[Domestic violence and its psychological consequences during the COVID-19 pandemic-key findings from German-speaking countries]. / Häusliche Gewalt und ihre psychischen Folgen während der COVID-19-Pandemie ­ Zentrale Befunde aus dem deutschsprachigen Raum.

The impact of traumatic experiences on mental health during the COVID-19 pandemic has been insufficiently discussed in the German-speaking countries. Against this background, a working group of scientifically and clinically active colleagues was formed on behalf of the German-Speaking Society for Psychotraumatology (DeGPT). The aim of the working group was to summarize central research findings on the incidence of domestic violence and associated psychological distress during the COVID-19 pandemic in German-speaking countries and to discuss their implications. In addition, associations between pre-existing childhood trauma and psychological distress during the pandemic should be illuminated. The present narrative review was prepared for this purpose.The results of the studies conducted indicate high prevalences of domestic violence during the COVID-19 pandemic, which, however, predominantly correspond to pre-pandemic prevalences. Adults with current or pre-existing interpersonal traumatic experiences during childhood or adolescence reported increased psychological distress during the pandemic compared with adults without such experiences. A number of risk factors (e.g., female gender, lower frequency of social contacts) increased the risk of psychological distress and posttraumatic stress disorder symptoms during the pandemic. According to these findings, people with current or past interpersonal trauma exposure represent a vulnerable group with special support needs during pandemic contexts.

[Psychometric Properties of a Short Alexithymia Scale (SAS-3) in the German General Population]. / Psychometrische Eigenschaften einer Kurzskala zur Erfassung von Alexithymie (SAS-3) in der deutschen Allgemeinbevölkerung.

OBJECTIVE: The literature on alexithymia has multiplied in recent decades as the construct has important implications for mental health. The so far used inventories are of limited use in epidemiological research, primary care, and other clinical settings where time and effort are important factors in assessment. Based on items of the authorized German version of the Toronto Alexithymia Scale, the aim of this study was to develop an ultra-short questionnaire for a condensed and unidimensional assessment of alexithymia. METHODS: Criteria for the abbreviated scale were: (a) one-dimensionality (necessary to calculate a global score), (b) one item from each of the originally postulated dimensions, and (c) no reverse-coded items (to avoid method artifacts). Data were drawn from two nationwide representative population surveys in Germany: a survey conducted in 1996 to develop the SAS-3 (N=2.047); and a survey conducted in 2013 (N=2.508) for the evaluation and calculation of SAS-3 percentiles. RESULTS: Reasonable correlations between the SAS-3 and the PHQ-2, the GAD-2, and the GBB-8 were observed. Based on a confirmatory factor analysis, the one-dimensionality of the SAS-3 could be confirmed, achieving very good fit indices. An additional invariance analysis regarding gender and different age groups resulted in (partial) strict invariance for the different multi-group analyses. Percentile ranks for SAS-3 sum score are reported stratified by gender and by age groups. CONCLUSIONS: The SAS-3 appears to be suitable in epidemiological research and other instances requiring an economical assessment of alexithymia.

Who beats their partner, and who beats their schoolmates? A comparison of teen dating and school physical violence perpetration in Lower Saxony, Germany.

Teen dating violence (TDV) and school violence (SV) are two major social problems in adolescence. Until recently, the antecedents of both TDV and SV have been analyzed largely independently of each other. This study analyses and compares the determinants of both TDV and SV, with a focus on physical violence. Based on a comprehensive survey of ninth-grade adolescents at the average age of 15 years (N = 3,800) conducted in the German federal state of Lower Saxony, the findings showed that there is a significant but low correlation between both physical TDV and SV (r = 0.21). Concerning the determinants, we found that males carry out physical SV significantly more often, but physical TDV significantly less often than female respondents. Acquaintance with violent friends shows a stronger correlation with SV but not with TDV. Low self-control and violent media consumption are determinants of both TDV and SV. Empathy as a protective factor and parental violence as another risk factor were found to be only weak and sometimes not significantly correlated with both TDV and SV.

