The prevalence of misophonia in a representative population-based survey in Germany.

PURPOSE: Misophonia is a new disorder, currently defined as significant emotional and physiological distress when exposed to certain sounds. Although there is a growing body of literature on the characteristics of the disorder, the prevalence in the general population is still relatively unknown. This study therefore aims at determining the prevalence and symptom severity of misophonia in a large and representative general population sample in Germany. METHODS: To examine the prevalence of misophonic sounds, misophonic reactions and misophonia severity, a cross-sectional population representative survey in Germany has been conducted. Participants (N = 2.522) were questioned retrospectively about misophonic symptoms using the Amsterdam Misophonie Scale - Revised (AMISOS-R). RESULTS: Overall 33.3% reported to be sensitive to at least one specific misophonic sound. Within the total sample, subthreshold symptoms were reported by 21.3%, mild symptoms were reported by 9.9%, moderate to severe symptoms were reported by 2.1%, and severe to extreme symptoms were reported in 0.1% of participants. CONCLUSION: Based on the diverging presentations and prevalence rates of misophonic sounds, reactions and symptoms according to the severity, it seems worthwhile to conceptualize misophonia as a rather continuous spectrum disorder (subthreshold, mild, moderate to severe), still taking into account that an additional categorical diagnostic approach might be necessary to derive a diagnosis in clinical practice.

[Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents]. / Sport- und Bewegungstherapie in der Behandlung psychischer Störungen bei Kindern und Jugendlichen.

Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents Abstract: Mental disorders are among the most common chronic diseases in childhood and adolescence in Germany and worldwide. The health benefits of a physically active lifestyle during adolescence are well documented. Furthermore, a growing body of evidence suggests a positive impact of physical activity on mental health and emotional well-being. Longitudinal studies also show an association between physical activity and reduced risk of developing a mental disorder. Therefore, therapeutic exercise plays an important role in child and adolescent psychiatry. High-quality randomized-controlled trials are needed to substantiate the described effects.

[Attitudes of Healthcare Professionals to Extremism and Treatment Options]. / Einstellung von Fachkräften aus den Heilberufen zum Thema Extremismus und zu Behandlungsoptionen.

OBJECTIVE: In view of the cruelty of acts of terrorism and violent extremism, it is often inconceivable what the underlying motives are. Analyzes of the attacks in Ansbach (2016), Halle (2019) and Hanau (2020) showed a picture of different psychological conspicuities among the perpetrators, which highlights the need to involve health care professionals in the prevention of extremism. Against this background, the treatment of people with extremist attitudes appears to be crucial in order to prevent negative consequences for those affected, but also for society. METHODS: Within the framework of an anonymous online survey, physicians and psychological psychotherapists were asked about previous experiences, attitudes and wishes regarding the treatment of patients with extremist attitudes. Furthermore, data on their own work was collected. RESULTS: A total of 364 physicians (18%), psychological psychotherapists (72%) and participants with other job descriptions (10%) took part in the study. Only one fifth state that they felt well trained in the subject. About half of the respondents would offer a place in therapy (if they could decide on the patients themselves), likewise about half have already dealt with the topic of extremism and the majority see a need to deal with the topic more in the future and indicate a need for further training. The analyses show that physicians have so far dealt with the topic somewhat more than those with psychological psychotherapeutic training, and professionals in private practive are more likely to see a connection between extremism and psychiatric illnesses than professionals in hospitals, but would be less willing to offer patients with extremist attitudes a place in therapy. DISCUSSION: Physicians and psychotherapists need further training on extremisms and should be better prepared fo the challenges of treating patients in this context. CONCLUSION: In order to increase the chances of providing adequate care for mentally ill people with extremist attitutdes, health professionals should be better prepared for the topic in the future, for example through further training or opportunities for cooperation.

[Experiences of dangerous situations in psychiatry and psychotherapy involving patients with extremist attitudes]. / Erfahrungen mit Gefährdungssituationen in Psychiatrie und Psychotherapie bei Patienten mit extremistischer Einstellung.

