[Effects of the COVID-19-Pandemic on the AffectiveWell-Being of Preschool Children]. / Einfluss der COVID-19-Pandemie auf das affektive Wohlbefinden von Kindergartenkindern.

The aim of this study was to determine the predictive value of corona-specific variables and post-traumatic stress symptoms associated with the COVID-19-pandemic, considering sociodemographic data and health-related quality of life, on the affective well-being of preschool children and to identify predictors of positive and negative affect. A secondary analysis of third-party assessment data by parents of three- to six-year-old preschool children from the Tyrolean COVID-19 Children's Study at two measurement time points (123 records at t1 in summer 2020; 467 records at t2 in winter 2020/21) was conducted. To answer the research question hierarchical multiple regression analyses were performed.The largest part of the variance explanation of affective well-being was explained by health-related quality of life: while self-esteem and psychological well-being were measurement-time-independent, effects of physical well-being, preschool, family, and friends were only significant in winter. Coronaspecific variables caused additional variance explanation due to subjective threat experience in winter; post-traumatic stress symptoms had an effect at both measurement-times. In times of crisis children's self-esteem, psychological well-being, and post-traumatic stress symptoms should be considered.Measurement-time-dependent results suggest that the pandemic course plays a decisive role regarding the influence on children's affective well-being. Everyday life and routines must be redefined accordingly and communicated to the children.

Comparative study of children's mental health outcomes in Tyrol, Austria, and South Tyrol, Italy, during the COVID-19 pandemic.

PURPOSE: This study aimed to compare the mental health outcomes of children in North Tyrol, Austria, and South Tyrol, Italy, during the coronavirus disease 2019 (COVID-19) pandemic, considering the sociocultural and contextual differences between the two regions. METHODS: The Tyrolean COVID-19 Children's Study (TCCS: n = 401; June 2021 to July 2021) and the Corona and Psyche in South Tyrol 2021 Study (COP­S; n = 3402; May 2021 to June 2021) were used for data analyses. Both studies employed cross-sectional designs and collected data through online questionnaires completed by children aged 7-13 years and their parents. Various psychosocial assessment tools including the Child and Adolescent Trauma Screening, Children Anxiety Test, Child Behavior Check List, Screen for Child Anxiety Related Emotional Disorders, and Health Behaviour in School-Aged Children were used in the surveys. RESULTS: The comparison between North Tyrol and South Tyrol revealed no significant differences in perceived threats, trauma, or anxiety among children. Similarly, there were no substantial disparities in psychosomatic complaints, indicating similar manifestations of emotional distress across the two regions. CONCLUSION: The comparative analysis of children's mental health outcomes in North Tyrol and South Tyrol during the COVID-19 pandemic confirmed the analogous influence of sociocultural and contextual factors on their wellbeing. Despite presumable variations in pandemic events, management strategies, and healthcare systems, the study suggests comparable resilience among children and highlights the importance of sociocultural factors in shaping their wellbeing. The findings emphasize the need for comprehensive understanding and targeted interventions to support children's mental health during challenging times.

Differences in perceived threat and trauma in children during the COVID-19 pandemic.

BACKGROUND: The past 2 years of the COVID-19 pandemic were stressful for most children and adolescents; some children may have experienced a high level of stress and trauma. To date, no study has examined self-reported stress and trauma levels due to COVID-19 in children. This study aimed to assess perceived threat, exposure and trauma symptoms in children aged 7-13 years. In addition, we explored whether parent-reported factors could predict a higher risk of COVID-19 vulnerability in their children. METHOD: Cross-sectional data were collected from 752 children to assess COVID-19 threat, exposure and trauma symptoms using the self- and parent-reported Child and Adolescent Trauma Screening Self-Report (CATS) Trauma questionnaire. We used exploratory analyses (factor analysis of mixed data and hierarchical clustering) to identify subgroups (i.e., clusters) of children sharing similar characteristics in the dataset. Linear regression modeling was applied to determine the likelihood of higher threat and vulnerability in children with parent-reported COVID-19 threat, exposure, CATS trauma symptoms, behaviors on the Child Behavior Checklist (CBCL), and posttraumatic growth (PTG). RESULTS: We identified a high-risk group of children reporting clinically relevant trauma symptoms and COVID-19-related fears. Parents' reports of trauma could be used to identify children at high risk. CONCLUSIONS: Approximately 25% of children reported moderate to clinically relevant levels of trauma symptom. It is especially important to offer adequate support to these children to ease the trauma and prevent their symptoms from developing into psychopathology.