[Measurement invariance and normative data of the 8-item short form of the Center of Epidemiological Studies-Depression Scale (CES-D-8)]. / Normierung und Evaluation der Messinvarianz der 8-Item-Kurzform der Center of Epidemiological Studies-Depression Scale (CES-D-8).

Measurement invariance and normative data of the 8-item short form of the Center of Epidemiological Studies-Depression Scale (CES-D-8) Objectives: Female gender is a risk factor for depression. It is questionable whether a given psychometric instrument depicts depressive symptom severity in men and women alike. Therefore, we examined measurement invariance of the Center of Epidemiological Studies Depression Scale-8 (CES-D-8) between women, men and different age groups. Additionally, we aimed providing normative data for CES-D-8. Methods: We assessed depressive symptoms in a German population-based sample (N = 2,507) with the CES-D-8. Gender-distorted items were excluded in the short form. Results: Using confirmatory factor analysis (CFA), we found good model fit for men, women and the overall sample. A multi-group CFA confirmed measurement invariance of CES-D-8 regarding the tested factors and their interaction. Gender- and age-group-specific norms were computed. Conclusion: The use of the CES-D-8 can be recommended in epidemiological contexts, for practice and research. Different values between women and men of different age groups can be compared appropriately from a psychometric perspective.

Epidemiology of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background: a representative study.

BACKGROUND: Data on the prevalence of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background are scarce. There are hints that this population is at risk. The aim of the study is to investigate the epidemiology of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background in Germany while taking gender-specific differences into consideration. METHODS: A representative study with N = 10,638 students (mean age 14.91 years, SD = .73).) in the state of Lower Saxony in Germany was conducted. In the 2014-2015 school year, 672 classes were selected by randomly sampling different school types. The participation rate was 84.1%, excluding any classes for which the director refused to provide consent. A total of 49.8% were female adolescents, and 23.3% of the participants had a migration background. Target variables were assessed with items from the Ottawa Self-Injury Inventory, the Self-Harm Behavior Questionnaire and the Self-Harm Inventory, partly adapted. RESULTS: Of all students, 7.6% had a lifetime history of suicide attempts, and 36.6% answered with a rating of at least "rarely" when asked to rate the lifetime prevalence of suicidal ideation. The 12-month prevalence of direct self-injurious behavior was 17.8%. Adolescents with a migration background showed a significantly higher prevalence of all three constructs (p = .006; p < .001; p = .006). Male students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (4.7% vs. 3.1%) than native males (p = .009). Female students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (15.9% vs. 10.4%) and suicidal ideation ("often" 12.1% vs. 8.9%) than native female students (p < .001; p = .008). CONCLUSION: Our assessment indicates an elevated risk for suicidal behaviors in adolescents with a migration background. From research on adults, it is known that the dominant motives for suicidal behavior in migrants are associated with their migration history/situation. As suggested by Cramer and Kapusta's (Front Psychol 8:1756, 2017) theoretical model, the Social-Ecological Framework of Theory, Assessment, and Prevention, there is a need for culturally sensitive preventions that take into account the specific reasons for suicide attempts in migrants.

[Impact of Intimate Partner Violence on Child's Cognitive Development - Results from the Evaluation of the Home Visiting Program "Pro Kind"]. / Einfluss von Partnergewalt auf die kindliche kognitive Entwicklung ­ Ergebnisse der Begleitforschung zum Hausbesuchsprogramm "Pro Kind".

Impact of Intimate Partner Violence on Child's Cognitive Development - Results from the Evaluation of the Home Visiting Program "Pro Kind" Intimate partner violence (IVP) is a socially relevant problem area of high prevalence. Direct or indirect IVP leads to well documented problems in child socioemotional development. Longitudinal studies on influences of IVP on child's cognitive development are rare. The present study adds to close this gap. We analyze data from n = 535 families living under psychosocial risk conditions. All families took part in the evaluation of the home visiting program "Pro Kind". We administered one item of a parent questionnaire to assess the occurrence of IVP. The child's cognitive development is assessed at the ages of 6, 12, and 24 months of age with the Bayley Scales-II. We test the hypothesis that IVP to the mother causally affects early cognitive development of children in a structural equation model with Cross-Lagged-Panel design. The results show a causal influence of IVP on child's cognitive development during the period from t3 (12 months of child's age) to t4 (24 months of child's age). The explanatory power of results is limited by methodological problems, e. g. the operationalization of IVP with only one item and a high panel mortality. Implications for early prevention and intervention of IVP are derived.

