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Egmose I, Steenhoff T, Tharner A, Væver MS. Parental reflective functioning in mothers and fathers of preschoolers: Associations with adult attachment and parenting behavior. Scand J Psychol 2024; 65:747-757. [PMID: 38581691 DOI: 10.1111/sjop.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/08/2024]
Abstract
Parental reflective functioning (PRF) is considered a key parental competence. Since most research on PRF has focused on infancy or the first years of life, there is a gap in our understanding of PRF among parents of older children. Therefore, we investigated PRF in mothers and fathers with preschool-aged children, examining associations between PRF, parent's romantic attachment, and observed parenting behavior. The sample comprised 50 mothers, 40 fathers, and their 5-year-old children. PRF was assessed using the parental reflective functioning questionnaire (PRFQ), parental romantic attachment was assessed using the experiences in close relationships scale-revised (ECR-R), and parenting behavior was assessed during a parent-child free-play interaction with the coding interactive behavior (CIB) coding system. Results showed that mothers scored higher on the interest and curiosity scale than fathers, indicating that mothers show a more active interest and curiosity in their child's mental states. Further, higher levels of attachment anxiety in fathers were associated with higher levels of pre-mentalizing modes. In mothers, higher levels of attachment avoidance were associated with lower levels of interest and curiosity. Finally, and unexpectedly, higher levels of interest and curiosity in mothers were associated with less sensitivity during free play. In summary, the study found meaningful associations between mothers' and fathers' romantic attachment and their PRF indicating a spill-over of their attachment strategies into their relationship with their child. Further, the study results suggest that very high levels of interest and curiosity in mothers reflect hypermentalizing.
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Affiliation(s)
- Ida Egmose
- Centre for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Tine Steenhoff
- Centre for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Tharner
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mette Skovgaard Væver
- Centre for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Slade A, Sleed M. Parental Reflective Functioning on the Parent Development Interview: A narrative review of measurement, association, and future directions. Infant Ment Health J 2024; 45:464-480. [PMID: 38650168 DOI: 10.1002/imhj.22114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/25/2024] [Accepted: 03/14/2024] [Indexed: 04/25/2024]
Abstract
A caregiver's capacity to mentalize is thought to be one of the most important features of secure parent-child relationships. Parental mentalizing can be measured using the Reflective Functioning (RF) coding system applied to the Parent Development Interview (PDI). In this narrative review, we summarize the research using this measure and synthesize what has been learnt about the predictors, correlates and sequelae of parental RF. Studies have consistently shown that PRF on the PDI is associated with both parent and child attachment and is an important factor in the intergenerational transmission of attachment. It is also related to the quality of parental representations, parent-child interactions, and child outcomes. While a number of social and clinical risk factors are associated with lower PRF, it is difficult to disentangle the unique contribution of each of these. We discuss these findings and present the direction of future work that is planned to expand and refine the PRF scale for the PDI.
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Affiliation(s)
- Arietta Slade
- Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Michelle Sleed
- Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud Centre and University College London, London, UK
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Larkin F, Oostenbroek J, Lee Y, Hayward E, Fernandez A, Wang Y, Mitchell A, Li LY, Meins E. A smartphone app effectively facilitates mothers' mind-mindedness: A randomized controlled trial. Child Dev 2024; 95:831-844. [PMID: 37965827 DOI: 10.1111/cdev.14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023]
Abstract
The efficacy of a smartphone app intervention (BabyMind©) in facilitating mind-mindedness was investigated in a randomized controlled trial, assigning mothers and their 6-month-olds (N = 152; 72 girls, 146 White) to intervention or active control conditions. Mothers who had received the BabyMind© app intervention scored higher for appropriate (d = .61, 95% CI .28, .94) and lower for non-attuned (d = -.55, 95% CI -.92, -.18) mind-related comments at follow-up (age 12 months), compared with their control group counterparts. Adjusting for missing data did not alter this pattern of findings. Mothers' baseline parental reflective functioning did not moderate these relations. Results are discussed in terms of the benefits of early intervention and exploring the efficacy of the app in more diverse populations.
