[Epistemological Misunderstandings of the German Federal Court of Justice in Criminal Cases Regarding the Null Hypothesis: Verification in the Credibility Assessment]. / Wissenschaftstheorethische Missverständnisse des BGH in Strafsachen.

Epistemological Misunderstandings of the German Federal Court of Justice in Criminal Cases Regarding the Null Hypothesis: Verification in the Credibility Assessment Abstract: Background: The article deals with the decision of the German Federal Court of Justice (Bundesgerichtshof, BGH) in criminal matters regarding credibility assessment dated 30 July 1999 (1 StR 618/98, BGHSt 45, 164). Regarding criminal matters, the BGH formulated specific requirements for credibility assessments based on two published scientific expert reports. Method: We analyzed conflicting postulates of scientific theory in the expert reports and the reception of these principles in the BGH judgment by examining the original quotes. Results: Given the central importance of this BGH decision, we analyzed the original expert reports for their epistemological content. The BGH formulated the scientific approach of starting from the assumption that the statement is untrue - the so-called "null hypothesis". In doing so, it referred to Popper's deductivism, albeit without addressing the rules of hypothesis testing. Based on the second expert report, which argues for inductive.

Agreement for posttraumatic stress symptoms among unaccompanied young refugees and professional caregivers.

Background: Prevalence rates for posttraumatic stress symptoms (PTSS) in unaccompanied young refugees (UYRs) are high. Research with biological parents indicates low agreement rates between self and caregiver reports for PTSS, although caregivers play an important role as gatekeepers to ensure appropriate treatment.Objective: This study examines youth and caregiver agreement on the endorsement of different trauma types, the PTSS severity score and symptom clusters, as well as the potential association between youth factors (age, comorbidity, and duration in facility) and disagreement.Method: The sample consisted of N = 610 UYRs, aged M = 16.75 (SD = 1.33, range: 12-20) years. Of these, 91.0% were male, and 43.4% were from Afghanistan, currently residing in German children and youth welfare facilities.Results: Agreement rates across trauma types were poor (accidental trauma: Cohen's k = .13; community violence: Cohen's k = .07; domestic violence: Cohen's k = .19; sexual abuse: Cohen's k = .38). Agreement rates for the PTSS severity score (ICC = .22) and symptom clusters were poor (re-experiencing: ICC = .27; avoidance: ICC = .02; negative alterations in cognitions and mood ICC = .12; hyperarousal: ICC = .25), with youth reporting significantly higher scores. Regression models showed that having comorbid symptoms and a shorter duration in the facility were associated with higher disagreement at the PTSS severity score (Adjusted -R2 = .21) and across symptom clusters (re-experiencing: Adjusted -R2 = .13; avoidance: Adjusted -R2 = .07; negative alterations in cognitions and mood: Adjusted -R2 = .16; hyperarousal: Adjusted- R2 = .16). Age was not significantly associated with disagreement rates.Conclusion: It is important to enhance the awareness and comprehension of caregivers regarding recognition of mental illnesses and their symptoms as well as assessing mental health among UYRs.

Agreement rates between unaccompanied young refugees and their professional caregivers on the endorsement of different trauma types were poor.Agreement rates for the posttraumatic stress symptom severity score and the respective symptom clusters were poor.Factors associated with higher disagreement on the posttraumatic stress symptom severity score and across symptom clusters were mental health comorbidity and a shorter duration in the facility.

New norm values of the brief resilience scale (BRS) from the German general population with new post-COVID-19 data.

BACKGROUND: The concept of psychological resilience has spurred extensive research across various fields, with the Brief Resilience Scale (BRS) emerging as a concise tool to measure an individual's ability to rebound from stress. It has been translated into multiple languages, including German, but the validation of the German version occurred prior to the COVID-19 pandemic. Therefore, the main objective of this study was to examine new norm values and psychometric properties of the BRS. METHODS: Norm values, the factor structure, reliability and validity of the BRS were examined using data from a representative survey of the German general population (N = 2522). RESULTS: The results indicated that the method-factor model showed the best fit, suggesting a nuanced understanding of resilience beyond a single-factor approach. The BRS demonstrated good convergent and discriminant validity based on both latent and manifest correlations. Moreover, the study revealed increasing postpandemic resilience scores. CONCLUSIONS: The results of this study provide support for the psychometric reliability and validity of the German version of the BRS after the COVID-19 pandemic and underscore the importance of assessing resilience amidst evolving societal challenges and highlight the need for further exploration in diverse populations.

