Z Kinder Jugendpsychiatr Psychother
· 2022 Nov · PMID 35775329
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Risk Factors for School Based Anxiety: An Empirical Study This article deals with the phenomenon of school absenteeism, with a special focus on school refusal behavior and the self-efficacy of students. Risk factors may...Risk Factors for School Based Anxiety: An Empirical Study This article deals with the phenomenon of school absenteeism, with a special focus on school refusal behavior and the self-efficacy of students. Risk factors may lead to avoidance and end up in disintegrative processes. For this reason, this quantitative study investigates potential influences on school absenteeism, addressing the hypothesis that anxiety in school and lower self-efficacy may lead to school-attendance problems. To this end, we interviewed students at schools in Lower Saxony.
Z Kinder Jugendpsychiatr Psychother
· 2022 Nov · PMID 35762908
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It is important to consider developmental issues when addressing school refusal (SR) in adolescence. Referral rates appear to be higher among adolescents relative to children, and treatment appears to be less effective a...It is important to consider developmental issues when addressing school refusal (SR) in adolescence. Referral rates appear to be higher among adolescents relative to children, and treatment appears to be less effective among adolescents. This paper provides an in-depth review of developmental issues associated with adolescent SR and treatment via cognitive-behavioral therapy (CBT). It begins by considering the reasons for the higher referral and poorer treatment outcomes, including the higher level of absenteeism in adolescence, higher rates of concurrent social anxiety disorder and depressive disorder, and the developmental challenges inherent to adolescence. Such challenges include increased academic and social demands in the secondary-school environment, and increasing autonomy which may contribute to family conflict. These developmental issues may potentiate and exacerbate an adolescent's difficulty attending school, make it difficult for families to cope, and complicate practitioners' efforts to provide effective treatment for SR. Further, the review describes CBT manuals for SR and the extent to which they are developmentally sensitive. There are five CBT manuals, which vary in their sensitivity to developmental issues. Various multimodal treatments employ interventions in addition to CBT, such as medication or inpatient treatment, to address the complexity of SR in adolescence. Nevertheless, nonresponse to treatment for adolescent SR ranges from one-third to two-thirds of youths. Attention thus needs to be given to ways of improving treatment outcomes.
Knollmann M, Waltz E, Reissner V
… +2 more, Neumann U, Hebebrand J
Z Kinder Jugendpsychiatr Psychother
· 2022 Nov · PMID 35748577
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Course of School Absenteeism 1.5-3 Years After Initial Evaluation: Symptoms, Psychosocial Functioning, and Help-Seeking Behavior To explore the course of patients with school absenteeism 1.5-3 years after their initial...Course of School Absenteeism 1.5-3 Years After Initial Evaluation: Symptoms, Psychosocial Functioning, and Help-Seeking Behavior To explore the course of patients with school absenteeism 1.5-3 years after their initial evaluation, including symptoms, school attendance, psychosocial functioning, and help-seeking behavior. Of the 237 patients from specialized psychiatric units for youths displaying school absenteeism, we successfully contacted 108 of them 1.5-3 years after initial admission. We conducted a telephone interview with their parents (SDQ, school situation, help-seeking behavior). Among others, we analyzed the extent of school absenteeism, the scales of the Inventory of School Attendance Problems (ISAP; Knollmann et al., 2019), and the quality of school absenteeism (school refusal vs. truancy vs. mixed group) at admission as possible predictors. The patients had received an extensive amount of youth-welfare measures and inpatient, daycare, and outpatient therapy. 46.3 % had elevated values in the SDQ total score at follow-up, mostly because of emotional problems or problems with peers. Psychosocial functioning, including school attendance, was described as poor for only about 30 %. School attendance problems were significantly predicted by having a conduct disorder and elevated scores on the ISAP-scales Aggression, Teacher Problems, and Peer Problems, though the effect sizes were weak. Externalizing symptoms and associated psychosocial problems seem to be predictive of a negative course of school absenteeism. Implications for prospective longitudinal studies are discussed.
Z Kinder Jugendpsychiatr Psychother
· 2022 Nov · PMID 35748572
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Inpatient Schema Therapy for School Avoidance - A Case Study After a short overview of the basic concepts and methods of schema therapy, we report a case study on the inpatient treatment of a 16-year-old youth with depr...Inpatient Schema Therapy for School Avoidance - A Case Study After a short overview of the basic concepts and methods of schema therapy, we report a case study on the inpatient treatment of a 16-year-old youth with depression and chronic school avoidance. The scores on the Schema inventories and Depression questionnaires are compared before vs. after the treatment, and we then discuss the opportunities and limitations of schema therapy with school-avoiding youths.
