@article{InhesternBultmannBeierleinetal.2016,
  author    = {Inhestern, Laura and Bultmann, Johanna Christine and Beierlein, Volker and M{\"o}ller, Birgit and Romer, Georg and Koch, Uwe and Bergelt, Corinna},
  title     = {Understanding parenting concerns in cancer survivors with minor and young-adult children},
  series = {Journal of psychosomatic research},
  volume    = {87},
  journal   = {Journal of psychosomatic research},
  doi       = {10.1016/j.jpsychores.2016.05.008},
  pages     = {1 -- 6},
  year      = {2016},
  abstract  = {OBJECTIVE Parents with cancer are concerned about the impact of their disease on their children. However, parenting concerns and associated factors in cancer survivors have not previously been analyzed. The purpose of this study is to examine parenting concerns and to test a path model for understanding parenting concerns in cancer survivors. METHODS In a cross-sectional study, a total of 1416 parents with cancer (mean age 47.5years, 74\% women) having minor or young-adult children were recruited through two cancer registries. Parenting concerns were assessed using the Parenting Concerns Questionnaire. Structural equation modeling (SEM) was used to analyze the associations between social support, parenting confidence, emotional distress, family functioning and parenting concerns. RESULTS Mothers reported higher total parenting concerns than fathers (p<0.001). We observed strong effects of emotional distress and parenting confidence on parenting concerns. Family dysfunctioning was associated with lower concerns. An indirect association between social support and parenting concerns was identified. CONCLUSION Parenting concerns in cancer survivors display the need for interventions and after care programs that focus on affected families with minor and young adult children. The results of the structural path model illustrate the associations between psychological and interactional factors. Supporting parents with cancer in their parenting confidence and strengthen social support and family functioning may not only reduce the long-term burden on the parents themselves but also the burden on the entire family.},
  subject      = {Adolescent},
  language  = {en}
}
@article{InhesternBultmannBeierleinetal.2017,
  author    = {Inhestern, Laura and Bultmann, Johanna Christine and Beierlein, Volker and M{\"o}ller, Birgit and Romer, Georg and Koch, Uwe and Bergelt, Corinna},
  title     = {Elterliche Sorgen und psychische Belastung bei krebskranken Eltern mit minderj{\"a}hrigen und jungerwachsenen Kindern},
  series = {Psychotherapie, Psychosomatik, medizinische Psychologie},
  volume    = {67},
  journal   = {Psychotherapie, Psychosomatik, medizinische Psychologie},
  doi       = {10.1055/s-0043-110139},
  pages     = {279 -- 287},
  year      = {2017},
  abstract  = {Background Aim of the study was to analyze parenting concerns in cancer survivors and to identify covariats for parenting concerns. Method In a cross-sectional epidemiological sample of cancer survivors with minor children (n=1416) demographic and disease-related variables and psychological distress (HADS) were assessed. Parenting concerns were assessed using the Parenting Concerns Questionnaire (PCQ). The instrument covers the 3 subscales concerns about the 'practical impact' of the disease on the children, about the 'emotional impact' and concerns about the 'co-parent'. Results 73\% of survivors were female; mean age was 47.5 years (SD 5.9). 24\% to 71\% of patients reporting parenting concerns showed normal levels of anxiety and depression. We identified living alone, younger age of the youngest child, higher tumor stage and suffering from a comorbidity as significantly associated with parenting concerns in all subscales of the PCQ. Low socio-economic status was found to be significantly associated with parenting concerns regarding the emotional and practical impact of the disease. Being a mother was associated with concerns in the subscale co-parent. Discussion Parents with cancer not only suffer from psychological distress but also from parenting concerns about the impact of their disease on their children. Psychological support services should broach the issue of parenting concerns. Families at risk should be identified to allocate tailored support. Hintergrund Ziel der dargestellten Untersuchung ist es, elterliche Sorgen von Krebs{\"u}berlebenden zu untersuchen und Kovariaten dieser