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Treier AK, Döpfner M, Ravens-Sieberer U, Görtz-Dorten A, Boecker M, Goldbeck C, Banaschewski T, Aggensteiner PM, Hanisch C, Ritschel A, Kölch M, Daunke A, Roessner V, Kohls G, Kaman A. Screening for affective dysregulation in school-aged children: relationship with comprehensive measures of affective dysregulation and related mental disorders. Eur Child Adolesc Psychiatry 2024; 33:381-390. [PMID: 36800039 PMCID: PMC10869411 DOI: 10.1007/s00787-023-02166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
Affective dysregulation (AD) is characterized by irritability, severe temper outbursts, anger, and unpredictable mood swings, and is typically classified as a transdiagnostic entity. A reliable and valid measure is needed to adequately identify children at risk of AD. This study sought to validate a parent-rated screening questionnaire, which is part of the comprehensive Diagnostic Tool for Affective Dysregulation in Children (DADYS-Screen), by analyzing relationships with comprehensive measures of AD and related mental disorders in a community sample of children with and without AD. The sample comprised 1114 children aged 8-12 years and their parents. We used clinical, parent, and child ratings for our analyses. Across all raters, the DADYS-Screen showed large correlations with comprehensive measures of AD. As expected, correlations were stronger for measures of externalizing symptoms than for measures of internalizing symptoms. Moreover, we found negative associations with emotion regulation strategies and health-related quality of life. In receiver operating characteristic (ROC) analyses, the DADYS-Screen adequately identified children with AD and provided an optimal cut-off. We conclude that the DADYS-Screen appears to be a reliable and valid measure to identify school-aged children at risk of AD.
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Affiliation(s)
- A-K Treier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany.
| | - M Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - U Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - M Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Goldbeck
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - P-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - C Hanisch
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - A Ritschel
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - M Kölch
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - A Daunke
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - V Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - G Kohls
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - A Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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2
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Giudice TD, Lindenschmidt T, Hellmich M, Hautmann C, Döpfner M, Görtz-Dorten A. Stability of the effects of a social competence training program for children with oppositional defiant disorder/conduct disorder: a 10-month follow-up. Eur Child Adolesc Psychiatry 2023; 32:1599-1608. [PMID: 35279770 PMCID: PMC10460314 DOI: 10.1007/s00787-021-01932-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 12/17/2021] [Indexed: 11/26/2022]
Abstract
The stability and effectiveness of the Treatment Program for Children with Aggressive Behavior (THAV) in terms of reducing behavioral problems in children with oppositional defiant disorder (ODD) and conduct disorder (CD) were examined at a 10-month follow-up (FU). A total of 76 families and their children (boys aged 6-12 years), who previously participated in a randomized controlled trial comparing THAV with an active control group, took part in the 10-month FU assessment. Outcome measures were rated by parents and included the evaluation of child aggressive behavior, prosocial behavior, problem-maintaining and problem-moderating factors, and comorbid symptoms. Linear mixed models for repeated measures (MMRM) were conducted. The results revealed that THAV effects remained stable (problem-maintaining and problem-moderating factors; comorbid symptoms) and even partially improved (aggressive behavior; ADHD symptoms) over the FU period. Additionally, the differences between the THAV intervention group and the control group, which were apparent at the end of the treatment (post), mainly also remained at the FU assessment. It can be concluded that THAV is an effective and stable intervention for boys aged 6-12 years with ODD/CD.
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Affiliation(s)
- Teresa Del Giudice
- Faculty of Medicine, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Timo Lindenschmidt
- Faculty of Medicine, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Faculty of Medicine, Institute of Medical Statistics and Computational Biology, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christopher Hautmann
- Faculty of Medicine, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Manfred Döpfner
- Faculty of Medicine, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, University of Cologne, Cologne, Germany
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anja Görtz-Dorten
- Faculty of Medicine, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, University of Cologne, Cologne, Germany
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
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Junghänel M, Wand H, Dose C, Thöne AK, Treier AK, Hanisch C, Ritschel A, Kölch M, Lincke L, Roessner V, Kohls G, Ravens-Sieberer U, Kaman A, Banaschewski T, Aggensteiner PM, Görtz-Dorten A, Döpfner M. Validation of a new emotion regulation self-report questionnaire for children. BMC Psychiatry 2022; 22:820. [PMID: 36550484 PMCID: PMC9773459 DOI: 10.1186/s12888-022-04440-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To examine and validate the self-report Questionnaire on the Regulation of Unpleasant Moods in Children (FRUST), which is a modified and shortened version of the Questionnaire for the Assessment of Emotion Regulation in Children and Adolescents (FEEL-KJ). METHODS The data comprised child and parent ratings of a community-screened sample with differing levels of affective dysregulation (AD) (N = 391, age: M = 10.64, SD = 1.33, 56% male). We conducted latent factor analyses to establish a factor structure. Subsequently, we assessed measurement invariance (MI) regarding age, gender, and AD level and evaluated the internal consistencies of the scales. Finally, we examined the convergent and divergent validity of the instrument by calculating differential correlations between the emotion regulation strategy (ERS) scales and self- and parent-report measures of psychopathology. RESULTS A four-factor model, with one factor representing Dysfunctional Strategies and the three factors Distraction, Problem-Solving and Social Support representing functional strategies provided the best fit to our data and was straightforward to interpret. We found strong MI for age and gender and weak MI for AD level. Differential correlations with child and parent ratings of measures of psychopathology supported the construct validity of the factors. CONCLUSIONS We established a reliable and valid self-report measure for the assessment of ERS in children. Due to the reduced number of items and the inclusion of highly specific regulatory behaviors, the FRUST might be a valuable contribution to the assessment of ER strategies for diagnostic, therapeutic, and research purposes.
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Affiliation(s)
- Michaela Junghänel
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Hildegard Wand
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Christina Dose
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Ann-Kathrin Thöne
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Anne-Katrin Treier
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Charlotte Hanisch
- grid.6190.e0000 0000 8580 3777Department of Special Education, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Anne Ritschel
- grid.6190.e0000 0000 8580 3777Department of Special Education, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Michael Kölch
- grid.6582.90000 0004 1936 9748Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany ,grid.413108.f0000 0000 9737 0454Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany ,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Ruppin-Brandenburg, Neuruppin, Germany
| | - Lena Lincke
- grid.413108.f0000 0000 9737 0454Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Veit Roessner
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Gregor Kohls
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Ulrike Ravens-Sieberer
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Banaschewski
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Pascal-M. Aggensteiner
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anja Görtz-Dorten
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969 Cologne, Germany ,grid.6190.e0000 0000 8580 3777Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany. .,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
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Dose C, Thöne AK, Del Giudice T, Görtz-Dorten A, Faber M, Benesch C, Hautmann C, Lindenschmidt T, Döpfner M. Child-therapist and parent-therapist alliances and outcome in the treatment of children with oppositional defiant/conduct disorder. Psychother Res 2022; 33:468-481. [PMID: 36305325 DOI: 10.1080/10503307.2022.2138791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE This study examined the quality of therapeutic alliance from different rater perspectives (child, parent, therapist) in cognitive behavioural therapy for children with oppositional defiant disorder (ODD) and conduct disorder (CD), and its association with symptom severity. Further, a panel model with an autoregressive cross-lagged panel design was used to explore whether therapist-rated and parent-rated therapeutic alliance influences change in symptom severity, or vice versa. METHODS Sixty boys aged 6-12 years with a principal diagnosis of ODD/CD, and their parents, received individually delivered social competence training for childhood aggressive behaviour problems. Child, therapist, and parent ratings of therapeutic alliance and symptom severity were measured twice. RESULTS Our results indicate good to very good therapeutic alliance that was relatively stable over time. The cross-sectional analyses of the alliance-symptom association revealed moderate correlations. However, effects of early alliance on later treatment outcome or of early symptom severity on later alliance were marginal. The only significant association was found between early parent-rated therapist-parent alliance and later parent-rated symptom severity. CONCLUSION Our study shows a moderate correlation between simultaneously assessed therapeutic alliance and symptoms. The findings of the panel model indicate that an early good therapeutic alliance is a component of later therapeutic success (parent perspective).
