[Attachment-Related Affect Regulation of Mothers in a Psychiatric Parent-Child Ward - A Case Study]. / Bindungsbezogene Affektregulierung von Müttern einer kinderpsychiatrischen Eltern-Kind-Station ­ eine Fallstudie.

Attachment researchers propose that the term affect regulation is associated with attachment-related defensive processes resulting from attachment experiences with primary caregivers. They serve to regulate attachment-related inner states. The Adult Attachment Projective Picture System (AAP) is a reliable and valid tool to classify attachment patterns and it allows to assess these attachment-related defensive processes. It provides information about the defensive processes that help clinicians to understand complex symptoms and interaction patterns in the parent-child relationship that can be integrated into psychiatric treatment. The present case study deals with a mother of a child with a feeding disorder. We will illustrate how information on attachment-related affect regulation can successfully be integrated into psychotherapeutic intervention in a psychiatric parent-child ward.

[Characteristics of the population of a parent-child unit: early interaction-based treatment as a chance in child and adolescent psychiatry]. / Merkmale der Inanspruchnahmepopulation einer Eltern-Kind-Station: Frühe interaktionszentrierte Behandlung als Chance in der Kinder- und Jugendpsychiatrie.

BACKGROUND: In inpatient child psychiatric parent-child treatment, the child is admitted as a patient and the parents as accompanying persons. Due to the importance of parent-child interaction in the development and maintenance of mental disorders in children, parents are integrated more centrally in the treatment of children with emotional or behavioral disorders. In order to further expand this form of treatment in the future and to make it more effective, the characteristics of the previous utilization population of a child psychiatric parent-child unit in Tyrol were examined with regard to child symptomatology and the burden on parents. METHODS: The Child Behavior Checklist 1 ½-5, Child Behavior Checklist 6-18R, and Tröster's (2011) Parent Stress Inventory scores of 96 parent-child pairs were used to examine child symptom expression and parent stress. RESULTS: The 6-10 year old patients had higher T­scores (M = 76.9, SD = 7.1) than the 0-5 year old patients (M = 63.1, SD = 12.4) on the CBCL total scale, t (50) = -3.52, p < 0.001. On the EBI total scale, the 0-5 year old patients and the 6-10 year old patients did not differ in terms of T­scores, t (54) = -0.75, p = 0.459, as well as in the EBI child domain t (54) = -1.75, p = 0.087 and in the EBI parent domain, t (54) = 0.19, p = 0.846. Also, the four diagnostic groups did not differ in the EBI total scale, F (4,58) = 1.34, p = 0.266, nor in the parent domain of the EBI, F (4,58) = 1.44, p = 0.232, nor in the child domain of the EBI, F (4,58) = 2.81, p = 0.033. CONCLUSIONS: Early identification and treatment of behavioral or mental disorders in very young children seems crucial to prevent long-term negative consequences as well as chronicity. Parent-child therapies should generally focus on identifying and changing current dysfunctional patterns of interaction between parent and child.

Early Detection of Temperament Risk Factors: A Comparison of Clinically Referred and General Population Children.

Despite an extensive literature on associations between early childhood temperament and behavior problems, most of this evidence is based on general population samples. Hence, relatively little is known about the temperament characteristics of children who have been referred for in- or outpatient treatment of emotional and/or behavioral problems. Whether temperament-to-behavior problems identified in community samples would also be found in samples of clinically referred children is poorly understood. To redress this limitation, we compared temperament attributes of a predominantly preschool-aged sample of children referred for treatment of emotional and/or behavioral disorders (N = 87) with those from a similarly-aged general population sample (N = 85) by using the Integrative Child Temperament Screener (ICTS)-a new nine-item scale to identify clinically significant temperament attributes. Behavioral symptoms in the clinical sample were assessed through diagnostic interviews in combination with the Child Behavior Checklist (CBCL), which was also administered to the general population children. Compared with general population children, referred children exhibited substantially higher scores on all ICTS subscales except behavioral inhibition. Furthermore, areas under the curve analyses showed that discrimination of both groups based on CBCL scales could be improved by adding the ICTS. Overall, the findings fill a long-standing gap in evidence regarding temperament characteristics of children with serious emotional and/or behavioral symptoms and suggest a useful role for the ICTS in assessment, screening, and prevention.