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Affiliation(s)
| | | | | | | | | | - Ying Wang
- Auckland University of Technology, Auckland, New Zealand
| | | | - Lydia Y Li
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kungl MT, Gabler S, White LO, Spangler G, Vrticka P. Precursors and Effects of Self-reported Parental Reflective Functioning: Links to Parental Attachment Representations and Behavioral Sensitivity. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01654-2. [PMID: 38326634 DOI: 10.1007/s10578-023-01654-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 02/09/2024]
Abstract
Parental reflective functioning is thought to provide a missing link between caregivers' own attachment histories and their ensuing parenting behaviors. The current study sought to extend research on this association involving 115 parents, both mothers and fathers, of 5-to-6-year-old preschoolers using the German version of the Parental Reflective Functioning Questionnaire (PRFQ). Our study was the first to combine Adult Attachment Interview classifications of parental attachment, behavioral observations of parental sensitivity and PRFQ ratings while drawing on a sizable father subsample. We found theoretically consistent significant relations between all measures, while our results particularly highlighted the role of dismissing attachment for decreases in parenting quality on both cognitive and behavioral levels as the dismissing status differentially affected specific components of self-reported parental reflective functioning and observed sensitivity. Interestingly, these patterns were largely comparable in mothers and fathers. Exploratory mediation analyses further suggested that decreased parental reflective functioning may partially mediate the relationship between parents' dismissing attachment and decreased parental sensitivity. Thus, for prevention and intervention programs targeting parental sensitivity and thus children's long term healthy mental development, the interplay between parental reflective functioning and parents' own attachment history emerges as a key mechanism. Finally, our study served as a further validation of the PRFQ given the caveat that the pre-mentalizing subscale may need further revision in the German version.
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Affiliation(s)
- Melanie T Kungl
- Department of Developmental Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Naegelsbachstrasse 49a, 91052, Erlangen, Germany.
| | - Sandra Gabler
- Department of Developmental Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Naegelsbachstrasse 49a, 91052, Erlangen, Germany
| | - Lars O White
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
- Berlin Psychological University, Am Köllnischen Park 2, 10179, Berlin, Germany
| | - Gottfried Spangler
- Department of Developmental Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Naegelsbachstrasse 49a, 91052, Erlangen, Germany
| | - Pascal Vrticka
- Department of Psychology, Centre for Brain Science, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1A, 04103, Leipzig, Germany
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Yazdanimehr R, Aflakseir A, Sarafraz M, Taghavi M. The structural model of mother-infant bonding in the first pregnancy based on the mother's attachment style and parenting style: the mediating role of mentalization and shame. BMC Psychol 2023; 11:396. [PMID: 37974255 PMCID: PMC10655332 DOI: 10.1186/s40359-023-01436-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate the relationship between the mother's attachment style and parenting style and mother-infant bonding in the first pregnancy considering the mediating role of mentalization and shame. METHODS This was a descriptive-correlational study. The sample population included the women who had gone through their first pregnancy and were referred to the health centers in Neyshabur, Iran in 2022. In total, 330 women were selected by convenience sampling. To collect data, we used a demographic questionnaire, the Attachment Style Questionnaire, the Parenting Style Questionnaire, the Mother-Infant Bonding Scale, the Reflective Functioning Questionnaire, and the Guilt and Shame Proneness Scale. Data analysis was conducted using descriptive indices, correlation coefficients, and pass analysis. RESULTS Overall, the findings showed that the studied model adequately fits the data. Further, the obtained results confirmed the mediating role of mentalization and shame in the relationship between the mother's attachment style and parenting style and mother-infant bonding. A significant correlation was also observed between attachment styles, parenting styles, and mother-infant bonding (p < 0.01). CONCLUSION Mother-infant bonding is correlated with the mother's attachment style/parenting style, shame, and mentalization. Thus, we can help vulnerable mothers by improving the quality of psychological care before the first pregnancy or during pregnancy.