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Affiliation(s)
- Christina Dose
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kathrin Thöne
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Teresa Del Giudice
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Faber
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christina Benesch
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christopher Hautmann
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Timo Lindenschmidt
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- School for Child and Adolescent Cognitive Behaviour Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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5
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Görtz-Dorten A, Frank M, Fessel A, Hofmann L, Döpfner M. Effects of a smartphone app-augmented treatment for children with oppositional defiant disorder / conduct disorder and peer-related aggressive behavior - a pilot study. Trials 2022; 23:554. [PMID: 35804379 PMCID: PMC9264298 DOI: 10.1186/s13063-022-06325-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background Social competence training interventions, especially child-focused ones, have proven to be effective in the treatment of children with conduct disorder. Therapy homework assignments implemented between the therapy sessions are essential for practicing strategies developed during treatment sessions and transferring them to everyday life. However, clinical experience shows that patients’ adherence regarding these assignments is often low, thus diminishing the treatment success. One obstacle in this regard is a lack of motivation. The use of smartphone apps in the context of child and adolescent psychotherapy is relatively new, and may provide novel ways to improve the transfer of coping strategies to daily life between treatment sessions. However, only a small number of high-quality studies have analyzed the systematic use of smartphone apps in therapy. The present study will therefore evaluate patients’ homework assignment adherence when using a smartphone app as compared to a paper-and-pencil method. Method The study will be conducted as a randomized controlled trial to evaluate the impact of a smartphone app on the adherence to therapy homework assignments (n = 35) in the treatment of children with aggressive behavior aged 6–12 years compared to paper-and-pencil homework assignments (n = 35). Discussion This trial is intended as a pilot study and aims to provide a basis for a subsequent multicenter trial. However, the results may already lead to recommendations for the development and use of mental health-related smartphone apps for children and adolescents with aggressive behavior problems. Trial registration Trial registration AUTHARK: German Clinical Trials Register (DRKS) DRKS00015625. Registered on 15th October 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06325-6.
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Affiliation(s)
- Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. .,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Marlin Frank
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Anja Fessel
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Leonie Hofmann
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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6
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Junghänel M, Thöne AK, Ginsberg C, Görtz-Dorten A, Frenk F, Mücke K, Treier AK, Labarga SZ, Banaschewski T, Millenet S, Fegert JM, Bernheim D, Hanisch C, Kölch M, Schüller A, Ravens-Sieberer U, Kaman A, Roessner V, Hinz J, Döpfner M. Correction to: Irritability and Emotional Impulsivity as Core Feature of ADHD and ODD in Children. J Psychopathol Behav Assess 2022. [DOI: 10.1007/s10862-022-09981-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Otto C, Kaman A, Barkmann C, Döpfner M, Görtz-Dorten A, Ginsberg C, Zaplana Labarga S, Treier AK, Roessner V, Hanisch C, Koelch M, Banaschewski T, Ravens-Sieberer U. The DADYS-Screen: Development and Evaluation of a Screening Tool for Affective Dysregulation in Children. Assessment 2022; 30:1080-1094. [PMID: 35301874 PMCID: PMC10152573 DOI: 10.1177/10731911221082709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Affective dysregulation (AD) in children is characterized by persistent irritability and severe temper outbursts. This study developed and evaluated a screening questionnaire for AD in children. The development included the generation of an initial item pool from existing instruments, a Delphi rating of experts, focus groups with experts and parents, and psychometric analyses of clinical and population-based samples. Based on data of a large community-based study, the final screening questionnaire was developed (n = 771; 49.7 % female; age M = 10.02 years; SD = 1.34) and evaluated (n = 8,974; 48.7 % female; age M = 10.00 years; SD = 1.38) with methods from classical test theory and item response theory. The developed DADYS-Screen (Diagnostic Tool for Affective Dysregulation in Children-Screening Questionnaire) includes 12 items with good psychometric properties and scale characteristics including a good fit to a one-factorial model in comparison to the baseline model, although only a "mediocre" fit according to the root mean square error of approximation (RMSEA). Results could be confirmed using a second and larger data set. Overall, the DADYS-Screen is able to identify children with AD, although it needs further investigation using clinical data.
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Affiliation(s)
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf, Germany
| | | | | | | | | | | | | | | | | | - Michael Koelch
- University of Ulm, Germany.,Rostock University Medical Center, Germany
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8
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Kaman A, Otto C, Devine J, Erhart M, Döpfner M, Banaschewski T, Görtz-Dorten A, Hanisch C, Kölch M, Roessner V, Ravens-Sieberer U. Assessing anger and irritability in children: psychometric evaluation and normative data for the German version of the PROMIS® Parent Proxy Anger Scale. Qual Life Res 2021; 31:831-839. [PMID: 34586583 PMCID: PMC8921038 DOI: 10.1007/s11136-021-03001-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/05/2022]
Abstract
Purpose Anger and irritability are common and impairing symptoms in children. The PROMIS Anger scales assess self- and parent-reported irritable and angry mood over the past 7 days. The aim of this study was to evaluate the psychometric properties of the German version of the PROMIS Parent Proxy Short Form v1.0—Anger and to provide normative data. Methods To evaluate the psychometric properties, data from the study ADOPT Epidemiology were used. In this study, the PROMIS Anger Scale was administered to a population-based sample of n = 8746 parents of children aged 8–12 years. Psychometric analyses were carried out including the investigation of distribution characteristics, factor structure, model fit, internal consistency, and congruent validity. Normative data were calculated as percentile ranks and T-scores. Results The PROMIS Anger Scale demonstrated good psychometric properties, including satisfactory distribution characteristics, unidimensionality, good internal consistency as well as congruent validity. German normative data for the PROMIS Anger Scale are presented. Conclusion Based on first psychometric analyses, the German version of the PROMIS Anger Scale can be recommended for use in research and practice; however, further investigations using clinical data are needed. The normative data will allow researchers and clinicians an interpretation of the test scores in future applications.