Factor structure and psychometric properties of the english version of the trier inventory for chronic stress (TICS-E).

BACKGROUND: Demands placed on individuals in occupational and social settings, as well as imbalances in personal traits and resources, can lead to chronic stress. The Trier Inventory for Chronic Stress (TICS) measures chronic stress while incorporating domain-specific aspects, and has been found to be a highly reliable and valid research tool. The aims of the present study were to confirm the German version TICS factorial structure in an English translation of the instrument (TICS-E) and to report its psychometric properties. METHODS: A random route sample of healthy participants (N = 483) aged 18-30 years completed the TICS-E. The robust maximum likelihood estimation with a mean-adjusted chi-square test statistic was applied due to the sample's significant deviation from the multivariate normal distribution. Goodness of fit, absolute model fit, and relative model fit were assessed by means of the root mean square error of approximation (RMSEA), the Comparative Fit Index (CFI) and the Tucker Lewis Index (TLI). RESULTS: Reliability estimates (Cronbach's α and adjusted split-half reliability) ranged from .84 to .92. Item-scale correlations ranged from .50 to .85. Measures of fit showed values of .052 for RMSEA (Cl = 0.50-.054) and .067 for SRMR for absolute model fit, and values of .846 (TLI) and .855 (CFI) for relative model-fit. Factor loadings ranged from .55 to .91. CONCLUSION: The psychometric properties and factor structure of the TICS-E are comparable to the German version of the TICS. The instrument therefore meets quality standards for an adequate measurement of chronic stress.

Psychometric properties and measurement invariance of the Beck hopelessness scale (BHS): results from a German representative population sample.

BACKGROUND: The Beck Hopelessness Scale (BHS) has been the most frequently used instrument for the measurement of hopelessness in the past 40 years. Only recently has it officially been translated into German. The psychometric properties and factor structure of the BHS have been cause for intensive debate in the past. METHODS: Based on a representative sample of the German population (N = 2450) item analysis including item sensitivity, item-total correlation and item difficulty was performed. Confirmatory factor analyses (CFA) for several factor solutions from the literature were performed. Multiple group factor analysis was performed to assess measurement invariance. Construct validity was assessed via the replication of well-established correlations with concurrently assessed measures. RESULTS: Most items exhibited adequate properties. Items #4, #8 and #13 exhibited poor item characteristics- each of these items had previously received negative evaluations in international studies. A one-dimensional factor solution, favorable for the calculation and interpretation of a sum score, was regarded as adequate. A bi-factor model with one content factor and two method factors (defined by positive/negative item coding) resulted in an excellent model fit. Cronbach's alpha in the current sample was .87. Hopelessness, as measured by the BHS, significantly correlated in the expected direction with suicidal ideation (r = .36), depression (r = .53) and life satisfaction (r = -.53). Strict measurement invariance could be established regarding gender and depression status. Due to limited research regarding the interpretation of fit indices with dichotomous data, interpretation of CFA results needs to remain tentative. CONCLUSION: The BHS is a valid measure of hopelessness in various subgroups of the general population. Future research could aim at replicating these findings using item response theory and cross-cultural samples. A one-dimensional bi-factor model seems appropriate even in a non-clinical population.

ICD-11 Prevalence Rates of Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in a German Nationwide Sample.

Prevalence rates are still lacking for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) diagnoses based on the new ICD-11 criteria. In a nationwide representative German sample (N = 2524; 14-99 years), exposure to traumatic events and symptoms of PTSD or CPTSD were assessed with the International Trauma Questionnaire. A clinical variant of CPTSD with a lower threshold for core PTSD symptoms was also calculated, in addition to conditional prevalence rates dependent on trauma type and differential predictors. One-month prevalence rates were as follows: PTSD, 1.5%; CPTSD, 0.5%; and CPTSD variant, 0.7%. For PTSD, the highest conditional prevalence was associated with kidnapping or rape, and the highest CPTSD rates were associated with sexual childhood abuse or rape. PTSD and CPTSD were best differentiated by sexual violence. Combined PTSD and CPTSD (ICD-11) rates were in the range of previously reported prevalences for unified PTSD (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; ICD-10). Evidence on differential predictors of PTSD and CPTSD is still preliminary.

