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Yükçü ŞB, Demircioğlu H. Developing the mother-child interaction inventory and uncovering mother-child interaction profiles in Türkiye. J Pediatr Nurs 2024; 77:e546-e557. [PMID: 38797644 DOI: 10.1016/j.pedn.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND In this study, we aimed to design a mother-report inventory to comprehensively assess mother-child interaction in the 0-3 age range, focusing on maternal and child interaction behavior and mutual attunement. METHODS Our research involved three stages, with 1061 mothers and their 0-3-year-old children: 45 in the pilot study, 498 in exploratory factor analysis and latent profile analysis, and 518 in confirmatory factor analysis. FINDINGS The Mother-Child Interaction Inventory emerged as a valid and reliable measurement tool, comprising three distinct scales: 1) Maternal Interaction Behavior Questionnaire with sensitive structuring, hostility, and intrusiveness subscales; 2) Child Interaction Behavior Questionnaire with emotional-behavioral involvement and child characteristics; and 3) Mutual Attunement Questionnaire with reciprocity and problem-solving subscales. Latent profile analysis revealed four mother-child interaction profiles, indicating different characteristics in maternal and child interaction behavior and mutual attunement, categorized as "Excellent interaction quality," "Average interaction quality 1", "Average interaction quality 2," and "Poor interaction quality." DISCUSSION The study underscores the significance of maternal and child interaction behavior and mutual attunement in determining the quality of mother-child interaction. The mother-report The Mother-Child Interaction Inventory is a functional measurement tool to evaluate interaction separately and holistically, unveiling mother-child interaction profiles in the Turkish context. PRACTICE IMPLICATIONS The practical implications of this research are significant for health professionals, educators, and stakeholders working with children and families. The Mother-Child Interaction Inventory provides a valuable tool for assessing interaction dynamics, offering insights that can be directly applied to improve mother-child interaction.
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Burback L, Forner C, Winkler OK, Al-Shamali HF, Ayoub Y, Paquet J, Verghese M. Survival, Attachment, and Healing: An Evolutionary Lens on Interventions for Trauma-Related Dissociation. Psychol Res Behav Manag 2024; 17:2403-2431. [PMID: 38912158 PMCID: PMC11193433 DOI: 10.2147/prbm.s402456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Purpose Dissociation is a necessary part of our threat response system, common to all animal species, normally temporarily activated under conditions of extreme or inescapable threat. Pathological dissociation, however, continues to occur after the initial threat has passed, in response to reminders or inaccessibility of safety and security. Present across the spectrum of psychiatric diagnoses, recurrent dissociative symptoms are linked to severe trauma exposure, insecure attachment, treatment non-response, and maladaptive coping behaviors such as substance use, suicidality, and self-harm. However, empirical studies testing treatments specific to dissociative processes remain scarce. This narrative review summarizes existing studies and provides theoretical, neurobiological, and evolutionary perspectives on dissociative processes and treatments for pathological dissociation. Methods A systematic search of five databases (MEDLINE, EMBASE, APA PsycINFO, CINAHL plus, Scopus) was conducted on April 13, 2023. Peer-reviewed clinical studies with adult participants, assessing intervention effects on dissociative symptoms, were included. Results were thematically analyzed and summarized. Results Sixty-nine studies were identified, mainly focused on posttraumatic stress disorder, trauma-exposed populations, and borderline personality disorder. Psychotherapy was studied in 72.5% of studies; other interventions included medications and neurostimulation. The majority reported positive outcomes, despite the heterogeneous spectrum of interventions. However, treatment of dissociative symptoms was the primary objective in only a minority. Conclusion Pathological dissociation is a complex phenomenon involving brain and body systems designed for perceiving and responding to severe threats, requiring an individualized approach. A literature is emerging regarding potentially evidence-based treatments to help those impacted by recurrent dissociative symptoms. When contextualized within a neurobiological and evolutionary perspective, these treatments can be understood as facilitating an internal and/or relational sense of safety, resulting in symptom reduction. Further studies are needed to explore effective treatments for dissociative symptoms.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Huda F Al-Shamali
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Yahya Ayoub
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Jacquelyn Paquet
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Myah Verghese
- Department of Neuroscience, University of Alberta, Edmonton, Alberta, Canada
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Oppenheim D, Koren-Karie N, Slonim M, Mottes-Peleg M, Sher-Censor E, Dolev S, Yirmiya N. Maternal and paternal insightfulness and reaction to the diagnosis in families of preschoolers with Autism spectrum disorder: associations with observed parental sensitivity and inter-parent interaction. Attach Hum Dev 2024; 26:22-40. [PMID: 38451115 DOI: 10.1080/14616734.2024.2326416] [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: 11/26/2023] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
Sensitivity among parents of children with Autism Spectrum Disorder (ASD) is based on parental insightfulness and on resolution regarding the child's diagnosis. This has been supported in studies of mothers, and we examined whether the same is true regarding fathers. Also, we asked whether parents' Insightfulness and Resolution tap general mentalization and therefore also be expressed in parent-parent interactions. Eighty preschooler boys with ASD and both of their parents participated. As expected, fathers who were more insightful and mothers who were more resolved were more sensitive. Contrary to expectations, no associations were found between fathers' resolution and mothers' insightfulness and their sensitivity. Associations were found between parental insightfulness and resolution and positive parent-parent interaction. The findings are the first to demonstrate the insightfulness-sensitivity link among fathers of children with ASD. Also, they suggest that both insightfulness and resolution involve general mentalization that is evident both in parent-child and parent-parent interactions.
