Polytraumatization in young male refugees from the Middle East and its association with internalizing and externalizing symptoms.

BACKGROUND: Young Middle Eastern male refugees are currently among the most vulnerable groups in Europe. Most of them have experienced potentially traumatic events (PTEs) such as rape, torture, or violent assaults. Compared to their peers, young refugees suffer more from internalizing and externalizing symptoms, especially when unaccompanied. Little is known about the cumulative impact of experiencing different types of PTEs on mental health outcomes (polytraumatization) of young male refugees from the Middle East. We investigated (1) whether there is a dose-response relationship between multiple PTE types experienced and mental health outcomes, (2) whether individual types of PTEs are particularly important, and (3) to what extent these are differentially associated with mental health outcomes among unaccompanied or accompanied peers. METHODS: In total, 151 young Middle Eastern male refugees in Germany (Mage = 16.81 years, SDage = 2.01) answered questionnaires on PTEs, mental health, and post-migration stress. RESULTS: Hierarchical regression analyses revealed, while controlling for age, duration of stay, unaccompanied status, and post-migration stress, (1) a dose-effect between PTE types on both internalizing and externalizing symptoms. Moreover, (2) regarding internalizing symptoms, violent family separation and experiencing life-threatening medical problems were particularly crucial. The latter was driven by unaccompanied refugees, who also reported higher levels of substance use. CONCLUSIONS: The results extend findings from the literature and suggest that not only may greater polytraumatization be related to greater depression among refugees, but also to a range of other mental health outcomes from the internalizing and externalizing symptom domains. Furthermore, the results highlight the mental health risks that unaccompanied and accompanied refugee adolescents face after exposure to PTEs, and provide information for practitioners as well as researchers about event types that may be particularly relevant.

Research review: A meta-analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years.

BACKGROUND: Children younger than 7 years can develop mental disorders that might manifest differently than in older children or adolescents. However, little is known about the prevalence of mental disorders at this early age. METHODS: We systematically searched the literature in the databases Web of Science, PsycINFO, PSYNDEX, MEDLINE, and Embase to identify epidemiological studies of community samples published between 2006 and 2020. A series of meta-analyses was conducted to estimate the pooled worldwide prevalence of mental disorders in general, specific mental disorders, and comorbidity in young children. RESULTS: A total of ten epidemiological studies reporting data on N = 18,282 children (12-83 months old) from eight countries met the inclusion criteria. The pooled prevalence of mental disorders in general was 20.1%, 95% CI [15.7, 25.4]. Most common disorders were oppositional defiant disorder (4.9%, 95% CI [2.5, 9.5]) and attention-deficit hyperactivity disorder (4.3%, 95% CI [2.5, 7.2]). The prevalence of any anxiety disorders was 8.5%, 95% CI [5.2, 13.5], and of any depressive disorders was 1.1%, 95% CI [0.8, 1.6]. Comorbidity was estimated at 6.4%, 95% CI [1.3, 54.0]. CONCLUSIONS: The literature search reveals that the epidemiology of mental disorders in children younger than 7 years is still a neglected area of research. The findings also indicate that there are a significant number of young children suffering from mental disorders who need appropriate age-adapted treatment.

Systematic review showed that low and moderate prenatal alcohol and nicotine exposure affected early child development.

AIM: We systematically reviewed the literature on the influence of low and moderate amounts of prenatal alcohol and nicotine exposure on early child development. This paper also suggests possible directions for future research in order to tackle the controversial findings identified. METHODS: The PubMed and Web of Science electronic databases were searched together with the reference lists of the selected papers. Empirical studies were included if they focused on the effects of low or moderate exposure, reported outcomes on child development within the first 2 years of life and were published in English between January 2009 and December 2019. The eligibility of the included studies was based on three authors reading the full text. RESULTS: The final sample comprised 17 papers. Of these, 13 focused on the effects of prenatal alcohol exposure and they reported decreased sensory sensibility, smaller body sizes and increased cognitive capacities. The other four looked at prenatal nicotine exposure, and they primarily found impairments in children's orienting, communication and motor skills. CONCLUSION: Any amount of prenatal alcohol and nicotine exposure appeared to risk healthy child development. There were many reasons for consumption and numerous effects on the child, but representative data from interdisciplinary research were missing.

Emotion regulation strategies predict weight loss during an inpatient obesity treatment for adolescents.