[Psychodynamic Oriented Multimodal Therapy for Inpatients with Borderline Personality Disorder: Effectiveness, Response, and Dropout]. / Stationäre psychodynamisch orientierte multimodale Therapie von Patienten mit Borderline-Persönlichkeitsstörung: Wirksamkeit, Response und Drop-out.

Psychodynamically oriented multimodal therapy approaches are efficacious for outpatients with borderline personality disorder (BPD). Until now, no study has reported the effectiveness, response, and dropout in a psychodynamic oriented multimodal therapy program for inpatients (PDOMT). In this study, we compared the results of 269 individuals seeking a 3-month inpatient treatment with previous studies for BPD inpatients by examining 269 individuals. The Borderline Personality Index (CUT-20-R) was used as the main outcome measure. Therapy outcome was defined in effect size (ES), response, and remission rates. In the pre-post comparison of the CUT-20-R, the ES was 0.74. The response and the remission rates were 34.6% and 2.6%. 50.6% of participants remained unchanged, 6.7% deteriorated, and 27.5% finished treatment prematurely. Male gender and patients with a dependent personality disorder increased the dropout risk. The results suggest that PDOMT might be effective for some, but not all BPD patients. Due to methodological shortcomings of the chosen strategy, future research should examine the effectiveness of PDOMT in a randomized controlled trial.

[Factors Influencing Theory of Mind Development in Preschoolers within the Context of Early Interventions]. / Einflussfaktoren auf die Theory of Mind-Entwicklung im Vorschulalter im Rahmen Früher Hilfen.

Factors Influencing Theory of Mind Development in Preschoolers within the Context of Early Interventions The Theory of Mind (ToM) competency is closely related to the child's cognitive, language, and socio-emotional development. In early interventions, skills and developmental processes associated with ToM development are often primary intervention targets, but empirical support for direct or indirect influences of early interventions on ToM development is missing so far. Within the home visiting program "Pro Kind" N = 755 families were accompanied by professionals from the last trimester of pregnancy until the child's second birthday. In the present follow-up study we investigated influences of treatment, pre- and postnatal family environment, parental competencies and child competencies on the ToM ability in a sample of n = 39 five-year-old children using Ctree analyses. Prenatal and current parental stress as well as an enriched family learning environment, and children's language competencies in interaction with temperament significantly predicted ToM competency. The treatment had no direct influence on ToM development. Thus, the results argue for the urgent need to address maternal stress regulation and mentalizing competencies in early interventions during pregnancy, as well as to focus on promoting positive stimulating learning environments and language development after the child's birth.

Population-based cost-offset analyses for disorder-specific treatment of anorexia nervosa and bulimia nervosa in Germany.

Previous research has shown that anorexia nervosa (AN) and bulimia nervosa (BN) are expensive illnesses to treat. To reduce their economic burden, adequate interventions need to be established. Our objective was to conduct cost-offset analyses for evidence-based treatment of eating disorders using outcome data from a psychotherapy trial involving cognitive behavioral therapy (CBT) and focal psychodynamic therapy (FPT) for AN and a trial involving CBT for BN. Assuming a currently running, ideal healthcare system using a 12-month, prevalence-based approach and varying the willingness to participate in treatment, we investigated whether the potential financial benefits of AN- and BN-related treatment outweigh the therapy costs at the population level. We elaborated on a formula that allows calculating cost-benefit relationships whereby the calculation of the parameters is based on estimates from data of health institutions within the German healthcare system. Additional intangible benefits were calculated with the aid of Quality-Adjusted Life Years. The annual costs of an untreated eating disorder were 2.38 billion EUR for AN and 617.69 million EUR for BN. Independent of the willingness to participate in treatment, the cost-benefit relationships for the treatment remained constant at 2.51 (CBT) and 2.33 (FPT) for AN and 4.05 (CBT) for BN. This consistency implies that for each EUR invested in the treatment, between 2.33 and 4.05 EUR could be saved each year. Our findings suggest that the implementation of evidence-based psychotherapy treatments for AN and BN may achieve substantial cost savings at the population level.

