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Bucksch J, Möckel J, Kaman A, Sudeck G. Physical activity of older children and adolescents in Germany - Results of the HBSC study 2022 and trends since 2009/10. J Health Monit 2024; 9:62-78. [PMID: 38559682 PMCID: PMC10977466 DOI: 10.25646/11874] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/01/2023] [Indexed: 04/04/2024]
Abstract
Background Physical activity is central to health, beginning in childhood and adolescence, and regular monitoring provides important information for strategic decisions on promoting physical activity in Germany. Methods The current survey cycle of the Health Behaviour in School-aged Children (HBSC) study gives an insight into the prevalence of the indicators daily recommended physical activity, high and low physical activity, and sporting activity among students aged between 11 and 15 for 2022. In addition, the data is compared to the survey cycles of the 2009/10, 2013/14, and 2017/18 school years and analysed over time. Results The results of the current survey cycle show that 10.8 % of girls, 20.9 % of boys, and 12.4 % of gender diverse adolescents fulfil the daily physical activity recommendation. There are also major gender-specific differences for the other indicators. The group of gender diverse adolescents needs to be analysed further. The changes over time between 2009/10 and 2022 are relatively small. While girls' physical activity habits decreased slightly for the various indicators between 2009/10 and 2022, boys' prevalence remained relatively stable over the same period. Conclusions Overall, in part due to the effects of the various COVID-19 lockdowns, the need for effective and population-based measures to promote physical activity in childhood and adolescence remains high.
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Affiliation(s)
- Jens Bucksch
- Heidelberg University of Education, Faculty of Natural and Social Sciences, Department of Prevention and Health Promotion
- Heidelberg University of Education, Heidelberg Centre for Prevention and Health Promotion
| | - Juliane Möckel
- Heidelberg University of Education, Faculty of Natural and Social Sciences, Department of Prevention and Health Promotion
- Heidelberg University of Education, Heidelberg Centre for Prevention and Health Promotion
| | - Anne Kaman
- University Medical Centre Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry and Psychotherapy, Child Public Health Research Section
| | - Gorden Sudeck
- Eberhard Karls University of Tübingen, Institute of Sports Science
- Eberhard Karls University of Tübingen, Interfaculty Research Institute for Sport and Physical Activity
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Reiß F, Behn S, Erhart M, Strelow L, Kaman A, Ottová-Jordan V, Bilz L, Moor I, Ravens-Sieberer U. Subjective health and psychosomatic complaints of children and adolescents in Germany: Results of the HBSC study 2009/10 - 2022. J Health Monit 2024; 9:7-22. [PMID: 38559686 PMCID: PMC10977472 DOI: 10.25646/11868] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/14/2023] [Indexed: 04/04/2024]
Abstract
Background Subjective health and well-being are important health indicators in childhood and adolescence. This article shows current results and trends over time between 2009/10 and 2022. Methods The Health Behaviour in School-aged Children (HBSC) study examined subjective health, life satisfaction and psychosomatic complaints of N = 21,788 students aged 11 to 15 years in the school years 2009/10, 2013/14, 2017/18 and in the calendar year 2022. Multivariate regression analyses show the associations between sociodemographic characteristics and well-being in 2022, as well as trends since 2009/10. Results The majority of children and adolescents indicate a good subjective health and high life satisfaction. About half of the girls and one third of the boys report multiple psychosomatic health complaints, with a clear increase over time. Older adolescents, girls and gender diverse adolescents are at an increased risk of poor well-being. Subjective health and life satisfaction varied between 2009/10 and 2022, with a significant deterioration between 2017/18 and 2022. Conclusions The high proportion of children and adolescents with psychosomatic complaints, as well as the observed gender and age differences, underline the need for target group-specific prevention, health promotion and continuous health monitoring.
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Affiliation(s)
- Franziska Reiß
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Steven Behn
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Michael Erhart
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
- Alice Salomon University of Applied Sciences Berlin, Health and Rehabilitation Science, Berlin, Germany
| | - Lisa Strelow
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Veronika Ottová-Jordan
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg, Institute of Health, Cottbus, Germany
| | - Irene Moor
- Martin Luther University Halle-Wittenberg, Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology, Halle (Saale), Germany
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
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Winter K, Moor I, Markert J, Bilz L, Bucksch J, Dadaczynski K, Fischer SM, Helmchen RM, Kaman A, Möckel J, Rathmann K, Ravens-Sieberer U, Reiß F, Schierl T, Schütz R, Sendatzki S, Stürmer E, Sudeck G, Richter M. Concept and methodology of the Health Behaviour in School-aged Children (HBSC) study - Insights into the current 2022 survey and trends in Germany. J Health Monit 2024; 9:99-117. [PMID: 38559683 PMCID: PMC10977469 DOI: 10.25646/11878] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/28/2023] [Indexed: 04/04/2024]
Abstract
Background Health Behaviour in School-aged Children (HBSC) is one of the largest international studies on child and adolescent health and cooperates with the World Health Organization (WHO). In Germany, adolescents aged 11, 13 and 15 are surveyed every four years about their health, health behaviour and social conditions. This article describes the HBSC study and in particular the methodology of the current 2022 survey and prior surveys conducted between 2009/10 and 2017/18. Method 174 schools with a total of 6,475 students participated in the 2022 survey. The survey was conducted using questionnaires and covered a wide range of topics (including mental health, physical activity, bullying experiences, social determinants of health and experiences related to COVID-19). The 2022 survey was complemented by a school principal survey (N = 160). In addition to the current sample, the samples of the three previous surveys with representative data for Germany are presented: 2009/10 (N = 5,005), 2013/14 (N = 5,961) and 2017/18 (N = 4,347). Discussion The health of children and adolescents is of great public health importance. The HBSC study makes a substantial contribution by providing internationally comparable results, analysing trends, and providing stakeholders with comprehensive and representative health monitoring data.
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Affiliation(s)
- Kristina Winter
- Martin Luther University Halle-Wittenberg, Halle (Saale)
- Hochschule Nordhausen – University of Applied Sciences
| | - Irene Moor
- Martin Luther University Halle-Wittenberg, Halle (Saale)
| | - Jenny Markert
- Martin Luther University Halle-Wittenberg, Halle (Saale)
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg
| | | | - Kevin Dadaczynski
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
- Leuphana University Lueneburg
| | | | - Ronja M. Helmchen
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf
| | | | - Katharina Rathmann
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
| | | | | | | | - Raphael Schütz
- Brandenburg University of Technology Cottbus-Senftenberg
| | - Saskia Sendatzki
- Fulda University of Applied Sciences, Department of Health Sciences
- Fulda University of Applied Sciences, Public Health Centre Fulda
| | | | - Gorden Sudeck
- University of Tübingen, Institute of Sports Science
- University of Tübingen, Interfaculty Research Institute for Sports and Physical Activity
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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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Orban E, Li LY, Gilbert M, Napp AK, Kaman A, Topf S, Boecker M, Devine J, Reiß F, Wendel F, Jung-Sievers C, Ernst VS, Franze M, Möhler E, Breitinger E, Bender S, Ravens-Sieberer U. Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies. Front Public Health 2024; 11:1275917. [PMID: 38259801 PMCID: PMC10800626 DOI: 10.3389/fpubh.2023.1275917] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Background The COVID-19 pandemic has significantly impacted the mental health of children and families, i.e., due to measures like social distancing and remote schooling. While previous research has shown negative effects on mental health and health-related quality of life (HRQoL), most studies have focused on pre-post comparisons in the early pandemic stages. This systematic review aims to examine longitudinal studies to understand the long-term impacts of the pandemic on children and adolescents. Methods This systematic review adhered to the PRISMA guidelines and was preregistered in the international prospective register of systematic reviews (Record ID: CRD42022336930). We systematically searched PubMed/MEDLINE, Web of Science, PsycINFO, PSYNDEX, and the WHO-COVID-19 database and included studies published up to August 30, 2022. Based on pre-defined eligibility criteria, longitudinal and prospective studies that assessed the mental health or quality of life of children or adolescents (0-19 years) in the general population over a longer time span (at two or more measurement points) during the COVID-19 pandemic were included in the review. The methodological quality of the included studies was assessed using an adapted version of the Effective Public Health Practice Project (EPHPP) checklist. Narrative data synthesis was used to summarize the findings. Results A total of 5,099 results were obtained from literature searches, with 4,935 excluded during title/abstract screening. After reviewing 163 full-text articles, 24 publications were included in the review. Sample sizes ranged between n = 86 and n = 34,038. The length of the investigated time periods and the number of assessment points, as well as outcomes, varied. The majority of studies were of moderate methodological quality. Mental health outcomes were more frequently studied compared to measures of HRQoL. The findings from these studies mostly suggest that children and adolescents experienced heightened mental health problems, specifically internalizing symptoms like anxiety and depression. Further, there was a decline in their overall HRQoL over the course of the COVID-19 pandemic that did not necessarily subside when lockdowns ended. Conclusion It is crucial to continue monitoring the mental health and well-being of children and adolescents following the pandemic to identify groups at risks and plan interventions. This should ideally be conducted by large systematic studies, using validated instruments, and encompassing representative samples to obtain reliable and comprehensive insights with the aim of improving youth mental health care.