Trajectories of mental health problems in unaccompanied young refugees in Germany and the impact of post-migration factors - a longitudinal study.

Unaccompanied young refugees (UYRs) are at an elevated risk of continuing psychological distress, including posttraumatic stress symptoms (PTSS), depression, and anxiety. The post-arrival situation in a host country plays an important role in increasing or reducing mental health risks for UYRs. This study aimed to examine the trajectory of psychological distress and post-migration factors experienced by UYRs in Germany with five assessments every six months over a two-year period.Standardised self-report questionnaires were used to assess PTSS (CATS-2), depression (PHQ-9), and anxiety (GAD-7) symptoms. Material and social stressors (DSSYR), sociocultural adjustment (BSAS), frequency of contact with family members, and distress regarding asylum status were included as post-migration factors. N = 131 UYRs (Mage = 17.04; SDage = 1.46; 81.1% male) living in residential care facilities in Germany were included in this study. There was a significant loss to follow up with n = 77 after 12 months at T2 (59% attrition), and n = 37 after 24 months at T4 (28% attrition).At baseline, clinically relevant symptom scores were found in 48.1% for PTSS, 42.0% for depression, and 22.9% for anxiety. Analysis of latent growth curve models revealed that the symptom severity of depression and anxiety did not change substantially over one year, but PTSS showed a significant decline. The number of traumatic events affected initial levels of mental health problems but not their trajectory over time. The impact of post-migration factors varied between measurement points and outcome measures and did not result in a homogeneous pattern.Despite limitations, this study demonstrated the persistence of high levels of psychological distress in UYRs. Effective interventions are required at an early stage to prevent chronic trajectories and support systems should adapt to constantly changing circumstances.Trial registration number/date of registration: DRKS00017453/11th December 2019.

Feasibility of a trauma-focused internet- and mobile-based intervention for youth with posttraumatic stress symptoms.

Background: Many youth with posttraumatic stress symptoms (PTSS) do not receive evidence-based care. Internet- and Mobile-Based Interventions (IMIs) comprising evidence-based trauma-focused components can address this gap, but research is scarce. Thus, we investigated the feasibility of a trauma-focused IMI for youth with PTSS.Methods: In a one-arm non-randomized prospective proof-of-concept study, 32 youths aged 15-21 years with clinically relevant PTSS (CATS ≥ 21) received access to a trauma-focused IMI with therapist guidance, comprising nine sessions on an eHealth platform accessible via web-browser. We used a feasibility framework assessing recruitment capability, sample characteristics, data collection, satisfaction, acceptability, study management abilities, safety aspects, and efficacy of the IMI in PTSS severity and related outcomes. Self-rated assessments took place pre-, mid-, post-intervention and at 3-month follow-up and clinician-rated assessments at baseline and post-intervention.Results: The sample mainly consisted of young adult females with interpersonal trauma and high PTSS levels (CATS, M = 31.63, SD = 7.64). The IMI sessions were found useful and comprehensible, whereas feasibility of trauma processing was perceived as difficult. Around one-third of participants (31%) completed the IMI's eight core sessions. The study completer analysis showed a significant reduction with large effects in self-rated PTSS at post-treatment [t(21) = 4.27; p < .001; d = 0.88] and follow-up [t(18) = 3.83; p = .001; d = 0.84], and clinician-rated PTSD severity at post-treatment [t(21) = 4.52; p < .001; d = 0.93]. The intention-to-treat analysis indicated significant reductions for PTSS at post-treatment and follow-up with large effect sizes (d = -0.97- -1.02). All participants experienced at least one negative effect, with the most common being the resurfacing of unpleasant memories (n = 17/22, 77%).Conclusion: The study reached highly burdened young adults. The IMI was accepted in terms of usefulness and comprehensibility but many youths did not complete all sessions. Exploration of strategies to improve adherence in trauma-focused IMIs for youth is warranted, alongside the evaluation of the IMI's efficacy in a subsequent randomized controlled trial.

Youth often lack access to evidence-based care after trauma. This study assessed the feasibility of a trauma-focused internet- and mobile-based intervention with therapist guidance.The intervention was accepted by youths, and the preliminary evaluation of participant responses suggests its efficacy.Future studies should examine strategies to improve adherence and the IMI's efficacy in a RCT.