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Affiliation(s)
- Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Psychosomatic Clinic and Outpatient Center, Argora Clinic, Berlin, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Alice Salomon University of Applied Science, Berlin, Germany.,Apollon University of Applied Science, Bremen, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Charlotte Hanisch
- Department of Special Education and Rehabilitation, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Michael Kölch
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.,Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, Rostock University Medical Center, Rostock, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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9
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Thöne AK, Junghänel M, Görtz-Dorten A, Dose C, Hautmann C, Jendreizik LT, Treier AK, Vetter P, von Wirth E, Banaschewski T, Becker K, Brandeis D, Dürrwächter U, Geissler J, Hebebrand J, Hohmann S, Holtmann M, Huss M, Jans T, Ketter J, Legenbauer T, Millenet S, Poustka L, Renner T, Romanos M, Uebel-von Sandersleben H, Wenning J, Ziegler M, Döpfner M. Disentangling symptoms of externalizing disorders in children using multiple measures and informants. Psychol Assess 2021; 33:1065-1079. [PMID: 34435849 DOI: 10.1037/pas0001053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The trait impulsivity theory suggests that a single, highly heritable externalizing liability factor, expressed as temperamental trait impulsivity, represents the core vulnerability for externalizing disorders. The present study sought to test the application of latent factor models derived from this theory to a clinical sample of children. Participants were 474 German children (age 6-12 years, 81% male) with symptoms of attention-deficit/hyperactivity disorder and externalizing behavior problems participating in an ongoing multicenter intervention study. Using confirmatory factor analyses (CFA) and exploratory structural equation modeling (ESEM), we evaluated several factor models of externalizing spectrum disorders (unidimensional; first-order correlated factors; higher-order factor; fully symmetrical bifactor; bifactor S-1 model). Furthermore, we assessed our prevailing factor models for measurement invariance across raters (clinicians, parents, teachers) and assessment modes (interview, questionnaires). While both CFA and ESEM approaches provided valuable insights into the multidimensionality, ESEM solutions were generally superior since they showed a substantially better model fit and less biased factor loadings. Among the models tested, the bifactor S-1 CFA/ESEM models, with a general hyperactivity-impulsivity reference factor, displayed a statistically sound factor structure and allowed for straightforward interpretability. Furthermore, these models showed the same organization of factors and loading patterns, but not equivalent item thresholds across raters and assessment modes, highlighting cross-situational variability in child behavior. Our findings are consistent with the assumption of the trait impulsivity theory that a common trait, presented as hyperactivity-impulsivity symptoms, underlies all externalizing disorders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Christina Dose
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
| | | | | | | | - Paula Vetter
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
| | - Elena von Wirth
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
| | | | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Ute Dürrwächter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | | | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | | | - Johanna Ketter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | | | - Jasmin Wenning
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | - Mirjam Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
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10
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Del Giudice T, Dose C, Görtz-Dorten A, Steiner J, Bruning N, Bell H, Roland P, Walter D, Junghänel M, Döpfner M. Dimensions of Autistic Traits Rated by Parents of Children and Adolescents with Suspected Autism Spectrum Disorders. J Autism Dev Disord 2021; 51:3989-4002. [PMID: 33420648 PMCID: PMC8510981 DOI: 10.1007/s10803-020-04850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/24/2022]
Abstract
To examine the factor structure of autism spectrum disorder (ASD) and the psychometric properties of the German Symptom Checklist for Autism Spectrum Disorders (SCL-ASD). Data were collected from 312 clinical referrals with suspected ASD (2–18 years). Confirmatory factor analyses and analyses of reliability, convergent and divergent validity were performed. A bifactor model with one general ASD factor and two specific factors (interaction-communication; restricted, repetitive behaviors) provided an adequate data fit. Internal consistencies of the SCL-ASD subscales and the total scale were > .70. Correlations with measures of ASD traits were higher than correlations with measures of externalizing and internalizing symptoms. The results support a factor structure consistent with DSM-5/ICD-11 criteria. The SCL-ASD has sound psychometric properties.
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Affiliation(s)
- Teresa Del Giudice
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Christina Dose
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Jennifer Steiner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Nicole Bruning
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Hannah Bell
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Pamela Roland
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Daniel Walter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Michaela Junghänel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. .,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany.
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11
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Görtz-Dorten A, Döpfner M. Störungen mit oppositionellem und trotzigem Verhalten und dissoziale Verhaltensstörungen. Z Kinder Jugendpsychiatr Psychother 2020; 49:494-498. [PMID: 33196401 DOI: 10.1024/1422-4917/a000764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Anja Görtz-Dorten
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie am Klinikum der Universität zu Köln
| | - Manfred Döpfner
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie am Klinikum der Universität zu Köln
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12
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Thöne AK, Görtz-Dorten A, Altenberger P, Dose C, Geldermann N, Hautmann C, Jendreizik LT, Treier AK, von Wirth E, Banaschewski T, Brandeis D, Millenet S, Hohmann S, Becker K, Ketter J, Hebebrand J, Wenning J, Holtmann M, Legenbauer T, Huss M, Romanos M, Jans T, Geissler J, Poustka L, Uebel-von Sandersleben H, Renner T, Dürrwächter U, Döpfner M. Toward a Dimensional Assessment of Externalizing Disorders in Children: Reliability and Validity of a Semi-Structured Parent Interview. Front Psychol 2020; 11:1840. [PMID: 32849082 PMCID: PMC7396521 DOI: 10.3389/fpsyg.2020.01840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/06/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study assesses the reliability and validity of the DSM-5-based, semi-structured Clinical Parent Interview for Externalizing Disorders in Children and Adolescents (ILF-EXTERNAL). METHOD Participant data were drawn from the ongoing ESCAschool intervention study. The ILF-EXTERNAL was evaluated in a clinical sample of 474 children and adolescents (aged 6-12 years, 92 females) with symptoms of attention-deficit/hyperactivity disorder (ADHD). To obtain interrater reliability, the one-way random-effects, absolute agreement models of the intraclass correlation (ICC) for single ICC(1,1) and average measurements ICC(1,3) were computed between the interviewers and two independent raters for 45 randomly selected interviews involving ten interviewers. Overall agreement on DSM-5 diagnoses was assessed using Fleiss' kappa. Further analyses evaluated internal consistencies, item-total correlations as well as correlations between symptom severity and the degree of functional impairment. Additionally, parents completed the German version of the Child Behavior Checklist (CBCL) and two DSM-5-based parent questionnaires for the assessment of ADHD symptoms and symptoms of disruptive behavior disorders (FBB-ADHS; FBB-SSV), which were used to evaluate convergent and divergent validity. RESULTS ICC coefficients demonstrated very good to excellent interrater reliability on the item and scale level of the ILF-EXTERNAL [scale level: ICC(1,1) = 0.83-0.95; ICC(1,3) = 0.94-0.98]. Overall kappa agreement on DSM-5 diagnoses was substantial to almost perfect for most disorders (0.38 ≤ κ ≤ 0.94). With some exceptions, internal consistencies (0.60 ≤ α ≤ 0.86) and item-total correlations (0.21 ≤ r it ≤ 0.71) were generally satisfactory to good. Furthermore, higher symptom severity was associated with a higher degree of functional impairment. The evaluation of convergent validity revealed positive results regarding clinical judgment and parent ratings (FBB-ADHS; FBB-SSV). Correlations between the ILF-EXTERNAL scales and the CBCL Externalizing Problems were moderate to high. Finally, the ILF-EXTERNAL scales were significantly more strongly associated with the CBCL Externalizing Problems than with the Internalizing Problems, indicating divergent validity. CONCLUSION In clinically referred, school-age children, the ILF-EXTERNAL demonstrates sound psychometric properties. The ILF-EXTERNAL is a promising clinical interview and contributes to high-quality diagnostics of externalizing disorders in children and adolescents.
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Affiliation(s)
- Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anja Görtz-Dorten
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Paula Altenberger
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christina Dose
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nina Geldermann
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christopher Hautmann
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lea Teresa Jendreizik
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne-Katrin Treier
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elena von Wirth
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zürich, Zurich, Switzerland
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Johanna Ketter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, Philipps-University Marburg, Marburg, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jasmin Wenning
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Tanja Legenbauer
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Jans
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Julia Geissler
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Henrik Uebel-von Sandersleben
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
| | - Ute Dürrwächter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
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13
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Döpfner M, Katzmann J, Hanisch C, Fegert JM, Kölch M, Ritschel A, Treier AK, Hellmich M, Roessner V, Ravens-Sieberer U, Banaschewski T, Görtz-Dorten A. Affective dysregulation in childhood - optimizing prevention and treatment: protocol of three randomized controlled trials in the ADOPT study. BMC Psychiatry 2019; 19:264. [PMID: 31477086 PMCID: PMC6720991 DOI: 10.1186/s12888-019-2239-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/14/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The terms affective dysregulation (AD) and irritability describe transdiagnostic dimensions and are characterized by an excessive reactivity to negative emotional stimuli with an affective (anger) and a behavioral component (aggression). Due to early onset, high prevalence and persistence, as well as developmental comorbidity, AD in childhood is one of the most psychosocially impairing and cost-intensive mental health conditions. AD is especially prevalent in children in the youth welfare service. Despite continuous research, there remains a substantial need for diagnostic approaches and optimization of individualized treatment strategies in order to improve outcomes and reduce the subjective and economic burden. METHODS The ADOPT (Affective Dysregulation - Optimizing Prevention and Treatment) Consortium integrates internationally established, highly experienced and interdisciplinary research groups. The work program encompasses (a) epidemiology, including prevalence of symptoms and disorders, (b) development and evaluation of screening and assessment tools, (c) stepped care approaches for clinically useful personalized medicine, (d) evaluation of an easily accessible and cost-effective online intervention as indicated prevention (treatment effects, moderation/mediation analysis), and (e) evaluation of an intensive personalized modular outpatient treatment in a cohort of children with AD who live with their parents and in a cohort of children with AD who live in out-of-home care (treatment effects, moderation/mediation analysis). DISCUSSION The results will lead to significant recommendations for improving treatment within routine clinical care in two cohorts of children with AD and coexisting conditions, especially oppositional-defiant disorder, conduct disorder and disruptive mood dysregulation disorder. TRIAL REGISTRATION Trial registration ADOPT Online: German Clinical Trials Register (DRKS) DRKS00014963 . Registered 27 June 2018. Trial registration ADOPT Treatment: German Clinical Trials Register (DRKS) DRKS00013317 . Registered 27 September 2018. Trial registration ADOPT Institution: German Clinical Trials Register (DRKS) DRKS00014581 . Registered 04 July 2018.