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Affiliation(s)
- Ester Orban
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Li
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Topf
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Child and Adolescent Psychiatry, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiß
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Flora Wendel
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Vanessa Sophie Ernst
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Marco Franze
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Eva Möhler
- Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Eva Breitinger
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Gilbert M, Boecker M, Reiss F, Kaman A, Erhart M, Schlack R, Westenhöfer J, Döpfner M, Ravens-Sieberer U. Gender and Age Differences in ADHD Symptoms and Co-occurring Depression and Anxiety Symptoms Among Children and Adolescents in the BELLA Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01622-w. [PMID: 37851158 DOI: 10.1007/s10578-023-01622-w] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most diagnosed neurodevelopmental disorders of childhood. Current studies addressing gender and age differences in ADHD are lacking. The present study aims to fill this research gap by dimensionally evaluating gender and age differences in ADHD symptoms, as measured by a DSM-5-based parent rating scale, in children and adolescents who participated in the two-year follow-up of the community-based BELLA study (n = 1326). Associations between ADHD symptoms and depression symptoms and anxiety symptoms were also examined. Multiple linear regressions revealed significant associations between gender and all ADHD symptoms. Age was significantly associated with hyperactive/impulsive symptoms. Additional multiple linear regressions demonstrated significant positive associations between depression and anxiety symptoms and ADHD symptoms. Further, female gender was found to be positively associated with both depression and anxiety symptoms. These findings may suggest a need for more gender-specific approaches to ADHD diagnosis and treatment, as well as more research into the intersections of ADHD and depression and anxiety symptoms in children and adolescents.
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Affiliation(s)
- Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Alice Salomon University of Applied Sciences, Berlin, Germany
- Apollon University of Applied Sciences, Bremen, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Joachim Westenhöfer
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Section "Child Public Health", University Medical Center Hamburg-Eppendorf, Martinistraße 52, W 29, 20246, Hamburg, Germany.
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Maurer J, Meyrose AK, Kaman A, Mauz E, Ravens-Sieberer U, Reiss F. Socioeconomic Status, Protective Factors, and Mental Health Problems in Transition from Adolescence to Emerging Adulthood: Results of the Longitudinal BELLA Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01582-1. [PMID: 37632556 DOI: 10.1007/s10578-023-01582-1] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 08/28/2023]
Abstract
Lower familial socioeconomic status (SES) is associated with more mental health problems in adolescence. The aim of this study was to identify factors that may protect adolescents from families with lower SES from developing mental health problems in emerging adulthood. Data of the population-based longitudinal BELLA study included n = 426 participants aged 13 to 17 years at t0 (2009-2012) and 18 to 24 years at t1 (2014-2017). Hierarchical multiple linear regressions with interaction terms were conducted, examining three selected protective factors (self-efficacy, family climate, and social support). Self-efficacy had a small protective effect for adolescents from families with lower SES for mental health problems in emerging adulthood. However, social support had a small protective effect for adolescents from families with higher SES. No moderating effect was found for family climate. Instead, better family climate in adolescents predicted fewer mental health problems in emerging adulthood with a small effect regardless the SES in adolescence. Results indicate the need for prevention measures for adolescents from families with lower SES for becoming mentally healthy emerging adults.
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Affiliation(s)
- Jenny Maurer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Developmental and Educational Psychology, Helmut Schmidt University, University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Clinical Psychology and Psychotherapy, Helmut Schmidt University, University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Felfe C, Saurer J, Schneider P, Vornberger J, Erhart M, Kaman A, Ravens-Sieberer U. The youth mental health crisis: Quasi-experimental evidence on the role of school closures. Sci Adv 2023; 9:eadh4030. [PMID: 37595042 PMCID: PMC10438447 DOI: 10.1126/sciadv.adh4030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/19/2023] [Indexed: 08/20/2023]
Abstract
During the COVID-19 pandemic, the youth mental health crisis has reached unprecedented levels. To which extent school closures, one of the most heavily debated pandemic measures, have contributed to or even caused this crisis is largely unknown. We seek to narrow this blind spot, by combining quasi-experimental variation in school closure and reopening strategies across the German federal states at the onset of the pandemic with nationwide, population-based survey data on youth mental health and high-frequency data from the largest crisis helpline. We show that prolonged school closures led to a substantial deterioration in youth health-related quality of life, precipitating early signs of mental health problems. The effects were most severe among boys, younger adolescents, and families with limited living space. We further provide evidence that family problems are a major issue that adolescents were struggling with when denied access to school. Overall, school closures largely explain the deterioration of youth mental health over the first pandemic wave.
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Affiliation(s)
- Christina Felfe
- University of Konstanz, Konstanz, Germany
- Center of Economic Performance, London, UK
- CESifo, Munich, Germany
- IZA, Bonn, Germany
| | | | - Patrick Schneider
- University of Konstanz, Konstanz, Germany
- Frankfurt Laboratory for Experimental Economic Research, Goethe University Frankfurt, 60323 Frankfurt, Germany
- The Center for Leadership and Behavior in Organizations, Goethe University Frankfurt, 60323 Frankfurt, Germany
| | | | - Michael Erhart
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Alice Salomon University of Applied Science, Berlin Apollon University of Applied Science, 28359 Bremen, Germany
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jörren HL, Schmidt H, Kaman A, Ravens-Sieberer U, Rumpf HJ, Pawils S. [Children's mental health: the role of screen time, parenting behavior, and parenting stress-a secondary data analysis of KiGGS and BELLA data]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03727-y. [PMID: 37322377 DOI: 10.1007/s00103-023-03727-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/17/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies established a link between high screen time and mental health problems in childhood. The role of possible influencing factors is currently unclear. This study aims at testing correlations among mental health problems, high screen time, parenting stress, and inconsistent and positive parenting behavior. METHODS This study is based on data from the KiGGS and BELLA studies. For the present study, data from preschool children (age: 3-5 years, N = 417) and school children (age: 7-13 years, N = 239) were analyzed. Binary-logistic regressions were carried out to test for correlations between high screen time and children's mental health problems in cross-sectional and longitudinal analyses. Socioeconomic status, the child's gender, the parent's gender, parenting stress, and inconsistent and positive parenting behavior were used as control variables. RESULTS In the cross-sectional analysis, mental health problems in preschool children were associated with high screen time (OR = 3.02; p = 0.003), parenting stress (OR = 17.00; p < 0.001), and positive parenting behavior (OR = 0.24; p < 0.001). In the longitudinal analysis, mental health problems in school children were associated with parenting stress (OR = 4.04; p < 0.001). Socioeconomic status and the child's and parent's gender were at no point associated with mental health problems. DISCUSSION The sole existence of high screen time cannot explain mental health problems in children. Parental variables seem to be critical for children's mental health and should be considered in a holistic apporach on children's mental health in terms of strengthening parental competencies.
