@article{MoellerNiederPreussetal.2014, author = {M{\"o}ller, Birgit and Nieder, Timo Ole and Preuss, Wilhelm F. and Becker, Inga and Fahrenkrug, Saskia and W{\"u}sthof, Achim and Briken, Peer and Romer, Georg and Richter-Appelt, Hertha}, title = {Versorgung von Kindern und Jugendlichen mit Geschlechtsdysphorie im Rahmen einer interdisziplin{\"a}ren Spezialsprechstunde}, series = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, volume = {63}, journal = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, issn = {0032-7034}, pages = {465 -- 485}, year = {2014}, abstract = {In Germany, the situation of health care services for children and adolescents with gender dysphoria is insufficient. In 2006 a specialized multiprofessional outpatient clinic was founded at the University Medical Center Hamburg-Eppendorf. Goals were improvement of health services for gender dysphoric children, development of treatment concepts, and gain of knowledge through research. After finishing a thorough interdisciplinary assessment an individualized, case-by-case treatment starts. Besides psychotherapy an interdisciplinary treatment (e. g. puberty suppression and cross-sex hormones) is provided if indicated. During childhood a watchful waiting and carefully observing attitude is necessary. If a marked increase of gender dysphoria occurs during the first phases of puberty development, puberty suppression and later cross sex-hormones might be indicated.}, subject = {Adolescent}, language = {de} } @article{ErnstBeierleinRomeretal.2013, author = {Ernst, Johanna Christine and Beierlein, Volker and Romer, Georg and M{\"o}ller, Birgit and Koch, Uwe and Bergelt, Corinna}, title = {Use and need for psychosocial support in cancer patients: a population-based sample of patients with minor children}, series = {Cancer}, volume = {119}, journal = {Cancer}, doi = {10.1002/cncr.28021}, pages = {2333 -- 2341}, year = {2013}, abstract = {BACKGROUND Cancer patients and their minor children have been shown to experience psychological distress. The objectives of the current study were to 1) describe the need for and use of psychosocial support and 2) determine predictors of family-centered support use in patients with minor children. METHODS A population-based sample of 1809 patients was recruited via 2 cancer registries. The eligibility criteria were age 25 years to 55 years, an initial diagnosis received no longer than 6 years before this survey, and having at least 1 minor child. Medical characteristics and self-report measures were used. RESULTS Overall, approximately 38\% cases were identified as being borderline or probable anxiety cases and 16\% were identified as being borderline or probable depression cases. Since diagnosis, 44\% of the patients had used psychosocial support and 9\% had received family-focused and child-focused support. These patients perceived a lower quality of life and poorer family functioning. Approximately 73\% of patients with children wanted information concerning or psychosocial services to support their children or parenting. Use of family-centered support was not found to be predicted by disease-related factors (eg, cancer staging) but rather by subjective needs (eg, mental health and having a distressed child in the family). CONCLUSIONS The results of the current study emphasize the importance of child and parenting concerns in psychosocial care in oncology. Screenings for children and appropriate training programs for health care may increase awareness of this issue.}, subject = {Adult}, language = {en} } @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{MoellerLamparterWiegandGrefe2012, author = {M{\"o}ller, Birgit and Lamparter, Ulrich and Wiegand-Grefe, Silke}, title = {Und pl{\"o}tzlich war ich ganz allein: Traumatisierende Erfahrungen einer Jugendlichen w{\"a}hrend des Hamburger Feuersturms und ihre transgenerationale Weitergabe uber drei Generationen}, series = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, volume = {61}, journal = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, issn = {0032-7034}, doi = {10.13109/prkk.2012.61.8.623}, pages = {623 -- 640}, year = {2012}, abstract = {Air strikes on Hamburg in 1943 (Operation Gomorrha) were a historical turning point and had a deep impact on both cityscape and history of Hamburg. Little is known about intraindividual and transgenerational consequences as well as its interaction with societal and historical processes. Aiming at closing this gap interviews with witnesses, their children and grandchildren, as well as the whole family, were conducted in the context of an interdisciplinary research project. Based on the example of an interview with a at the time of the Operation Gomorrha eleven years old witness, her daughter, and grandson the biographical localisation of war experiences and transgenerational transmission will be explained and discussed.