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Affiliation(s)
- Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany. .,School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969, Cologne, Germany.
| | - Josepha Katzmann
- 0000 0000 8580 3777grid.6190.eDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany ,0000 0000 8580 3777grid.6190.eSchool for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Charlotte Hanisch
- 0000 0000 8580 3777grid.6190.eFaculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Jörg M. Fegert
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Michael Kölch
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany ,Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School Brandenburg, Neuruppin, Germany ,Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Anne Ritschel
- 0000 0000 8580 3777grid.6190.eFaculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Anne-Katrin Treier
- 0000 0000 8580 3777grid.6190.eDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany ,0000 0000 8580 3777grid.6190.eSchool for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Martin Hellmich
- 0000 0000 8580 3777grid.6190.eInstitute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veit Roessner
- 0000 0001 2111 7257grid.4488.0Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Ulrike Ravens-Sieberer
- 0000 0001 2180 3484grid.13648.38Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics & Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Banaschewski
- 0000 0001 2190 4373grid.7700.0Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anja Görtz-Dorten
- 0000 0000 8580 3777grid.6190.eDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany ,0000 0000 8580 3777grid.6190.eSchool for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
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Perri D, Dose C, Görtz-Dorten A, Woitecki K, Breuer D, Döpfner M. Erfassung des Selbstkonzepts von Kindern und Jugendlichen. Zeitschrift für Klinische Psychologie und Psychotherapie 2019. [DOI: 10.1026/1616-3443/a000543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das Self-Perception Profile for Children (SPPC) ist international weit verbreitet und erhebt das Selbstkonzept von Kindern und Jugendlichen. Fragestellung: Die psychometrischen Eigenschaften einer modifizierten Version werden für eine deutsche klinische Stichprobe ( N = 195; Altersbereich 6 – 18 Jahre) geprüft. Methode: Konfirmatorische Faktorenanalysen, Reliabilitäts- sowie Validitätsanalysen zur divergenten, konvergenten und differentiellen Validität werden durchgeführt. Ergebnisse: Das Bifaktormodell und das Modell mit fünf korrelierten Faktoren zeigen die besten Fit-Indizes. Die internen Konsistenzen der Skalen sind zufriedenstellend. Die Omega-Statistiken verdeutlichen psychometrische Schwächen der Subskalen. Hinweise zur konvergenten, divergenten und differentiellen Validität werden gefunden. Schlussfolgerungen: Die modifizierte Fassung des SPPC ist für die Erfassung des Selbstkonzepts von Kindern und Jugendlichen einer klinischen Stichprobe geeignet; Adaptionen zur Optimierung der Güte werden diskutiert.
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Affiliation(s)
- Daniela Perri
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
| | - Christina Dose
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
| | - Anja Görtz-Dorten
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
| | - Katrin Woitecki
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
| | - Dieter Breuer
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
| | - Manfred Döpfner
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
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15
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Abstract
The prevention of externalizing disturbances Abstract. Objectives: Externalizing disturbances (attention deficit-hyperactivity disorders, oppositional defiant disorders, conduct disorders) in children and adolescents have a high prevalence, are stable over time, and precipitate a high individual and economic burden. Method: This review article presents the state of research based on selected current meta-analyzes and systematic reviews. Additionally, evidenced-based German-language prevention programs are discussed. Results: As in treatment, a multimodal approach to prevention is recommended which aims at reducing externalizing symptoms in specific settings. Interventions that focus on the specific environment in the family and the (pre-)school are preferable. Child-focused interventions are especially important in the context of peer-related problematic behavior because parent-based or teacher-based interventions may be less able to affect peer interactions. Conclusions: Comprehensive parent-based and (pre-)school-based preventive interventions of externalizing disturbances should be implemented. These should also include child-based approaches and additional parent-based group interventions. The effects of these interventions should be tested in large-scale studies.
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Affiliation(s)
- Anja Görtz-Dorten
- AKiP Köln, Ausbildungsinstitut für
Kinder- und Jugendlichenpsychotherapie, Uniklinik, Köln.,Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität, Köln
| | | | - Christopher Hautmann
- AKiP Köln, Ausbildungsinstitut für
Kinder- und Jugendlichenpsychotherapie, Uniklinik, Köln
| | - Manfred Döpfner
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Universität, Köln.,AKiP Köln, Ausbildungsinstitut für
Kinder- und Jugendlichenpsychotherapie, Uniklinik, Köln.,Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität, Köln
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16
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Viefhaus P, Feldhausen M, Görtz-Dorten A, Volk H, Döpfner M, Woitecki K. A new treatment for children with chronic tic disorders - Resource activation. Psychiatry Res 2019; 273:662-671. [PMID: 31207850 DOI: 10.1016/j.psychres.2019.01.083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 11/15/2022]
Abstract
The aim of this pilot study is to evaluate the efficacy of a resource activation (RA) program as an alternative intervention for children and adolescents with tic disorders. RA interventions focus on the strengths and abilities of the patients. This is expected to improve the patients' perceptions regarding their own resources, which may indirectly result in a reduction of tic symptoms, impairment and comorbid conditions. A within-subject design with two phases (8 weeks diagnostic; 16 sessions treatment) was analyzed using multilevel modeling (n = 24). During the treatment phase, significant reductions of tics were found in clinical rating (Yale Global Tic Severity Scale; YGTSS), parent rating and video observation (motor tics). Moreover, an improvement was shown on most tic-related impairment and subjective burden (SB) ratings. No significant improvement was found regarding comorbid problems and self-esteem. Compared to the preceding diagnostic phase, a significant incremental treatment effect emerged in clinical rating of tic symptoms (YGTSS) and video observation (motor tics). This pilot study provides first hints that RA may represent an effective treatment for reducing tic symptoms, impairment and SB. However, further research is needed in order to establish RA as an effective treatment for tic disorders.