OBJECTIVE: Weight loss during an inpatient obesity treatment is an important predictor of subsequent weight maintenance. However, psychological factors influencing weight loss are not well established. Psychological models suggest some importance of executive functioning and emotion regulation strategies. Therefore, this study investigated whether these factors predict weight loss during an inpatient obesity treatment and whether this effect holds after controlling for general personal and treatment characteristics. METHOD: A total of 158 adolescents with diagnosed obesity underwent inpatient obesity treatment at a German rehabilitation clinic. Psychological factors (executive functioning and emotion regulation) were measured at admission and used to predict BMI reduction after treatment completion. RESULTS: More frequent use of reappraisal as an emotion regulation strategy, but not suppression or executive functioning, predicted weight loss at the end of the obesity treatment, even after controlling for age, gender, treatment duration, and BMI at admission. CONCLUSION: Functional emotion regulation strategies, like reappraisal, might offer an additional target for obesity treatment programmes, complementary to the more traditional components of psychoeducation, physical activity, and caloric restriction.

Influence of executive functions on the self-reported health-related quality of life of children with ADHD.

PURPOSE: ADHD is regarded as a neurodevelopmental disorder associated with deficits in executive functions (EF). The presence of these deficits is associated with increased symptom severity. However, so far there is little knowledge, whether deficits in EFs relate to a reduced health-related quality of life (HRQoL) in children with ADHD. METHODS: Hence, n = 100 children with a confirmed ADHD diagnosis were compared with a non-cases group (n = 100) with regard to their HRQoL (6-12 years old). The clinical group was divided into ADHD-specific drug treatment intake (drug treatment: n = 42; no drug treatment: n = 58) or deficits in EF (n = 29; no deficits in EF: n = 71). RESULTS: Children with ADHD (without medication) reported a significantly worse HRQoL than healthy children (d = .72), when controlled for age and sex. Even if they were treated with drug treatment, they reported a lower HRQoL than the non-case group in the area Family (d = .53). Drug treatment of ADHD leads to a significant difference in HRQoL in school area (d = .39). Children with ADHD and EF problems reported impairments in the social context of HRQoL compared to healthy children (d = .51 to .70). In addition, a significant negative association between set-shifting and HRQoL in children with ADHD (without drug treatment) was demonstrated (r = - .27 to r = - .35). CONCLUSIONS: By assessing the HRQoL, an impairment in the functioning of children with ADHD can be detected, which is essential for the diagnosis. Furthermore, executive problems have an influence on the social sphere, which should be clarified and improved in therapy with the involvement of parents.

Executive functions and intelligence from the CHC theory perspective: Investigating the correspondence between the WAIS-IV and the NAB Executive Functions Module.

Substantial overlap between executive functions (EFs) and intelligence has been reported. Yet further research is required with respect to how the specific components of the two constructs are interrelated. The present study was aimed at exploring the relationship between EFs and intelligence by examining the latent structure of the Wechsler Adult Intelligence Scale (WAIS-IV) and the Executive Functions Module from the Neuropsychological Assessment Battery (NAB). The aim was also to test the correspondence of the two measures to the Cattell-Horn-Carroll (CHC) theory. 205 healthy participants, aged 18-89 years, were administered the NAB and WAIS-IV. Confirmatory factor analysis (CFA) was employed to explore the latent constructs underlying the two test batteries. Models based on the current WAIS-IV index structure showed worse model fit than models based on the CHC theory. In particular, factors representing broad CHC abilities comprehension knowledge (Gc), fluid reasoning (Gf), visual processing (Gv), processing speed (Gs), and working memory capacity (Gwm) proved model fit improvement. The best model fit, however, provided a five-factor model combining the Gf and Gwm abilities into one factor and additionally including a retrieval fluency (Gr) factor. The results demonstrate strong relationships between the WAIS-IV and the NAB Executive Functions Module and suggest substantial overlap between EFs and intelligence within the CHC framework. Nevertheless, according to the recent update of the CHC theory, the NAB fluency tasks may represent a distinct EF factor comprising Gr abilities independent from the WAIS-IV.

Measurement Invariance Across Gender on the Second-Order Five-Factor Model of the German Wechsler Intelligence Scale for Children-Fifth Edition.

The present study investigated measurement invariance across gender on the German Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V). The higher order model that was preferred by the test publishers was tested on a population-representative German sample of 1,411 children and adolescents aged between 6 and 16 years. Confirmatory factor analyses were conducted to test for measurement invariance. As soon as partial scalar invariance could be established by freeing nonequivalent subtest intercepts, results demonstrated that 11 out of 15 subtest scores have the same meaning for male and female children. These findings support interpretable comparisons of the WISC-V test scores between males and females but only in due consideration of partial scalar invariance and with respect to the underlying factor structure. Despite this, however, results did not support the overall structural validity of the higher order model. Thus, replacing the former Perceptual Reasoning factor by Fluid Reasoning and Visual Spatial may be considered inappropriate due to the redundancy of the FRI as a separate factor. Results also indicated that the WISC-V provides stronger measurement of general intelligence (Full Scale IQ) than measurements of cognitive subdomains (WISC-V indexes). Interpretative emphasis should thus be placed on the Full Scale IQ rather than the WISC-V indexes.