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Affiliation(s)
- Reza Yazdanimehr
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran.
| | - Abdolaziz Aflakseir
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mehdireza Sarafraz
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mohammadreza Taghavi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
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Rebecchini L, Bind RH, Allegri B, Zamparelli A, Biaggi A, Hazelgrove K, Osborne S, Conroy S, Pawlby S, Sethna V, Pariante CM. Women with depression in pregnancy or a history of depression have decreased quality of mentalization in the speech to their infants. Acta Psychiatr Scand 2023. [PMID: 37931907 DOI: 10.1111/acps.13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/20/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Our study aims to understand whether depression, either in pregnancy or lifetime, affects cognitive biases (comprising the attentional focus and affective state) and mentalizing features (ability to understand children's internal mental states, thereby detecting and comprehending their behavior and intention), in maternal speech during mother-infant interaction in the first postnatal year. METHODS We recruited 115 pregnant women (44 healthy, 46 with major depressive disorder [MDD] in pregnancy, and 25 with a history of MDD but healthy pregnancy) at 25 weeks' gestation. Three-minute videos were recorded at 8 weeks and 12 months postnatally for each dyad. Maternal speech was transcribed verbatim and coded for cognitive biases and mentalizing comments using the Parental Cognitive Attributions and Mentalization Scale (PCAMs). RESULTS Women suffering from antenatal depression showed a decreased proportion of mentalizing comments compared with healthy women, at both 8 weeks (0.03 ± 0.01 vs. 0.07 ± 0.01, P = 0.002) and 12 months (0.02 ± 0.01 vs. 0.04 ± 0.01, P = 0.043). Moreover, compared with healthy women, both those with antenatal depression and those with a history of depression showed decreased positive affection in speech (0.13 ± 0.01 vs. 0.07 ± 0.01 and 0.08 ± 0.02, respectively P = 0.003 and P = 0.043), and made significantly fewer comments focused on their infants' experience at 8 weeks (0.67 ± 0.03 vs. 0.53 ± 0.04 and 0.49 ± 0.05, respectively P = 0.015 and P = 0.005). In linear regression models women's socioeconomic difficulties and anxiety in pregnancy contribute to these associations, while postnatal depression did not. CONCLUSIONS Both antenatal depression and a lifetime history of depression are associated with a decreased quality of women's speech to their infants, as shown by less focus on their infant's experience, decreased positive affection, and less able to mentalize. Examining maternal speech to their infants in the early postnatal months may be particularly relevant to identify women who could benefit from strategies addressing these aspects of the interactive behavior and thus improve infant outcome in the context of depression.
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Affiliation(s)
- Lavinia Rebecchini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Beatrice Allegri
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Arianna Zamparelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Sarah Osborne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Vaheshta Sethna
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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Dinzinger A, Ismair S, Brisch KH, Sperl W, Deneault AA, Nolte T, Hitzl W, Priewasser B. Mentalizing in first-time fathers: reflective functioning as a mediator between attachment representation and sensitivity. Attach Hum Dev 2023; 25:544-565. [PMID: 37815537 DOI: 10.1080/14616734.2023.2258354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 09/09/2023] [Indexed: 10/11/2023]
Abstract
Sensitivity in parent-child interaction is essential for child development. Since fathers are increasingly involved in childrearing, identifying factors leading to paternal sensitivity is crucial. We examined the relation between attachment representation and reflective functioning (RF) as factors influencing paternal sensitivity in a longitudinal study including N = 40 first-time fathers (Mage = 33) and their 6-month-old children. We used the Adult Attachment Interview during pregnancy to assess paternal attachment representation and general RF, the Parental Development Interview to assess fathers' parental RF, and the Emotional Availability Scale to measure sensitivity at child's age of 6 month. Data show that secure paternal attachment representation, high general and parental RF are associated with higher levels of paternal sensitivity. Further, parental RF mediates the association between attachment representation and paternal sensitivity. These findings contribute to the identification of a causal interplay in that they suggest an explanatory effect of RF on the association between fathers' attachment representation, and sensitivity.