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Affiliation(s)
- Paula Viefhaus
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital, Cologne, Pohligstr. 9, Köln D-50969, Germany.
| | - Marion Feldhausen
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital, Cologne, Pohligstr. 9, Köln D-50969, Germany
| | - Anja Görtz-Dorten
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital, Cologne, Pohligstr. 9, Köln D-50969, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Robert-Koch-Str. 10, Cologne D-50931, Germany
| | - Helene Volk
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital, Cologne, Pohligstr. 9, Köln D-50969, Germany
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital, Cologne, Pohligstr. 9, Köln D-50969, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Robert-Koch-Str. 10, Cologne D-50931, Germany
| | - Katrin Woitecki
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital, Cologne, Pohligstr. 9, Köln D-50969, Germany
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17
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Katzmann J, Döpfner M, Görtz-Dorten A. Child-based treatment of oppositional defiant disorder: mediating effects on parental depression, anxiety and stress. Eur Child Adolesc Psychiatry 2018; 27:1181-1192. [PMID: 29948233 DOI: 10.1007/s00787-018-1181-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 06/08/2018] [Indexed: 10/14/2022]
Abstract
Previous research has shown that child-oppositional defiant disorder (ODD) and conduct disorders (CD) are associated with parental symptoms of depression, anxiety and/or stress, probably in a bidirectional relationship with mutual influences. It is, therefore, reasonable to assume that in child-centered treatment, a decrease in child-oppositional behavior problems constitutes (at least in part) a mechanism of change for a subsequent reduction in parental psychopathology. The aim of the present study (Clinical trials.gov Identifier: NCT01406067) was to examine whether the reduction in ODD symptoms due to child-based cognitive behavioral treatment (CBT) led to a reduction in parental depression, anxiety and stress. Eighty-one boys (age 6-12 years) with a diagnosis of ODD/CD were randomized either to a cognitive behavioral intervention group or an educational play group (acting as control group). Mediation analyses were conducted using path analysis. The stronger reduction in child ODD symptoms in the CBT group compared to the control group led to a decrease in parental depression and stress, as indicated by significant indirect effects (ab = 0.07 and ab = 0.08, p < 0.05). The proposed model for mechanisms of change was, therefore, confirmed for two of the three outcome parameters. Parental psychopathology and stress can be modified by child-centered CBT. The preceding reduction in ODD symptoms acts as a mediator for at least some of the changes in parental depression and stress. However, due to some limitations of the study, other possible explanations for the results found cannot be completely ruled out and are, therefore, discussed.
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Affiliation(s)
- Josepha Katzmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, School of Child and Adolescent Cognitive Behavior Therapy, University Hospital Cologne, Pohligstraße 9, 50969, Cologne, Germany.
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry and Psychotherapy, School of Child and Adolescent Cognitive Behavior Therapy, University Hospital Cologne, Pohligstraße 9, 50969, Cologne, Germany.,Institute of Child and Adolescent Psychotherapy of the Christoph-Dornier-Foundation for Clinical Psychology, University of Cologne, Cologne, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
| | - Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry and Psychotherapy, School of Child and Adolescent Cognitive Behavior Therapy, University Hospital Cologne, Pohligstraße 9, 50969, Cologne, Germany.,Institute of Child and Adolescent Psychotherapy of the Christoph-Dornier-Foundation for Clinical Psychology, University of Cologne, Cologne, Germany
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18
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Viefhaus P, Feldhausen M, Görtz-Dorten A, Volk H, Döpfner M, Woitecki K. Efficacy of Habit Reversal Training in Children With Chronic Tic Disorders: A Within-Subject Analysis. Behav Modif 2018; 44:114-136. [PMID: 30146896 DOI: 10.1177/0145445518796203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this study is to evaluate a cognitive-behavioral treatment for children and adolescents with tic disorder including habit reversal training (HRT) in a sample of children and adolescents (n = 27). Multiple outcome measures were used to assess the effects of the treatment on tic symptoms. In addition, impairment/subjective burden ratings and the self-efficacy to control tics were assessed. A within-subject design with two phases (8 weeks diagnostic; 16 sessions treatment) was analyzed using multilevel modeling (MLM). During the treatment phase, significant improvements in tic symptoms, impairment, and self-efficacy to control tics were found on most outcome measures. Treatment effects were found on the clinical rating of tic symptoms (Yale Global Tic Severity Scale [YGTSS]), the self-efficacy to control tics, and the video-observed motor tic frequency by comparing the improvements during treatment with the course of the outcome measures during the preceding diagnostic phase.
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Affiliation(s)
- Paula Viefhaus
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital, Cologne, Germany
| | - Marion Feldhausen
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital, Cologne, Germany
| | - Anja Görtz-Dorten
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital, Cologne, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Germany
| | - Helene Volk
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital, Cologne, Germany
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital, Cologne, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Germany
| | - Katrin Woitecki
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital, Cologne, Germany
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19
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Perri D, Görtz-Dorten A, Breuer D, Lerner T, Döpfner M. Erfassung störungsaufrechterhaltender Komponenten sozialer Angst bei Kindern und Jugendlichen im Eltern- und Selbsturteil. Zeitschrift für Klinische Psychologie und Psychotherapie 2017. [DOI: 10.1026/1616-3443/a000416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Der Fragebogen zur Erfassung störungsaufrechterhaltender Komponenten sozialer Angst bei Kindern und Jugendlichen (FESKA) erhebt kognitive, behaviorale und interaktionelle Komponenten sozialer Angststörungen von Kindern und Jugendlichen zwischen 4 und 14 Jahren. Fragestellung: Der FESKA wird im Eltern- (N = 259) und Selbsturteil (N = 159) an einer kombinierten Feld- und klinischen Stichprobe untersucht. Methode: Überprüft werden faktorielle Validität, Reliabilität und Aspekte divergenter und konvergenter Validität. Ergebnisse: Konfirmatorische Faktorenanalysen bestätigen das zugrundeliegende dreifaktorielle Bedingungsmodell. Interne Konsistenzen der Gesamtskalen und der Komponentenskalen sind zufriedenstellend, ihre Wiederholungszuverlässigkeiten sind für das Selbsturteil bedingt und für das Elternurteil nicht zufriedenstellend. Die Korrelationen der Skalen zwischen den Beurteilern fallen geringer als erwartet aus. Die konvergente Validität kann bestätigt werden. Schlussfolgerungen: Unter Berücksichtigung verschiedener Limitationen bestätigen die Befunde die Verwendung des FESKA in Klinik und Forschung.
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Affiliation(s)
- Daniela Perri
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität zu Köln
| | - Anja Görtz-Dorten
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität zu Köln
| | - Dieter Breuer
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
| | - Tatjana Lerner
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
| | - Manfred Döpfner
- AKiP Köln, Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie an der Uniklinik Köln
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Uniklinik Köln
- Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität zu Köln
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20
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Rodenacker K, Hautmann C, Görtz-Dorten A, Döpfner M. Bifactor Models Show a Superior Model Fit: Examination of the Factorial Validity of Parent-Reported and Self-Reported Symptoms of Attention-Deficit/Hyperactivity Disorders in Children and Adolescents. Psychopathology 2016; 49:31-9. [PMID: 26731122 DOI: 10.1159/000442295] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/08/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Various studies have demonstrated that bifactor models yield better solutions than models with correlated factors. However, the kind of bifactor model that is most appropriate is yet to be examined. The current study is the first to test bifactor models across the full age range (11-18 years) of adolescents using self-reports, and the first to test bifactor models with German subjects and German questionnaires. SAMPLING AND METHODS The study sample included children and adolescents aged between 6 and 18 years recruited from a German clinical sample (n = 1,081) and a German community sample (n = 642). To examine the factorial validity, we compared unidimensional, correlated factors and higher-order and bifactor models and further tested a modified incomplete bifactor model for measurement invariance. RESULTS Bifactor models displayed superior model fit statistics compared to correlated factor models or second-order models. However, a more parsimonious incomplete bifactor model with only 2 specific factors (inattention and impulsivity) showed a good model fit and a better factor structure than the other bifactor models. Scalar measurement invariance was given in most group comparisons. CONCLUSION An incomplete bifactor model would suggest that the specific inattention and impulsivity factors represent entities separable from the general attention-deficit/hyperactivity disorder construct and might, therefore, give way to a new approach to subtyping of children beyond and above attention-deficit/hyperactivity disorder.