An 8-item short form of the Eating Disorder Examination-Questionnaire adapted for children (ChEDE-Q8).

Eating disturbances are common in children placing a vulnerable group of them at risk for full-syndrome eating disorders and adverse health outcomes. To provide a valid self-report assessment of eating disorder psychopathology in children, a short form of the child version of the Eating Disorder Examination (ChEDE-Q) was psychometrically evaluated. Similar to the EDE-Q, the ChEDE-Q provides assessment of eating disorder psychopathology related to anorexia nervosa, bulimia nervosa, and binge-eating disorder; however, the ChEDE-Q does not assess symptoms of avoidant/restrictive food intake disorder, pica, or rumination disorder. In 1,836 participants ages 7 to 18 years, recruited from two independent population-based samples, the factor structure of the recently established 8-item short form EDE-Q8 for adults was examined, including measurement invariance analyses on age, gender, and weight status derived from objectively measured weight and height. For convergent validity, the ChEDE-Q global score, body esteem scale, strengths and difficulties questionnaire, and sociodemographic characteristics were used. Item characteristics and age- and gender-specific norms were calculated. Confirmatory factor analysis revealed good model fit for the 8-item ChEDE-Q. Measurement invariance analyses indicated strict invariance for all analyzed subgroups. Convergent validity was provided through associations with well-established questionnaires and age, gender, and weight status, in expected directions. The newly developed ChEDE-Q8 proved to be a psychometrically sound and economical self-report assessment tool of eating disorder psychopathology in children. Further validation studies are needed, particularly concerning discriminant and predictive validity.

German Beck Scale for Suicide Ideation (BSS): psychometric properties from a representative population survey.

BACKGROUND: Suicidal ideation has been identified as one of the major predictors of attempted or actual suicide. Routinely screening individuals for endorsing suicidal thoughts could save lives and protect many from severe psychological consequences following the suicide of loved ones. The aim of this study was to validate the German version of the Beck Scale for Suicide Ideation (BSS) in a sample representative for the Federal Republic of Germany. METHODS: All 2450 participants completed the first part of the Scale, the BSS-Screen. A risk group of n = 112 individuals (4.6%) with active or passive suicidal ideation was identified and subsequently completed the entire BSS. RESULTS: Satisfactory internal reliability (α = .97 for the BSS-Screen; α = .94 for the entire BSS) and excellent model fit indices for the one-dimensional factorial structure of the BSS-Screen (CFI = .998; TLI = .995; RMSEA = .045 [95%-CI: .030-.061]) were confirmed. Measurement invariance analyses supported strict invariance across gender, age, and depression status. We found correlations with related self-report measures in expected directions comparable to previous studies, indicating satisfactory construct validity. LIMITATIONS: Our study involved cross sectional data, hence neither predictive validity nor retest-reliability were examined. As only the risk group of n = 112 individuals completed the entire measure, confirmatory factor analyses could not be conducted for the full BSS. CONCLUSION: The German translation of the BSS is a reliable and valid instrument for assessing suicidal ideation in the general population. Using it as a screening device in general and specialized medical care could substantially advance suicide prevention.

Mini - social phobia inventory (mini-SPIN): psychometric properties and population based norms of the German version.