}, subject = {Adolescent}, language = {de} } @article{KuehneKrattenmacherBergeltetal.2013, author = {K{\"u}hne, Franziska and Krattenmacher, Thomas and Bergelt, Corinna and Beierlein, Volker and Herzog, Wolfgang and V Klitzing, Kai and Weschenfelder-Stachwitz, Heike and Romer, Georg and M{\"o}ller, Birgit}, title = {There is still so much ahead of us - Family functioning in families of palliative cancer patients}, series = {Families, systems \& health : the journal of collaborative family healthcare}, volume = {31}, journal = {Families, systems \& health : the journal of collaborative family healthcare}, doi = {10.1037/a0032274}, pages = {181 -- 193}, year = {2013}, abstract = {Adopting a systems approach, parental cancer has its impact on patients, spouses, and dependent children. The purpose of the current study was to examine family functioning dependent on parental disease stage and on family member perspective in families of cancer patients with adolescent children. The cross-sectional study was conducted within a German multisite research project of families before their first child-centered counseling encounter. The sample comprised individuals nested within N = 169 families. Analyses performed included analysis of covariance (ANCOVA) and intraclass correlation. Open answers were analyzed following quantitative content analysis procedures. Between 15\% and 36\% of family members reported dysfunctional general functioning scores. Parents indicated more dysfunctional scores on the Family Assessment Device scale Roles, and adolescents more dysfunctional Communication scores. Regarding assessment of family functioning, there was higher agreement in families with parents in a palliative situation. For adolescents with parents in palliation, incidents because of the disease tend to become more dominant, and spending time with the family tends to become even more important. As our study pointed out, parental cancer, and especially parental palliative disease, is associated with both perceived critical and positive aspects in family functioning. Supporting families in these concerns as well as encouraging perceptions of positive aspects are important components of psycho-oncological interventions for families with dependent children.}, subject = {Adolescent}, language = {en} } @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{InhesternBultmannBeierleinetal.2016, author = {Inhestern, Laura and Bultmann, Johanna C. and Beierlein, Volker and M{\"o}ller, Birgit and Romer, Georg and Muriel, Anna C. and Moore, Cynthia W. and Koch, Uwe and Bergelt, Corinna}, title = {Psychometric properties of the Parenting Concerns Questionnaire in cancer survivors with minor and young adult children}, series = {Psycho-oncology}, volume = {25}, journal = {Psycho-oncology}, doi = {10.1002/pon.4049}, pages = {1092 -- 1098}, year = {2016}, abstract = {OBJECTIVE Although cancer patients with minor children have become more of a focus of psycho-oncological research, little is known about specific parenting concerns. Instruments to assess the concerns and worries of parents with cancer are rare. The Parenting Concerns Questionnaire (PCQ) addresses this issue. We analyzed parenting concerns in cancer survivors and evaluated the German version of the PCQ. METHODS A total of 1416 cancer survivors with minor and young adult children (≤21 years) were recruited in a register-based study. Descriptive analyses as well as reliability and validity analyses were conducted. We performed a confirmatory factorial analysis of the factor structure proposed by the authors of the original version on the PCQ. RESULTS Seventy-three percent of the cancer survivors were women, average age was 47.5 years (SD 5.9). Mean time since diagnosis was 44 months (SD 23.4). Between 18 and 31\% of survivors reported that they were concerned about their children. The PCQ proved to be a reliable and valid instrument showing medium correlations with standardized measures in expected directions and discriminating between survivors with and without use of psychosocial support services. The factor structure was supported by the confirmatory factorial analysis. CONCLUSIONS Assessing parenting concerns gives an additional insight into the situation of parents with cancer. In our sample of cancer survivors, we identified one out of three survivors being concerned regarding the impact of their illness on their children. The PCQ can be considered as a valid and reliable instrument with regard to identifying concerned parents with cancer. Copyright © 2015 John Wiley \& Sons, Ltd.