Parent-child relationship measures and pre-post treatment changes for a clinical preschool sample using DC:0-3R.

BACKGROUND: To reduce psychopathologies in children, various treatment approaches focus on the parent-child relationship. Disruptions in the parent-child relationship are outlined in the most recently revised versions of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R/DC:0-5). The measures used to assess the parent-child relationship include the Parent-Infant Relationship Global Assessment Scale (PIRGAS) and the Relationship Problems Checklist (RPCL), which cover, e.g., essential concepts like over- or underinvolvement of the caregiver. However, not much is known about the cross-sectional and predictive value of PIRGAS and RPCL scores at admission to discharge, namely whether changes in these scores are correlated with child and maternal psychopathologies and changes through treatment. METHODS: Based on clinical records of 174 preschool-aged children of the Family Day Hospital, we report related basic descriptive data and changes from admission to discharge for the parent-child relationship, child behaviour, and maternal psychopathology. We used a Pearson correlation or a point-biserial correlation to describe the associations and performed a paired t-test to examine differences before and after measurement. RESULTS: Our results show overall improvements in our parent-child relationship measures and in child and maternal psychopathology. However, we observed little or no correlation between the parent-child relationship measures and child or maternal psychopathology. CONCLUSIONS: We highlight potential drawbacks and limitations of the two relationship measures used that may explain the results of this study on the associations between the variables assessed. The discussion emphasizes the assessment of DC:0-3R/DC:0-5, which are popular in clinical practice for economic reasons.

Assessment and Diagnostic Classification Using DC:0-5 in Early Childhood Mental Health Clinics: The Protocol for the Developmental Psychiatry Diagnostic Challenges Study (DePsy).

Mental health problems in early childhood are common, but there is a lack of psychiatric research on this age group. DC:0-5 is a multiaxial classification system for mental disorders in early childhood, providing a framework for standardizing clinical practice and research. However, research on the validity of DC:0-5 is scarce. The Developmental Psychiatry Diagnostic Challenges Study (DePsy) is a multi-site, prospective clinical study including six German early childhood mental health (ECMH) clinics. The main objective of the study is to contribute to the validation of Axis I and Axis II of DC:0-5. A second aim of the study is to describe the population of the participating clinics regarding diagnoses, family context, and treatment outcomes. Additionally, the impact of environmental risk factors, including parental Adverse Childhood Experiences (ACEs) and media use, on child psychopathology and caregiver-child relationships will be examined. Over two years, patients aged 0.0-5.9 years old will be enrolled in the study. Assessments include ICD-10 and DC:0-5 diagnoses, developmental tests, video-based observations of caregiver-child interactions, and questionnaires on child psychopathology, media use, parental stress, and treatment satisfaction. Study results will promote the standardization of assessment and treatment in ECMH clinics aiming to improve the development of patients and their families.

["Is Anything HappeningThere? And if so,What?" Video-Diagnostic Assessment of Parental Interaction Qualities in a Preschool Psychiatric Sample]. / "Tut sich da denn was? Und wenn ja, was?" Videodiagnostische Beurteilung elterlicher Interaktionsqualitäten in einer vorschulpsychiatrischen Stichprobe.

Standardized video diagnostic instruments, such as the Play-PAB used in this study, are suitable for an objective and multidimensional assessment of early parent-child interactions. Furthermore, the present results support the assumption that early parent-child interaction is a multivariate construct.The correlation analyses show that various influencing factors, such as parental stress, are related to specific parental interaction qualities, such as intrusiveness, and as a consequence, affect the relationship building process with the child.Therefore, video diagnosticmethods are suitable for both objective therapy evaluation and individualizing therapy in preschool psychiatric settings.

Are emotionally competent adults emotionally available parents? Examination of theoretical and empirical relationships in a video-recorded parent-child interaction clinical preschool-aged sample.

OBJECTIVE: Emotional competence (EC) describes one's general ability to perceive, express, process, and regulate their own emotions as well as those of others. In the clinical context of parent-child interactions, the specific ability to perceive, express and regulate a child's emotions is conceptually covered by the Emotional Availability Scales (EAS). We aim to examine theoretical and empirical overlaps between EC (Rindermann) and emotional availability (EA; Biringen) for theoretical, diagnostic, and therapeutic reasons. METHODS: Parents of a clinically referred sample of preschool-aged children (55 dyads) filled out a self-report questionnaire (ECQ), and certified and blinded raters applied the EAS via observations. In a novel approach, the EC was additionally estimated with independent ratings made by two further observers. All dyads were coded on 10-min video-recorded parent-child interactions during free play. RESULTS: In bivariate and multivariate analyses, EC scores from observational ratings were strongly associated with independently rated clinical emotional availability scores. EC scores from self-reports were moderately associated with emotional availability scores. A post hoc power analysis estimated ß error probabilities. CONCLUSIONS: EC may represent an important personal precondition to an emotionally available parent. As such, we discuss implications for early risk factor assessments for child development and highlight new prevention approaches, new diagnostic options, and refined treatment goals. Limitations included the sample size, assessment, and the influence of study design on results.

[The Requirement of a Situated Approach in the Treatment of Preschool Children with a Refugee Background: Discussion of a Case Study]. / Die Notwendigkeit eines situierten Ansatzes bei der Behandlung von Vorschulkindern mit Fluchthintergrund: Diskussion eines Fallbeispiels.