The prevalence of misophonia in a representative population-based survey in Germany.

PURPOSE: Misophonia is a new disorder, currently defined as significant emotional and physiological distress when exposed to certain sounds. Although there is a growing body of literature on the characteristics of the disorder, the prevalence in the general population is still relatively unknown. This study therefore aims at determining the prevalence and symptom severity of misophonia in a large and representative general population sample in Germany. METHODS: To examine the prevalence of misophonic sounds, misophonic reactions and misophonia severity, a cross-sectional population representative survey in Germany has been conducted. Participants (N = 2.522) were questioned retrospectively about misophonic symptoms using the Amsterdam Misophonie Scale - Revised (AMISOS-R). RESULTS: Overall 33.3% reported to be sensitive to at least one specific misophonic sound. Within the total sample, subthreshold symptoms were reported by 21.3%, mild symptoms were reported by 9.9%, moderate to severe symptoms were reported by 2.1%, and severe to extreme symptoms were reported in 0.1% of participants. CONCLUSION: Based on the diverging presentations and prevalence rates of misophonic sounds, reactions and symptoms according to the severity, it seems worthwhile to conceptualize misophonia as a rather continuous spectrum disorder (subthreshold, mild, moderate to severe), still taking into account that an additional categorical diagnostic approach might be necessary to derive a diagnosis in clinical practice.

Corrigendum: Epistemic trust and personality functioning mediate the association between adverse childhood experiences and posttraumatic stress disorder and complex posttraumatic stress disorder in adulthood.

[This corrects the article DOI: 10.3389/fpsyt.2022.919191.].

Health behavior and psychological treatment utilization in adults with avoidant/restrictive food intake disorder symptoms.

BACKGROUND: Avoidant/restrictive food intake disorder (ARFID), an eating disorder not associated with weight and shape concerns, results in nutrient or energy deficiencies related with further health consequences and a pronounced need for specialized treatment. These interventions need to be tailored to individual health behavior. However, research about health behavior and treatment utilization in ARFID is scarce, particularly in adults, as ARFID is more common in children despite occurring across the lifespan. One important aspect of health behavior is the individual's health regulatory focus (i.e., health prevention and health promotion). Additionally, symptoms of eating disorders have generally been associated with various health risk behaviors, such as smoking, drinking, or unhealthy physical (in)activity. Therefore, the present study aimed to investigate health behavior and psychological treatment utilization in adults with symptoms of ARFID. METHODS: A representative adult population sample (N = 2415) completed several self-report questionnaires assessing symptoms of eating disorders and health behavior. Differences between groups (symptoms of ARFID vs. no symptoms of ARFID) were tested with analysis of variance, Mann-Whitney-U-tests, and binary logistic regression. RESULTS: Individuals with symptoms of ARFID (n = 20) did not differ in their health regulatory focus, smoking status, physical activity or psychological treatment utilization from individuals without symptoms of ARFID (n = 2395). However, they reported higher alcohol misuse than individuals without symptoms of ARFID. CONCLUSION: The findings suggest a relevance of further exploration of the relationship between alcohol misuse and ARFID, given the preliminary nature of these results. This exploration could inform treatment strategies for addressing potential comorbid substance misuse. Furthermore, the low psychological treatment utilization in adults with symptoms of ARFID suggest a need for more specialized psychological treatment services, public education about ARFID being an indication for psychological treatment, and further research about treatment barriers.

Avoidant/restrictive food intake disorder (ARFID), an eating disorder not associated with body image or weight concerns, results in nutrient or energy deficiencies related with further health consequences. It is most common in children, but can occur across the lifespan, although there is little research in adults. Therefore, the study investigated if adults with symptoms of ARFID differ from adults without symptoms of ARFID in health behaviors. A total of 2415 adults from a German national population sample completed questionnaires assessing symptoms of ARFID, health regulatory focus (health promotion focus with the aim of improving one's health and health prevention focus aiming to avoid any deterioration in health), alcohol misuse, smoking behavior, physical activity and psychological treatment utilization. Adults with symptoms of ARFID did not differ from those without symptoms of ARFID in treatment utilization or any of the assessed health behaviors except reporting higher alcohol misuse. We, therefore, suggest to further explore potential alcohol misuse in individuals with ARFID. Furthermore, more research about treatment barriers in ARFID and more specialized psychological treatment services as well as public education about ARFID being an indication for psychological treatment, are needed to address the low psychological treatment utilization.