}, subject = {Adult}, language = {en} } @article{BultmannBeierleinRomeretal.2014, author = {Bultmann, Johanna Christine and Beierlein, Volker and Romer, Georg and M{\"o}ller, Birgit and Koch, Uwe and Bergelt, Corinna}, title = {Parental cancer: Health-related quality of life and current psychosocial support needs of cancer survivors and their children}, series = {International journal of cancer}, volume = {135}, journal = {International journal of cancer}, doi = {10.1002/ijc.28905}, pages = {2668 -- 2677}, year = {2014}, abstract = {The presence of cancer and additional parental responsibilities can increase strain for individual patients as well as for their children. The construct of health-related quality of life (HRQL) is appropriate to measure a combination of physical, mental and social consequences as a result of disease. However, previous research has merely focused on symptom checklists. This study addresses the following questions: (i) does HRQL in children and their parents with cancer differ compared to the general population? (ii) Are there any variables that are associated with HRQL in children? (iii) What are current psychosocial support needs? A population-based survey of 976 survivors (<6 years post diagnosis) with minor children between 6 and 18 years (n = 1,449) was conducted with two German cancer registries. HRQL was assessed using SF-8 (survivors) and Kidscreen (children). The results were compared to normative populations, and predictors associated with HRQL in children were evaluated within a multilevel model. We found that the HRQL in children was better compared to the norm. Only children with support needs had worse HRQL. Older age, having a mother with cancer, having a parent not living together with a partner, and worse parental physical and mental health influenced HRQL in children. Illness characteristics were irrelevant. Even with a mean of 3.5 years after diagnosis, survivors had lower physical and mental health compared to the norm. Our findings reinforce the need for health professionals to pay attention to younger patients and their children. Even years after diagnosis, life might not have returned to normal.}, subject = {Adolescent}, language = {en} } @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{BeierleinBultmannMoelleretal.2017, author = {Beierlein, Volker and Bultmann, Johanna Christine and M{\"o}ller, Birgit and Klitzing, Kai and Flechtner, Hans-Henning and Resch, Franz and Herzog, Wolfgang and Br{\"a}hler, Elmar and F{\"u}hrer, Daniel and Romer, Georg and Koch, Uwe and Bergelt, Corinna}, title = {Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD)}, series = {Journal of psychosomatic research}, volume = {93}, journal = {Journal of psychosomatic research}, doi = {10.1016/j.jpsychores.2016.11.007}, pages = {110 -- 117}, year = {2017}, abstract = {OBJECTIVE The concept of family functioning is gaining importance in psycho-oncology research and health care services. The Family Assessment Device (FAD) is a well-established measure of family functioning. Psychometric properties inherent in the German 51-item adaptation of the FAD are examined in different samples of families with parental cancer. METHODS Acceptance, reliability, and validity of FAD scales are analysed in samples from different study settings (N=1701 cancer patients, N=261 partners, N=158 dependent adolescent children 11 to 18years old). RESULTS Missing items in the FAD scales (acceptance) are rare for adults (<1.1\%) and adolescent children (<4.4\%). In samples of adults and older adolescents (15 to 18years), all FAD scales except for the Roles scale are significantly reliable (0.75≤Cronbach's α≤0.88). The scales correlate highly (0.46≤Pearson's r≤0.59) with the criterion satisfaction with family life (convergent validity), and have smaller correlations (0.16≤r≤0.49) with measures of emotional distress and subjective well-being (divergent validity). In most FAD scales, adults seeking family counselling report worse family functioning (0.24≤Cohen's d≤0.59) than adults in other samples with parental cancer (discriminative validity). CONCLUSION Overall, the German 51-item adaptation of the FAD reveals good acceptance, reliability, and validity for cancer patients and their relatives. Particularly the scale General Functioning shows excellent psychometric properties. The FAD is suitable in the assessment of families with parental cancer for adults and adolescents older than 11years.}, subject = {Adolescent}, language = {en} }