BACKGROUND AND OBJECTIVES: Dangerous situations in connection with the treatment of persons with suspected extremist attitudes have become increasingly relevant. A survey of physicians and psychotherapists is intended to provide information about concrete dangerous situations among these patients. MATERIALS AND METHODS: By means of an anonymous online survey, which comprised 16 main questions and up to 95 additional questions, a total of 364 health professionals were asked about the general situation and about patients, as well as relatives with suspected extremist attitudes. RESULTS: In all, 17.5% of the participants were physicians, 72.1% psychotherapists. 47.7% work exclusively in a hospital, 34.2% in a private practice. A total of 57.7% of the participants have already treated patients with suspected extremist attitudes (46.7% treated relatives); 27.6% were confronted with situations of self-endangerment (30.1% in the case of relatives), 49.5% with situations of danger to others (18.3% in the case of relatives), in which they often did not feel safe. Altogether, 20.3% of the professionals informed security authorities, and not quite half found this contact to be comparatively unhelpful/not at all helpful (45.5% among relatives). The majority of the participants had no contact to other agencies, such as specialized counselling centres for deradicalization. Physicians experienced the situations of endangerment more often than non-medical psychotherapists. A comparison between professionals from hospitals and private practices shows no significant differences. DISCUSSION: The study was able to show that extremism and the associated dangerous situations are an important topic in the treatment of patients and that physicians and non-medical psychotherapists should be well prepared. Networking with extremism prevention agencies and good cooperation with security authorities would be important and desirable for the future.

[Misophonia in Childhood and Adolescence: A Narrative Review]. / Misophonie im Kindes- und Jugendalter: Eine narrative Übersichtsarbeit.

Misophonia in Childhood and Adolescence: A Narrative Review Abstract. Misophonia describes a phenomenon in which the affected children and adolescents show a strong negative physiological and emotional reaction when confronted with specific (misophonic) auditory stimuli (most commonly eating or breathing sounds). Several studies with adults yielded prevalence rates between 6 % and 20 % in various (clinical) samples, but the representativeness of samples was largely limited. More than 80 % of the first manifestation of symptoms occurs during childhood and adolescence. Regarding comorbid disorders, studies show great heterogeneity, with estimates ranging from 28-76 % of comorbid mental disorders and approximately 25 % with comorbid physical disorders. The exact etiology is currently not well studied. Initial neurophysiological explanations and imaging studies point to a specific physiological response in misophonia patients. Although many case reports are now available, and diagnostic criteria and measurement tools have been developed, misophonia currently does not represent a distinct neurological, audiological, or psychiatric disorder in the DSM-5 or ICD-11.

[Development of Mental Health Problems of Girls and Boys in Residential Care Between 2008 and 2020]. / Entwicklung von psychischen Auffälligkeiten bei Mädchen und Jungen in stationären Jugendhilfeeinrichtungen zwischen den Jahren 2008 und 2020.

Development of Mental Health Problems of Girls and Boys in Residential Care Between 2008 and 2020 Abstract. Objective: Studies show a high prevalence of mental health problems in children and adolescents in youth-welfare facilities compared to the general population. However, to date, studies on this development over time are lacking. The present study examines the development of mental health problems and psychosocial functioning in the years 2008 to 2020. Method: Mental health problems were assessed with the CBCL, psychosocial functioning with Axis VI of the MAS. In total, data from 3,269 children and adolescents from residential-care facilities located throughout Germany were included in the analysis. Results: a decrease in externalizing behaviour was observed regarding the frequency of mental health problem in children and adolescents in youth-welfare facilities from 2008 to 2020. Particularly boys aged 12 and older show less deviant behavior. Older girls show high internalizing behavior problem scores over time, but there is no consistent trend. More than a quarter of the institutionalized children in youth-welfare institutions show severely impaired psychosocial functioning at a consistent level over time. Conclusions: In light of the age and gender effects associated with the development of mental health problems over time, there is a need to regard the care situation in youth-welfare institutions.