Evaluation of "Cognitive Behavioral Intervention for Trauma in Schools" (CBITS) in child welfare programs in Germany: study protocol of a randomized controlled trial.

BACKGROUND: Children and adolescents growing up in child welfare institutions have been frequently exposed to traumatic events and psychosocial stress and show elevated rates of mental disorders. Yet, there is a lack of empirically supported treatments to provide adequate mental health care for children in care suffering from trauma-related mental disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is an evaluated trauma-focused cognitive-behavioral group intervention, which has proven to be effective in reducing symptoms of PTSD, depression, and anxiety for traumatized children in group settings. The trial will evaluate the effectiveness of the CBITS intervention as an outreach treatment compared with an enhanced treatment-as-usual condition (TAU +) within the German mental health and child welfare system. METHODS: In a randomized controlled trial (RCT) involving N = 90 children and adolescents, we will compare CBITS with TAU + . Participants between 8 and 16 years, reporting at least one traumatic event and moderate posttraumatic stress symptoms (PTSS), will be randomized within their child welfare institution to either one of the conditions using a CATS-2 severity-stratified block randomization. Assessments will take place at baseline, as well as 4 months and 10 months after baseline. The primary outcome is the severity of PTSS after 4 months. Secondary outcomes are depression, anxiety, irritability/anger, quality of life, and global functioning level. DISCUSSION: The results of our trial will provide evidence regarding effective treatment options for traumatized children in care, which represent an understudied population with limited access to mental health care. Additionally, it could serve as a blueprint for implementing trauma-focused outreach group treatments for children in care and increase the accessibility to appropriate treatment. TRIAL REGISTRATION: Clinical Trials.gov NCT06038357 D. September 13, 2023.

Development and validation of the caregiver-report version of the international depression questionnaire (IDQ-CG) and international anxiety questionnaire (IAQ-CG).

The International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ) are self-report measures of ICD-11 single episode depressive disorder (DD) and generalised anxiety disorder (GAD). The present study sought to describe the development and psychometric evaluation of the caregiver-report versions of the IDQ and IAQ for children, referred to as the IDQ-CG and IAQ-CG, respectively. Participants were 639 parents living in Ukraine who provided data on themselves and one child in their household as part of "The Mental Health of Parents and Children in Ukraine Study: 2023 Follow-up" study. The latent structure of the IDQ-CG and IAQ-CG were tested using confirmatory factor analysis (CFA), composite reliability (CR) estimates were estimated, and convergent validity was assessed. Prevalence rates of probable ICD-11 DD and GAD were also estimated. CFA results indicated that the IDQ-CG and IAQ-CG were unidimensional, while the internal reliability of both scales was excellent. Convergent validity was established via associations with external measures of internalizing, externalizing, and attention problems as well as trauma exposure. Factors associated with increased IDQ-CG and IAQ-CG scores included pharmacological support for emotional or behavioural problems, delayed milestone development, being forced to move to another part of Ukraine, serious life disruption due to the war, and having experienced a bereavement. Of the total sample, 1.6% met diagnostic requirements for ICD-11 DD and 5.8% met diagnostic requirements for ICD-11 GAD. This study supports the psychometric properties of the IDQ-CG and IAQ-CG. These measures can be effectively used to identify young people in need of mental health support.

Utilization of Mental Health Provision, Epistemic Stance and Comorbid Psychopathology of Individuals with Complex Post-Traumatic Stress Disorders (CPTSD)-Results from a Representative German Observational Study.

Background: Complex post-traumatic stress disorder (CPTSD) is a severely debilitating recently added symptom cluster in the International Classification of Diseases (ICD-11). So far, only limited information on mental health treatment-uptake and -satisfaction of individuals with CPTSD is available. The aim of this study is to investigate these aspects in a representative sample of the German general population. Methods: Participants completed the International Trauma Questionnaire (ITQ) to identify participants with CPTSD, as well as questionnaires on mental health treatment uptake and satisfaction, adverse childhood experiences, anxiety, depression, working ability, personality functioning, and epistemic trust. Results: Of the included n = 1918 participants, n = 29 (1.5%) fulfilled the criteria for CPTSD. Participants with CPTSD had received mental health treatment significantly more often than participants with PTSD or depression (65.5% vs. 58.8% vs. 31.6%; p = 0.031) but reported significantly less symptom improvement (52.9% vs. 78.0% vs. 80.0%; p = 0.008). Lower levels of epistemic trust were associated with higher CPTSD symptoms (p < 0.001). Conclusions: Our study shows that while the vast majority of individuals with CPTSD had received mental health treatment, subjective symptom improvement rates are not satisfactory. CPTSD was associated with a broad number of comorbidities and impairments in functioning. Lower levels of epistemic trust may partially explain worse treatment outcomes.