BACKGROUND: A short screening for social anxiety disorder is useful in clinical and epidemiological contexts. However, the German version of the short form of the Social Phobia Inventory (mini-SPIN) has not been evaluated yet. Therefore, our aim was to determine reliability, validity and population based norms of the German mini-SPIN. METHODS: The mini-SPIN was evaluated in a clinical (N = 1254) and in a representative community sample (N = 1274). Clinical diagnoses, the Patient Health Questionnaire depression (PHQ-9) and somatization modules (PHQ-15), the Generalized Anxiety Disorder Scale (GAD-7), the Liebowitz Social Anxiety Scale (LSAS), and the Short-Form-12 Health Survey (SF-12) were used in the clinical sample. In the community sample, participants filled out socio-demographic and health related questions and short versions of the PHQ (PHQ-2, GAD-2, panic item). Internal consistency, test-retest reliability, sensitivity to change, discriminant validity, and convergent validity were examined. Receiver operating characteristic curve analyses were performed to determine cut-off scores. Population based norms were computed from the community sample. RESULTS: We found internal consistencies between 0.80 and 0.83. Test-retest correlation was Rho = 0.61; sensitivity to change was comparable to the LSAS. Correlations indicated good convergent and discriminant validity of the mini-SPIN. Strict measurement invariance can be assumed regarding age and gender. Receiver operating characteristic curve analysis suggested a cut-off of 6 or higher for a probable diagnosis of SAD. CONCLUSIONS: The German version of the mini-SPIN is a reliable and valid instrument. Its brevity makes it valuable for screening and assessing changes of social anxiety in clinical and epidemiological studies.

Addendum to "Four-Year Follow-Up of a Randomized Controlled Trial of Triple P Group for Parent and Child Outcomes".

A previous article published in Prevention Science 3 years ago (Heinrichs et al. 2014) presented the results of a randomized controlled trial of the Triple P group program 4 years (FU4) after administration as a universal prevention approach in preschools. The present addendum resolves inconsistencies in outcome reporting (e.g., total scores of scales versus subscale scores) and provides information on measures that were additionally available to analyze further potential effects of the intervention. Effects in secondary outcome domains not reported in Heinrichs et al. (2014) are furthermore analyzed and reported. The original data analyses were varied using a different statistical model in this addendum. Re-analyses supported the original results, including changes in self-reported maternal and paternal positive parenting, in maternal dysfunctional parenting behavior as well as in maternal reports of child behavior. In addition, when analyzing the externalizing and internalizing dimensions, analysis revealed a statistically significant change in externalizing but not internalizing child symptoms. No significant intervention effects were found for secondary outcome domains. Considering important limitations in the study design [such as baseline differences at pre-assessment with mothers from intervention preschools reporting more child behavioral problems prior to introducing the intervention and predominantly non-significant effects from (a) fathers perspective, (b) teacher ratings at 1-year follow up (FU1), and (c) behavioral observations at FU1], we believe that this trial alone cannot be taken as sufficient evidence for a significant and meaningful change in child behavioral problems, which is the ultimate goal of child prevention programs. Therefore, future studies need to replicate and extend upon these results by including larger sample sizes and overcome the discussed limitations.

[Effectiveness of CBT on Unemployed Compared to Employed Individuals Suffering from Prevalent Mental Disorders - A Naturalistic Study]. / Effektivität von kognitiver Verhaltenstherapie bei arbeitslosen und erwerbstätigen Patienten mit prävalenten psychischen Störungen ­ Eine naturalistische Studie.

Background Unemployed individuals suffer more from mental strain than those who have jobs. Up until now, little information could be found regarding the effectiveness of cognitive behavioral therapy (CBT) for unemployed people with mental disorders. The aim of this study was to compare the impact of CBT on employed versus unemployed individuals in a naturalistic setting. Methods 92 outpatients with prevalent mental disorders (depression and anxiety) were matched post-hoc and assessed pre-treatment, post-treatment, and at follow-up. Results Unemployed individuals were more impaired at all assessment points. The multi-level analysis showed that both groups benefited equally. Moderate-to-large effect sizes were found in both groups. At follow-up-assessment, one third of the unemployed sample and one-fifth of those with jobs were classified as unimpaired. The job integration rate was 26%. Discussion The effect sizes indicate that CBT is beneficial for both groups. However, unemployed participants were as impaired at post-treatment as the employed were at pre-treatment. The job integration rate of 26% was comparable to the general integration rate in Germany (25%), although no work-focused interventions were carried out during the adjustment period. Conclusions CBT is effective for unemployed individuals, but because the unemployed participants were still more impaired at post-treatment, they might have a higher risk of relapse.

The eating disorder examination-questionnaire 8: A brief measure of eating disorder psychopathology (EDE-Q8).