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Affiliation(s)
- Hannah Lea Jörren
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
| | - Hannah Schmidt
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Deutschland
| | - Anne Kaman
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Ulrike Ravens-Sieberer
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Hans-Jürgen Rumpf
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Silke Pawils
- Institut für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Ravens-Sieberer U, Devine J, Napp AK, Kaman A, Saftig L, Gilbert M, Reiß F, Löffler C, Simon AM, Hurrelmann K, Walper S, Schlack R, Hölling H, Wieler LH, Erhart M. Three years into the pandemic: results of the longitudinal German COPSY study on youth mental health and health-related quality of life. Front Public Health 2023; 11:1129073. [PMID: 37397777 PMCID: PMC10307958 DOI: 10.3389/fpubh.2023.1129073] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose For the past three years, the German longitudinal COPSY (COVID-19 and PSYchological Health) study has monitored changes in health-related quality of life (HRQoL) and the mental health of children and adolescents during the COVID-19 pandemic. Methods A nationwide, population-based survey was conducted in May-June 2020 (W1), December 2020-January 2021 (W2), September-October 2021 (W3), February 2022 (W4), and September-October 2022 (W5). In total, n = 2,471 children and adolescents aged 7-17 years (n = 1,673 aged 11-17 years with self-reports) were assessed using internationally established and validated measures of HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2), psychosomatic complaints (HBSC-SCL), and fear about the future (DFS-K). Findings were compared to prepandemic population-based data. Results While the prevalence of low HRQoL increased from 15% prepandemic to 48% at W2, it improved to 27% at W5. Similarly, overall mental health problems rose from 18% prepandemic to W1 through W2 (30-31%), and since then slowly declined (W3: 27%, W4: 29%, W5: 23%). Anxiety doubled from 15% prepandemic to 30% in W2 and declined to 25% (W5) since then. Depressive symptoms increased from 15%/10% (CES-DC/PHQ-2) prepandemic to 24%/15% in W2, and slowly decreased to 14%/9% in W5. Psychosomatic complaints are across all waves still on the rise. 32-44% of the youth expressed fears related to other current crises. Conclusion Mental health of the youth improved in year 3 of the pandemic, but is still lower than before the pandemic.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- 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
| | - Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lynn Saftig
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiß
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Constanze Löffler
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Robert Schlack
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Heike Hölling
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lothar Heinz Wieler
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Research Cluster Digital Global Public Health, Hasso-Plattner-Institute, University of Potsdam, Potsdam, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Public Health, Alice Salomon University of Applied Sciences, Berlin, Germany
- Department of Psychology, Apollon University of Applied Sciences, Bremen, Germany
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11
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Ravens-Sieberer U, Kaman A, Devine J, Reiß F. [The COVID-19 pandemic-How did it affect the mental health of children?]. Monatsschr Kinderheilkd 2023; 171:1-7. [PMID: 37362308 PMCID: PMC10243683 DOI: 10.1007/s00112-023-01775-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic has had a substantial impact on the daily life of children and adolescents due to lockdowns, contact restrictions, closings of childcare, schools and leisure facilities. Objective This article examines the impact of the pandemic on the mental health of children and adolescents in Germany. Material and methods In the population-based longitudinal COPSY study (COVID-19 and Psychological Health) 1600 parents of children aged 7-17 years old and 1000 children and adolescents aged 11-17 years old completed established questionnaires at 5 online survey points (t1: May and June 2020 to t5: September and October 2022). For comparison, pre-pandemic data were obtained from the representative BELLA study. Results During the pandemic the portion of children and adolescents, who reported a low health-related quality of life, increased from pre-pandemic 15% to 48% in the first year of the pandemic and improved in year 3 to 27%. This is still substantially above pre-pandemic levels. Similar trajectories were found for mental health problems which rose from 18% (pre-pandemic) to 31% and improved in year 3 to 23%. For anxiety and depression, the changes were similar except that depressive symptoms returned to pre-pandemic levels in year 3. The physical activity of almost one third of the youth was still very low in year 3. Conclusion The mental health of children and adolescents was ignored during the pandemic for a long time. Now support and allocation of funding is urgently needed to mitigate the negative mental health effects and prevent further impairment by new crises.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Deutschland
| | - Anne Kaman
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Deutschland
| | - Janine Devine
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Deutschland
| | - Franziska Reiß
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Deutschland
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12
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Reiß F, Kaman A, Napp AK, Devine J, Li LY, Strelow L, Erhart M, Hölling H, Schlack R, Ravens-Sieberer U. [Epidemiology of mental well-being in childhood and adolescence. Results from three epidemiological studies before and during the COVID-19 pandemic]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03720-5. [PMID: 37249582 DOI: 10.1007/s00103-023-03720-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Continuous nationwide health monitoring is important to track the well-being of children and adolescents and to map developmental trajectories. Based on the results of three selected epidemiological studies, developments in child well-being over the past 20 years are presented. METHODS Data are based on (1) the mental health module of the German National Health Interview and Examination Survey among Children and Adolescents (BELLA study, 2003-2017, N = 1500 to 3000), which is a module of the KiGGS study; (2) the COvid-19 and PSYchological Health Study (COPSY, 2020-2022, N = 1600-1700), which is based on the BELLA Study; and (3) the International Health-Behaviour in School-aged Children Study (HBSC, 2002-2018, N = 4300-7300). Well-being was assessed in 7‑ to 17-year-olds using indicators of health-related quality of life (KIDSCREEN-10), life satisfaction (Cantril Ladder), and mental health problems (Strenghts and Difficulties Questionnaire (SDQ), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Center for Epidemiological Studies Depression Scale for Children (CES-DC)). RESULTS Overall, children and adolescents show consistently high health-related quality of life and high overall life satisfaction pre-pandemic (2002-2018), which initially worsened with the onset of the 2020 COVID-19-pandemic. Two years later, improvements are evident but have not yet reached baseline levels. Psychological problems, as well as symptoms of anxiety and depression, increased by up to 12 percentage points at the beginning of the pandemic and are still higher two years after the onset of the pandemic compared to pre-pandemic studies. CONCLUSION The epidemiology of child well-being provides a necessary data basis to assess the support needs of children and adolescents and to use this as a basis for developing measures of health promotion, prevention, and intervention.
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Affiliation(s)
- Franziska Reiß
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Anne Kaman
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Ann-Kathrin Napp
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Janine Devine
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Lydia Y Li
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Lisa Strelow
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Michael Erhart
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
- Alice Salomon Hochschule, Berlin, Deutschland
- Apollon Hochschule der Gesundheitswirtschaft, Bremen, Deutschland
| | | | | | - Ulrike Ravens-Sieberer
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
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13
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Napp AK, Kaman A, Erhart M, Westenhöfer J, Ravens-Sieberer U. Eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic. Front Psychiatry 2023; 14:1157402. [PMID: 37304440 PMCID: PMC10254422 DOI: 10.3389/fpsyt.2023.1157402] [Citation(s) in RCA: 1] [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: 02/02/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Background Disordered eating is highly prevalent among children and adolescents. Since the outbreak of the COVID-19 pandemic, hospitalizations due to eating disorders have peaked and overweight has risen. The aim of this study was to determine differences in the prevalence of eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic and to identify associated factors. Materials and methods Eating disorder symptoms and associated factors were examined in a sample of n = 1,001 participants of the nationwide population-based COPSY study in autumn 2021. Standardized and validated instruments were used to survey 11-17-year-olds along with a respective parent. To identify differences in prevalence rates, logistic regression was used to compare results with data from n = 997 participants of the prepandemic BELLA study. Multiple logistic regression analyses were performed to examine associations with relevant factors in the pandemic COPSY sample. Results Eating disorder symptoms were reported by 17.18% of females and 15.08% of males in the COPSY study. Prevalence rates were lower overall in the COPSY sample compared to before the pandemic. Male gender, anxiety, and depressive symptoms were associated with increased odds for eating disorder symptoms in the pandemic. Conclusion The pandemic underscores the importance of further research, but also prevention and intervention programs that address disordered eating in children and adolescents, with a focus on age - and gender-specific differences and developments. In addition, screening instruments for eating disorder symptoms in youths need to be adapted and validated.
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Affiliation(s)
- Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Public Health, Alice Salomon University of Applied Sciences, Berlin, Germany
- Department of Psychology, Apollon University of Applied Sciences, Bremen, Germany
| | - Joachim Westenhöfer
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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14
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Holler A, Maldei-Gohring T, Reiß F, Opdensteinen KD, Kaman A, Ravens-Sieberer U, Hechler T. COVID statt Kita. Zeitschrift für Klinische Psychologie und Psychotherapie 2023. [DOI: 10.1026/1616-3443/a000692] [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: 03/19/2023]
Abstract
Zusammenfassung: Theoretischer Hintergrund: Die COVID-19 Pandemie führte im Frühjahr 2020 bei Vorschulkindern in Deutschland zu einer Zunahme von Verhaltensauffälligkeiten. Fragestellung: Ziel der vorliegenden Studie ist es, die anhaltenden Auswirkungen der Pandemie auf die psychische Gesundheit von Vorschulkindern zu untersuchen und potentielle Einflussfaktoren zu identifizieren. Methode: In zwei unabhängigen Online-Erhebungen im März und November 2021 befragten wir die Eltern von N = 331 Vorschulkindern in Rheinland-Pfalz hinsichtlich der Verhaltensauffälligkeiten ihrer Kinder. Die Ergebnisse verglichen wir mit Daten einer bevölkerungsbezogenen Stichprobe aus der Zeit vor der Pandemie. Mithilfe von logistischen Regressionen untersuchten wir potenzielle Einflussfaktoren auf die psychische Gesundheit. Ergebnis: Im Verlauf der Pandemie zeigte sich ein erhöhtes Ausmaß an Verhaltensauffälligkeiten bei Vorschulkindern. Als potenzielle Einflussfaktoren identifizierten wir die psychische Belastung und emotionale Kompetenz der Eltern, sowie die Emotionsregulation der Kinder als möglichen Schutzfaktor. Schlussfolgerungen: Die Befunde verdeutlichen die Notwendigkeit von Präventionsprogrammen mit Fokus auf die sozio-emotionale Kompetenzen von Vorschulkindern und ihren Eltern.