[Traumatic Experiences and Posttraumatic Stress Disorder of Adolescents in Boarding Schools]. / Traumatische Erfahrungen und Posttraumatische Belastungsstörungen von Jugendlichen in Internaten.

In the context of abuse cases in boarding schools, stress among children and adolescents in boarding schools in Germany was discussed for the first time. So far, however, there is a lack of studies dealing with post-traumatic stress disorders of adolescents in boarding schools.The aim was to analyze the extent of trauma experiences and symptoms of post-traumatic stress disorders as well as psychopathological abnormalities in adolescents in boarding schools on the basis of self-reports using a secondary analysis of theMAYSI-2 and UCLA PTSD Reaction Index for DSM-IV screening questionnaires and to derive implications for research and care concepts. Data was available from155 adolescents, 70%of whomweremale.The adolescents had been in boarding schools for an average of 3.26 years (SD = 2.48). A traumatic experience was evident in 69.7%(n = 108) of the adolescents, and 51.6%(n = 80) of the adolescentswere "conspicuous" in at least one of the six scales of theMAYSI-2. Taken together, 33.5%(n = 52) of the adolescents met the criteria for a suspected post-traumatic stress disorder according to ICD-10. Screening procedures should be established in boarding schools to identify traumatic experiences and psychopathological abnormalities in a timely manner. Concepts from youth welfare institutions can be used to deal with trauma experiences.There is a need for further research on traumatic experiences directly related to the boarding school placement situation.

The Prevalence of Sexual Abuse in Institutions: Results From a Representative Population-Based Sample in Germany.

The lifetime prevalence of sexual abuse in institutional settings in Germany was examined in a sample representative of the general adult population (N = 2,437). Participants completed a survey on whether they had ever experienced such abuse, its nature (contact, noncontact, forced sexual, intercourse), the type of institution (e.g. school, club), and the relationship of perpetrator to victim (peer, caregiver, staff member). Overall, 3.1% of adult respondents (women: 4.8%, men: 0.8%) reported having experienced some type of sexual abuse in institutions. Adult women reported higher rates of all types than did men, with rates of 3.9% versus 0.8% for contact sexual abuse, 1.2% versus 0.3% for noncontact sexual abuse, and 1.7% versus 0.2% for forced sexual intercourse. We conclude that a remarkable proportion of the general population experiences sexual abuse in institutions, underscoring the need for development of protective strategies. Especially, schools seem to represent good starting points for primary prevention strategies.

[Clinical diagnostics of psycho-social and cognitive standard of performance in youth with mental disabilities.] / Diagnostik des psychosozialen und kognitiven Entwicklungsstandes bei Intelligenzminderung im Kindes- und Jugendalter.

Clinical diagnostics of psycho-social and cognitive standard of performance in youth with mental disabilities. Abstract. The clinical diagnostics of cognitive limitations and the resulting problems of social development occurring in childhood and adolescence are essential for further stimulation as well as for possible treatment strategies for comorbid mental diseases. This complex process should be carried out on several levels and with different methods. The resulting praxis-oriented question is defined via the pros and cons of the current procedure for the recording of psycho-social and cognitive stage of development of young people with mental disabilities. The online-based research in relevant databases was conducted systematically and yielded 3,324 articles. After fully reviewing the disqualifying criteria, 30 procedures remained. Twenty-four procedures could be assigned to "tests of development and intelligence" and six to "observer rating and self-report methods". It becomes clear that the majority of treatments have been standardized for children and adolescents of average intelligence. Meaning, only inaccurate information regarding the participation of children and adolescents with intelligence impairments in the standardized sample were given. This goes hand in hand with qualifying criteria that were not tested in consideration of the needs of people with intelligence impairment. Despite the current unsatisfactory situation, there is a demand for diagnostic instruments of the psycho-social and cognitive standard of performance in youth with mental disabilities. Currently, K-ABC II and ADOS-2 are recommended in combination with the observer rating methods ADI-R, VFE, and SRS.