[Resilient Children: Evaluation of a Programme to Promote Resilience in Kindergarten and Elementary School]. / Resiliente Kinder: Evaluation eines Programms zur Förderung der Resilienz in der Elementar- und Primarpädagogik.

In the project "Resilient Children", a resilience promotion program for kindergartens and elementary schools was directly applied and evaluated during the COVID-19-crisis.The aim of the study was to strengthen the three sources of resilience according to Grotberg (1995) I HAVE, I AM and I CAN through targeted exercises and resilience-promoting communication (transfer to everyday life). Additionally, gender differences with regard to the effect of the programme were addressed. "Resilient Children" was evaluated at the impact level (pre-post design) and process level. Eight kindergartens and three elementary schools with 125 children participated. A total of 122 teachers and 70 parents provided information about the children. The results at the impact level showed that from the parent and teacher perspective, and from the self-perspective (children), the three sources of resilience were significantly strengthened. With regard to gender differences, the results from the perspective of teachers and parents showed that girls were characterised by greater changes than boys. Compared to the girls, the physical andmental well-being of the boys improved fromthe parents' point of view. The results of the process evaluation revealed a high level of motivation and enthusiasm for participation in the programme on the part of participating children and teachers. The success of "Resilient Children" depends on the identification of the teachers with the program.

Children's Mental Health During the First Two Years of the COVID-19 Pandemic: Burden, Risk Factors and Posttraumatic Growth - A Mixed-Methods Parents' Perspective.

The COVID-19 pandemic and the accompanying containment measures such as physical distancing and school closures led to major changes in children's everyday lives. By means of a mixed-methods study, the "Tyrolean COVID-19 Children's Study" investigated the effects of the pandemic and factors influencing mental health and health-related quality of life of North Tyrolean (Austria) and South Tyrolean (Italy) children aged 3-13 years. Parents filled out N = 2,691 online questionnaires (951 preschool children: 3-6 years; 1,740 schoolchildren: 7-13 years) at four measurement time points (March 2020, December 2020, June 2021, December 2021). For both age groups, children's mental health outcomes (internalising problems, posttraumatic stress symptoms) were worse in December 2021 (t4) than children's mental health outcomes in March 2020 (t1). With regard to aggressive behaviour, this difference was only found among schoolchildren. Thematic analysis of an open ended, written question revealed the following positive changes in children during the Corona crisis: (1) the importance of intra- and extra-familial relationships, (2) new competences and experiences, (3) values and virtues, (4) use of time, and (5) family strength. Using multilevel modelling, threat experience, economic disruption, and perceived posttraumatic growth were shown to be the strongest predictors of all outcomes. Additionally, male gender was shown to be a predictor of aggressive behaviour. In terms of age, schoolchildren showed more internalising problems, aggressive behaviour, and threat experience than preschool children. With regard to time, parents in December 2021 reported more threat experience in older children and less perceived posttraumatic growth in both older and younger children, than parents at the beginning of the pandemic. Targeted support for vulnerable children may prevent longer-term development of psychopathologies and contribute to society's psychosocial resilience in the current COVID-19 pandemic. Moreover, sustainable promotion of children's posttraumatic growth can also contribute to children's mental health and could even offer a chance to turn the crisis into an opportunity.

Communicative and social competence in the medical curriculum of the Medical University of Innsbruck: learning objectives, content, and teaching methods.