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Affiliation(s)
- Alicia Holler
- Abteilung für Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Trier, Deutschland
| | - Tobias Maldei-Gohring
- Abteilung für Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Trier, Deutschland
| | - Franziska Reiß
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | - Kim D. Opdensteinen
- Abteilung für Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Trier, Deutschland
| | - Anne Kaman
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | - Ulrike Ravens-Sieberer
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | - Tanja Hechler
- Abteilung für Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Trier, Deutschland
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Reiß F, Napp AK, Erhart M, Devine J, Dadaczynski K, Kaman A, Ravens-Sieberer U. [Prevention perspective: mental health of schoolchildren in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:391-401. [PMID: 36899197 PMCID: PMC10005858 DOI: 10.1007/s00103-023-03674-8] [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] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/06/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic has impacted the learning and health of children and adolescents. The aim of this paper is to examine school students' mental health problems, family burden, and support needs during the pandemic depending on the type of school. Approaches to school-based prevention and health promotion are discussed. METHODS Findings are based on data from the population-based COPSY study (T1: 05/2020 - T4: 02/2022) and the BELLA study (T0, pre-pandemic comparison). Approximately 1600 families with children aged 7 to 19 years were surveyed at each measurement point (T). Mental health problems were assessed using the SDQ, while family burden and support needs were captured with individual items in the parent report. RESULTS Mental health problems increased among students in all school types at the beginning of the pandemic and have stabilized at a high level. Elementary school students are particularly affected (increase from 16.9% pre-pandemic to 40.0% at T2), especially in behavioral problems (11.7% to 24.6%) and hyperactivity (13.9% to 34.0%). Secondary school students also show higher levels of mental health problems (21.4% to 30.4%). Pandemic-related burden is consistently high, as is the need for family support received from schools/teachers and experts. DISCUSSION There is a high need for mental health promotion and prevention measures in the school setting. These should start at primary school age in the sense of a "whole school approach" at different levels and include external stakeholders. In addition, binding legal requirements are needed in all federal states to create framework conditions and structures for school-based health promotion and prevention, including access to necessary resources.
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Affiliation(s)
- Franziska Reiß
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Ann-Kathrin Napp
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Michael Erhart
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Alice Salomon Hochschule, Berlin, Deutschland
- Apollon Hochschule der Gesundheitswirtschaft, Bremen, Deutschland
| | - Janine Devine
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Kevin Dadaczynski
- Fachbereich Gesundheitswissenschaften, Hochschule Fulda, Fulda, Hessen, Deutschland
| | - Anne Kaman
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Ulrike Ravens-Sieberer
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Forschungssektion Child Public Health, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 5, 20246, Hamburg, Deutschland.
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Vagedes J, Michael K, Sobh M, Islam MOA, Kuderer S, Jeske C, Kaman A, Martin D, Vagedes K, Erhart M, Ravens-Sieberer U, Zdražil T. Lessons Learned-The Impact of the Third Wave of the COVID-19 Pandemic on German Waldorf Parents' Support Needs and Their Rating of Children's Health-Related Quality of Life: A Cross-Sectional Online Survey. Int J Environ Res Public Health 2023; 20:4756. [PMID: 36981668 PMCID: PMC10049119 DOI: 10.3390/ijerph20064756] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND COVID-19-related lockdowns and homeschooling have imposed a substantial burden on school-aged children and parents. Waldorf education is a reform-educational concept. Little is known about the situation of German Waldorf families under pandemic conditions. METHODS A cross-sectional, online, parent-proxy survey was conducted regarding the third pandemic wave. The primary outcome was parents' support needs, assessed with questions from the German COPSY (COVID-19 and PSYchological Health) study; the secondary outcome was children's HRQoL (KIDSCREEN-10, proxy version). RESULTS We analyzed questionnaires from 431 parents of 511 Waldorf students aged 7 to 17 years. While 70.8% of Waldorf parents (WPs) reported a general need for support in dealing with their children, 59.9% of COPSY parents (CPs) indicated this need. WPs' support needs in dealing with their children's academic demands were similar to CPs' needs but relatively higher in terms of dealing with emotions and moods, behavior, and relationships within the family. WPs sought support mainly from school and teachers (65.6%). Support needs were high, although WPs rated their children's HRQoL higher than CPs. CONCLUSIONS Our results underline the substantial pandemic-related burden on families across school types. WPs participating in this survey gave evidence that supports should focus on academic demands as well as psychosocial issues.
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Affiliation(s)
- Jan Vagedes
- Academic Research in Complementary and Integrative Medicine (ARCIM Institute), 70794 Filderstadt, Germany
- Department of Neonatology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Karin Michael
- Community Hospital Witten-Herdecke, 58313 Herdecke, Germany
- Department of Health and Pedagogy, Freie Hochschule Stuttgart, 70188 Stuttgart, Germany
| | - Mohsen Sobh
- Academic Research in Complementary and Integrative Medicine (ARCIM Institute), 70794 Filderstadt, Germany
| | - Mohammad O. A. Islam
- Academic Research in Complementary and Integrative Medicine (ARCIM Institute), 70794 Filderstadt, Germany
| | - Silja Kuderer
- Academic Research in Complementary and Integrative Medicine (ARCIM Institute), 70794 Filderstadt, Germany
| | - Christian Jeske
- Academic Research in Complementary and Integrative Medicine (ARCIM Institute), 70794 Filderstadt, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - David Martin
- Department of Human Medicine, Faculty of Health, Witten-Herdecke University, 58455 Witten, Germany
- Department of Pediatric Oncology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Katrin Vagedes
- Academic Research in Complementary and Integrative Medicine (ARCIM Institute), 70794 Filderstadt, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Public Health, Alice Salomon University of Applied Sciences, 12627 Berlin, Germany
- Department of Psychology, Apollon University of Applied Sciences, 28359 Bremen, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Tomáš Zdražil
- Department of Health and Pedagogy, Freie Hochschule Stuttgart, 70188 Stuttgart, Germany
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17
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Herrmann L, Reiss F, Becker-Hebly I, Baldus C, Gilbert M, Stadler G, Kaman A, Graumann L, Ravens-Sieberer U. Systematic Review of Gender-Specific Child and Adolescent Mental Health Care. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01506-z. [PMID: 36849848 DOI: 10.1007/s10578-023-01506-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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 03/01/2023]
Abstract
Gender differences in mental health emerge as early as in childhood and adolescence, highlighting the potential need for gender-specific child and adolescent mental health care. However, it is unclear how gender-specific child and adolescent mental health care is implemented and whether its' approaches are useful. Therefore, this study reviews gender-specific interventions and their effectiveness for child and adolescent mental health. Five databases were searched for articles published between 2000 and 2021. In total, 43 studies were included. Most interventions were conducted in school (n = 15) or community settings (n = 8). Substance-related disorders (n = 13) and eating disorders (n = 12) were addressed most frequently. Most interventions targeted girls (n = 31). Various gender-specific aspects were considered, including gender-specific risk and protective factors (n = 35) and needs (n = 35). Although most interventions yielded significant improvements in mental health outcomes (n = 32), only few studies reported medium or large effect sizes (n = 13). Additionally, there was a lack of strong causal evidence derived from randomized controlled trials, calling for more rigorous trials in the research field. Nevertheless, our findings indicate that gender-specific mental health care can be a promising approach to meet gender-specific mental health needs.
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Affiliation(s)
- Lena Herrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Inga Becker-Hebly
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Christiane Baldus
- German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Gertraud Stadler
- Institute of Gender in Medicine, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Lina Graumann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany.
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18
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Devine J, Kaman A, Seum TL, Zoellner F, Dabs M, Ottova-Jordan V, Schlepper LK, Haller AC, Topf S, Boecker M, Schuchard J, Forrest CB, Ravens-Sieberer U. German translation of the PROMIS ® pediatric anxiety, anger, depressive symptoms, fatigue, pain interference and peer relationships item banks. J Patient Rep Outcomes 2023; 7:16. [PMID: 36810699 PMCID: PMC9943801 DOI: 10.1186/s41687-023-00548-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/14/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The present study aimed at the translation and cross-cultural adaptation of six PROMIS® pediatric self- and proxy- item banks and short forms to universal German: anxiety (ANX), anger (ANG), depressive symptoms (DEP), Fatigue (FAT), pain interference (P) and peer relationships (PR). METHODS Using standardized methodology approved by the PROMIS Statistical Center and in line with recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force, two translators for each German-speaking country (Germany, Austria, and Switzerland) commented on and rated the translation difficulty and provided forward translations, followed by a review and reconciliation phase. An independent translator performed back translations, which were reviewed and harmonized. The items were tested in cognitive interviews with 58 children and adolescents from Germany (16), Austria (22), and Switzerland (20) for the self-report and 42 parents and other caregivers (Germany (12), Austria (17), and Switzerland (13)) for the proxy-report. RESULTS Translators rated the translation difficulty of most items (95%) as easy or feasible. Pretesting showed that items of the universal German version were understood as they were intended, as only 14 out of 82 items of the self-report and 15 out of 82 items of the proxy-report versions required minor rewording. However, on average German translators rated the items more difficult to translate (M = 1.5, SD = 0.20) than the Austrian (M = 1.3, SD = 0.16) and the Swiss translators (M = 1.2, SD = 0.14) on a three-point Likert scale. CONCLUSIONS The translated German short forms are ready for use by researchers and clinicians ( https://www.healthmeasures.net/search-view-measures ).