[The relationship between a sense of security and psychological problems in adolescents living in boarding schools and youth-welfare institutions]. / Zusammenhang von Sicherheitsgefühl und psychischen Auffälligkeiten bei Jugendlichen in Internaten und Jugendhilfeeinrichtungen.

Objective: The willingness to participate and a sense of security are important aspects to be fostered in the institutional care of adolescents. Although these aspects are increasingly being examined from the perspective of the affected adolescents, it has yet to be considered whether psychological problems can be attributed to their experiences with the above-mentioned aspects. Methods: A total of 216 adolescents aged 14 to 18 years answered an online questionnaire the sense of security in their institution and their perception of the institution. Their willingness to participate was also examined. Psychological symptoms were assessed with the Strengths and Difficulties Questionnaire Self-Report (SDQ-S). Results: There is a significant correlation between sense of security and the overall SDQ score, with prosocial behavior, and with the positive perception of the institution. In addition, sense of security had a significant influence on the SDQ factors, the positive perception of the institution, and the items on the willingness to participate of the adolescents. The subsequent t-tests also showed significant results. Among other things, it was shown that the factor problems of adolescents is related to sense of security. Conclusion: The results provide an initial indication that there is a link between sense of security and psychological symptoms as well as willingness to participate and perception of the institution. Especially problems of adolescents in dealing with peers must be taken into account.in the development of protective concepts to increase the sense of security and their willingness to participate.

The Relationship Between Narcissism and Personality Traits of the Five-Factor-Model in Adolescents and Young Adults.

Narcissism is seen as a multidimensional construct that consists of two manifestations: grandiose and vulnerable narcissism. In order to define these two manifestations, their relationship to personality factors has increasingly become of interest. However, so far no studies have considered the relationship between different phenotypes of narcissism and personality factors in adolescents. Method: In a cross-sectional study, we examine a group of adolescents (n = 98; average age 16.77 years; 23.5 % female) with regard to the relationship between Big Five personality factors and pathological narcissism using self-report instruments. This group is compared to a group of young adults (n = 38; average age 19.69 years; 25.6 % female). Results: Grandiose narcissism is primarily related to low Agreeableness and Extraversion, vulnerable narcissism to Neuroticism. We do not find differences between adolescents and young adults concerning the relationship between grandiose and vulnerable narcissism and personality traits. Discussion: Vulnerable and grandiose narcissism can be well differentiated in adolescents, and the pattern does not show substantial differences compared to young adults.

[Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population]. / Kindheitserlebnisse von Jugendlichen in Internaten. Ein Vergleich mit Jugendlichen aus Jugendhilfeeinrichtungen und der Allgemeinbevölkerung.

Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population Various studies indicate that students in boarding schools experience a lot of violence during their accommodation. However, it is not proved whether adolescents in boarding schools are also a burdensome group regarding early childhood experiences such as neglect and abuse. The aim of the study was to find out more about the experiences of adolescents in boarding schools and to determine whether there are differences between adolescents in residential care and between the general population. Furthermore, it should be examined whether boys and girls differ in their experiences. In the study, adolescents of boarding schools and of residential care all over Germany, starting at the age of 15 (n = 322), were asked regarding physical and emotional neglect/abuse, light/severe parent violence, negative/positive educational behavior of the parents. The results show that students in boarding schools were less likely to be affected by childhood maltreatment and more likely to have experienced positive parental behavior compared to children in residential care. Compared to the general population, students in boarding schools were more often and more severely affected by parental violence. Moreover, girls had experienced parental violence more often than boys. The results indicate that in boarding schools there is a need for support offers for adolescents with a history of violent experiences and that the risk group should be identified directly at the admission to the school.

[Mental Disorders of Adolescents in Boarding Schools: A Germany-Wide Survey]. / Psychische Auffälligkeiten von Jugendlichen in Internaten: Eine deutschlandweite Befragung.