Aktueller Stand der Interkulturellen Öffnung der psychiatrischpsychotherapeutischen Versorgung von Kindern und Jugendlichen aus Sicht von Fachkräften / The Current Status of the Intercultural Opening of the Psychiatric-Psychotherapeutic Care for Children and Adolescents from the Perspective of Professionals.

The Current Status of the Intercultural Opening of the Psychiatric-Psychotherapeutic Care for Children and Adolescents from the Perspective of Professionals Children and adolescents with a migration background have a high demand for psychiatricpsychotherapeutic care in Germany. Nevertheless, they often do not receive the care needed, despite the Intercultural Opening, which aims at adjusting the services to their needs.The aim of the study is to get insights in the current status of the Intercultural Opening of the psychiatric- psychotherapeutic care system by examining the perspectives and needs of the staff working with this vulnerable population. A sample of N = 232 pedagogical and health care professionals completed the online survey. Intercultural competencies, further training needs and challenges in their work were assessed by open and closed questions. Overall, our results demonstrate high intercultural competencies. Pedagogical and health care professionals reported several challenges in their work (e. g. with the language barrier). There was a great demand for specific transcultural trainings. Despite high intercultural competencies of the professionals, there is a clear need for action to improve the Intercultural Opening of the psychiatric-psychotherapeutic care systems. Further transcultural trainings and several structural improvements (e. g. changes in the training curriculum of the professionals, provision of more trained translators) would help to open the care system.

Mental health in Ukraine in 2023.

BACKGROUND: Very little is known about the mental health of the adult population of Ukraine following Russia's full-scale invasion in February 2022. In this study, we estimated the prevalence of seven mental health disorders, the proportion of adults screening positive for any disorder, and the sociodemographic factors associated with meeting requirements for each and any disorder. METHODS: A non-probability quota sample (N = 2,050) of adults living in Ukraine in September 2023 was collected online. Participants completed self-report questionnaires of the seven mental health disorders. Logistic regression was used to determine the predictors of the different disorders. RESULTS: Prevalence estimates ranged from 1.5% (cannabis use disorder) to 15.2% (generalized anxiety disorder), and 36.3% screened positive for any of the seven disorders. Females were significantly more likely than males (39.0% vs. 33.8%) to screen positive for any disorder. Disruption to life due to Russia's 2014 invasion of Ukraine, greater financial worries, and having fewer positive childhood experiences were consistent risk factors for different mental health disorders and for any or multiple disorders. CONCLUSION: Our findings show that approximately one in three adults living in Ukraine report problems consistent with meeting diagnostic requirements for a mental health disorder 18 months after Russia's full-scale invasion. Ukraine's mental healthcare system has been severely compromised by the loss of infrastructure and human capital due to the war. These findings may help to identify those most vulnerable so that limited resources can be used most effectively.

Suicidal ideation in patients with diabetes and childhood abuse - The mediating role of personality functioning: Results of a German representative population-based study.

AIMS: Suicidal ideation (SID) in patients with diabetes mellitus is increasingly acknowledged. Still, the underlying mechanisms are unclear. We examined SID prevalences in patients with diabetes, its association with different types of abuse, and a mediating effect of personality functioning. METHODS: In a representative population sample (N = 2,515), diabetes, SID, abuse (ICAST-R), personality functioning (OPD-SQS), and depression/anxiety (PHQ-4) were assessed by self-report. Statistical analyses comprised Chi2-Tests, logistic regression and mediation analyses. RESULTS: The prevalence of SID (21.8 %) was three fold higher in patients with diabetes compared to the general population. Abuse further increased the likelihood to report SID in diabetes patients (sexual: 48.1 % vs. 18.2 %; χ2(1) = 12.233, p <.001; emotional: 35.7 % vs. 15.7 %; χ2(1) = 10.892, p <.001). A dose-response relationship between the number of abuse experiences and SID was observed (one abuse experience: OR = 1.138, 95 %-CI [0.433, 2.990], p =.793, >2 abuse experiences: OR = 2.693, 95 %-CI [1.278, 5.675], p =.009). Impaired personality functioning had an indirect effect on the association between emotional abuse and SID (b = 0.25, 95 %-CI [0.037, 0.551]). CONCLUSIONS: Diabetes patients experience increased SID prevalences, especially those with emotional or sexual abuse. In individuals with a history of emotional abuse, impaired personality functioning partly explained SID and should therefore be considered and addressed in this patient group.