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Affiliation(s)
- J. Devine
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - A. Kaman
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - T. L. Seum
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - F. Zoellner
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - M. Dabs
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - V. Ottova-Jordan
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - L. K. Schlepper
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - A.-C. Haller
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - S. Topf
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - M. Boecker
- grid.13648.380000 0001 2180 3484Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany ,grid.412301.50000 0000 8653 1507Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany
| | - J. Schuchard
- grid.239552.a0000 0001 0680 8770Applied Clinical Research Center, Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA
| | - C. B. Forrest
- grid.239552.a0000 0001 0680 8770Applied Clinical Research Center, Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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19
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Witt S, Quitmann J, Höglund AT, Russ S, Kaman A, Escherich G, Frygner-Holm S. Effects of a Pretend Play Intervention on Health-Related Quality of Life in Children With Cancer: A Swedish-German Study. J Pediatr Hematol Oncol Nurs 2023; 40:158-169. [PMID: 36734043 DOI: 10.1177/27527530221121726] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Cancer diagnosis can lead to massive physical, emotional, and social burdens on children and their families. Although children have the right to be informed and participate in their care, research shows that children's views are often not considered in care situations. Thus, it is essential to strengthen children's communication and self-efficacy (SE) to convey desires and needs. The present study explores whether a play intervention is associated with improved health-related quality of life (HrQoL) and SE for communication in care situations. We hypothesize that HrQoL and SE for communication will increase from the beginning to after the pretend play intervention. Methods: Children with cancer from Germany and Sweden were enrolled. The pretend play intervention consisted of six to 10 play sessions. A heterogenic selection of questionnaires was used to measure children's HrQoL and SE before the first pretend play session and after the last play intervention. Results: Nineteen families were included in the presented analyses, including 14 self-reports of children and 19 proxy reports of parents. We found improvements in child-reported communication, and emotional and psychosocial well-being using generic and cancer-specific HrQoL measurements. Further, children's SE in care situations improved during the play intervention. Parents also reported minor improvements in the physical dimensions in both generic and chronic-generic HrQoL, along with improvements in independence. Discussion: Overall, the cancer-specific pretend play intervention offers young children with cancer a secure environment and can contribute to their well-being, and communication skills, during or after cancer treatment.
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Affiliation(s)
- Stefanie Witt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Quitmann
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna T Höglund
- Center for Research Ethics and Bioethics, 8097Uppsala University, Uppsala, Sweden
| | - Sandra Russ
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Anne Kaman
- Research Section "Child Public Health", Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, Center for Obstetrics and Pediatrics, University Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sara Frygner-Holm
- Department of Neuroscience, Section of Physiotherapy, 8097Uppsala University, Uppsala, Sweden
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20
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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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21
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Heinz A, Sischka PE, Catunda C, Cosma A, García-Moya I, Lyyra N, Kaman A, Ravens-Sieberer U, Pickett W. Item response theory and differential test functioning analysis of the HBSC-Symptom-Checklist across 46 countries. BMC Med Res Methodol 2022; 22:253. [PMID: 36175865 PMCID: PMC9520881 DOI: 10.1186/s12874-022-01698-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/29/2021] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Symptom Checklist (SCL) developed by the Health Behaviour in School-aged Children (HBSC) study is a non-clinical measure of psychosomatic complaints (e.g., headache and feeling low) that has been used in numerous studies. Several studies have investigated the psychometric characteristics of this scale; however, some psychometric properties remain unclear, among them especially a) dimensionality, b) adequacy of the Graded Response Model (GRM), and c) measurement invariance across countries. METHODS Data from 229,906 adolescents aged 11, 13 and 15 from 46 countries that participated in the 2018 HBSC survey were analyzed. Adolescents were selected using representative sampling and surveyed by questionnaire in the classroom. Dimensionality was investigated using exploratory graph analysis. In addition, we investigated whether the GRM provided an adequate description of the data. Reliability over the latent variable continuum and differential test functioning across countries were also examined. RESULTS Exploratory graph analyses showed that SCL can be considered as one-dimensional in 16 countries. However, a comparison of the unidimensional with a post-hoc bifactor GRM showed that deviation from a hypothesized one-dimensional structure was negligible in most countries. Multigroup invariance analyses supported configural and metric invariance, but not scalar invariance across 32 countries. Alignment analysis showed non-invariance especially for the items irritability, feeling nervous/bad temper and feeling low. CONCLUSION HBSC-SCL appears to represent a consistent and reliable unidimensional instrument across most countries. This bodes well for population health analyses that rely on this scale as an early indicator of mental health status.
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Affiliation(s)
- Andreas Heinz
- Department of Social Sciences, University of Luxembourg, Maison des Sciences Humaines, 11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg. .,Department of Health, IU Internationale Hochschule, Erfurt, Germany.
| | - Philipp E Sischka
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Carolina Catunda
- Department of Social Sciences, University of Luxembourg, Maison des Sciences Humaines, 11, Porte des Sciences, L-4366, Esch-sur-Alzette, Luxembourg
| | - Alina Cosma
- Sts Cyril and Methodius Faculty of Theology, Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czech Republic.,Department of Sociology, Trinity College Dublin, Dublin, Ireland
| | - Irene García-Moya
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Seville, Spain
| | - Nelli Lyyra
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - William Pickett
- Department of Health Sciences, Brock University, St Catharines, Canada.,Department of Public Health Sciences, Queen's University, Kingston, Canada
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22
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Reiß F, Erhart M, Kaman A, Devine J, Ravens-Sieberer U. Soziale Ungleichheit und psychische Gesundheit von Kindern und
Jugendlichen während der COVID-19 Pandemie. Ergebnisse der
längsschnittlichen COPSY-Studie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- F Reiß
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
| | - M Erhart
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
- Alice-Salomon-Hochschule Berlin, Gesundheits- und
Rehabilitationswissenschaft mit Schwerpunkt angewandte Versorgungsforschung,
12627, Deutschland
| | - A Kaman
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
| | - J Devine
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
| | - U Ravens-Sieberer
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik
für Kinder- und Jugendpsychiatrie, -psychotherapie und
-psychosomatik/Forschungssektion „Child Public Health“,
20246, Deutschland
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23
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Beyer AK, Schlack R, Neuperdt L, Kuhnert R, Hölling H, Romanos M, Jans T, Berner A, Hetzke L, Weyrich S, Emser T, Hauer D, Scholz V, Ulsamer S, Wallau C, Ravens-Sieberer U, Kaman A, Gilbert M, Greiner W, Witte J, Seck K, Heuschmann PU, Fiessler C, Widmann J, Riederer C. Das Projekt INTEGRATE-ADHD: Vergleich und Integration administrativer
und epidemiologischer ADHS-Diagnosedaten durch klinisches Assessment bei Kindern
und Jugendlichen in Deutschland. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A-K Beyer
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - R Schlack
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - L Neuperdt
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - R Kuhnert
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - H Hölling
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - M Romanos
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - T Jans
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - A Berner
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - L Hetzke
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - S Weyrich
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - T Emser
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - D Hauer
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - V Scholz
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
- Radboud University, Donders Institute for Brain, Cognition and
Behaviour, Nijmegen, Niederlande
| | - S Ulsamer
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - C Wallau
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - U Ravens-Sieberer
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - A Kaman
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - M Gilbert
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - W Greiner
- Universität Bielefeld, Lehrstuhl für
Gesundheitsökonomie und Gesundheitsmanagement, Bielefeld,
Deutschland
| | - J Witte
- Vandage GmbH, Bielefeld, Deutschland
| | - K Seck
- Vandage GmbH, Bielefeld, Deutschland
| | - PU Heuschmann
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
| | - C Fiessler
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
| | - J Widmann
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
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Ravens-Sieberer U, Kaman A, Devine J, Löffler C, Reiß F, Napp AK, Gilbert M, Naderi H, Hurrelmann K, Schlack R, Hölling H, Erhart M. The Mental Health and Health-Related Behavior of Children and Parents During the COVID-19 Pandemic. Dtsch Arztebl Int 2022; 119:436-437. [PMID: 36178311 PMCID: PMC9549892 DOI: 10.3238/arztebl.m2022.0173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/02/2022] [Accepted: 03/27/2022] [Indexed: 11/27/2022]
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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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26
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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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Adedeji A, Otto C, Kaman A, Reiss F, Devine J, Ravens-Sieberer U. Peer Relationships and Depressive Symptoms Among Adolescents: Results From the German BELLA Study. Front Psychol 2022; 12:767922. [PMID: 35046870 PMCID: PMC8761859 DOI: 10.3389/fpsyg.2021.767922] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 09/01/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Poor mental health affects adolescent development and is associated with health and social outcomes in later life. The current study uses cross-sectional data to explore the understudied aspects of peer relationships as a predictor of depressive symptom severity of adolescents in Germany. Method: Data from the German BELLA study were analyzed. We focused on the most recent measurement point of the BELLA study and analyzed data of 446 adolescents (aged 14-17 years). Peer relationship was measured using four items from the internationally established Patient-Reported Outcome Measurement Information System (PROMIS). Depressive symptoms were assessed via seven items of the German version of the Centre for Epidemiological Studies Short Depression Scale (CES-D). Hierarchical linear regression models were computed to explore the association between depressive symptoms and peer relationships. Hierarchical linear regression models served to determine the added predictive effects of each aspect of peer relationships. Result: The regression model showed that 22% of the variance of the severity of depressive symptoms could be explained by the quality of adolescents' peer relationships (F(1,444) = 125.65, p < 0.001). Peer acceptance has the most substantial unique contribution to peer relationship as a predictor of depressive symptom severity (Change in R 2 = 0.05; Change in F = 27.01, p < 0.001). The gender-specific analysis shows different trends for boys and girls. Conclusion: The quality of peer relationships is a significant predictor of adolescents' depressive symptoms severity. Improved peer acceptance, dependability, and ease of making new friends are significantly associated with reduced depression symptoms for Germany's adolescent population.