Mental Disorders of Adolescents in Boarding Schools: A Germany-Wide Survey Overall, research on children and adolescents in boarding schools is still scarce. Especially mental disorders of students in boarding schools have not been investigated. As part of this study, a standardized questionnaire survey helped to ask adolescents starting from the age of 15 in boarding schools about mental disorders and depressive symptoms. 169 adolescents from a total of twelve boarding schools in Germany participated in the study. The results of the present Germany-wide survey of adolescents in boarding schools show that the students are a group of rather inconspicuous adolescents, especially the group of boys. Girls show increased risk of depressive behavior and externalizing problems in comparison to the general population. Therefore, child and adolescent psychiatric care should be considered when placed in a boarding school.

[Mental Stress of Professionals in Residential Care for Children and Adolescents]. / Belastungen von Fachkräften in stationären Einrichtungen für Kinder und Jugendliche.

An increasingly important issue is the mental strain of professionals in residential care for children and adolescents. However, only few studies investigate mental strain and overload of professionals in an educational context in general and even less in youth welfare institutions. The goal of this study was to examine mental strain experiences of professionals with the "Perceived Stress Questionnaire" (PSQ) in youth welfare institutions, as well as to investigate the relationship between age, duration of employment in this work environment and gender of participants. A total of 426 care providers participated in the online survey. The results tend to show higher stress levels among younger professionals and significantly higher values in tension compared to older employees, but no effect of gender. Furthermore, there is no relation between stress experience and duration of employment in this work environment, but a significant correlation between a feeling of security from violence in this institution and stress level. The total score for stress experience of professionals is similar to that of healthy adults, while in the subscales compared to the norm sample professionals show higher scores on requirements in terms of deadlines and time pressure as well as on tension. The results indicate a high vulnerability of young professionals, which could be addressed by institutional interventions. More studies are needed to clarify causal relationships.

Comparison of Psychopathological Symptoms in Adolescents Who Experienced Sexual Violence as a Victim and/or as a Perpetrator.

Research on sexual violence victims and perpetrators indicates that victims in general are found to report higher levels of psychopathological symptoms, especially internalizing behavior, whereas perpetrators often show externalizing behavior. Little is known, however, about the psychopathology of perpetrators of sexual violence who have also experienced sexual victimization (victim-perpetrators). Thus, the aim of the current study was to examine this group within a sample of adolescents living in residential care or federal boarding schools. Participants reported their lifetime experience with sexual violence (both as victim and perpetrator) and completed the Youth Self Report. Results indicate that all three groups of adolescents with sexual violence experience report higher total problem scores than adolescents without this experience. Victim-perpetrators show results more similar to those of perpetrators only than those of victims only. The discussion deals with the implications of our findings for the treatment of victims of sexual violence.

[Intervention and Therapy for Perpetrators and Victims of Bullying: A Systematic Review]. / Intervention und Therapie für Täter und Opfer von Schulbullying: Ein systematisches Review.

Intervention and Therapy for Perpetrators and Victims of Bullying: A Systematic Review Bullying is a form of repeated and aggressive behavior with serious consequences for victims and perpetrators, who often suffer from their experiences long after the bullying episodes have ended. However, the therapeutic treatment of bullying and its consequences represents a neglected topic in bullying research. Objective of the present article is to review publications systematically describing targeted interventions for the treatment of bullying (for victims and perpetrators) and associated disorders. The selection process consisted of a comprehensive systematic search in national and international databases that identified 34 targeted interventions in 31 publications from 14 different countries. The review of ten interventions featuring a controlled design revealed that in particular treatments on both the individual and socio-ecological level (particularly parents) are effective. The remaining 24 treatments lack a controlled evaluation. Two thirds of the interventions focus on victims. In contrast to the treatment of perpetrators, the emphasis here lies on group therapy. Although treatments of bullying apply a range of therapeutic approaches and methods, cognitive behavioral therapy is represented most prominently. As a conclusion one can observe an existing lack of research in evidence-based targeted interventions for the treatment of bullying and its consequences for victims and perpetrators. To our knowledge, this is the first systematic review of therapeutic interventions for bullying in children and adolescents.

The prevalence of Nonsuicidal Self-Injury (NSSI) in a representative sample of the German population.