Neuropsychological Measures in the Diagnosis of ADHD in Preschool: Can Developmental Research Inform Diagnostic Practice?

Objective: The diagnosis of ADHD in preschool is challenging. Behavioral ratings are less reliable, but the value of neuropsychological tests in the diagnosis of ADHD has been debated. Method: This article provides an overview of neuropsychological measures utilized in preschoolers with ADHD (3-5 years). In addition, the manuscript discusses the extent to which these measures have been tested for their diagnostic capacity. Results: The diagnostic utility of computerized continuous performance tests and working memory subtests from IQ-batteries has been demonstrated in a number of studies by assessing their psychometric properties, sensitivity, and specificity. However, findings from developmental and basic research attempting to describe risk factors that explain variance in ADHD show the most consistent associations of ADHD with measures of delay aversion. Conclusion: Results from developmental research could benefit studies that improve ADHD diagnosis at the individual level. It might be helpful to consider testing as a structured situation for behavioral observation by the clinician.

Sex Similarities and Differences in Intelligence in Children Aged Two to Eight: Analysis of SON-R 2-8 Scores.

The aim of this study was to investigate sex similarities and differences in visuospatial and fluid abilities and IQ scores based on those abilities in children aged two to eight. Standardization data from the Snijders-Oomen Nonverbal Intelligence Test for Children aged 2-8 (SON-R 2-8) were used. A representative sample composed of 965 children from the Netherlands and 762 children from Germany was examined. Small but significant mean sex differences favoring girls were observed until age four. At ages six and seven, boys achieved similar cognitive development levels to girls regarding all abilities assessed and outperformed girls on the Mosaics subtest measuring visuospatial cognition. Boys also displayed higher variability rates in performance. The distribution of IQ scores, with the overrepresentation of girls scoring above mean and the overrepresentation of boys scoring below mean in early childhood, altered with age towards parity between the sexes. The results suggest that girls tend to mature earlier with respect to cognitive abilities. During the course of development, however, the differences between girls and boys may become negligible.

[Applicability of the SON-R 2-8 in Children with Special Educational Needs and Children with German as a Second Language]. / Zur Aussagekraft des SON-R 2-8 bei Kindern mit kognitiven Auffälligkeiten und Kindern mit Deutsch als Zweitsprache.

Applicability of the SON-R 2-8 in Children with Special Educational Needs and Children with German as a Second Language The SON-R 2-8 is an intelligence test that allows a non-verbal assessment of the general cognitive abilities of children with difficulties or limitations in the field of speech and language development and communication. The validity of the SON-R 2-8 in children with cognitive impairments and children with German as a second language is examined with matched groups. It is shown that the SON-R 2-8 can differentiate well between normal children and cognitive impaired children and is suitable for use in children with German as a second language.

Contingent negative variation in acute trauma patients: A prospective exploratory study.

It is still unclear why some individuals completely recover after an acute trauma and others develop a long-lasting post-traumatic stress disorder (PTSD). This study investigates whether the contingent negative variation (CNV) - a slow negative event-related potential - may be associated with the occurrence of PTSD after acute trauma. CNV (auditory 2-stimulus reaction time paradigm) was recorded within one month as well as 6 months after an acute trauma (dangerous or grave physical injuries, witnessing of attempted suicide or murder, robbery, extortion, accidents, heavy illness, death or loss of an important person, hostage-taking) in 39 otherwise healthy adults and compared with CNV recordings in 38 healthy control subjects without potentially traumatizing experience in their history. According to their subsequent clinical course, these subjects were divided into two groups: participants who recovered completely 1 month after the trauma (PTSD- group, n = 31), and those who began to experience PTSD (PTSD+ group, n = 8). Patients from both trauma groups were characterized by a significantly longer reaction time immediately after the trauma. The PTSD+ group demonstrated lower amplitudes of the late CNV component immediately and six months after the trauma compared with the PTSD- and the control group. Whether the lower CNV amplitudes in patients who develop PTSD after the acute trauma, which is already present in the first days after the trauma, may be related to a higher risk for development of PTSD in these subjects, this has to be clarified in further prospective studies.