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Affiliation(s)
- David Oppenheim
- School of Psychological Sciences and Center for the Study of Child Development, University of Haifa, Haifa, Israel
| | - Nina Koren-Karie
- School of Social Work and Center for the Study of Child Development, University of Haifa, Haifa, Israel
| | - Michal Slonim
- School of Psychological Sciences and Center for the Study of Child Development, University of Haifa, Haifa, Israel
| | - Michal Mottes-Peleg
- School of Psychological Sciences and Center for the Study of Child Development, University of Haifa, Haifa, Israel
| | - Efrat Sher-Censor
- School of Psychological Sciences and Center for the Study of Child Development, University of Haifa, Haifa, Israel
| | - Smadar Dolev
- Oranim Academic College of Education, Department of Early Childhood Education, Tivon, Israel
| | - Nurit Yirmiya
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
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Sprengeler MK, Mattheß J, Galeris MG, Eckert M, Koch G, Reinhold T, Berghöfer A, Fricke J, Roll S, Keil T, Ludwig-Körner C, Kuchinke L, von Klitzing K, White LO, Schlensog-Schuster F. Being an Infant in a Pandemic: Influences of the COVID-19 Pandemic on Infants, Toddlers and Their Mothers in a Clinical Population. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1885. [PMID: 38136087 PMCID: PMC10742006 DOI: 10.3390/children10121885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child's sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants' regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group.
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Affiliation(s)
- Mona Katharina Sprengeler
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Janna Mattheß
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Mirijam-Griseldis Galeris
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Melanie Eckert
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Gabriele Koch
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, 97080 Wuerzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, 97688 Bad Kissingen, Germany
| | - Christiane Ludwig-Körner
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Lars Kuchinke
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Lars Otto White
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Franziska Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
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McLean MA, Scoten OC, Chau CMY, Synnes A, Miller SP, Grunau RE. Association of Neonatal Pain-Related Stress and Parent Interaction With Internalizing Behaviors Across 1.5, 3.0, 4.5, and 8.0 Years in Children Born Very Preterm. JAMA Netw Open 2022; 5:e2238088. [PMID: 36269352 PMCID: PMC9587482 DOI: 10.1001/jamanetworkopen.2022.38088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE Internalizing (anxiety and/or depressive) behaviors are prevalent in children born very preterm (24-32 weeks' gestation). Procedural pain-related stress in the neonatal intensive care unit (NICU) is associated with long-term internalizing problems in this population; however, whether positive parenting during toddlerhood attenuates development of internalizing behaviors across childhood is unknown. OBJECTIVE To investigate whether neonatal pain-related stress is associated with trajectories of internalizing behaviors across 1.5, 3.0, 4.5, and 8.0 years, and whether supportive parenting behaviors and lower parenting stress at 1.5 and 3.0 years attenuate this association. DESIGN, SETTING, AND PARTICIPANTS In this prospective longitudinal cohort study, preterm neonates (born at 24-32 weeks' gestation) were recruited from August 16, 2006, to September 9, 2013, with follow-up visits at ages 1.5, 3.0, 4.5, and 8.0 years. The study was conducted at BC Women's Hospital, Vancouver, Canada, with recruitment from a level III neonatal intensive care unit and sequential developmental assessments performed in a Neonatal Follow-up Program. Data analysis was performed from August to December 2021. MAIN OUTCOMES AND MEASURES Parental report of child internalizing behaviors on the Child Behavior Checklist at 1.5, 3.0, 4.5, and 8.0 years. RESULTS A total of 234 neonates were recruited, and 186 children (101 boys [54%]) were included in the current study across ages 1.5 (159 children), 3.0 (169 children), 4.5 (162 children), and 8.0 (153 children) years. After accounting for clinical factors associated with prematurity, greater neonatal pain-related stress was associated with more internalizing behaviors across ages (B = 4.95; 95% CI, 0.76 to 9.14). Higher parenting stress at age 1.5 years (B = 0.17; 95% CI, 0.11 to 0.23) and a less supportive parent environment (less sensitivity, structure, nonintrusiveness, nonhostility, and higher parenting stress; B = -5.47; 95% CI, -9.44 to -1.51) at 3.0 years were associated with greater internalizing problems across development to age 8.0 years. CONCLUSIONS AND RELEVANCE In this cohort study of children born very preterm, exposure to repetitive neonatal pain-related stress was associated with persistent internalizing behavior problems across toddlerhood to age 8.0 years. Supportive parenting behaviors during early childhood were associated with better long-term behavioral outcomes, whereas elevated parenting stress was associated with more child anxiety and/or depressive behaviors in this population. These findings reinforce the need to prevent pain in preterm neonates and inform future development of targeted parent-led behavioral interventions.