Aim: The Austrian Competence Level Catalogue for Medical Skills clearly states the importance of teaching communicative and social competence in the different subject areas of undergraduate medical and dental education. This paper aims to present an overview of the academic courses at the Medical University of Innsbruck that explicitly address the promotion of communication and social skills in medical students. Method: This paper focuses on educators' descriptions of how communicating with patients is taught. The Medical University's longitudinal curriculum on medical interviewing is presented in detail. The courses on ethical principles in the dissection course, palliative medicine, and gender medicine are also outlined as examples. In addition, lecturers (n=536) participated in an online survey to determine the teaching and testing content regarding patient communication and to measure the value attached to the associated teaching and learning methods. Results: The examples given by educators to illustrate learning objectives, educational content, and the teaching methods used to impart communicative and social competence provide an overview of the courses which focus on this topic or intentionally address it during the course. The results of the online survey offer a broad overview of the awareness of the topic at the university. Different testing formats are used to assess the skills being taught. Conclusion: Familiarity with the various teaching methods used in the different courses is important for developing communicative and social competence in medical education. Active networking is necessary to anchor communicative and social competency as a major thread throughout an entire medical curriculum.

Prevalence of adverse childhood experiences (ACEs) and associated physical and mental health problems amongst hospital patients: Results from a cross-sectional study.

BACKGROUND: Adverse childhood experiences (ACEs) can have severe detrimental effects on physical and mental health. This study aimed to present prevalence rates of ACEs amongst a mixed sample of hospital patients. METHODS: In- and outpatients at seven departments of the University Hospital of Innsbruck (Austria) participated in the study. They completed questionnaires regarding retrospective assessments of ACEs, physical and mental health and experience of domestic violence. The impact of ACEs on patients' health was evaluated by calculation of odds ratios (OR) in binary logistic regressions. RESULTS: A total of n = 2392 (74.3% of all approached patients) were included in the analyses. The results showed that 36.1% of them reported at least one form of ACEs, and 6.3% were polyvictimized (i.e. they reported ≥4 forms of ACEs). Most frequent forms of ACE were emotional abuse (18.3%), peer abuse (14.2%), and neglect (12.3%). ACEs were significantly associated with increased ORs for various physical diseases, mental health problems and domestic violence. CONCLUSION: Retrospectively assessed ACEs are highly prevalent amongst hospital patients and exposure to high numbers of ACEs is associated with decreased physical and mental health. The identification of patients with symptoms following ACEs and referral to appropriate treatment is a crucial challenge for health-care professionals.

[Validation of a German-Language Version of the Multidimensional Offline and Online Peer Victimization Scale (MOOPV) in Adolescent Students]. / Validierung der deutschsprachigen Version der Multidimensional Offline and Online Peer Victimization Scale (MOOPV) für Jugendliche an einer Schülerstichprobe.

Peer victimisation (PV) in childhood and adolescence can come along with psychological stress through the life span. Even though there exist a large number of questionnaires that measure PV, evidence of the use is often missing. Particularly instruments for capturing cyberbullying lack psychometric calculations such as factor analysis for investigating scales and data on validity and reliability. An exception constitutes the Multidimensional Offline and Online Peer Victimization Scale (MOOPV) of Sumter et al., which is only available in Dutch. This questionnaire is not medium-specifically designed, has been psychometrically properly explored, and differentiates between direct and indirect as well as online and offline PV. The present study aims to investigate the psychometric properties of the German version of the Multidimensional Offline and Online Peer Victimization Scale (MOOPV). The factor structure, validity and reliability was examined in a sample of 777 pupils aged 10-20. Confirmatory factor analysis supported the original four-factor model. The scales direct offline, indirect offline, direct online, and indirect online demonstrated high internal reliability and construct validity. The MOOPV can be used as a validated instrument in research and practice to capture PV in childhood and adolescence.

A cross-sectional study of mother-child agreement on PTSD symptoms in a south Indian post-tsunami sample.

BACKGROUND: Few studies examine caregiver-child agreement on posttraumatic stress disorder (PTSD) symptoms in non-Western cultures. The present study investigated mother-child agreement for PTSD symptoms in a South Indian sample, which was affected by the Indian Ocean Tsunami in 2004. METHODS: Data was collected four years post-disaster. In total, 80 mothers rated PTSD symptoms for their 164 children and gave information about their own trauma symptoms. In addition, the children aged 8 to 17 reported about their own PTSD symptoms. RESULTS: Results showed that mother-child agreement on posttraumatic stress symptoms was poor, and a child's age, gender and living situation (fishing village vs. family-based out-of-home care) did not positively influence this concordance. Moreover, mothers' own posttraumatic symptoms were strongly related to maternal reports of the child's PTSD symptoms. Multivariate analyses showed that mothers' PTSD symptoms were the only significant predictor for discrepancies in the rating of the child's PTSD symptoms. That means, if mothers reported clinically relevant PTSD symptoms, the likelihood for disagreement on the child's PTSD ratings more than doubled. Neither age, nor gender nor the living situation had an influence on children's self-rated posttraumatic stress reactions. CONCLUSIONS: In general, long-term monitoring of posttraumatic stress symptoms of mothers and children should be planned by relief actions as recovery processes are decelerated through lacking resources in developing countries such as India. Specifically, the assessment of mothers' trauma symptoms is inevitable because the mothers' own responses to disaster highly influence their assessment of their children's symptoms. Mother-child agreement is discussed against the background of socio-cultural aspects.

