[The Operationalized Psychodynamic Diagnostic of Children and Adolescents (OPD-KJ-2) in Everyday Clinical Practice with the Plämobox: Applicability and Interrater Reliability]. / Die Operationalisierte Psychodynamische Diagnostik des Kindes- und Jugendalters (OPD-KJ-2) im klinischen Alltag mit dem Plämokasten.

The Operationalized Psychodynamic Diagnostic of Children and Adolescents (OPD-KJ-2) in Everyday Clinical Practice with the Plämobox: Applicability and Interrater Reliability Abstract: Objective: The OPD-CA2 manual for assessing psychodynamic aspects in children and adolescents is well established in clinical practice. However, publications regarding its reliability and validity are limited to (1) adolescents, (2) the structure of the first version of the manual and not to the comprehensive revision of the OPD-CA2, (3) the axes "structure" and (partly) "conflict" but not the axis "relationship," and (4) missing applicability in everyday clinical practice. Methodology: The present study comprised 42 children aged 6-12 years (age level 2 of the OPD-CA2), with and without mental illness, and assessed them using two randomly assigned raters. We assessed them using a low-structured diagnostic symbol game with miniature figurines and objects based on videotapes. We also tested the interrater reliability of the OPD-CA2 axes. Results: The overall assessment of structure and the assessment of the four subdimensions succeeded with good to very good agreement. We could also determine the presence of relevant conflict dynamics with very high agreement, while not recognizing specific conflicts in the clinical sample. Our assessment of the items of the relationship axis shows a low level of agreement. Conclusions: Overall, we can confirm the reliability of the OPD-CA2 for everyday clinical assessment in the younger age groups. Finally, we discuss which factors contribute to the heterogeneous picture.

All the Same? Different Measures of Personality Functioning Are Similar but Distinct. A Comparative Study from a Psychodynamic Perspective Using Exploratory Graph Analysis.

Personality functioning (PF) is a central construct in many theories of personality pathology. Based on psychodynamic theories, two screening questionnaires to assess PF are widely used: The Inventory of Personality Organization-16 item version and the Operationalized Psychodynamic Diagnosis-Structure Questionnaire Short Form. This study aimed to explore the similarities and differences of the two questionnaires in a large clinical sample of N = 1636 psychotherapeutic inpatients. Correlation analyses were conducted to examine the associations between the global scores and between the subscales. The study further used Exploratory Graph Analysis (EGA) to explore the dimensionality of the items. The stability of estimates was evaluated using a bootstrap version of EGA (bootEGA). The results indicated that the two questionnaires are highly correlated, yet not multicollinear, and moderate to large correlations were found between their subscales. EGA revealed six dimensions that fairly represented the original subscales. BootEGA showed that the dimensions and items were stable, except for one item that did not load sufficiently on any dimension. The findings suggest that although the questionnaires are highly correlated, their subscales tap into distinct domains of PF. We discuss implications stemming from these findings for clinical and scientific practice.

Exploring the associations between psychodynamic constructs and psychopathology: A network approach.

Psychodynamic therapy effectively reduces symptomatology by focusing on underlying (unconscious) processes instead of symptoms. Nevertheless, the exact interrelationship between psychodynamic constructs and psychopathology remains unclear. This study uses network analysis to explore these associations. We computed a cross-sectional partial correlation network between psychodynamic constructs (i.e., personality functioning, interpersonal relations, and active and passive modes of intrapsychic conflicts according to the Operationalized Psychodynamic Diagnostics [OPD] system) and psychopathology (i.e., depression and somatization) in a naturalistic sample of 341 adults registering for psychodynamic outpatient therapy. We estimated node centrality, node predictability, and bridge symptoms and used community detection analysis. Bootstrap methods were applied to assess network stability. Psychodynamic constructs and psychopathology resulted in separate but connected clusters. Personality functioning emerged as the most influential node in the network and was bridging the clusters. The network was found to be highly stable, allowing reliable interpretations. The results offer important insights on how psychodynamic constructs relate to psychopathology, which can be used to inform treatment approaches. The findings suggest that personality functioning may be an important intervention target. However, future research is needed to include a broader range of diagnoses. In addition, longitudinal studies may clarify the direction of causality.