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Affiliation(s)
- Mia A. McLean
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Olivia C. Scoten
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Cecil M. Y. Chau
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne Synnes
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- BC Women’s Hospital, Vancouver, British Columbia, Canada
| | - Steven P. Miller
- Department of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Ruth E. Grunau
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- BC Women’s Hospital, Vancouver, British Columbia, Canada
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Almeida AS, Giger JC, Mendonça S, Fuertes M, Nunes C. Emotional Availability in Mother-Child and Father-Child Interactions as Predictors of Child's Attachment Representations in Adoptive Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084720. [PMID: 35457588 PMCID: PMC9028699 DOI: 10.3390/ijerph19084720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/20/2022] [Accepted: 03/26/2022] [Indexed: 11/16/2022]
Abstract
Emotional availability (EA) in parent-child interactions is associated with positive child outcomes, including attachment security. However, little is known about EA in adoptive families. This study investigated the associations between secure representations of attachment in adopted children and the adoptive parents' EA. The participants (n = 75) included 26 mothers, 23 fathers, and 26 children who were aged 3 to 9 years. Children completed the Attachment Story Completion Task. Adult-child dyadic relationships were assessed using the EA® System. The results showed that the children's and parents' EA, age when adopted, and time elapsed since adoption were associated with more secure children's attachment representations. Implications for family support and public policy are discussed.
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Affiliation(s)
- Ana Susana Almeida
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (J.-C.G.); (C.N.)
- Correspondence:
| | - Jean-Christophe Giger
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (J.-C.G.); (C.N.)
| | - Sandra Mendonça
- CDI.UP—Cooperativa de Desenvolvimento Infantil e União Parental, CRL, 8125-196 Quarteira, Portugal;
| | - Marina Fuertes
- Centro de Psicologia da Universidade do Porto (CPUP) & Escola Superior de Educação (ESELX-IPL), Campus de Benfica do IPL, 1549-003 Lisboa, Portugal;
| | - Cristina Nunes
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (J.-C.G.); (C.N.)
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Provenzi L, Grumi S, Rodrigo MJ. Editorial: Neural and Epigenetic Factors in Parenting, Individual Differences and Dyadic Processes. Brain Sci 2022; 12:brainsci12040478. [PMID: 35448009 PMCID: PMC9028230 DOI: 10.3390/brainsci12040478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Correspondence:
| | - Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy;
| | - Maria José Rodrigo
- Department of Developmental Psychology and Education, Faculty of Psychology, University of La Laguna, 38200 La Laguna, Spain;
- University Institute of Neuroscience, University of La Laguna, 38200 La Laguna, Spain
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Köhler-Dauner F, Mayer I, Hitzler M, Karabatsiakis A, Matits L, Bach AM, Rost K, Fegert JM, Kolassa IT, Ziegenhain U. Atypical maternal interaction is associated with elevated levels of hair cortisol in children. Front Pediatr 2022; 10:994882. [PMID: 36760689 PMCID: PMC9905701 DOI: 10.3389/fped.2022.994882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/07/2022] [Indexed: 01/26/2023] Open
Abstract
The quality of maternal caregiving is an important factor in the healthy development of a child. One consequence of prolonged insensitive and atypical maternal interaction behavior (e.g., withdrawing from interactions with the child and role-reversal, i.e., the takeover of the parental role or parts of it by the child) in mother-child-dyads can cause alteration of the child's stress response system. Higher salivary cortisol concentrations were reported in infants and toddlers directly after negative interactions with their parents. However, no study to date has examined the association between atypical maternal interaction behavior and hair cortisol concentrations (HCC) in infants. Here, we studied the association of maternal interaction behavior with HCC of the child. Mother-child dyads (N = 112) participated in the longitudinal study My Childhood-Your Childhood. The AMBIANCE scale and its subscales were used to assess atypical maternal interaction behavior during the Strange Situation Procedure. Chronic stress levels in the child were assessed by HCC of 3 cm hair strands at the age of 12 months. Maternal educational level (operationalized in highest education level) served as a control variable. Robust multiple linear regression analyses revealed that role/boundary confusion was associated with HCC, i.e., the higher atypical interaction behavior of the mother the higher the HCC in the children. By measuring hair cortisol in this study, it is possible to determine the average long-term activity of the child's stress response system.Thus, atypical maternal interaction behavior could be a risk factor for persistent stress in children, contributing to a higher risk for negative health outcomes in later life. The results of this study highlight the importance of early intervention programs that focus on the relationship between mother and child.
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Affiliation(s)
| | - Inka Mayer
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Melissa Hitzler
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Karabatsiakis
- Department of Psychology, Clinical Psychology II, University of Innsbruck, Innsbruck, Austria
| | - Lynn Matits
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,Division of Sports and Rehabilitation Medicine, Department of Medicine, Ulm University Hospital, Ulm, Germany
| | - Alexandra M Bach
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Katharina Rost
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
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