Walter D, Heindrichs L, Rademacher C
… +2 more, Matthias EK, Doepfner M
Z Kinder Jugendpsychiatr Psychother
· 2022 Nov · PMID 35704288
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Highly-controlled, randomized controlled trials have provided considerable evidence for the efficacy of outpatient cognitive-behavioral therapy (CBT) for patients with school absenteeism and anxiety disorders. However, t...Highly-controlled, randomized controlled trials have provided considerable evidence for the efficacy of outpatient cognitive-behavioral therapy (CBT) for patients with school absenteeism and anxiety disorders. However, the effectiveness of outpatient CBT under routine-care conditions for youth with school absenteeism remains unproven. This observational study used file records to analyze the changes under routine CBT in a sample of = 49 clinically referred adolescents aged 11 to 18 years with school absenteeism and mental disorders who were being treated in a university outpatient clinic. At the start and end of treatment, we assessed the severity of school absenteeism as well as mental health problems as rated by parents and by the adolescents themselves. The analysis yielded a statistically highly significant decline in school absenteeism (large effect, Cohen's = 0.80) and in mental health problems (small-to-large effect, Cohen's = 0.33 to = 0.82). However, a substantial proportion of the sample remained in the clinical range at the end of treatment. These findings suggest that CBT is effective for adolescents with school absenteeism when administered under routine-care conditions, though the results must be interpreted with caution because of the lack of a control condition.
Z Kinder Jugendpsychiatr Psychother
· 2023 Mar · PMID 35611610
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Development of Mental Health Problems of Girls and Boys in Residential Care Between 2008 and 2020 Studies show a high prevalence of mental health problems in children and adolescents in youth-welfare facilities compare...Development of Mental Health Problems of Girls and Boys in Residential Care Between 2008 and 2020 Studies show a high prevalence of mental health problems in children and adolescents in youth-welfare facilities compared to the general population. However, to date, studies on this development over time are lacking. The present study examines the development of mental health problems and psychosocial functioning in the years 2008 to 2020. Mental health problems were assessed with the CBCL, psychosocial functioning with Axis VI of the MAS. In total, data from 3,269 children and adolescents from residential-care facilities located throughout Germany were included in the analysis. a decrease in externalizing behaviour was observed regarding the frequency of mental health problem in children and adolescents in youth-welfare facilities from 2008 to 2020. Particularly boys aged 12 and older show less deviant behavior. Older girls show high internalizing behavior problem scores over time, but there is no consistent trend. More than a quarter of the institutionalized children in youth-welfare institutions show severely impaired psychosocial functioning at a consistent level over time. In light of the age and gender effects associated with the development of mental health problems over time, there is a need to regard the care situation in youth-welfare institutions.
Z Kinder Jugendpsychiatr Psychother
· 2023 Mar · PMID 35579542
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Honors granted by the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) and its predecessors Abstracts: This research on the "honors" granted by the German Society for Child...Honors granted by the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) and its predecessors Abstracts: This research on the "honors" granted by the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) investigated all persons honored by the society from 1950 (following the postwar reestablishment of the society) up through 1990 (German reunification). We explored the adequacy of the honors regarding the professional ethics of the honorees during the NS-regime. Ethics violations included so-called T4-assessments (euthanasia) leading to death, working in "special units" where children were murdered using drugs, or any form of nontherapeutic experiments on humans. The Heinrich Hoffman Medal was first awarded in 1957, with honorary memberships being conferred from 1963 onward. From 1957 to 1990, the DGKJP awarded 19 honorary memberships and 9 Heinrich Hoffman Medal to 27 recipients (one person received both). Of those honored, three were detected as violators of professional ethics. After long internal discussions, the DGKJP had already distanced itself from Elisabeth Hecker (1895-1986), Hans-Alois Schmitz (1899-1973), and Werner Villinger (1887-1961). The ideology shared by these three was formulated by Villinger as the "ineducability" of their child victims because of an "inferiority paradigm." The rejection by the DGKJP went little noticed in public, and until 2021 was only briefly mentioned in the society's newsletter. Eleven honored persons were former members of the NSDAP without demonstrable ethical transgressions; the investigations are still ongoing for three others, whose ethical transgressions have neither been ruled out nor confirmed.