Dimensions of posttraumatic growth in a German-speaking sample using mixed methods.

Background: Highly adverse events can shatter fundamental assumptions about one's self and the expected course of life actuating a process of adjustment regarding new appraisals. This struggle in the aftermath of adversity might yield posttraumatic growth (PTG), which refers to positive transformation within the person. PTG is a concept that has been established within a Western cultural framework and has both universal and culture-specific characteristics. Although across cultures individuals perceive benefits from their struggles with life crises, the nature of PTG might be coloured by cultural factors. Objective: This study aimed to identify aspects of PTG in a German-speaking sample (Austria and Germany) that are unique to this individualistic culture and not yet covered by the Posttraumatic Growth Inventory (PTGI). Method: We used a convergent parallel mixed methods design. In sum, 188 German-speaking adults were recruited via snowball sampling. They reported on their worst experience ever and completed the PTGI, and 54 participants detailed in open-ended questions possible positive changes additionally to the questionnaire. Results: The existing growth dimensions of the German PTGI were confirmed by participants' qualitative statements. Additionally, qualitative data analysis revealed the elaboration of two PTGI dimensions, and the emergence of two new domains: (1) 'lessons learned', which involves newfound knowledge about oneself and one's life, and (2) 'processing of adversity with potential growth experiences', which illustrates the tightrope walk of growth. Conclusions: The results support Tedeschi and Calhoun's model of the process and outcomes of PTG. By including qualitative methodology this study contributed to (1) revealing culture-specific growth experiences (i.e. different sub-forms of individualism were identified), and (2) underscoring the importance of 'potential growth' so that further promotion of growth is possible at an early stage of processing adversities.

Antecedentes: Los eventos altamente adversos pueden destruir las suposiciones fundamentales sobre uno mismo y el curso de vida esperado, activando un proceso de adaptación con respecto a las nuevas valoraciones. Este conflicto después de la adversidad podría producir un crecimiento postraumático (CPT), que se refiere a la transformación positiva dentro de la persona. CPT es un concepto que se ha establecido dentro de un marco cultural occidental y tiene características tanto universales como específicas de la cultura. Aunque en todas las culturas las personas perciben los beneficios de sus conflictos con las crisis de la vida, la naturaleza del CPT puede verse influida por factores culturales.Objetivo: Este estudio tuvo como objetivo identificar aspectos de CPT en una muestra de habla alemana (Austria y Alemania) que son exclusivos de esta cultura individual y que aún no están cubiertos por el Inventario de crecimiento postraumático (ICPT).Método: Utilizamos un diseño de métodos mixtos paralelos convergentes. En total, 188 adultos de habla alemana fueron reclutados mediante muestreo de bolas de nieve. Informaron sobre su peor experiencia y completaron el ICPT, y 54 participantes detallaron en preguntas abiertas posibles cambios positivos adicionales al cuestionario.Resultados: Las dimensiones de crecimiento existentes del ICPT alemán fueron confirmadas por las declaraciones cualitativas de los participantes. Además, el análisis de datos cualitativos reveló la elaboración de dos dimensiones ICPT y la aparición de dos nuevos dominios: (1) 'lecciones aprendidas', que implica un nuevo conocimiento sobre uno mismo y la propia vida, y (2) 'procesamiento de la adversidad con potenciales experiencias de crecimiento', que ilustra el camino del crecimiento en la cuerda floja.Conclusiones: Los resultados apoyan el modelo de Tedeschi y Calhoun del proceso y los resultados de CPT. Al incluir una metodología cualitativa, este estudio contribuye a (1) revelar experiencias de crecimiento específicas de la cultura (es decir, se identificaron diferentes subformas individualismo) y (2) subrayar la importancia del 'crecimiento potencial', de modo que sea posible una mayor promoción del crecimiento en una etapa temprana de procesamiento de adversidades.