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Affiliation(s)
- Antonia Dinzinger
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Selina Ismair
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Karl Heinz Brisch
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Dr. von Hauner Children's Hospital Ludwig Maximilians University, Munich, Germany
| | - Wolfang Sperl
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | | | - Tobias Nolte
- Research Department for Clinical, Educational and Health Psychology, University College London, UK
| | - Wolfgang Hitzl
- Research and Innovation Management, Biostatistics, Paracelsus Medical University, Salzburg, Austria
| | - Beate Priewasser
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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Georg AK, Meyerhöfer S, Taubner S, Volkert J. Is parental depression related to parental mentalizing? A systematic review and three-level meta-analysis. Clin Psychol Rev 2023; 104:102322. [PMID: 37572565 DOI: 10.1016/j.cpr.2023.102322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 08/14/2023]
Abstract
This systematic review and meta-analysis is aimed to summarize the state of research on the relation between parental depression and parental mentalizing. To account for the multifaceted nature of parental mentalizing, several conceptualizations and measures were included and compared. The last database search was conducted on March 13, 2023. Using three-level meta-analytic modelling, we analyzed a total of 12,665 participants from 63 studies with 233 effect sizes. Taken together, higher depression was only weakly associated with lower mentalizing (r = -0.06). Specifically, parents with higher depression scored lower on questionnaire measures of parental reflective functioning (r = -0.11). No significant correlations were found for interview measures of parental reflective functioning, the observational and interview measure of mind-mindedness, or insightfulness. The data showed substantial heterogeneity. The mean effect size for self-reported pre-mentalizing (r = -0.23 for reverse-coded subscale scores) was significantly stronger compared to other self-report subscales. In studies including parents with diagnosis and controls, there was limited evidence suggesting a larger negative correlation between depression, mind-mindedness, and insightfulness. Therefore, more research is needed in clinical samples. Due to their correlational nature, our results do not allow causal inferences. Future studies should target moderators that explain variability (e.g., comorbid psychological problems, coparenting, child behavior).
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Affiliation(s)
- Anna K Georg
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany.
| | | | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Germany
| | - Jana Volkert
- Department of Psychology, MSB Medical School Berlin, Germany
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Stuhrmann LY, Göbel A, Bindt C, Mudra S. Parental Reflective Functioning and Its Association With Parenting Behaviors in Infancy and Early Childhood: A Systematic Review. Front Psychol 2022; 13:765312. [PMID: 35310277 PMCID: PMC8927808 DOI: 10.3389/fpsyg.2022.765312] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Background Parental reflective functioning (PRF) refers to parents’ mental capacity to understand their own and their children’s behaviors in terms of envisioned mental states. As part of a broader concept of parental mentalization, PRF has been identified as one of the central predictors for sensitive parenting. However, the unique contribution of PRF to the quality of various parenting behaviors has not yet been addressed systematically. Thus, the present article provides a systematic overview of current research on the associations between PRF or its sub-dimensions and observed parenting behaviors in infancy and early childhood, while considering the influence of contextual factors. Methods The review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Systematic searches were carried out in five electronic databases. The eligibility and methodological quality of the identified studies were assessed using pre-defined criteria and a standardized checklist. Results Sixteen studies with moderate to high quality on a total of 15 parenting behaviors were included, the majority of which examined positive parenting behaviors, while negative parenting behaviors were rarely investigated. Most of the associations indicated a positive effect of PRF on parenting behavior, with mostly small-sized effects. The strength and direction of the associations varied depending on the dimensionality of PRF, observation settings, sample types, socioeconomic factors, and cultural background. Moreover, five assessment instruments for PRF and 10 observation instruments for parenting behaviors were identified. Conclusion In summary, PRF has shown a positive association with parenting quality. However, its complex interaction with further contextual factors emphasizes the need for differentiation of PRF dimensions and the consideration of the observation settings, assessment time points, psychosocial risks, and sample types in observational as well as intervention studies. Further high-quality studies with multivariate analyses and diverse study settings are required.
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Affiliation(s)
- Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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