 37368082 PMCID: PMC10986680 DOI: 10.1007/s00787-023-02251-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
To investigate developmental changes in emotion dysregulation (ED) and associated symptoms of emotional lability, irritability, anxiety, and depression, among girls and boys with and without ADHD from childhood through adolescence. Data were collected from a sample of 8-18-year-old children with (n = 264; 76 girls) and without (n = 153; 56 girls) ADHD, with multiple time-points from a subsample of participants (n = 121). Parents and youth completed rating scales assessing child ED, emotional lability, irritability, anxiety, and depression. Mixed effects models were employed to examine effects and interactions of diagnosis, sex [biological sex assigned at birth], age among boys and girls with and without ADHD. Mixed effects analyses showed sexually dimorphic developmental patterns between boys and girls, such that boys with ADHD showed a greater reduction in ED, irritability, and anxiety with age compared to girls with ADHD, whose symptom levels remained elevated relative to TD girls. Depressive symptoms were persistently elevated among girls with ADHD compared to boys with ADHD, whose symptoms decreased with age, relative to same-sex TD peers. While both boys and girls with ADHD showed higher levels of ED during childhood (compared to their sex-matched TD peers), mixed effects analyses revealed substantial sexually dimorphic patterns of emotional symptom change during adolescence: Boys with ADHD showed robust improvements in emotional symptoms from childhood to adolescence while girls with ADHD continued to show high and/or increased levels of ED, emotional lability, irritability, anxiety and depression.
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Affiliation(s)
- Alyssa C De Ronda
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Laura Rice
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Yi Zhao
- Department of Biostatistics, Indiana University School of Medicine, 410 West 10th Street, Indianapolis, IN, 46202, USA
| | - Keri S Rosch
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins University School of Medicine , 716 North Broadway, Baltimore, MD, 21205, USA
| | - Karen E Seymour
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA.
- Department of Mental Health, Johns Hopkins University School of Public Health, 6701 Rockledge Drive, Bethesda, MD, 20892, USA.
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2
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Bodalski EA, Flory K, Meinzer MC. A Scoping Review of Factors Associated With Emotional Dysregulation in Adults With ADHD. J Atten Disord 2023; 27:1540-1558. [PMID: 37470198 DOI: 10.1177/10870547231187148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Emotion dysregulation is frequently seen in adults with ADHD and is associated with many adverse outcomes. We conducted a scoping review of factors associated with emotion dysregulation in adults with ADHD. METHOD PubMed and PsycInfo (EBSCO) were searched. Articles were included if they measured ADHD, emotional dysregulation or some aspect of emotional dysregulation, and at least one other construct. Studies examining physiological underpinnings as well as clinical trials examining the effect of ADHD medications on emotional dysregulation were excluded because recent reviews have already examined these topics. RESULTS Thirty-five studies were included in the review. Factors such as biological sex, comorbidities, attachment style, using certain emotional regulation strategies, and ADHD subtype tend to be related to emotion dysregulation. CONCLUSION Clinicians working with adults with ADHD can collect information on these factors to better understand risk for emotion dysregulation, and emotion regulation skills may be one area for intervention.
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Affiliation(s)
| | - Kate Flory
- University of South Carolina, Columbia, USA
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3
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Gisbert-Gustemps L, Lugo-Marín J, Ramos IS, Martín GE, Vieta E, Bonnín CM, Quiroga JAR. Functioning assessment short test (FAST): validity and reliability in adults with Autism Spectrum Disorder. BMC Psychiatry 2021; 21:321. [PMID: 34187406 PMCID: PMC8243726 DOI: 10.1186/s12888-021-03330-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 06/08/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The assessment of functional impairment is crucial both for the diagnosis and the therapeutic approach to autism spectrum disorder (ASD). The purpose of the present study was to evaluate whether the FAST is a reliable and valid tool to assess functional impairment in adults with Level 1 ASD and to study the differences in psychosocial functioning between younger and older adults with ASD. METHODS A case-control study was carried out in a sample of 150 participants, 71 adults with Level 1 ASD, and 79 adults without psychiatric history records. RESULTS Results showed good psychometric properties in terms of validity and reliability. Cronbach's alpha for the total scale was .91 and the area under the curve was .98. The study also showed that adults with ASD present different profiles of functional impairment depending on their age: while younger patients present greater impairment in autonomy, older patients show more difficulties in interpersonal relationships. CONCLUSIONS Our results support the use of the FAST in the evaluation of adaptive functioning in adults with Level 1 ASD.