Domestic violence victims in a hospital setting: prevalence, health impact and patients' preferences - results from a cross-sectional study.

Background: Domestic violence (DV) is a widespread yet commonly underdetected problem with severe impact on physical and mental health. To date, only limited information is available on prevalence and detection-rates of victims of DV in hospital settings. Objective: The aim of this study was (a) to assess the prevalence and impact of DV on physical and mental health as well as risk-factors associated with it, (b) to determine how many patients had been asked directly about DV in the hospital and (c) to investigate patients' preferences about being asked about DV in a hospital setting. Methods: Adult inpatients and outpatients at seven somatic departments at the University Hospital Innsbruck (Austria) were included consecutively in this ad-hoc, cross-sectional paper-and-pencil questionnaire-based study. In total, n = 2,031 patients were assessed regarding their experiences with DV. They also reported on whether they had been asked about DV at the hospital and whether they would mind being asked about it. To evaluate the impact of DV on patients' self-reported physical and mental health, odds ratios were calculated using binary logistic regression. Results: DV was reported by 17.4% of patients, with 4.0% indicating current DV exposure. Lifetime DV exposure was associated with a significant risk for both physical and mental health-problems. Only 4.8% of patients with DV exposure had ever been asked about it by hospital staff. While patients with a history of DV were more open to being asked about DV than patients without DV (78.2% vs. 72.9%), overall acceptance was still high (74%). Conclusion: DV is a frequently overlooked problem with detrimental effects on physical and mental health. While high acceptance of DV assessment was found, only a small proportion of affected patients had indeed been assessed for DV. Screening for DV in hospitals may thus increase the number of identified patients.

Antecedentes: La violencia doméstica es un problema extendido, pero poco detectado, que tiene un impacto severo sobre la salud física y mental. A la fecha, únicamente se encuentra disponible información limitada sobre la prevalencia y tasas de detección de víctimas de violencia doméstica en entornos hospitalarios.Objetivo: El propósito de este estudio fue de a) determinar la prevalencia y el impacto de la violencia doméstica sobre la salud física y mental, además de los factores de riesgo a ella asociadas, b) determinar a cuántos pacientes se les ha preguntado directamente en el hospital sobre la violencia doméstica, y c) investigar las preferencias de los pacientes sobre el hecho de preguntarles respecto a la violencia doméstica en un entorno hospitalario.Métodos: Se incluyeron pacientes hospitalizados y ambulatorios de siete departamentos somáticos de la Universidad de Innsbruck (Austria) en este estudio ad-hoc, transversal y basado en un cuestionario resuelto a mano. Se evaluó un total de n = 2031 pacientes respecto a sus experiencias en torno a la violencia doméstica. También reportaron si se les preguntó respecto a la violencia doméstica en el hospital, y si les importaba que se les pregunte sobre ello. Para evaluar el impacto de la violencia doméstica sobre su estado autoreportado de salud física y mental, se calculó la proporción de probabilidades mediante regresión logística binaria.Resultados: La violencia doméstica fue reportada por el 17,4% de los pacientes, con un 4,0% reportando violencia doméstica en curso. La prevalencia de vida de exposición a la violencia doméstica se asoció con un riesgo significativo de problemas de salud tanto físicos como mentales. El personal del hospital preguntó sobre violencia doméstica solo a un 4,8% de pacientes con exposición a ella. Pese a que los pacientes con antecedente de violencia doméstica eran más abiertos a que se les pregunte sobre ella que los pacientes sin antecedente de violencia doméstica (78,2% contra 72,9%), la aceptación general era aún alta (74%).Conclusión: La violencia doméstica es un problema con frecuencia ignorado que presenta consecuencias nocivas sobre la salud física y mental. A pesar de que se encontró una alta aceptación para la evaluación de la violencia doméstica, solo a una pequeña proporción de pacientes en efecto se les evaluó respecto la violencia doméstica. Por tanto, un tamizaje sobre violencia doméstica en hospitales podría incrementar el número de pacientes identificados.