Posttraumatic Stress Disorder in Very Young Children: Diagnostic Agreement Between ICD-11 and DSM-5.

The prevalence of posttraumatic stress disorder (PTSD) in very young children depends on the diagnostic criteria. Thus far, studies have investigated the International Classification of Diseases (11th rev.; ICD-11) criteria for PTSD only in samples of children older than 6 years of age. The aim of this study was to test the diagnostic agreement between the ICD-11 and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for children who are 6 years old and younger. Caregivers of children aged 3-6 years in foster care in Germany (N = 147) and parents of children aged 1-4 years who had attended a hospital in Switzerland following burn injuries (N  = 149) completed a questionnaire about children's PTSD. Rates of PTSD were calculated according to ICD-11 (considering a specific and a more general conceptualization of intrusive memories) and DSM-5 criteria and were compared using McNemar's tests and Cohen's kappa. The proportion of children who met the ICD-11 criteria was 0.6-25.8% lower than the proportion of PTSD cases according to the DSM-5 criteria. The diagnostic agreement between each ICD-11 algorithm and DSM-5 was moderate, κ = 0.52-0.66. A systematic investigation of adaptions of the ICD-11 avoidance cluster identified alternative symptom combinations leading to higher agreement with the DSM-5 requirements. Furthermore, DSM-5 had higher predictive power for functional impairment than the ICD-11 algorithms. In conclusion, the findings suggest that the ICD-11 criteria show less sensitivity in very young children, which can be explained by the more stringent avoidance cluster.

A Brief Introduction to the Multidimensional Intercultural Training Acculturation Model (MITA) for Middle Eastern Adolescent Refugees.

The large number of adolescent refugees around the world constitutes a great challenge for societies. However, current models of acculturation have been developed for migrants, but not specifically for adolescent refugees. Crucial factors to describe adolescent refugee acculturation, such as intentions to return to their homeland, especially with respect to adolescent refugees with temporary residency and experiences of potentially traumatic events, are missing. Hence, the Multidimensional Intercultural Training Acculturation (MITA) model is introduced. The model proposes that two major concerns for adolescent refugees, which are socio-cultural adjustment and mental health, are predicted by intercultural and social⁻emotional competence, intentions to return to their homeland, and experiences of traumatic events. Moreover, the effects of three modes of acculturation are also proposed in the model. It is expected that these variables mediate the effects of intercultural competence, social⁻emotional competence, intentions to return to the homeland, and experiences of traumatic events on socio-cultural adjustment as well as mental health. Finally, it is also expected that in-group social support and out-group social support moderate the direct connection between the experiences of traumatic events and mental health.

Innate or Acquired? - Disentangling Number Sense and Early Number Competencies.

The clinical profile termed developmental dyscalculia (DD) is a fundamental disability affecting children already prior to arithmetic schooling, but the formal diagnosis is often only made during school years. The manifold associated deficits depend on age, education, developmental stage, and task requirements. Despite a large body of studies, the underlying mechanisms remain dubious. Conflicting findings have stimulated opposing theories, each presenting enough empirical support to remain a possible alternative. A so far unresolved question concerns the debate whether a putative innate number sense is required for successful arithmetic achievement as opposed to a pure reliance on domain-general cognitive factors. Here, we outline that the controversy arises due to ambiguous conceptualizations of the number sense. It is common practice to use early number competence as a proxy for innate magnitude processing, even though it requires knowledge of the number system. Therefore, such findings reflect the degree to which quantity is successfully transferred into symbols rather than informing about quantity representation per se. To solve this issue, we propose a three-factor account and incorporate it into the partly overlapping suggestions in the literature regarding the etiology of different DD profiles. The proposed view on DD is especially beneficial because it is applicable to more complex theories identifying a conglomerate of deficits as underlying cause of DD.

Are core self-evaluations a suitable moderator in stressor-detachment relationships? A study among managers' perceived job demands, detachment and strain reactions.

BACKGROUND: The relationships among job demands, personality factors, recovery and psychological health receive increasing attention but are not well understoodOBJECTIVE:Therefore, the present study tests moderating effects among a sample of managers as proposed by the stressor-detachment model. We aimed to determine whether core self-evaluations (CSE) had an influence on the correlations between detachment and strain reactions (depressive symptoms, irritation, exhaustion) and between job demands and detachment. Further, we tested whether detachment attenuates the positive relation between job demands and strain reactions. METHODS: A convenience sample of managers in three German settings (N = 282) participated in the cross-sectional study. RESULTS: Results based on hierarchical regression analysis showed that high CSE significantly weakened the negative relationship between detachment and depressive symptoms in this sample. However, CSE did not moderate the negative relationship between job demands and detachment. Moreover, results revealed that detachment moderated the positive relation between job demands and exhaustion. CONCLUSIONS: The authors tested whether CSE was able to moderate the relationship between job demands, psychological detachment and different stress reactions. Although we found a significant interaction effect, CSE may be too distal to moderate all respective associations.