BACKGROUND: Non-suicidal self-injury (NSSI) is a proposed new "condition for further study" in the DSM-5. To date no prevalence data has been available on this diagnostic entity from a representative sample of the general population. METHODS: A representative sample of the German population (N = 2509, mean age = 48.8 years, SD = 18.1, female 55.4 %) completed the NSSI section of the German version of the Self-Injurious Thoughts and Behaviors Interview (SITBI-G). RESULTS: A history of NSSI at least once during lifetime was reported by 3.1 % of all participants, with higher lifetime prevalence rates in younger age groups. DSM-5 NSSI disorder criteria were met by 0.3 %. The most common function of NSSI was automatic negative reinforcement (e.g. to alleviate negative feelings). CONCLUSIONS: To the best of our knowledge, this is the first study reporting rates for the proposed NSSI category in DSM-5 from a representative sample of the general population. In comparison to findings from community samples of adolescents, adults seem to have lower lifetime prevalence rates of NSSI, thus making it necessary to emphasize prevention and treatment efforts in younger age groups.

[Leaking: Frequency and correlates of announcements and threats of homicidal violence reported by Berlin schools between 1996 and 2007]. / Leaking: Häufigkeit und Korrelate von Ankündigungen und Androhungen tödlicher Gewalt nach Meldungen Berliner Schulen zwischen 1996 und 2007.

Threats and announcements of homicidal violence at schools may have massive consequences like evacuations, police searches, criminal investigations, or loss of the sense of security by students, teachers, and parents. However, there is a lack of systematic studies about that phenomenon. The present article would like to contribute to closing the research gap. It presents results about the frequency and structure of threats and announcements of homicidal violence in schools in Berlin. The study is based on an official dataset from school administration reports of violent acts in Berlin schools which has been studied within the Berlin Leaking-Projekt. The sample consists of 427 threats and announcements of homicidal violence between 1996 and 2007. The study is an exceptional analysis of the phenomenon: it presents crosscutting results about frequency and characteristics of threats and the threatening students as well as results of a longitudinal analysis about the development of threats and announcements. Results show a rate of 0,3 threats and announcements per 1 000 student and year. During the observation time span a steady increase of threats and announcements ­ year by year, influenced by imitation effects after school shootings ­ has been observed.

[Power to the children? ­ Machiavellianism in children and adolescents]. / Kinder an die Macht? ­ Machiavellismus im Kindes- und Jugendalter.

The desire for power and social dominance plays a significant role in the development of social aggression. Although the construct of Machiavellianism reflects these aspects well, it has hardly been recognized in Germany. In this review article the construct of Machiavellianism will be presented. Previous research on the relationship between Machiavellianism and particularly aggressive behavior in children and adolescents are critically discussed and implications for future studies are derived.

[Disclosure of Adolescents in Residential Care Institutions and Boarding Schools after Exposure to Sexual Violence]. / Disclosure von Jugendlichen in Jugendhilfeeinrichtungen und Internaten nach sexueller Gewalterfahrung.

Disclosure of Adolescents in Residential Care Institutions and Boarding Schools after Exposure to Sexual Violence In international research, many papers exist about the issue of disclosure after having experienced sexual violence. However, specific research regarding disclosure processes of children and adolescents in institutional care are missing, even though those are particularly often affected by sexual violence. In the Germany-wide study "Sprich mit!", adolescents from the age of 15 up (n = 322; average age 16,69 (SD = 1,3); 57,1 % males) who live in residential care or boarding schools were asked for experiences of sexual violence and their consequences by means of a self-report questionnaire. Results showed that the majority of the adolescents (82 %) entrusted themselves to someone, mostly towards peers (56 %) and less frequent towards adults (24 %). Boys and girls opened up equally often, regardless of the severity of the experienced violence. Adolescents who entrusted themselves towards their peers indicated retrospectively more satisfaction than those entrusting themselves towards adults, even if there were no consequences following the disclosure. Considering that the disclosure towards peers did not initiate a process of help, adolescents in institutional care should be better informed about relevant possibilities to entrust themselves and receive support.