Hohmann S, Häge A, Millenet S
… +1 more, Banaschewski T
Z Kinder Jugendpsychiatr Psychother
· 2021 May · PMID 35514173
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The Genetic Basis of ADHD - An Update Genetic risks play an important role in the etiology of attention-deficit/hyperactivity disorder (ADHD). This review presents the current state of knowledge concerning the genetic b...The Genetic Basis of ADHD - An Update Genetic risks play an important role in the etiology of attention-deficit/hyperactivity disorder (ADHD). This review presents the current state of knowledge concerning the genetic basis of the disorder. It discusses the results of twin- and family-based studies, linkage and association studies as well as recent findings resulting from Genome Wide Association Studies (GWAS). Furthermore, it elaborates on the relevance of polygenic risk scores, rare variants, and epigenetic alterations, especially in light of findings on genetic pleiotropy in the context of frequent psychiatric comorbidities in patients with ADHD.
Schmidt H, Heidemann LS, Menrath I
… +3 more, Bomba F, Thyen U, Ernst G
Z Kinder Jugendpsychiatr Psychother
· 2023 Jan · PMID 35510814
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Transition-oriented patient education program for adolescents and young adults with ADHD The transition from child- to adult-centered treatment includes numerous challenges in the treatment of chronic disorders. This p...Transition-oriented patient education program for adolescents and young adults with ADHD The transition from child- to adult-centered treatment includes numerous challenges in the treatment of chronic disorders. This process can be further complicated by disease-specific characteristics of attention-deficit/hyperactivity disorders (ADHD). This secondary analysis evaluated a transition workshop in individuals with ADHD. In total, 56 adolescents and young adults with ADHD (age = 17.3 years, = 1.1; 17.9 % female) and their parents were quasi-randomly assigned to a control group (CG, = 28) or an intervention group (IG, = 28). The CG received regular medical care, whereas the IG additionally participated in a one-and-a-half-day transition workshop (ModuS-T). Before and 4 weeks after the intervention, transition competence was assessed with the Transition Competence Scale (TKS), patient activation with the Patient Activation Measure 13 for Adolescents (PAM® 13), and satisfaction with care with the Patient Satisfaction Questionnaire (ZUF-8). The IG showed significantly improved transition competence ( .001) compared to the CG. There was no significant intervention effect in terms of patient activation ( = .194). Overall, the IG was highly satisfied with the workshop. To date, transition workshops have been evaluated predominantly in individuals with chronic somatic disorders. This secondary analysis indicates that a generic workshop is also associated with improved transition competence and high satisfaction in individuals with chronic mental disorders. The integration of such approaches into routine care needs to be discussed.
Kuitunen-Paul S, Rustler C, Lochbühler K
… +6 more, Teichmann M, Mühlig S, Rüther T, Roessner V, Smolka MN, Rabenstein A
Z Kinder Jugendpsychiatr Psychother
· 2023 Jan · PMID 35502525
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Non-smoker protection and tobacco cessation Whereas, on the one hand, employees in child and adolescent psychiatric institutions (CAP) have to enforce smoking bans among patients, on the other hand, they have a high li...Non-smoker protection and tobacco cessation Whereas, on the one hand, employees in child and adolescent psychiatric institutions (CAP) have to enforce smoking bans among patients, on the other hand, they have a high likelihood of being smokers themselves. Little data are available on the enforcement of smoking regulations and what cessation support is offered by CAP institutions. In an online survey, = 78 senior staff members or directors of German CAP institutions (41.9 % of all addressed CAP institutions) responded to questions on smoking regulations, exceptions, and cessation support for employees. The enforcement of comprehensive smoking bans is rarely reported (<20 % of CAP institutions). Employees are exempted or allowed to smoke mostly outside of the building (e. g., in designated smoking areas: 69-78 % depending on ward type). Cessation support was offered by less than half of the CAP institutions (47%). The data presented point toward future areas for tobacco control in CAP care, including transparent regulations, staff training, and dissemination of support for occupational smoking cessation.