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Affiliation(s)
- Klaas Rodenacker
- Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany
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21
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Abstract
Zusammenfassung. Ziel dieser Arbeit ist die Analyse der psychometrischen Qualität des Fremd- und des Selbstbeurteilungsbogens zur Erfassung von Angst- und Zwangsstörungen (FBB-ANZ/SBB-ANZ) in zwei klinischen Stichproben (n = 182 bzw. n = 130). Ergänzend wurde die Faktorenstruktur der Bögen in zwei Feldstichproben (n = 724 bzw. n = 281) untersucht. Für die Skalen beider Fragebögen ergaben sich größtenteils zufriedenstellende interne Konsistenzen (.59 ≤ α ≤ .93). Exploratorische Hauptachsenanalysen mit Promax-Rotation ergaben stichprobenübergreifend für beide Fragebögen Faktoren, welche die a priori definierten, ICD-10- und DSM-IV-basierten Subskalen weitgehend abbilden. Zwischen den Subskalen innerhalb der Fragebögen zeigten sich geringe bis moderate Interkorrelationen, die für eine gute Abgrenzbarkeit der Skalen sprechen. Es fanden sich größtenteils moderate Beurteilerübereinstimmungen zwischen den korrespondierenden Skalen des Fremd- und Selbstbeurteilungsbogens. Die Ergebnisse weisen darauf hin, dass die Fragebögen überwiegend reliable und valide Instrumente darstellen. Weiterer Untersuchungsbedarf besteht insbesondere hinsichtlich der konvergenten und divergenten Validität der Subskalen.
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22
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Walter D, Dachs L, Faber M, Goletz H, Görtz-Dorten A, Kinnen C, Rademacher C, Schürmann S, Woitecki K, Metternich-Kaizman TW, Plück J, Hautmann C, Ise E, Döpfner M. Alltagswirksamkeit ambulanter Verhaltenstherapie von Kindern und Jugendlichen im Urteil der Eltern in einer universitären Ausbildungsambulanz. Zeitschrift für Klinische Psychologie und Psychotherapie 2015. [DOI: 10.1026/1616-3443/a000321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Hintergrund: Die Wirksamkeit von kognitiver Verhaltenstherapie bei Kindern und Jugendlichen unter Routinebedingungen ist bislang noch wenig untersucht. Fragestellung: Es wurden Veränderungen psychischer Auffälligkeiten von Kindern und Jugendlichen im Elternurteil während ambulanter Verhaltenstherapie in einer universitären Ausbildungsambulanz untersucht. Die Therapien wurden durchgeführt von Diplom-Psychologen, Pädagogen, Sozialpädagogen und Sozialarbeitern in fortgeschrittener Ausbildung zum Kinder- und Jugendlichenpsychotherapeuten mit Schwerpunkt Verhaltenstherapie. Alle Therapien wurden im Verhältnis 1:4 supervidiert. Methode: Für 976 Therapien wurden Completeranalysen als Prä-Post-Vergleiche mit Effektstärken auf der Child Behavior Checklist (CBCL) berechnet und die klinische Bedeutsamkeit der Veränderungen analysiert–jeweils für die Gesamtgruppe und für die auf der CBCL zu Therapiebeginn klinisch Auffälligen. Zusätzlich wurde die Repräsentativität dieser Analyse für die gesamte Stichprobe überprüft. Ergebnisse: In der Gesamtgruppe fanden sich kleine bis mittlere, in der Gruppe der im Elternurteil auf der CBCL klinisch Auffälligen hauptsächlich große, statistisch signifikante Verminderungen psychischer Auffälligkeiten, die nicht durch Spontanveränderungen oder Regressionseffekte erklärt werden können. Allerdings wurden 1/4 bis 1/3 der Patienten auch nach Therapieende von ihren Eltern weiterhin als klinisch auffällig eingeschätzt. Schlussfolgerungen: Die Ergebnisse weisen auf die Wirksamkeit kognitiv-behavioraler Therapie bei psychisch kranken Kindern und Jugendlichen unter Anwendungsbedingungen hin. Aufgrund der mangelnden experimentellen Kontrolle ist die Aussagekraft der Ergebnisse begrenzt.
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Affiliation(s)
- Daniel Walter
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Lydia Dachs
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Martin Faber
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Hildegard Goletz
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Anja Görtz-Dorten
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Claudia Kinnen
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Christiane Rademacher
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
| | - Stephanie Schürmann
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
| | - Katrin Woitecki
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Tanja Wolff Metternich-Kaizman
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Julia Plück
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
| | - Christopher Hautmann
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Elena Ise
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Manfred Döpfner
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
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Döpfner M, Hautmann C, Görtz-Dorten A, Klasen F, Ravens-Sieberer U. Long-term course of ADHD symptoms from childhood to early adulthood in a community sample. Eur Child Adolesc Psychiatry 2015; 24:665-73. [PMID: 25395380 DOI: 10.1007/s00787-014-0634-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/15/2014] [Indexed: 11/30/2022]
Abstract
Comparatively little information is available from population-based studies on subgroup trajectories of attention-deficit/hyperactivity disorder (ADHD) core symptoms of inattention and hyperactivity-impulsivity (particularly as defined by DSM-IV and ICD-10). Recent report of a subgroup with high and increasing inattention symptoms across development requires replication. To identify the different trajectory subgroups for inattention, hyperactivity-impulsivity and total symptoms of ADHD in children and adolescents aged 7-19 years. Eleven birth cohorts from 2,593 families with children and adolescents who had parent ratings for the outcome measures of inattention, hyperactivity-impulsivity or total symptoms were considered. Data were analysed using an accelerated longitudinal design and growth mixture modelling was applied to detect subgroups. For all three outcome measures, three trajectories with low (78.3-83.3 %), moderate (13.4-18.8 %) and high (2.8-3.2 %) symptom levels were detected. Course within these subgroups was largely comparable across outcome domains. In general, a decrease in symptoms with age was observed in all severity subgroups, although the developmental course was stable for the high subgroups of inattention and total symptoms. About 3 % of children in a community-based sample follow a course with a high level of ADHD symptoms. In this high trajectory group, hyperactivity-impulsivity symptoms decrease with age from 7 to 19 years, whilst inattention and total symptoms are stable. There was no evidence for an increase in symptoms across childhood/adolescence in any of the severity groups.
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Affiliation(s)
- Manfred Döpfner
- Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany,
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24
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Görtz-Dorten A, Ise E, Hautmann C, Walter D, Döpfner M. Psychometric properties of a German parent rating scale for oppositional defiant and conduct disorder (FBB-SSV) in clinical and community samples. Child Psychiatry Hum Dev 2014; 45:388-97. [PMID: 24126739 DOI: 10.1007/s10578-013-0409-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Fremdbeurteilungsbogen für Störungen des Sozialverhaltens (FBB-SSV) is a commonly used DSM- and ICD-based rating scale for disruptive behaviour problems in Germany. This study examined the psychometric properties of the FBB-SSV rated by parents in both a clinical sample (N = 596) and a community sample (N = 720) of children aged 4-17 years. Results indicate that the FBB-SSV is internally consistent (α = .69-.90). Principal component analyses produced two-factor structures that are largely consistent with the distinction between oppositional defiant disorder (ODD) and conduct disorder (CD). Diagnostic accuracy was examined using receiver operating characteristic analyses, which showed that the FBB-SSV is excellent at discriminating children with ODD/CD from those in the community sample (AUC = .91). It has satisfactory diagnostic accuracy for detecting ODD/CD in the clinical sample (AUC = .76). Overall, the results show that the FBB-SSV is a reliable and valid instrument. This finding provides further support for the clinical utility of DSM- and ICD-based rating scales.