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Affiliation(s)
- Laura Gisbert-Gustemps
- Department of Psychiatry, Universitari Vall d'Hebron Hospital, Barcelona, Catalonia, Spain.
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.
| | - Jorge Lugo-Marín
- Department of Psychiatry, Universitari Vall d'Hebron Hospital, Barcelona, Catalonia, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.
| | - Imanol Setien Ramos
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Gemma Español Martín
- Department of Psychiatry, Universitari Vall d'Hebron Hospital, Barcelona, Catalonia, Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - C Mar Bonnín
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Josep Antoni Ramos Quiroga
- Department of Psychiatry, Universitari Vall d'Hebron Hospital, Barcelona, Catalonia, Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
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4
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Janiri D, Conte E, De Luca I, Simone MV, Moccia L, Simonetti A, Mazza M, Marconi E, Monti L, Chieffo DPR, Kotzalidis G, Janiri L, Sani G. Not Only Mania or Depression: Mixed States/Mixed Features in Paediatric Bipolar Disorders. Brain Sci 2021; 11:brainsci11040434. [PMID: 33805270 PMCID: PMC8065627 DOI: 10.3390/brainsci11040434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/15/2021] [Accepted: 03/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: early onset is frequent in Bipolar Disorders (BDs), and it is characterised by the occurrence of mixed states (or mixed features). In this systematic review, we aimed to confirm and extend these observations by providing the prevalence rates of mixed states/features and data on associated clinical, pharmacological and psychopathological features. Methods: following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched from inception to 9 February 2021 for all studies investigating mixed states/mixed features in paediatric BD. Data were independently extracted by multiple observers. The prevalence rates of mixed states/features for each study were calculated. Results: eleven studies were included in our review, involving a total patient population of 1365 individuals. Overall, of the patients with paediatric age BD, 55.2% had mixed states/features (95% CI 40.1–70.3). Children with mixed states/features presented with high rates of comorbidities, in particular, with Attention Deficit Hyperactivity Disorder (ADHD). Evidences regarding the psychopathology and treatment response of mixed states/features are currently insufficient. Conclusions: our findings suggested that mixed states/features are extremely frequent in children and adolescents with BD and are characterised by high levels of comorbidity. Future investigations should focus on the relationship between mixed states/features and psychopathological dimensions as well as on the response to pharmacological treatment.
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Affiliation(s)
- Delfina Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry and Neurology, Sapienza University of Rome, 00168 Rome, Italy
| | - Eliana Conte
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Eating Disorders Treatment Unit, Casa di Cura Villa Armonia Nuova, 00100 Rome, Italy
| | - Ilaria De Luca
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Maria Velia Simone
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Lorenzo Moccia
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Alessio Simonetti
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
| | - Marianna Mazza
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Elisa Marconi
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy
| | - Laura Monti
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | | | - Georgios Kotzalidis
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy;
| | - Luigi Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy
- Correspondence: ; Tel.: +39-063355896764; Fax: +39-063051343
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Brevik EJ, Lundervold AJ, Haavik J, Posserud MB. Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD. Brain Behav 2020; 10:e01605. [PMID: 32285644 PMCID: PMC7303368 DOI: 10.1002/brb3.1605] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To validate the Adult ADHD Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) in a well-characterized sample of adult attention-deficit/hyperactivity disorder (ADHD) patients and population controls. METHODS Both the ASRS and the WURS were administered to clinically diagnosed adult ADHD patients (n = 646) and to population controls (n = 908). We performed principal component analyses (PCA) and calculated receiver operating curves (ROC) including area under the curve (AUC) for the full WURS and ASRS, as well as for the PCA generated factors and the ASRS short screener. RESULTS We found an AUC of 0.956 (95% CI: 0.946-0.965) for the WURS, and 0.904 (95% CI: 0.888-0.921) for the ASRS. The ASRS short screener had an AUC of 0.903 (95%CI: 0.886-0.920). Combining the two full scales gave an AUC of 0.964 (95% CI: 0.955-0.973). We replicated the two-factor structure of the ASRS and found a three-factor model for the WURS. CONCLUSION The WURS and the ASRS both have high diagnostic accuracy. The short ASRS screener performed equally well as the full ASRS, whereas the WURS had the best discriminatory properties. The increased diagnostic accuracy may be due to the wider symptom range of the WURS and/or the retrospective childhood frame of symptoms.