OBJECTIVE: The aim of this study was to develop, evaluate, and standardize a short form of the well-established Eating Disorder Examination-Questionnaire (EDE-Q). The newly developed EDE-Q8 was required to reflect the originally postulated structure of the EDE-Q. METHOD: Data were drawn from two nationwide representative population surveys in Germany: a survey conducted to develop the EDE-Q8 in 2009 (N = 2,520); and a survey conducted in 2013 (N = 2,508) for the evaluation and calculation of EDE-Q8 percentiles. RESULTS: The EDE-Q8 had excellent item characteristics, very good reliability and a very good model fit for the postulated second-order factorial structure. Furthermore, a strong correlation between the EDE-Q8 and a 13 item short form of the Eating Attitudes Test was observed. DISCUSSION: The EDE-Q8 appears to be particularly suitable in epidemiological research, when an economical assessment of global eating disorder psychopathology is required. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:613-616).

[Psychometric Evaluation of an Arabic Version of the PHQ-4 Based on a Representative Survey of Syrian Refugees]. / Psychometrische Prüfung einer Hocharabischen Übersetzung des PHQ-4 anhand einer repräsentativen Befragung syrischer Geflüchteter.

Background: This study addresses the need for methodologically sound, brief screening procedures (e. g., the PHQ-4) which need to be validated for refugees in their native languages. Method: A cohort of Syrian refugees in the state of Lower Saxony was investigated with the PHQ-4 translated into Standard Arabic language by a professional translation bureau. Based on representative data, the prevalence of anxiety and depressive disorders was estimated among refugees. N=864 persons of mainly male sex (68%) answered with a mean age of M=31.5 (SD=9.3 years, ranging from 16 to 93 years). Results: Internal consistency was good (PHQ-2, respectively GAD-2: α=0.76/0.83; women α=0.76/0.83; men: α=0.76/0.83). Confirmatory factor analyses revealed good to excellent fit: RMSEA=0,068 [95%-KI: 0.028, 0.117], TLI=0.971, CFI=0.995. Measurement invariance was demonstrated for sex. The prevalence of depression was 20%, which corresponds to results reported for the German population; generalized anxiety was moderately higher in the Syrian sample (19.3 vs. 15.2%). Discussion: The Arabic version of the PHQ-4 is an ultra-short and valid screening procedure suitable for refugees from Arabic countries. The finding that the prevalence of depression and anxiety symptoms was moderate may be due to the sample composition, which comprised predominantly young men. Given the often traumatic circumstances of their flight, additional symptoms beyond the scope of this study (esp. PTSD) can be expected.

Four-year follow-up of a randomized controlled trial of triple p group for parent and child outcomes.

Approximately 15-20% of children experience behavioral and/or emotional difficulties. Evidence-based treatment will likely not be sufficient to reduce the prevalence of these difficulties in children and adolescents. Effective prevention programs are therefore also needed to enable families access to support at multiple points across the lifecourse. The aim of the current investigation was to evaluate the 4-year efficacy of the group-based Triple P (Positive Parenting Program) as a prevention program administered universally. Seventeen preschools were randomly assigned to Triple P (n = 11 preschools, 186 families) or a no parenting intervention control group (n = 6 preschools, 94 families). Long-term efficacy was analyzed with hierarchical linear models using maternal and paternal self-report measures. Mothers and fathers from the intervention preschool group reported significant reductions in dysfunctional parenting behavior (d = 0.24 and 0.19, respectively). Mothers also reported a less steep decline from pre- to post-intervention in positive parenting behavior, which was maintained 4 years later (d = 0.38). Fathers from intervention preschools reported a delayed less steep decline in positive parenting during the follow-up (d = 0.33). In addition, mothers from intervention preschools reported immediate improvement in child behavior problems during the program while mothers from control preschools did not report this immediate change. However, with mothers from intervention preschools reporting more child behavior problems at baseline, the effect disappeared by the fourth year (d = 0.19). The results support the long-term efficacy of the Triple P-group program as a universal prevention intervention for changing parenting behavior while there was little evidence for maintenance of change in behavior problems.