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Affiliation(s)
- Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany
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Frölich J, Banaschewski T, Döpfner M, Görtz-Dorten A. An evaluation of the pharmacokinetics of methylphenidate for the treatment of attention-deficit/ hyperactivity disorder. Expert Opin Drug Metab Toxicol 2014; 10:1169-83. [PMID: 24856438 DOI: 10.1517/17425255.2014.922542] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Methylphenidate (MPH) plays a principal role in the multimodal treatment of attention-deficit/hyperactivity disorder (ADHD). Controlled studies have demonstrated an effective reduction in the core symptoms of the disorder following MPH therapy, although long-term studies also demonstrate that the therapeutic benefits dissipate in the absence of combined psychosocial interventions. AREAS COVERED This review article focuses on the pharmacological characteristics of MPH, examining its effects on brain metabolism and the neurotransmitter system. Neuropsychological and clinical effects of different immediate and extended release MPH formulations are discussed to aid clinicians in choosing the appropriate formulation. The drug's addictive potency and abuse potential is also discussed. Data came from a literature search of relevant studies performed using the PubMed database up to June 2013. EXPERT OPINION MPH is effective in the treatment of the core symptoms of ADHD. Considerable clinical expertise is required to identify an individually well-adapted dosage which will produce the optimal clinical effects with potential side effects minimized. Due to low adherence to medication, especially in adolescents, motivation to treatment and attentive clinical monitoring is mandatory, as is the consideration of risks of abuse or the presence of a comorbid addictive disorder.
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Affiliation(s)
- Jan Frölich
- Central Institute of Mental Health, Child and Adolescent Psychiatry Clinic , Postbox: 12 21 20, 68072 Mannheim , Germany +49 711 2845928 ; +49 711 2845929 ;
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Ise E, Görtz-Dorten A, Döpfner M. Reliability and validity of teacher-rated symptoms of oppositional defiant disorder and conduct disorder in a clinical sample. Psychopathology 2014; 47:312-8. [PMID: 24993973 DOI: 10.1159/000362373] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 03/19/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS It is recommended to use information from multiple informants when making diagnostic decisions concerning oppositional defiant disorder (ODD) and conduct disorder (CD). The purpose of this study was to investigate the reliability and validity of teacher-rated symptoms of ODD and CD in a clinical sample. METHODS The sample comprised 421 children (84% boys; 6-17 years) diagnosed with ODD, CD, and/or attention deficit hyperactivity disorder (ADHD). Teachers completed a standardized ODD/CD symptom rating scale and the Teacher Report Form (TRF). RESULTS The reliability (internal consistency) of the symptom rating scale was high (α = 0.90). Convergent and divergent validity were demonstrated by substantial correlations with similar TRF syndrome scales and low-to-moderate correlations with dissimilar TRF scales. Discriminant validity was shown by the ability of the symptom rating scale to differentiate between children with ODD/CD and those with ADHD. Factorial validity was demonstrated by principal component analysis, which produced a two-factor solution that is largely consistent with the two-dimensional model of ODD and CD proposed by the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR, although some CD symptoms representing aggressive behavior loaded on the ODD dimension. CONCLUSION These findings suggest that DSM-IV-TR-based teacher rating scales are useful instruments for assessing disruptive behavior problems in children and adolescents.
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Affiliation(s)
- Elena Ise
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
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Benesch C, Görtz-Dorten A, Breuer D, Döpfner M. Erfassung aggressionsauslösender und -aufrechterhaltender Faktoren bei Kindern mit oppositionellen und aggressiven Verhaltensstörungen im Eltern-, Lehrer- und Selbsturteil. Zeitschrift für Klinische Psychologie und Psychotherapie 2013. [DOI: 10.1026/1616-3443/a000226] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Theoretischer Hintergrund: Der Fragebogen zum aggressiven Verhalten von Kindern (FAVK) dient der Erfassung vier möglicher aggressionsauslösender und -aufrechterhaltender Komponenten von Kindern und Jugendlichen zwischen 4 und 14 Jahren. Fragestellung: Der FAVK soll erstmals im Eltern- (n = 156), Lehrer- (n = 104) und Selbsturteil (n = 91) an einer klinischen Stichprobe (6 – 12 Jahre) untersucht werden. Methode: Überprüft werden faktorielle und interne Validität, Reliabilität und Aspekte divergenter und konvergenter Validität. Ergebnisse: Konfirmatorische Faktorenanalysen bestätigen das zugrundeliegende vierfaktorielle Bedingungsmodell und eine in Feldstichproben gefundene dreifaktorielle Struktur. Interne Konsistenzen der Gesamtskalen sind zufriedenstellend (α > .70), ihre Wiederholungszuverlässigkeiten nicht. Die Korrelationen der Skalen zwischen den Beurteilern fallen geringer als erwartet aus. Zumindest im Elternurteil lassen sich die konvergente und divergente Validität bestätigen. Schlussfolgerung: Unter Berücksichtigung verschiedener Limitationen bestätigen die Befunde die Verwendung des FAVK in Klinik und Forschung.
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Affiliation(s)
- Christina Benesch
- Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln
- Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität Köln
| | - Anja Görtz-Dorten
- Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln
- Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität Köln
| | - Dieter Breuer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln
| | - Manfred Döpfner
- Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln
- Institut für Klinische Kinderpsychologie der Christoph-Dornier-Stiftung an der Universität Köln
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Kierfeld F, Ise E, Hanisch C, Görtz-Dorten A, Döpfner M. Effectiveness of telephone-assisted parent-administered behavioural family intervention for preschool children with externalizing problem behaviour: a randomized controlled trial. Eur Child Adolesc Psychiatry 2013; 22:553-65. [PMID: 23463180 DOI: 10.1007/s00787-013-0397-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 02/18/2013] [Indexed: 12/20/2022]
Abstract
Externalizing problem behaviour is one of the most common childhood disorders. Parent training is an effective treatment for these children and there is growing interest in the effects of parent-administered interventions with minimal therapist contact. This randomized controlled study examined the efficacy of a telephone-assisted parent-administered behavioural intervention (bibliotherapy) in families with preschool children with externalizing problem behaviour. Families were randomly assigned to a treatment group (n = 26) and an untreated waitlist control group (n = 22). The intervention comprised the reading of an 11 chapter self-help book and 11 weekly telephone consultations. Compared to the control group, the treatment group demonstrated significant decreases in parent-reported externalizing and internalizing child problem behaviour and dysfunctional parenting practices. Moreover, treated parents reported less parenting-related strains and decreases in parental depression, anxiety, and stress. The results suggest that telephone-assisted self-administered parent training is an effective alternative to more intensive forms of behavioural family intervention for preschool children with externalizing problem behaviour.
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Affiliation(s)
- Frauke Kierfeld
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany
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Hautmann C, Hoijtink H, Eichelberger I, Görtz-Dorten A, Hanisch C, Plück J, Walter D, Döpfner M. Any indication for bias due to participation? Comparison of the effects of a parent management training rated by participating and non-participating parents. Clin Psychol Psychother 2012; 20:384-93. [PMID: 22362610 DOI: 10.1002/cpp.1784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 01/24/2012] [Accepted: 01/24/2012] [Indexed: 11/05/2022]
Abstract
UNLABELLED Ratings of parents that have participated in a parent training for child externalizing behaviour problems might be biased (e.g., they may report symptom reduction to reward their own endeavours for attending the training). The potential for bias in parent ratings was investigated in a secondary analysis of an effectiveness study of a parent management training for children (aged 3-10 years) with externalizing behaviour problems under routine care conditions. For the 56 families included in the current analysis, we compared the ratings of training participants (predominately mothers) and training non-participants (predominately fathers). A 3-month waiting period prior to treatment served as the control condition. Outcome measures were attention problems and conduct problems of the children and perceived parental self-efficacy rated by both the mothers and fathers. Child attention problems and conduct problems both decreased significantly during the treatment period for participating and non-participating parents, and the changes in ratings during treatment were of a similar magnitude for participants compared with non-participants. Taking into account the methodological limitations of the current analysis, no indication was found that treatment effects are strongly biased due to participation in the training. KEY PRACTITIONER MESSAGES Previous positive findings of mothers' and fathers' ratings on parent management training for children with externalizing problem behaviour have mostly come from parents who also attended the training. For child behavioural problems, the results of the current analysis demonstrate similar perceived changes by parents who did and did not participate in the training. Our findings underscore the relevance and importance of parent ratings for treatment evaluation.