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Affiliation(s)
- Adekunle Adedeji
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Christiane Otto
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiss
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Janine Devine
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Argora Clinic, Psychosomatic Clinic and Outpatient Center, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ravens-Sieberer U, Kaman A, Erhart M, Devine J, Schlack R, Otto C. Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry 2022; 31:879-889. [PMID: 33492480 PMCID: PMC7829493 DOI: 10.1007/s00787-021-01726-5] [Citation(s) in RCA: 383] [Impact Index Per Article: 191.5] [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] [Received: 10/29/2020] [Accepted: 01/16/2021] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic has caused unprecedented changes in the lives of 1.6 billion children and adolescents. First non-representative studies from China, India, Brazil, the US, Spain, Italy, and Germany pointed to a negative mental health impact. The current study is the first nationwide representative study to investigate the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and mental health of children and adolescents in Germany from the perspective of children themselves. A representative online survey was conducted among n = 1586 families with 7- to 17-year-old children and adolescents between May 26 and June 10. The survey included internationally established and validated instruments for measuring HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). Results were compared with data from the nationwide, longitudinal, representative BELLA cohort study (n = 1556) conducted in Germany before the pandemic. Two-thirds of the children and adolescents reported being highly burdened by the COVID-19 pandemic. They experienced significantly lower HRQoL (40.2% vs. 15.3%), more mental health problems (17.8% vs. 9.9%) and higher anxiety levels (24.1% vs. 14.9%) than before the pandemic. Children with low socioeconomic status, migration background and limited living space were affected significantly more. Health promotion and prevention strategies need to be implemented to maintain children's and adolescents' mental health, improve their HRQoL, and mitigate the burden caused by COVID-19, particularly for children who are most at risk.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, 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 of Healthcare Economy, Bremen, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,Argora Clinic, Psychosomatic Clinic and Outpatient Center, Berlin, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Meißner C, Meyrose AK, Kaman A, Michalkiewicz M, Ravens-Sieberer U. Associations Between Mental Health Problems in Adolescence and Educational Attainment in Early Adulthood: Results of the German Longitudinal BELLA Study. Front Pediatr 2022; 10:828085. [PMID: 35281228 PMCID: PMC8914221 DOI: 10.3389/fped.2022.828085] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Mental health problems (MHP) in adolescence are a major public health concern of the 21st century. Global prevalence estimates range between 10 and 20%. Most MHP manifest by adolescence and persistence rates are high, often accumulating further impairment in early adulthood and beyond. We analyzed data of N = 433 participants from the German longitudinal BELLA study to examine whether MHP in adolescence negatively affect educational attainment in early adulthood. Externalizing and internalizing MHP among adolescents aged 11-17 years were assessed at baseline using the Strengths and Difficulties Questionnaire. Educational attainment was assessed at the 6-year follow-up based on level of education, failure to attain the expected level of education, and dropout from vocational or academic training. Findings from logistic regression analyses suggest that more pronounced externalizing MHP in adolescence predict a lower level of education in early adulthood. We did not find a corresponding effect for internalizing MHP. Adolescents with higher-educated parents were less likely to attain a lower level of education themselves and less likely to fail in attaining their expected level of education. Our findings support that educational attainment presents a central channel for intergenerational reproduction of education and forms an important pathway for upward, but also downward social mobility. The current study emphasizes school as a central setting to implement measures to prevent onset and persistence of MHP and to foster equal opportunities in education.
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Affiliation(s)
- Carina Meißner
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Michalkiewicz
- Institute for Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Güzelsoy N, Ravens-Sieberer U, Westenhöfer J, Devine J, Erhart M, Hölling H, Kaman A. Risks and Resources for Depressive Symptoms and Anxiety in Children and Adolescents During the COVID-19 Pandemic - Results of the Longitudinal COPSY Study. Front Psychiatry 2022; 13:901783. [PMID: 35873222 PMCID: PMC9301280 DOI: 10.3389/fpsyt.2022.901783] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/20/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mental health during the COVID-19 pandemic is of particularly high relevance. Especially for children and adolescents, the pandemic and its restrictions represent a significant burden. The present study aims to identify risks and resources for depressive symptoms and anxiety in children and adolescents during the pandemic in Germany. MATERIALS AND METHODS Self-reported data from the first wave of the longitudinal COVID-19 and Psychological Health (COPSY) study were used to investigate risks and resources among n = 811 children and adolescents aged 11-17 years. Depressive symptoms and anxiety were measured at the first follow-up 6 months later. Multivariate linear regression analyses were performed to investigate the effects of risks and resources on depressive symptoms and anxiety. RESULTS Parental depressive symptoms predicted depressive symptoms and anxiety in children and adolescents 6 months later. Female gender was identified as a risk factor for anxiety during the pandemic. None of the potential resources were associated with depressive symptoms or anxiety at the follow-up. CONCLUSION The findings provide evidence of risk factors for depressive symptoms and anxiety during the COVID-19 pandemic. Children and adolescents who face risk factors need to be identified early and monitored during the pandemic. Family-based intervention programs are needed to help vulnerable children and adolescents cope with the challenges of the pandemic.
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Affiliation(s)
- Neslihan Güzelsoy
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joachim Westenhöfer
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Public Health, Alice Salomon University of Applied Science, Berlin, Germany.,Department of Psychology, Apollon University of Applied Science, Bremen, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ravens-Sieberer U, Kaman A, Otto C, Adedeji A, Napp AK, Becker M, Blanck-Stellmacher U, Löffler C, Schlack R, Hölling H, Devine J, Erhart M, Hurrelmann K. [Mental health and psychological burden of children and adolescents during the first wave of the COVID-19 pandemic-results of the COPSY study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1512-1521. [PMID: 33649901 PMCID: PMC7920639 DOI: 10.1007/s00103-021-03291-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The drastic changes during the COVID-19 pandemic may have a negative impact on the psychological wellbeing of children and adolescents. OBJECTIVES COPSY is the first national, representative German study to examine mental health and quality of life of children and adolescents during the pandemic. Results are compared with data of the representative longitudinal BELLA study conducted before the pandemic. MATERIALS AND METHODS Internationally established instruments for measuring health-related quality of life and mental health (including anxiety and depressive symptoms) were administered to n = 1586 parents with 7‑ to 17-year-old children and adolescents, of whom n = 1040 11- to 17-year-olds also provided self-reports, from 26 May to 10 June 2020. Data were analyzed using descriptive statistics and bivariate tests. RESULTS Seventy-one percent of the children and adolescents and 75% of the parents felt burdened by the first wave of the COVID-19 pandemic. Compared to the time before the pandemic, the children and adolescents reported a lower health-related quality of life, the percentage of children and adolescents with mental health problems almost doubled, and their health behavior worsened. Socially disadvantaged children felt particularly burdened by the COVID-19 pandemic. Two-thirds of the parents would like to receive support in coping with their child during the pandemic. CONCLUSIONS The COVID-19 pandemic poses a mental health risk to children and adolescents. Schools, doctors, and society are called to react by providing low-threshold and target-group-specific prevention and mental health promotion programs.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Anne Kaman
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Christiane Otto
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Adekunle Adedeji
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Ann-Kathrin Napp
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Marcia Becker
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Ulrike Blanck-Stellmacher
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Constanze Löffler
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Robert Schlack
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, Berlin, Deutschland
| | - Heike Hölling
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, Berlin, Deutschland
| | - Janine Devine
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Michael Erhart
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
- Alice Salomon Hochschule, Berlin, Deutschland
- Apollon Hochschule der Gesundheitswirtschaft, Bremen, Deutschland
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Otto C, Kaman A, Erhart M, Barkmann C, Klasen F, Schlack R, Ravens-Sieberer U. Risk and resource factors of antisocial behaviour in children and adolescents: results of the longitudinal BELLA study. Child Adolesc Psychiatry Ment Health 2021; 15:61. [PMID: 34686200 PMCID: PMC8539834 DOI: 10.1186/s13034-021-00412-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/08/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Antisocial behaviour is a common phenomenon in childhood and adolescence. Information on psychosocial risk and resource factors for antisocial behaviour are important for planning targeted prevention and early intervention programs. The current study explores risk and resource factors of antisocial behaviour in children and adolescents based on population-based longitudinal data. METHODS We analysed longitudinal data from the German BELLA study (n = 1145; 11 to 17 year-olds) measured at three measurement points covering two years. Latent growth analysis, linear regression models and structural equation modelling were used to explore cross-sectional and longitudinal data. RESULTS Based on baseline data, we found that stronger self-efficacy and worse family climate were each related to stronger antisocial behaviour. Longitudinal data revealed that more severe parental mental health problems, worse family climate at baseline, deteriorating family climate over time, and more social support were each associated with increasing antisocial behaviour over time. We further found a moderating effect for family climate. CONCLUSIONS Our study provides important exploratory results on psychosocial risk, resource and protective factors in the context of antisocial behaviour in children and adolescents, which need confirmation by future research. Our exploratory results point in the direction that family-based interventions for antisocial behavior in children and adolescents may benefit from considering the family climate.