spezifischen Belastungen zu identifizieren. Material \& Methoden In einer epidemiologischen Stichprobe von n=1416 an Krebs erkrankten Eltern wurden soziodemografische und medizinische Merkmale sowie die psychische Belastung der Eltern (HADS) erhoben. Elterliche Sorgen wurden mit dem Parenting Concerns Questionnaire (PCQ) erhoben, der die Subskalen Sorgen um die ‚praktischen Auswirkungen' der Erkrankung auf die Kinder, ‚emotionale Auswirkungen' auf die Kinder und Sorgen in Bezug auf den ‚Co-Elternteil' umfasst. Ergebnisse 73\% der Krebs{\"u}berlebenden sind Frauen, das durchschnittliche Alter liegt bei 47,5 Jahren (SD 5,9). Zwischen 24\% und 71\% der Patienten mit elterlichen Sorgen zeigen in den Skalen der HADS unauff{\"a}llige Werte. Alleinleben, j{\"u}ngeres Alter des j{\"u}ngsten Kindes, ein h{\"o}heres Tumorstadium und das Vorhandensein einer weiteren k{\"o}rperlichen Erkrankung sind mit Sorgen in allen 3 Subskalen des PCQ positiv assoziiert. Ein niedriger Sozialstatus konnte als Kovariate f{\"u}r elterliche Sorgen auf emotionaler Ebene und auf praktischer Ebene identifiziert werden. Weibliches Geschlecht ist assoziiert mit Sorgen auf der Subskala Co-Elternteil. Diskussion Betroffene Eltern sind neben der allgemeinen psychischen Belastung durch die Erkrankung auch durch Sorgen um ihre Kinder belastet. Psychologische Unterst{\"u}tzungsangebote f{\"u}r krebskranke Eltern sollten auch spezifische elterliche Sorgen thematisieren. Eltern mit Risikokonstellationen f{\"u}r eine erh{\"o}hte Belastung sollten besonders ber{\"u}cksichtigt werden, um bedarfsgerecht Unterst{\"u}tzung anbieten zu k{\"o}nnen.},
  subject      = {Adolescent},
  language  = {de}
}
@article{KuehneHaagenBaldusetal.2013,
  author    = {K{\"u}hne, Franziska and Haagen, Miriam and Baldus, Christiane and Diareme, Stavroula and Grether, Andrea and Schmitt, Florence and Stanescu, Dan and St{\"o}ckl, Margit and Thastum, Mikael and M{\"o}ller, Birgit and Romer, Georg},
  title     = {Implementation of preventive mental health services for children of physically ill parents: experiences in seven European countries and health care systems},
  series = {General hospital psychiatry},
  volume    = {35},
  journal   = {General hospital psychiatry},
  doi       = {10.1016/j.genhosppsych.2012.10.005},
  pages     = {147 -- 153},
  year      = {2013},
  abstract  = {OBJECTIVE Parental physical disease is a family issue, but families' minor children are seldom considered. The current study analyzed experiences with implementation of counseling for families with physically ill parents and minor children during a European multisite pilot project. METHOD Implementation protocols of seven European partner centers collaborating in a joint research project were analyzed by Mayring's qualitative content analysis. Both an inductive approach and a deductive approach were chosen. Satisfaction of families and therapists was considered based on information from three partner centers. RESULTS Satisfaction with counseling was rather high. Mentioned problems referred to aspects related to liaison partners, family-related aspects and physicians' concerns. Recommendations related to contacting families, liaising with other professions, implementing counseling together with a research project, and training. Results are integrated in the current dissemination literature. CONCLUSION Successful implementation was mostly determined by aspects of interdisciplinary cooperation and communication, perceived relative advantage and organizational premises. With regard to this kind of innovative child-centered family mental health services, top-down and bottom-up implementation strategies should be combined, and strategies of maintenance and sustainability should be considered from the very beginning.},
  subject      = {Adolescent},
  language  = {en}
}
@article{KrattenmacherKuehneFuehreretal.2012,
  author    = {Krattenmacher, Thomas and K{\"u}hne, Franziska and F{\"u}hrer, Daniel and Ernst, Johanna and Br{\"a}hler, Elmar and Herzog, Wolfgang and Klitzing, Kai and Flechtner, Hans-Henning and Bergelt, Corinna and Romer, Georg and M{\"o}ller, Birgit},
  title     = {Kinder krebskranker Eltern - elterliches Coping, famili{\"a}res Funktionsniveau und psychosoziale Anpassung der Kinder},
  series = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  volume    = {61},
  journal   = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  issn      = {0032-7034},