Internet- and mobile-based psychological interventions for post-traumatic stress symptoms in youth: a systematic review and meta-analysis.

Psychological interventions can help reduce posttraumatic stress symptoms (PTSS) in youth, but many do not seek help. Internet- and mobile-based interventions (IMIs) show promise in expanding treatment options. However, the overall evidence on IMIs in reducing PTSS among youth remains unclear. This systematic review and meta-analysis investigated the efficacy of IMIs in PTSS reduction for youth exposed to traumatic events. A comprehensive literature search was conducted in January 2023 including non-randomized and randomized-controlled trials (RCT) investigating the effects of IMIs on PTSS in youth aged ≤25 years. Six studies were identified with five providing data for the meta-analysis. The majority of studies included youth with different types of trauma irrespective of PTSS severity at baseline (k = 5). We found a small within-group effect in reducing PTSS from baseline to post-treatment (g = -0.39, 95% CrI: -0.67 to -0.11, k = 5; n = 558; 9 comparisons). No effect emerged when comparing the effect of IMIs to control conditions (g = 0.04; 95%-CrI: -0.52 to 0.6, k = 3; n = 768; k = 3; 4 comparisons). Heterogeneity was low between and within studies. All studies showed at least some concerns in terms of risk of bias. Current evidence does not conclusively support the overall efficacy of IMIs in addressing youth PTSS. This review revealed a scarcity of studies investigating IMIs for youth exposed to traumatic events, with most being feasibility studies rather than adequately powered RCTs and lacking a trauma focus. This underscores the demand for more high-quality research.

Traumatic events and posttraumatic stress symptoms in a treatment-seeking sample of Ukrainian children during the war.

BACKGROUND: The Russian invasion of Ukraine resulted in a dramatic increase of children and adolescents being confronted with war and other traumatic experiences, which could result in an increase of trauma-related mental health disorders such as posttraumatic stress disorder (PTSD) in an entire generation. This study aims at reporting the prevalence of traumatic events, PTSD, and Complex PTSD (CPTSD) in children and adolescents seeking for mental health treatment since the Russian invasion. Additionally, the consistency of child and caregiver reported trauma, PTSD and CPTSD will be examined. METHODS: This study is part of the "TF-CBT Ukraine" project in which Ukrainian therapists were trained in assessing their patients via the "Child and Adolescent Trauma Screen" (CATS-2) before initiating trauma-focused treatment, if indicated. Altogether N = 200 Ukrainian children and adolescents (Mage = 12.01, range 4-21; 62.0% female) were included in the study between October 2022 and August 2023. Data were analysed descriptively, via t-tests and bivariate correlations. RESULTS: The children and adolescents reported on average four different traumatic events, most frequently war (n = 123; 68.7%), bullying threats (n = 71; 39.7%) and domestic violence (n = 68; 38.0%). Almost 70% (n = 123) of the participants fulfilled the DSM-5 PTSD criteria, 31% (n = 56) fulfilled the ICD-11 PTSD criteria and 21% (n = 38) the ICD-11 CPTSD criteria. Rates of PTSD were even higher in preschool children (95%). The comparisons of self-and caregiver reports on traumatic events and PTSD/CPTSD severity scores indicated moderate to high correlations between the patients and their caregivers (r = 0.710-0.767). CONCLUSIONS: This study shows that Ukrainian children and adolescents starting treatment report a high number of traumatic events and trauma-related symptoms, which could have a long-lasting negative impact on their social-emotional development and quality of life. The implementation of evidence-based trauma-focused interventions for these children is therefore crucial.