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Affiliation(s)
- Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
- Alice Salomon University of Applied Sciences, Berlin, Germany
- Apollon University of Applied Sciences, Bremen, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Fionna Klasen
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, General-Pape- Straße 62-66, D-12101, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany.
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Ravens-Sieberer U, Kaman A, Erhart M, Otto C, Devine J, Löffler C, Hurrelmann K, Bullinger M, Barkmann C, Siegel NA, Simon AM, Wieler LH, Schlack R, Hölling H. Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study. Eur Child Adolesc Psychiatry 2021; 32:575-588. [PMID: 34636964 PMCID: PMC8506100 DOI: 10.1007/s00787-021-01889-1] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [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: 05/10/2021] [Accepted: 09/29/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic. METHODS A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors. RESULTS The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic. DISCUSSION Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,Alice Salomon University of Applied Sciences, Berlin, Germany ,Apollon University of Applied Sciences, Bremen, 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 ,Argora Clinic, Psychosomatic Clinic and Outpatient Center, Berlin, Germany
| | - Constanze Löffler
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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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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Yalçinkaya R, Öz FN, Erdoğan G, Kaman A, Aydın Teke T, Yaşar Durmuş S, Bayhan GI, Metin Akcan Ö, Gayretli Aydin ZG, Gülenç N, Tanir G. Turkish pediatric residents' knowledge, perceptions, and practices of blood culture sampling. Arch Pediatr 2021; 28:191-196. [PMID: 33707101 DOI: 10.1016/j.arcped.2021.02.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/26/2021] [Accepted: 02/21/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Pediatrics is one of the medical specialties in which blood cultures for bloodstream infections are performed very frequently. This study aimed to evaluate pediatric residents' knowledge and perceptions of blood culture sampling. MATERIAL AND METHODS Between June 2019 and September 2019, a questionnaire comprising 20 questions about blood culture sampling was sent via email to participants who were pediatric residents at five different hospitals in Turkey. There were 11 true/false and nine multiple-choice questions that assessed three aspects of culture sampling: indications, sampling practice and knowledge, and contamination. The percentage of correct answers was used to calculate an overall score and subsection scores. RESULTS A total of 132 pediatric residents [102 (77%) female] with a mean age of 28.3±2.8 years completed the questionnaire. Forty-five (35%) were in their 1st year of residency. Sixty (46%) participants reported that they had not performed blood culture sampling in the last week. There was a negative relationship between years in training and the number of cultures performed (Kendal's tau-b=-0.297, p<0.001). The overall median score was 65 (range, 35-90) and it seemed to increase with years of training. The lowest median score was in the contamination subscale and only one (0.76%) participant correctly answered all questions concerning contamination. CONCLUSION Residents who obtained the majority of blood cultures had the lowest knowledge levels. Therefore, it is evident that the knowledge levels of pediatric residents must be increased in order to improve blood culture sampling practices in centers where they perform blood culture sampling.
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Affiliation(s)
- R Yalçinkaya
- Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey.
| | - F N Öz
- Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - G Erdoğan
- Ankara Training and Research Hospital, Department of Microbiology, Ankara, Turkey
| | - A Kaman
- Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - T Aydın Teke
- Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - S Yaşar Durmuş
- Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - G I Bayhan
- Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Ö Metin Akcan
- Necmettin Erbakan University, Meram Faculty of Medicine, Department of Pediatric Infectious Diseases, Konya, Turkey
| | - Z G Gayretli Aydin
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Infectious Diseases, Trabzon, Turkey
| | - N Gülenç
- Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Department of Pediatrics, Ankara, Turkey
| | - G Tanir
- Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
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Ravens-Sieberer U, Kaman A, Otto C, Adedeji A, Devine J, Erhart M, Napp AK, Becker M, Blanck-Stellmacher U, Löffler C, Schlack R, Hurrelmann K. Mental Health and Quality of Life in Children and Adolescents During the COVID-19 Pandemic-Results of the Copsy Study. Dtsch Arztebl Int 2021; 117:828-829. [PMID: 33568260 DOI: 10.3238/arztebl.2020.0828] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/18/2020] [Accepted: 10/15/2020] [Indexed: 11/27/2022]
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Kaman A, Otto C, Klasen F, Westenhöfer J, Reiss F, Hölling H, Ravens-Sieberer U. Risk and resource factors for depressive symptoms during adolescence and emerging adulthood - A 5-year follow-up using population-based data of the BELLA study. J Affect Disord 2021; 280:258-266. [PMID: 33220562 DOI: 10.1016/j.jad.2020.11.036] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/18/2020] [Accepted: 11/07/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Depression is one of the most common mental disorders in adolescents and young adults worldwide, and causes a high burden for both individuals and society. The present study aims to investigate the role of risk and resource factors for depressive symptoms during adolescence and emerging adulthood in a German population-based cohort. METHODS Within the longitudinal BELLA study, data on risk and resource factors were collected among n = 632 children and adolescents aged 11 to 17 years. Depressive symptoms were measured five years later. Multivariate linear regression models served to investigate effects of risk and resource factors on depressive symptoms. Regression models were stratified by gender. Moreover, we explored potential interaction effects. RESULTS A negative mother-child relationship predicted depressive symptoms in girls, whereas school stress served as a risk factor in boys. Peer competence was associated with fewer depressive symptoms in girls, and family cohesion was identified as a resource factor in boys. In addition, few moderating effects of resource factors on the association between risk factors and depressive symptoms were found. LIMITATIONS As the BELLA study is a population-based observational study, we only identified associations between risk and resource factors and no cause-effect relationships. CONCLUSIONS Findings provide evidence of gender-specific risk and resource factors for depression. Individuals who are exposed to risk factors must be monitored during the transition into adulthood. Gender-sensitive prevention and early intervention programs are needed.
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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
| | - Fionna Klasen
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joachim Westenhöfer
- Hamburg University of Applied Sciences, Faculty of Life Sciences, Department Health Sciences, Competence Center Health, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Fischer SM, John N, Melzer W, Kaman A, Winter K, Bilz L. Traditional bullying and cyberbullying among children and adolescents in Germany - Cross-sectional results of the 2017/18 HBSC study and trends. J Health Monit 2020; 5:53-68. [PMID: 35146273 PMCID: PMC8734197 DOI: 10.25646/6902] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/25/2020] [Indexed: 11/22/2022]
Abstract
Bullying is a specific form of violence that can potentially lead to numerous and long-term negative health implications. Despite consistent coverage in the media, particularly on cyberbullying, as of yet there are only few representative findings on the frequency of (cyber)bullying in Germany. This article analyses how widespread bullying and cyberbullying were at schools in Germany in 2018, what differences exist between girls and boys, age groups and various types of schools, and changes in bullying trends between 2002 and 2018. Our findings are based on an analysis of the data provided by the 2017/18 cycle (N=4,347 students, 53.0% female) and previous cycles of the German Health Behaviour in School-aged Children (HBSC) study. In the 2018 cycle, boys reported having bullied other children more frequently than girls, but were bullied just as often. 15-year-olds reported having bullied other children more frequently than 11- to- 13-year-olds but reported being bullied less frequently. Students at grammar schools (Gymnasium) least frequently reported any involvement in bullying. Only few children and adolescents reported cases of cyberbullying. Compared to all previous survey years, 2018 saw the lowest number of children that reported having bullied others. However, reports of having been bullied have remained almost stable. The findings highlight the need for evidence-based prevention and intervention anti-bullying programmes and measures across all types of general education schools and age groups.