  doi       = {10.13109/prkk.2012.61.6.447},
  pages     = {447 -- 462},
  year      = {2012},
  abstract  = {Children exposed to parental cancer have an increased risk of mental health problems. However, the parental illness itself and its features do not predict children's psychological adjustment. Parent- and family-related factors are more predictive for children's well-being and the incidence of psychopathological symptoms, respectively. This study focuses on parental ways of coping with illness from both, the ill and healthy parent's perspective, and the relationship with family functioning and children's adjustment. Results show a significant impact of parental coping styles on children's health-related quality of life and psychopathological symptoms and, furthermore, that this relationship is mediated by aspects of family functioning. This study support the importance of family systems approaches. Implications for further studies and practical issues are discussed.},
  subject      = {Adaptation},
  language  = {de}
}
@article{BergeltErnstBeierleinetal.2012,
  author    = {Bergelt, Corinna and Ernst, Johanna Christine and Beierlein, Volker and Inhestern, Laura and Holes, Sarah and M{\"o}ller, Birgit and Romer, Georg and Koch, Uwe},
  title     = {Reaktive Ver{\"a}nderungen in Befinden und Verhalten von Kindern bei elterlicher Krebserkrankung--Ergebnisse einer epidemiologischen Patientenbefragung},
  series = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  volume    = {61},
  journal   = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  issn      = {0032-7034},
  doi       = {10.13109/prkk.2012.61.6.378},
  pages     = {378 -- 395},
  year      = {2012},
  abstract  = {Children of cancer patients are at risk for developing psychological symptoms. The parental appraisal of the child's psychological condition is a key variable for the utilization of child-centred psychosocial services. This study aimed at the systematic analysis of parental appraisals of changes in the emotional condition or behaviour of their children. We conducted an epidemiologic survey with a sample size of 1,809 patients with different cancer diagnoses, giving information about 2,581 children aged 21 years or younger at time of diagnosis. Quantitative information on children's distress during the disease and on changes in psychological condition or behaviour and qualitative information on the kind of changes were analysed. About half of the children were considered to be psychologically strongly affected during the disease. For about 25 \% negative changes in psychological condition or behaviour are reported, positive changes are reported for 20 \% of the children. Negative changes are most frequently described in young children (up to five years), positive changes are most frequently described in young adults (18 to 21 years). The results indicate that from the cancer parent's view many children are substantially distressed. Thus, the implementation of additional preventive psychosocial services seems reasonable and necessary.},
  subject      = {Adolescent},
  language  = {de}
}
@article{BeckerGjergjiLamaRomeretal.2014,
  author    = {Becker, Inga and Gjergji-Lama, Voltisa and Romer, Georg and M{\"o}ller, Birgit},
  title     = {Merkmale von Kindern und Jugendlichen mit Geschlechtsdysphorie in der Hamburger Spezialsprechstunde},
  series = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  volume    = {63},
  journal   = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  issn      = {0032-7034},
  pages     = {486 -- 509},
  year      = {2014},
  abstract  = {Given the increasing demand for counselling in gender dysphoria in childhood in Germany, there is a definite need for empirical data on characteristics and developmental trajectories of this clinical group. This study aimed to provide a first overview by assessing demographic characteristics and developmental trajectories of a group of gender variant boys and girls referred to the specialised Gender Identity Clinic in Hamburg. Data were extracted from medical charts, transcribed and analysed using qualitative content analysis methods. Categories were set up by inductive-deductive reasoning based on the patients' parents' and clinicians' information in the files. Between 2006 and 2010, 45 gender variant children and adolescents were seen by clinicians; 88.9\% (n = 40) of these were diagnosed with gender identity disorder (ICD-10). Within this group, the referral rates for girls were higher than for boys (1:1.5). Gender dysphoric girls were on average older than the boys and a higher percentage of girls was referred to the clinic at the beginning of adolescence (> 12 years of age). At the same time, more girls reported an early onset age. More girls made statements about their (same-sex) sexual orientation during adolescence and wishes for gender confirming medical interventions. More girls than boys revealed self-mutilation in the past or present as well as suicidal thoughts and/or attempts. Results indicate that the presentation of clinically referred gender dysphoric girls differs from the characteristics boys present in Germany; especially with respect to the most salient age differences. Therefore, these two groups require different awareness and individual treatment approaches.},
  subject      = {Adolescent},
  language  = {de}
}
@article{KuehneKrattenmacherBergeltetal.2013,
  author    = {K{\"u}hne, Franziska and Krattenmacher, Thomas and Bergelt, Corinna and Bierbaum, Anna-Lena and Christine Ernst, Johanna and Flechtner, Hans-Henning and Keller, Monika and Klitzing, Kai V. and Romer, Georg and M{\"o}ller, Birgit},
  title     = {Elternschaft und Krebserkrankung: Dyadische Analyse von psychosozialer Belastung und gesundheitsbezogener Lebensqualit{\"a}t von krebskranken Eltern minderj{\"a}hriger Kinder},
  series = {Psychotherapie, Psychosomatik, medizinische Psychologie},
  volume    = {63},
  journal   = {Psychotherapie, Psychosomatik, medizinische Psychologie},
  doi       = {10.1055/s-0033-1341454},
  pages     = {473 -- 481},
  year      = {2013},
  abstract  = {The purpose of this study was the analysis of psychological distress and health-related quality of life (HRQoL) of parents with minor children during curative resp. palliative treatment.Cross-sectional design with a sample of N=89 parent dyads. Dyadic analysis of demographic, illness and family variables via mixed linear models.Patients and healthy partners indicated psychological distress on different subscales. Intradyadic correlations were small-moderate. Most important predictors of psychological distress and HRQoL were treatment stadium, gender, family functioning, and employment status.Dependent on demographic variables, psychooncological support was evident mainly for parents in palliative care and for families with dysfunctional functioning.},
  subject      = {Adult},
  language  = {de}
}
@article{MoellerStegemannRomer2008,
  author    = {M{\"o}ller, B. and Stegemann, T. and Romer, Georg},
  title     = {Psychosoziale Belastungen bei Kindern k{\"o}rperlich kranker Eltern: Perspektiven der seelischen Gesundheitsvorsorge},
  series = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},
  volume    = {51},
  journal   = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},
  issn      = {1436-9990},
  doi       = {10.1007/s00103-008-0542-5},
  pages     = {657 -- 663},
  year      = {2008},
  abstract  = {Irrespective of their well-known increased risk for mental health problems, children of somatically ill parents are a clinically underserved as well as under-researched group. In this article, the authors introduce the epidemiologic and clinical relevance of this topic and present a theoretical framework for understanding the sequelae of a serious parental illness on minor-age children, based on family dynamics and developmental concepts. This is followed by a comprehensive review of current empirical studies in this field, with a special emphasis on results from a transnational European collaborative study (COSIP = Children of Somatically Ill Parents), which was coordinated by the last author. The most important recommendations from intervention concepts published to date are summarized. Some outlooks for clinical practice as well as future research are presented.},
  subject      = {Adaptation},
  language  = {de}
}
@article{MoellerSchreierLietal.2009,
  author    = {M{\"o}ller, Birgit and Schreier, Herbert and Li, Alice and Romer, Georg},
  title     = {Gender identity disorder in children and adolescents},
  series = {Current problems in pediatric and adolescent health care},
  volume    = {39},
  journal   = {Current problems in pediatric and adolescent health care},
  doi       = {10.1016/j.cppeds.2009.02.001},
  pages     = {117 -- 143},
  year      = {2009},
  subject      = {Adolescent},
  language  = {en}
}