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Affiliation(s)
- Erlend Joramo Brevik
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Biomedicine, K.G. Jebsen Centre for Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Astri J Lundervold
- Department of Biomedicine, K.G. Jebsen Centre for Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Biomedicine, K.G. Jebsen Centre for Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Maj-Britt Posserud
- Department of Biomedicine, K.G. Jebsen Centre for Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
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6
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Gisbert L, Richarte V, Corrales M, Ibáñez P, Bosch R, Bellina M, Fadeuilhe C, Casas M, Ramos-Quiroga JA. The Relationship Between Neuropsychological Deficits and Emotional Lability in Adults With ADHD. J Atten Disord 2019; 23:1514-1525. [PMID: 29890879 DOI: 10.1177/1087054718780323] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The objective of this study was to investigate the extent to which neuropsychological performance parameters implicated in ADHD might mediate the relationship between emotional lability (EL) and this disorder. Method: Eight hundred twelve adult patients with ADHD were examined. EL was assessed using the EL subscale of Conners' Adult ADHD Rating Scales (CAARS). To assess cognitive and executive functions, a battery of neuropsychological tests was performed in 262 patients with ADHD and high EL symptomatology and 550 patients with ADHD and low EL symptomatology. Results: Several differences between groups were found regarding neuropsychological performance; however, nearly all significant differences disappeared when the effect of gender, inattention, and hyperactive symptoms and psychiatric comorbidities were taken into account. Conclusion: Our results do not support the hypothesis that neuropsychological deficits are associated with EL in adults with ADHD.
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Affiliation(s)
- Laura Gisbert
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Vanesa Richarte
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Montserrat Corrales
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Pol Ibáñez
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain
| | - Rosa Bosch
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Mariano Bellina
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain
| | - Christian Fadeuilhe
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain
| | - Miquel Casas
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
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7
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Otto C, Barkmann C, Döpfner M, Petermann F, Schlack R, Ravens-Sieberer U, Klasen F. Der Global-Index der Conners-Skalen. DIAGNOSTICA 2019. [DOI: 10.1026/0012-1924/a000214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Aufmerksamkeitsdefizits- / Hyperaktivitätsstörungen (ADHS) treten in der Kindheit und Jugend häufig auf und ziehen oftmals psychische Probleme im Erwachsenenalter nach sich. Der Global-Index der etablierten Conners-Skalen dient als Screening-Instrument für eine ADHS und weitere psychische Auffälligkeiten bei Kindern und Jugendlichen in der klinischen Routine sowie in Forschungsstudien. Die vorliegende Untersuchung präsentiert die psychometrische Analyse einer deutschen Eltern- und Selbstberichtsversion des Global-Index sowie Normwerte basierend auf Daten von N = 967 13- bis 17-Jährigen aus der Allgemeinbevölkerung. Die Resultate zeigen für den Eltern- und den Selbstbericht des Global-Index sowie für die zugehörige Subskala Rastlos-Impulsiv jeweils neben einer guten internen Konsistenz Hinweise auf eine ausreichende bis gute konvergente Validität, aber die entsprechenden Kennwerte für die Subskala Emotional-Labil waren nicht ausreichend. Für beide Urteilerperspektiven wurden Stärken, aber auch strukturelle Schwächen entdeckt, die in weiteren Studien untersucht werden sollten. Die Subskala Emotional-Labil sollte mit Vorsicht verwendet werden. Die Befunde sollten nicht auf Kinder und Jugendliche außerhalb des untersuchten Altersbereichs übertragen werden.
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Affiliation(s)
- Christiane Otto
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Claus Barkmann
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Manfred Döpfner
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Robert Schlack
- Abteilung Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut Berlin
| | - Ulrike Ravens-Sieberer
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
| | - Fionna Klasen
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf
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