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Affiliation(s)
- Christopher Hautmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
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Görtz-Dorten A, Breuer D, Hautmann C, Rothenberger A, Döpfner M. What contributes to patient and parent satisfaction with medication in the treatment of children with ADHD? A report on the development of a new rating scale. Eur Child Adolesc Psychiatry 2011; 20 Suppl 2:S297-307. [PMID: 21901412 PMCID: PMC3180627 DOI: 10.1007/s00787-011-0207-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Satisfaction with medication is important in the evaluation of overall treatment outcome. There is a lack of consistent and validated rating scales for satisfaction with medication in ADHD, therefore comparison across studies is difficult. Here, we analyse the psychometric properties of the satisfaction with medication scale (SAMS), a new item-based questionnaire that assesses satisfaction with ADHD medication. Furthermore, we evaluate the predictive effect of ADHD symptoms and quality of life (QoL) on satisfaction. Data on satisfaction with Equasym XL(®) (methylphenidate) were collected in the OBSEER study using the parent (SAMS-P, n = 589) and patient (SAMS-S, n = 552) versions of the SAMS questionnaire. Internal consistency, item-total and cross-informant correlations, and the stability of satisfaction ratings over time were assessed. Satisfaction with medication scores were then correlated with ratings of ADHD symptoms and QoL. Rates of overall satisfaction with Equasym XL(®) among parents and children were high (>70%), as was internal consistency for both SAMS-P and SAMS-S (Cronbach's alpha > 0.9). Similarly, item-total correlations were high (r = 0.71-0.90) for SAMS-P and medium-high (r = 0.57-0.77) for SAMS-S. Cross-informant correlations and the stability of satisfaction ratings were moderate (r = 0.54-0.59 and 0.48-0.60, respectively). ADHD symptom and QoL ratings were significantly negative and positive predictors of satisfaction, explaining 36-52% of satisfaction variance at the final visit. The results show that parent and patient satisfaction was high and could be assessed reliably with the new SAMS questionnaire. Parent and patient ratings were moderately correlated, and symptom severity, functional impairment and QoL were the most significant predictors of satisfaction.
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Affiliation(s)
- Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
| | - Dieter Breuer
- Department of Child and Adolescent Psychiatry, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
| | - Christopher Hautmann
- Department of Child and Adolescent Psychiatry, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry, University of Göttingen, Göttingen, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
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Breuer D, Görtz-Dorten A, Rothenberger A, Döpfner M. Assessment of daily profiles of ADHD and ODD symptoms, and symptomatology related to ADHD medication, by parent and teacher ratings. Eur Child Adolesc Psychiatry 2011; 20 Suppl 2:S289-96. [PMID: 21901413 PMCID: PMC3180560 DOI: 10.1007/s00787-011-0206-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
DAYAS is a new two-part rating scale that assesses: (1) ADHD and ODD symptoms (externalising symptom ratings) and (2) symptomatology potentially related to ADHD medication (potentially medication-related symptoms) in real-world settings at different time periods throughout a normal school day. Data from a proof-of-concept study and two observational trials (Medikinet(®) retard [methylphenidate] and the Equasym XL(®) [methylphenidate] OBSEER study) evaluated: (1) validity of weekly externalising symptom ratings using DAYAS, in place of daily ratings; (2) reliability and internal consistency of DAYAS ratings for externalising symptoms and potentially medication-related symptoms; and (3) convergent and divergent validity of the externalising symptom ratings with existing validated scales. From the proof-of-concept study, daily scores by period of day and during the whole day correlated strongly with equivalent weekly scores (r = 0.83-0.92). Internal consistency of externalising symptom rating scales calculated from pooled data were acceptable or good by period of day (Cronbach's alpha = 0.68-0.90) and very high for whole day scores (Cronbach's alpha = 0.88-0.95). Internal consistency of the rating scale for potentially medication-related symptoms was also good for both teacher and parent ratings. From OBSEER data, correlations between FBB-ADHD total symptom scores and ratings on both parent and teacher versions of DAYAS were high (r = 0.73 and r = 0.84, respectively). Correlations between DAYAS and SDQ were highest for the SDQ subscales hyperactivity and conduct problems and substantially lower for pro-social behaviour, peers and emotional problems. The DAYAS rating scale had good internal consistency, and DAYAS scores correlated well with existing validated scales and the SDQ subscales hyperactivity and conduct problems. Weekly DAYAS scores (whole day and by period of day) could be considered a suitable replacement for daily assessment scores.
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Affiliation(s)
- Dieter Breuer
- Department of Child and Adolescent Psychiatry, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
| | - Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry, University of Göttingen, Göttingen, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, University of Cologne, Robert-Koch-Str. 10, 50931 Cologne, Germany
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Görtz-Dorten A, Döpfner M. Aufmerksamkeitsdefizit-/Hyper- aktivitätsstörungen von Kindern und Jugendlichen im Elternurteil. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie 2009; 37:183-94. [DOI: 10.1024/1422-4917.37.3.183] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Fragestellung: Der Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (FBB-ADHS) ist Bestandteil des Diagnostik-Systems für psychische Störungen im Kindes- und Jugendalter nach ICD-10 und DSM-IV (DISYPS-II). Er erfasst in 20 Items die Symptomkriterien nach ICD-10 und DSM-IV und enthält zusätzlich 6 Kompetenzitems. Die vorliegende Studie untersucht in einer repräsentativen Stichprobe auf der Basis der Elternurteile Symptom- und Diagnoseprävalenzen, Reliabilität und faktorielle Validität, Korrelationen mit anderen Auffälligkeiten, Komorbiditätsraten sowie Alters- und Geschlechtseffekte. Methodik: Der Fragebogen wurde in einer per Zufall ausgewählten Feldstichprobe von N = 713 Eltern von Kindern und Jugendlichen im Alter von 4;0 bis 17;11 Jahren beantwortet. Ergebnisse: Laut Elternurteil schwanken die Symptomprävalenzen zwischen 4.5 % und 22.3 %. Die Diagnoseprävalenzen auf der Basis der Symptomkriterien nach DSM-IV liegen bei 11.5 %; nach ICD-10 bei 3.4 %. Bei Berücksichtigung von Funktionseinschränkungen sinken die Prävalenzraten auf 7.9 % bzw. 3.0 %. Die Reliabilitäten der Subskalen sind zufrieden stellend bis sehr gut. In den exploratorischen Faktorenanalysen ließ sich sowohl die Einteilung nach DSM-IV (Unaufmerksamkeit versus Impulsivität/Hyperaktivität) als auch die Aufteilung nach ICD-10 mit drei Faktoren (Hyperaktivität, Impulsivität und Unaufmerksamkeit) replizieren. Signifikante Alters-/Geschlechtseffekte zeigen sich auf den meisten Skalen. Zu den Elternurteilen über Störungen des Sozialverhaltens, Angst- und depressive Störungen fanden sich mittlere Korrelationen und Komorbiditätsraten zwischen 7 % und 39 %. Schlussfolgerungen: Die ermittelten Prävalenzraten entsprechen den Ergebnissen internationaler Studien. Der FBB-ADHS ist als Elternfragebogen ein intern konsistentes und valides Verfahren. Mit der Vorlage von Normen kann er in der Praxis gut eingesetzt werden.
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Affiliation(s)
| | - Manfred Döpfner
- Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universität Köln
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