What to do when the unwanted happens? Negative event management in studies on internet- and mobile-based interventions for youths and adults with two case reports.

Background: Despite severely burdened individuals, often being excluded from research studies on internet- and mobile-based interventions (IMIs), negative events (NEs) including suicidal thoughts and behaviors (STBs) can still occur during a trial. NEs require monitoring and adequate safety measures. However, study protocols frequently lack comprehensive descriptions of procedures for managing NEs. Aims: This study aimed to illustrate the assessment, monitoring, and procedures for addressing NEs in two studies on IMIs in adults and youth using case reports, to identify strengths and weaknesses of the NE management approaches, and to derive key learnings and recommendations. Methods: Two case reports were drawn from two distinct IMI studies. The first study, PSYCHOnlineTHERAPY, evaluates the combination of an IMI with on-site psychotherapy for anxiety and depressive disorders in adults (adult blended study). The second study evaluates a standalone, therapist-guided IMI for post-traumatic stress disorder (PTSD) in youth (youth standalone study). Potential NEs were predefined depending on the study sample. The case studies thoroughly document the systematic recording and ongoing monitoring of NEs through self-report and observer-based assessments during the interventions. The cases illustrate a variety of NE management strategies, including automated and personalized approaches, adapted to the specific nature and severity of the NEs. The NE management approaches are visualized using decision trees. Results: In the adult blended case study, online questionnaires detected STBs and triggered automated support information. As on-site therapy had already ended, a telephone consultation session allowed for the identification and discussion of the heightened intensity of suicidal thoughts, along with the development of specific additional help options. In the youth standalone case study, heightened tension in an adolescent with PTSD during trauma processing could be addressed in a telephone therapeutic session focusing on resource activation and emotion regulation. The referral to on-site treatment was supported. Overall, advantages of the NE management included automated procedures, multimodal assessment of a wide range of NEs, and standardized procedures tailored to different severity levels. Weaknesses included the use of single-item assessments for STBs and lack of procedures in case of deterioration or nonresponse to treatment. Conclusion: This study provides practical insights and derives key learnings and recommendations regarding the management of NEs in different IMI contexts for both adults and youth.

To trust or not to trust in the thrall of the COVID-19 pandemic: Conspiracy endorsement and the role of adverse childhood experiences, epistemic trust, and personality functioning.

RATIONALE: Conspiracy endorsement is a public health challenge for the successful containment of the COVID-19 pandemic. While usually considered a societal phenomenon, little is known about the equally important developmental backdrops and personality characteristics like mistrust that render an individual prone to conspiracy endorsement. There is a growing body of evidence implying a detrimental role of adverse childhood experiences (ACEs) - a highly prevalent developmental burden - in the development of epistemic trust and personality functioning. This study aimed to investigate the association between ACEs and conspiracy endorsement in the general population, specifically questioning a mediating role of epistemic trust and personality functioning. METHODS: Based on cross-sectional data from a representative German survey collected during the COVID-19 pandemic (N = 2501), we conducted structural equation modelling (SEM) where personality functioning (OPD-SQS) and epistemic trust (ETMCQ) were included as mediators of the association between ACEs and conspiracy endorsement. Bootstrapped confidence intervals (5000 samples, 95%-CI) are presented for all paths. RESULTS: ACEs were significantly associated with conspiracy endorsement (ß = 0.25, p < 0.001) and explained 6% of its variance. Adding epistemic trust and personality functioning as mediators increased the explained variance of conspiracy endorsement to 19% while the direct association between ACEs and conspiracy endorsement was diminished (ß = 0.12, p < 0.001), indicating an indirect effect of personality functioning and epistemic trust in the association between ACEs and conspiracy endorsement. Fit indices confirmed good model fit. CONCLUSIONS: Establishing an association between ACEs and conspiracy endorsement further increases the evidence for early childhood adversities' far-reaching and detrimental effects. By including epistemic trust and personality functioning, these findings contribute to a deeper understanding of the underlying mechanisms in the way that ACEs may be associated with conspiracy endorsement.

Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany.

BACKGROUND: Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity. OBJECTIVES: Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations. METHOD: A representative sample of the German population (N = 2531; Mage = 48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE patterns. Multiple regression analyses were used to investigate the association of latent classes of ACEs with social participation and health-related QoL and to explore potential moderators. RESULTS: Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses. CONCLUSIONS: This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.