Hähnle S, Fegert JM, König E
… +1 more, Hoffmann U
Z Kinder Jugendpsychiatr Psychother
· 2022 Jul · PMID 35481771
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Burnout Symptoms Among Child and Adolescent Psychiatric/Psychotherapy Professionals During the 2020/2021 Winter Lockdown of the Covid-19 Pandemic Professionals in clinics and Departments of Child and Adolescent Psychia...Burnout Symptoms Among Child and Adolescent Psychiatric/Psychotherapy Professionals During the 2020/2021 Winter Lockdown of the Covid-19 Pandemic Professionals in clinics and Departments of Child and Adolescent Psychiatry/Psychotherapy are often confronted with stress during their daily work. Such psychological pressure can cause stress symptoms such as burnout. This article examines the consequences of burnout symptoms at the institutional level, such as staff turnover. We examined the connection between burnout symptoms and the institutional consequences of presenteeism, absenteeism, turnover tendency, and reduced quality of job performance during the winter lockdown (2020/2021) of the Covid-19-pandemic at psychiatric hospitals or departments for children and adolescents in Germany using a sample of = 172 professionals. The results show that signs of burnout symptoms impact the turnover tendency, presenteeism, and job performance of professionals. In addition, evidence emerged that professionals were more stressed during the winter lockdown (2020/2021) of the Covid-19 pandemic, and that this influenced turnover tendency, presenteeism, and absenteeism as well as the quality of job performance. Work-related stress of professionals should be addressed early to protect clinics and departments for child and adolescent psychiatry/psychotherapy from potential consequences, and to ensure care connectivity and quality of care.
Della Casa A, Urben S, Hefti S
… +6 more, Wöckel L, Beutler H, Holzer L, Riedo V, Schimmelmann BG, Schmid M
Z Kinder Jugendpsychiatr Psychother
· 2023 Mar · PMID 35394364
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Questionnaire on Treatment Satisfaction in Inpatient Child and Adolescent Psychiatry (FBZ-KJP) - Results of a Swiss Pilot Study Patient satisfaction is an established indicator for medical interventions. Existing quest...Questionnaire on Treatment Satisfaction in Inpatient Child and Adolescent Psychiatry (FBZ-KJP) - Results of a Swiss Pilot Study Patient satisfaction is an established indicator for medical interventions. Existing questionnaires for the assessment of patient satisfaction in child and adolescent psychiatry are too global to target quality improvement in child and adolescent psychiatric hospitals. The assessment of patient satisfaction in child and adolescent psychiatry is very challenging because specific demands (development status, role of parents in treatment) have been taken into account. Therefore, an expert team leaded by the Swiss Society of Child and Adolescent Psychiatry developed a targeted instrument to assess patient satisfaction in both language regions (i. e., German and French). The article reviews the development of a new child and adolescent psychiatric questionnaire for the assessment of patient satisfaction as well as the findings of a survey conducted in a representative sample of 174 patients and 145 parents in six hospitals. The internal consistency (Cronbach's = .93) is excellent. The questionnaire has high levels of both convergence and face validity, and the correlation with the Client Satisfaction Questionnaire (CSQ-8) is = .80 (patient-report) and .83 (parent-report). Furthermore, this questionnaire reveals the relative strengths and weaknesses of individual hospitals. The correlation between patient and parent assessment is, as expected, moderate ( = .29, for the total score and = .39 for the CSQ-8). The Patient Satisfaction Questionnaire can be recommended to professionals as a standard for collecting data on client satisfaction within child and adolescent psychiatry.
Marckhoff M, Siebald M, Timmesfeld N
… +3 more, Janßen M, Romer G, Föcker M
Z Kinder Jugendpsychiatr Psychother
· 2022 Jul · PMID 35343802
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To describe the impact of the COVID-19 pandemic-related restrictions (PR) in April and May 2020 on physical activity (PA), sedentary screen time (SST), and mental well-being (MWB) in German adolescents, and to analyze as...To describe the impact of the COVID-19 pandemic-related restrictions (PR) in April and May 2020 on physical activity (PA), sedentary screen time (SST), and mental well-being (MWB) in German adolescents, and to analyze associations between these variables. The Münster District Government invited all secondary school students (aged 11-17) in the region to take part in the online survey that assessed PA, SST, and MWB. For data analysis, we calculated descriptive statistics and ran linear regression analysis. 1,038 students (627 [60.4%] female; 14.18 [± 1.97] years) were included in the analysis. During the PR, a marked decline in overall PA ( < .001) and a significant increase ( < .001) in SST were observed. One-third of the students reported worrying more and being less satisfied with their lives since PR. A decrease in life satisfaction (ß = -.524, < .001) as well as an increase in general worrying (ß = -.336, = .015) were associated with a decrease in PA during PR. The results show that the restrictions led to a decrease in physical activity, which may have detrimental effects on the students' mental and physical health.