Intraindividual Variability in Executive Function Performance in Healthy Adults: Cross-Sectional Analysis of the NAB Executive Functions Module.

The current study was aimed at investigating across-tasks intraindividual variability, also termed dispersion, in EF performance. The German adaptation of the Neuropsychological Assessment Battery (NAB) was used as a measure of EFs. Data of 444 participants aged 18-99 from six NAB Executive Functions Module subtests (i.e., Planning, Mazes, Letter Fluency, Judgment, Categories, and Word Generation) along with the NAB Total Index score as a measure of overall cognitive ability were analyzed. Maximum discrepancy (MD) was applied as a measure of dispersion. MD values ranged from 0.47 to 5.20 indicating substantial across-tasks dispersion in EF performance. Furthermore, dispersion moderately decreased with advancing age. Taking overall cognitive ability into account revealed that dispersion might be lower at older ages; especially, when associated with low overall ability levels. The dedifferentiation hypothesis offers a plausible explanation for these findings. That is, the cognitive profiles of older people might be less heterogenous than that of younger people, which may be due to age-related central nervous system constraints.

["How Beautiful Must I be?"- Physical Attractiveness and Mental Health in Adolescents]. / "Wie schön muss ich sein?" ­ Körperliche Attraktivität und psychische Gesundheit bei Jugendlichen.

"How Beautiful Must I be?"- Physical Attractiveness and Mental Health in Adolescents Physical attractiveness is a high priority for young people. The beauty ideals and presentations spread in the media often reinforce self-doubt and self-insecurity. In 730 adolescents (age 13 to 20 years) it was measured, how they experience appearance-related social pressure (FASD), the extent to which physical deficits are perceived (BDDQ), and how these features are related to mental symptoms (SDQ). The results demonstrate that young people are very concerned about their appearance (30.7 %) and are overly concerned with perceived physical defects (29.5 %). In addition, there is a strong appearance-related social pressure through peers and parents. The young people particularly affected in these areas report more emotional and behavioral problems. The results suggest that attention should be given to physical self-assessment as an important factor in diagnosis and therapy.

[Gender-specific Differences in the Degree of Burden on Children and Adolescents Taken into Custody]. / Geschlechtsspezifische Unterschiede im Belastungsausmaß bei in Obhut genommenen Kindern und Jugendlichen (§42, SGB VIII).

Gender-specific Differences in the Degree of Burden on Children and Adolescents Taken into Custody Children and adolescents who were taken into care are a high-risk group for mental disorders such as externalizing problems or conduct disorders. 95 children and adolescents who were taken into care were tested with the Screening Child Trauma Questionnaire (CTQ) and the Massachusetts Youth Screening Instrument 2 (MAYSI-2). In a large proportion of those children and adolescents emotional and physical neglect and abuse was identified. There were sex differences in suicidal thoughts, somatoform disorders, and emotional abuse. The knowledge of mental disorders as well as the gender-specific characteristics is important for specialists of inhospital institutions, in order to optimize their quality of care.

[Mental health of preschool foster care children: How do foster families influence the way children cope with trauma?] / Psychische Gesundheit von Pflegekindern im Vorschulalter: Wie stark hängt die Bewältigung traumatischer Erfahrungen von der Pflegefamilie ab?

Mental health of preschool foster care children: How do foster families influence the way children cope with trauma? Abstract. Parents and other significant persons have an important role when preschool children develop or cope with psychological symptoms following traumatic experiences. The underlying mechanisms of the interaction between traumatic experiences and influences of the foster family are still unclear. This study investigates foster parents' stress levels and parenting styles as moderators or mediators in the context of trau- matic experiences. Foster parents of 286 children between three and seven years participated in an online or paper-and-pencil survey. The results suggest a connection between the traumatic experiences of foster children and the stress levels as well as the parenting styles of their foster parents. While verbosity and laxness as parenting styles moderated the impact of traumatic experiences on externalising symptoms, stress levels mediated the impact of traumatic experiences on children's internalising and externalising symptoms. The results underscore the necessity of standardized preparation of and support for foster parents in order to avoid deterioration of psychological symptoms following traumatic events.