Violence from childhood to adulthood: The influence of child victimization and domestic violence on physical health in later life.

OBJECTIVE: Previous research has shown a detrimental effect of child victimization (CV) on physical disease and mortality. Additionally, individuals with adverse experiences in childhood frequently face domestic violence (DV) in later life. As DV has also been observed to harm physical health, a potential cumulative effect has been proposed. Currently, however, only limited data on such a cumulative effect and its impact on patients' physical health are available. METHODS: A cross-sectional observational study at the University Hospital of Innsbruck was conducted. Data on CV, DV and physical health were collected using self-report questionnaires. To evaluate the impact of CV and DV on patients' health, odds ratios (OR) were calculated using binary logistic regression. RESULTS: A total of 1480 patients from various departments participated in the study. CV was found for 38% and DV for 16% of participants. A significantly higher occurrence of physical disease was observed in patients with poly-victimization (4+ CVs). When accounting for the cumulative effect of CV and DV, the occurrence was further increased for musculoskeletal disorders (OR:5.1), chronic pain (OR:5.0), gastrointestinal diseases (OR:3.0), metabolic diseases (OR:2.8) and respiratory diseases (OR:2.4). CONCLUSION: CV and DV were found to be prevalent and highly correlated in patients treated in a primary care hospital. CV and DV - individually, combined and cumulatively - may thus present risks for physical health. Screening patients for the risk of DV as well as assessing CV may aid in early identification and initiation of psychosocial interventions to avoid further aggravation of physical and psychological problems.

Exploring posttraumatic growth in Tamil children affected by the Indian Ocean Tsunami in 2004.

Few studies explore posttraumatic growth (PTG) in children from Eastern cultures. To help address this gap, the present study examined PTG among 177 South Indian children aged 8-17 years who were affected by the 2004 Tsunami. The study identifies the underlying factor structure of the Tamil version of the Revised Posttraumatic Growth Inventory for Children (PTGI-C-R), and aims to explore the prevalence of PTG, the relationship between distress and growth, and gender and age differences in PTG. The results of the principal component analysis indicated a two-factor structure with an interpersonal and a person-centred dimension of growth. The total scores of the Tamil PTGI-C-R were positively associated with posttraumatic stress symptoms (PTSS) and age. Moreover, there was a significant relationship between age and the person-centred growth subscale. Non-parametric tests found no gender differences in perceived growth. The role of socio-cultural factors on the nature of PTG is discussed.

Measuring Self-Soothing Ability in Patients with Childhood Trauma - Psychometric Evaluation of the Self-Soothing Scale in a Clinical Sample.

OBJECTIVES: The regulation of strong emotions is an essential skill for traumatized patients. The present instrument was developed for the measurement of the self-soothing ability in traumatized patients. METHODS: The psychometric properties of the SBS were investigated in a clinical sample of patients with childhood trauma (N = 143). In addition, the study explored the factorial structure, internal consistency, retest reliability, convergent validity, and responsiveness of the instrument. RESULTS: Results of an exploratory factor analysis indicated a two-factor structure: 'self-soothing' and 'impulse control', explaining 55% of the variance. The total score showed a good internal consistency (α = .83) and re-test reliability (rtt = .87) as well as good validity and responsiveness. CONCLUSIONS: The 7-item SBS is a suitable instrument for the measurement of self-soothing ability in traumatized patients.

Field study on the choice of friends in two multi-racial pre-schools (South Africa/London).

The present research examined the influence of the two independent variables sex and race on the choice of friends in pre-school children. Data for this investigation were collected in two pre-schools, one situated in Stellenbosch, South Africa, the other in London, U.K. Both schools have in common that they accommodate children of different racial backgrounds (black, white, and coloured children), but the children's experience with desegregated classrooms differ. Friendship was operational defined with thirteen categories, summarized to the basic category pro-social behaviour. Fifty hours of free-play time were taped with one video camera in South Africa, and hundred hours were taped with two video cameras in London. The results showed that sex and race interact in their effect on the choice of friends. In South Africa race is supposed to be a strong indicator for friendship choices, especially for black children, whereas the black children in London choose friends more or less on the basis of sex.