In recent years, increasingly more German-born preschool children of refugee parents have been referred to the 'specialized consultation service for refugee minors' of the Department of Child and Adolescent Psychiatry at the University Hospital Münster. This 'change' in the use of the above-mentioned consultation service could be understood as a 'natural' consequence of the family life cycle of forced migrants who some years ago came to Germany as adolescents or young adults and started here a family. The treatment of 'preschoolers with a refugee background', as we may call this group of patients, confronts mental health practitioners with particular challenges. In this contribution, we specify some of these challenges and argue that, due to the deep intertwinement of different aspects of these patients' condition, a 'situated approach' is required when treating this population.When planning therapeutic interventions for preschoolers with refugee background, their families should be conceived as unified systems which in their social and transcultural embeddedness exhibit trans-individual vulnerabilities and resources. By discussing a case study, we illustrate how an extremely challenging child psychiatric treatment could succeed only on the condition that we focused on the interconnectedness of various factors determining not merely the patient's symptomatic behavior but, furthermore, the behavior of the family, i. e., on the condition of focusing on the situated nature of the problematic.

[Diagnostic of Parent-Child-Interaction andTheir Relationship: Results from a Multiprofessional and Task Specific Survey]. / Diagnostik der Eltern-Kind-Interaktion und -Beziehung: Ergebnisse einer multiprofessionellen und tätigkeitsspezifischen Umfrage und Vorschläge für eine standardisierte Dokumentation.

The assessment of parent-child interactions and relationships (PCIR) plays an important role for many diagnostic purposes in child and adolescent psychology and psychological health care. While child and adolescent psychology has been intensively researched, the field still faces a lack of knowledge about health care practice. To offer knowledge about practical routine needs and derived needs in these domains, we aimed to obtain information from professionals who routinely assess PCIR.We aimed to gain a basic description of task-specific diagnostic fields, professional staff and their education, their clients, key diagnostic questions, observational settings, guidelines used in assessing PCIR and professionals' personal understanding of PCIR. To gain information on how professionals assess PCIR, we used an online survey containing multiple choice questions and rating scales.We describe differences between task-specific diagnostic fields of inpatient and outpatient settings, consulting and officially appointed surveyors for court decision. Only responses from professionals performing PCIR are analyzed (N = 166). PCIR is regularly used for more than a half of children between 0-12 years of age and for more than a third of adolescents for answering a broad spectrum of diagnostical questions. We describe differences for nearly all facets of PCIR except for the content related domain. Based on these differences between task-specific fields, we give suggestions for standardized documentation of PCIR and how findings from this study can be used for scientific development.

[What Works for Whom? Differential Effects of Predictive Validity of Parenting Behaviours: Externalizing Versus Internalizing Behaviour Problems]. / Was hilft bei wem? Unterschiedliche Auswirkungen der prädiktiven Validität von Erziehungsverhalten: Externalisierende versus internalisierende Verhaltensprobleme.

A variety of instruments are available for assessing parental and child behaviour in the context of interaction observation. This study investigated whether the Laboratory Parenting Assessment Battery (Lab-PAB) can be used to make predictive statements about the therapeutic success of child psychiatric treatment. The success of therapy was measured through pre- and post-intervention assessments using the Child Behavior Checklist (CBCL) and the Parent-Infant Relationship Global Assessment Scale (PIR-GAS). A particular focus was placed on discriminating between externalizing and internalizing problems of the child. It was observed that positive items of the interaction offer a greater resource for the therapeutic success of children with externalizing problems than stopping negative behaviour of the parents. In the case of internalizing problems, the elimination of negative interaction items seems to be essential for a good therapy success.

COVID-19: Effects of Pandemic Related Restrictions on Physical Activity, Screen Time, and Mental Well-being in German adolescents.

Objective: To describe the impact of the COVID-19 pandemic-related restrictions (PR) in April and May 2020 on physical activity (PA), sedentary screen time (SST), and mental well-being (MWB) in German adolescents, and to analyze associations between these variables. Methods: The Münster District Government invited all secondary school students (aged 11-17) in the region to take part in the online survey that assessed PA, SST, and MWB. For data analysis, we calculated descriptive statistics and ran linear regression analysis. Results: 1,038 students (627 [60.4%] female; 14.18 [± 1.97] years) were included in the analysis. During the PR, a marked decline in overall PA (p < .001) and a significant increase (p < .001) in SST were observed. One-third of the students reported worrying more and being less satisfied with their lives since PR. A decrease in life satisfaction (ß = -.524, p < .001) as well as an increase in general worrying (ß = -.336, p = .015) were associated with a decrease in PA during PR. Conclusion: The results show that the restrictions led to a decrease in physical activity, which may have detrimental effects on the students' mental and physical health.

Impaired predictability: enhanced fluctuations in the parenting behaviour of mothers of pre-school children with clinical diagnoses across three different play tasks.

Fluctuations in parenting behaviour are thought to be important for the development of child psychopathology. This study focusses on fluctuations in the parenting behaviour of mothers with 3-6-year-old children with a clinical diagnosis according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) (N = 39) and compared them with a control group of mothers with children without a clinical diagnosis (N = 41). In a laboratory setting, we compared the quality of mother-child interactions between both groups using three increasingly challenging co-operation tasks. At first, the mother and child interacted via a free play task. They then co-operated within a constructional play task and finally within a challenging problem-solving task. We analysed the mothers' parenting behaviour using the Laboratory Parenting Assessment Battery (LAB-PAB) and children's problem behaviours by means of their mothers' rating using the Child Behavior Checklist 1 ½-5 (CBCL). The results corroborated our hypotheses. Mothers of the group of children with clinical diagnoses had a lower parenting quality and higher fluctuations in parenting behaviour across situations compared with the non-clinical group. Further analysis revealed that specific fluctuations in maternal involvement and hostility uniquely predicted child psychopathology, measured with the CBCL, showing incremental validity of fluctuations in maternal involvement, when controlling for parenting quality and maternal difficulties in emotion regulation, measured with the Difficulties in Emotional Regulation scale. The results are discussed in terms of their implications for clinical interventions, as well as theoretical implications and future research.