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Affiliation(s)
- Saskia M. Fischer
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Social Work, Health Care and Music, Institute of Health,Corresponding author Saskia M. Fischer, Brandenburg University of Technology Cottbus-Senftenberg, Faculty 4 Institute of Health, Universitätsplatz 1, 01968 Senftenberg, Germany, E-mail:
| | - Nancy John
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Social Work, Health Care and Music, Institute of Health
| | | | - Anne Kaman
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics
| | - Kristina Winter
- Martin Luther University Halle-Wittenberg Medical Faculty, Institute of Medical Sociology
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Social Work, Health Care and Music, Institute of Health,Brandenburg University of Technology Cottbus-Senftenberg Faculty of Health Sciences
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Moor I, Winter K, Bilz L, Bucksch J, Finne E, John N, Kolip P, Paulsen L, Ravens-Sieberer U, Schlattmann M, Sudeck G, Brindley C, Kaman A, Richter M. The 2017/18 Health Behaviour in School-aged Children (HBSC) study - Methodology of the World Health Organization's child and adolescent health study. J Health Monit 2020; 5:88-102. [PMID: 35146275 PMCID: PMC8734187 DOI: 10.25646/6904] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/08/2020] [Indexed: 06/14/2023]
Abstract
The Health Behaviour in School-aged Children (HBSC) study is an international research project in collaboration with the World Health Organization (WHO) for over 35 years. HBSC is the largest study on child and adolescent health and one of the most important sources of data for the WHO's international comparative health monitoring. Every four years, data on the health and health behaviour of students aged 11, 13 and 15, as well as the social contexts and conditions for growing up healthy, are collected. A total of 50 countries belong to the HBSC network, with 45 countries taking part in the 2017/18 survey. Germany has contributed to the HBSC surveys since 1993/94. For the most recent 2017/18 cycle, students at 146 schools in Germany were interviewed (response rate of schools: 15.6%). A net sample of n = 4,347 girls and boys was achieved for Germany (response rate: 52.7%). Participation was voluntary and the survey was conducted in German school years five, seven and nine (corresponding to ages 11, 13 and 15). A weighting procedure was applied to allow for representative findings on the health of children and adolescents in Germany. HBSC offers a valuable contribution to health monitoring and provides numerous starting points to identify needs, risk groups and fields of action to initiate targeted and actual needs-based measures of prevention and health promotion in the school setting.
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Affiliation(s)
- Irene Moor
- Martin Luther University Halle-Wittenberg Medical Faculty, Institute of Medical Sociology
| | - Kristina Winter
- Martin Luther University Halle-Wittenberg Medical Faculty, Institute of Medical Sociology
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Social Work, Health Care and Music, Institute of Health
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Health Sciences
| | - Jens Bucksch
- University of Education Heidelberg Faculty of Natural and Sociological Sciences, Department of Prevention and Health Promotion
| | - Emily Finne
- Bielefeld University School of Public Health, Department Prevention and Health Promotion
| | - Nancy John
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Social Work, Health Care and Music, Institute of Health
| | - Petra Kolip
- Bielefeld University School of Public Health, Department Prevention and Health Promotion
| | - Lisa Paulsen
- University of Education Heidelberg Faculty of Natural and Sociological Sciences, Department of Prevention and Health Promotion
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics
| | - Marina Schlattmann
- Bielefeld University School of Public Health, Department Prevention and Health Promotion
| | - Gorden Sudeck
- Eberhard Karls University of Tübingen Institute of Sport Science
- Eberhard Karls University of Tübingen Interfaculty Research Institute for Sport and Physical Activity
| | - Catherina Brindley
- University of Education Heidelberg Faculty of Natural and Sociological Sciences, Department of Prevention and Health Promotion
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics
| | - Matthias Richter
- Martin Luther University Halle-Wittenberg Medical Faculty, Institute of Medical Sociology
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Kaman A, Ottová-Jordan V, Bilz L, Sudeck G, Moor I, Ravens-Sieberer U. Subjective health and well-being of children and adolescents in Germany - Cross-sectional results of the 2017/18 HBSC study. J Health Monit 2020; 5:7-20. [PMID: 35146270 PMCID: PMC8734126 DOI: 10.25646/6899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 05/28/2020] [Indexed: 11/18/2022]
Abstract
Subjective health is understood as a multidimensional construct that encompasses the physical, mental and social dimensions of a person's well-being. Promoting the subjective health and well-being of children and adolescents has strong public health relevance because health impairments in childhood and adolescence are often associated with long-term health problems in adulthood. Therefore, it is very important to gain information about potential risk and resource factors involved. This article presents current prevalences for subjective health, life satisfaction and psychosomatic health complaints among children and adolescents in Germany aged 11, 13 and 15 years from the 2017/18 Health Behaviour in School-Aged Children (HBSC) study (N=4,347, 53.0% girls). It also examines the sociodemographic and psychosocial factors that influence subjective well-being. Most children and adolescents provided positive ratings of their health and life satisfaction. Nevertheless, about one third of girls and one fifth of boys were affected by multiple psychosomatic health complaints. Impairments in subjective well-being were particularly evident in girls, older adolescents, young people with low levels of family affluence and those under a lot of pressure at school. In contrast, high family support was associated with better subjective well-being. These results illustrate the need for target group-specific prevention and health promotion measures aimed at improving the subjective health and well-being of children and adolescents.
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Affiliation(s)
- Anne Kaman
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics
| | - Veronika Ottová-Jordan
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Social Work, Health Care and Music, Institute of Health
- Brandenburg University of Technology Cottbus-Senftenberg Faculty of Health Sciences
| | - Gorden Sudeck
- Eberhard Karls University Tübingen Institute of Sport Science
| | - Irene Moor
- Martin Luther University Halle-Wittenberg Medical Faculty, Institute of Medical Sociology
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics
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Abstract
PURPOSE To assess the long-term anatomical and functional results of balloon buckle surgery for rhegmatogenous retinal detachment. PATIENTS AND METHODS Twenty-five selected detachments with a single break or a group of breaks close together were treated with a temporary parabulbar balloon. Adhesion was obtained with transconjunctival cryopexy and argon laser photocoagulation. Retinal detachment was associated with the following risk factors: myopia (15 eyes), aphakia (2 eyes), blunt trauma (1 eye). Twenty-three eyes had a detached macula. The balloon was withdrawn after one week. The patients were kept under observation for at least six months (mean 44.7 months). RESULTS Initial retinal attachment was achieved in 29 eyes. After the balloon was removed redetachment occurred in two eyes; thus, complete attachment was attained in 27 eyes. Causes of failure were: undetected break (2 eyes), inadequate buckle (4 eyes), proliferative vitreoretinopathy (2 eyes). Conventional scleral buckling and subretinal fluid drainage was done in all failed cases. Vitrectomy and silicone oil were employed in one patient, and finally retinal attachment was achieved in all patients. CONCLUSIONS Temporary balloon buckling is a simple and curative technique for a selected group of patients with retinal detachments.
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Affiliation(s)
- I Oge
- Department of Ophthalmology, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
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Affiliation(s)
- H Birinci
- Department of Ophthalmology, University of Ondokuz Mayis, Samsun, Turkey
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Abstract
A cluster sample survey was conducted in 1998 in 30 schools to assess the effect of the growth of Niamey during the last decade on a urinary schistosomiasis urban focus described in 1989. Two thousand and forty-two children (11.0 + 0.1 years old) had a urine filtration test and answered a behavioural questionnaire. Snail populations of the sites used by schoolchildren were followed up in 1999. The global prevalence was 15.7% in 1998, as opposed to 23.7% in 1989. The prevalence was very low in schools far from the river and higher in those along the Niger banks, particularly in villages on the periphery of the urban area. Geographical factors were more important than socio-economic ones in explaining the distribution of the disease. Only 46% of the children in Niamey reported water contact; mainly in the river, rarely in pools and the canal. The infection risk was low in pools (RR = 1.6), high in the river (RR = 3.5) and very high in the canal (RR = 12.5). Malacological studies confirmed the location of transmission sites obtained through parasitological studies and the questionnaire. Sixty-one per cent of the children travelled outside Niamey to the hyperendemic surrounding areas. However, these movements did not increase their infection level. The results are discussed in relation to water contact behaviour and Schistosoma haematobium transmission features.
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Affiliation(s)
- J C Ernould
- Institut de Recherche pour le Développement, BP 11416 Niamey, Niger.
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