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.

[Facets of diagnostics of mentalization in children]. / Aspekte der Mentalisierungsdiagnostik bei Kindern.

Clinical relevance of variations within the ability to mentalize is usually reported in the field of psychopathology in adults. This might be due to difficulties in methods for empirical assessment of this capacity in children. In this short report the author discusses facets and abilities of how to engage the inner world of young children with story stem techniques and especially how to register variations in the ability to mentalize. Ideas for assessment in early childhood are presented and illustrated along two clinical vignettes. This paper gives a short impression of clinical diagnostics of mentalization in childhood.

[How children who's siblings are diagnosed with cancer experience and regulate the disease]. / Wie Geschwister krebskranker Kinder die Erkrankung erleben und verarbeiten.

The aim of this study is to investigate behaviour problems and emotional regulation of children who's siblings are diagnosed with cancer. Participants were assessed with the Strengths and Difficulties Questionnaire (SDQ) and the MacArthur Story Stem Battery (MSSB). Both instruments were administered twice (shortly after diagnosis and at the end of treatment). Brothers and sisters of 14 children suffering from cancer were compared with 18 siblings of healthy individuals. In the SDQ no differences between the two groups were found. At time 1 the MSSB showed significant differences in number and quality of displayed contents, representation of parents and the way of performing the narrative. At time 2 narratives changed particularly in the treatment group, but some differences still remained. Overall siblings of children suffering from cancer showed more intrapsychic reaction to the disease than became obvious in their behaviour. This fosters the conclusion that there may be a need for specific support for siblings of children with cancer in order to prevent them from psychic disorders and pathological mourning reactions.

[Behavior problems and identification of mental states in preschoolers]. / Verhaltensprobleme und das Erkennen mentaler Zustände im Vorschulalter.

Aim of the study is to present a method to map the ability of children to identify emotions and intentions in emotionally relevant situations (intentional and emotional reflectiveness). Moreover we analyze interrelation between this ability and behavior problems. Therefore we administered Story Stem Interviews with 70 children and added demand questions focusing emotions and intentions of diverse characters within the child constructed stories. All the given answers we displayed on a six-ary scale. To review the clinical relevance we correlated this measure with questionnaire-based behavior screenings by educators in kindergarten. We found correlations between behavior problems and especially answers to emotion questions (emotional reflectiveness). We regard this as evidence that the ability to identify emotions and intentions in others has an important protective function even in childhood.

[Differences in doll play of four-year old children of different ethnic groups]. / Unterschiede im Spielverhalten von Vierjährigen aus unterschiedlichen ethnischen Gruppen.

In its psychological development, the child learns social-emotional competences in order to be able to cope with conflicts. Since ethnic diversity increases due to globalization, the influence of the ethnic background on the social competence children development must be investigated furthermore. The present study examines the differences of the social-emotional competences of children of various ethnic groups. To track the social-emotional competence in play, 84 Asian-American, Latin-American and African-American kindergarteners (age = 4) were tested with the Mac Arthur Story Stem Battery and the attachment representation using the Attachment Doll Play manual. There were significant differences in the avoidance of conflict, empathic and moral themes in problem-solving among the ethnic groups. Furthermore, according to ethnic background the children significantly differed in the dimensions of attachment representation, freezing/blocking, constriction and controlling. Since ethnically specific social competence, attachment dimensions and their inter-correlation were found, the children started Kindergarten with differing qualifications. There are indications that the differences in attachment accentuations in children call for ethnic differences in social competence and interpretations of social situations in adults and children.

[Mental representation, psychic structure, and behaviour problems in preschool children]. / Repräsentanz, psychische Struktur und Verhaltensprobleme im Vorschulalter.

Mental health problems in terms of deviant behaviour and emotional problems are assumed in context with mental representations and indicators of internal psychic structure. In distinction to adults there is little empirical research concerning this matter. On the basis of Childrens' Play Narratives (MacArthur Story Stem Battery) we collected data about content-themes, structural indicators and process criteria of 73 preschool children and implicated these information with behaviour ratings of parents and kindergarden teachers. Many correlations were found particularly with structural indicators, process criteria and behaviour ratings. The results are discussed both with respect to content and methodical aspects.