@article{KuhlmannRomerMoeller2020,
  author    = {Kuhlmann, Anna-Lena and Romer, Georg and M{\"o}ller, Birgit},
  title     = {„Wenn man sich so besser f{\"u}hlt …"},
  series = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  volume    = {69},
  journal   = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  issn      = {0032-7034},
  doi       = {10.13109/prkk.2020.69.6.524},
  pages     = {524 -- 540},
  year      = {2020},
  abstract  = {If One Feels Better Like That …. Adolescent Sibling Relationship in the Context of Transgender Development A transgender development in youth can influence the relationship of concerned youth and their siblings. While in most surveys, the focus lies on transgender adolescents, both sides shall be interviewed here to capture the situation of siblings and to relate the results. For this purpose, guide interviews with ten transgender adolescents and twelve of their siblings were analysed in accordance to Grounded Theory. In most cases, participants were satisfied with the sibling relationship. After the coming-out of the transgender adolescent they showed both positive and negative reactions that, however, changed to respect and acceptance by time without exception. Doubt, compassion and grief were short lived and often replaced by joy for the transgender adolescent. Transgender youth were mostly satisfied with the reaction of their sibling though the amount of support varied. The time of coming-out and transition often led to an improvement in sibling relationship, more closeness and family cohesion. In general, siblings seem to be immediately concerned by transgenderism in adolescence. In clinical practice, they should thus be included from the beginning. By taking into account their situation, negative developments can be prevented, and the sibling relationship become usable as a resource. Zusammenfassung Eine transidente Entwicklung im Jugendalter kann die Beziehung der Betroffenen und ihrer Geschwister beeinflussen. W{\"a}hrend in den meisten Untersuchungen der Fokus eher auf den transidenten Jugendlichen liegt, wurden hier beide Seiten befragt, um die Situation der Geschwister zu erfassen und die Ergebnisse zueinander in Beziehung setzen zu k{\"o}nnen. Hierzu wurden Leitfaden-gest{\"u}tzte Interviews mit zehn transidenten Jugendlichen sowie zw{\"o}lf ihrer Geschwister nach den Regeln der Grounded Theory ausgewertet. In den meisten F{\"a}llen zeigten sich die Teilnehmenden mit der Geschwisterbeziehung zufrieden. Auf das Coming-out des transidenten Jugendlichen zeigten die Geschwister positive wie negativen Reaktionen, die sich jedoch im Laufe der Zeit ausnahmslos zu Respekt und Akzeptanz wandelten. Zweifel, Mitleid und Trauer waren nur von kurzer Dauer und wurden oft durch Freude f{\"u}r den transidenten Adoleszenten ersetzt. Die transidenten Jugendlichen zeigten sich mit der Reaktion des Geschwisters grunds{\"a}tzlich zufrieden, obwohl das Maß an Unterst{\"u}tzung unterschiedlich war. Die Zeit des Coming-out und der Transition f{\"u}hrte h{\"a}ufig zu einer Verbesserung der Geschwisterbeziehung, mehr N{\"a}he und famili{\"a}rem Zusammenhalt. Insgesamt zeigte sich, dass die Geschwister bei einer Transidentit{\"a}t im Jugendalter unmittelbar mitbetroffen sind und daher im klinischen Alltag von Anfang an mit einbezogen werden sollten. Durch Ber{\"u}cksichtigung ihrer Situation kann negativen Entwicklungen vorgebeugt und die Geschwisterbeziehung als Ressource nutzbar werden.},
  subject      = {Adolescent},
  language  = {de}
}
@article{WiechKutlarGuenthardetal.2020,
  author    = {Wiech, Matthias and Kutlar, Cemre and G{\"u}nthard, Manuela and Schenker, Tanja and Pauli, Dagmar and M{\"o}ller, Birgit},
  title     = {Psychische Auff{\"a}lligkeiten und gesundheitsbezogene Lebensqualit{\"a}t bei Jugendlichen mit Geschlechtsdysphorie},
  series = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  volume    = {69},
  journal   = {Praxis der Kinderpsychologie und Kinderpsychiatrie},
  issn      = {0032-7034},
  doi       = {10.13109/prkk.2020.69.6.554},
  pages     = {554 -- 569},
  year      = {2020},
  abstract  = {Mental Stress and Health-Related Quality of Life in Adolescents with Gender Dysphoria Although the level of mental stress in adolescents with gender dysphoria is found to be generally high in many studies, differences have been shown between samples of gender dysphoria clinics for adolescents in different countries. However, a comparison within the German speaking area is lacking. In this article we compared samples of gender dysphoria clinics from Munster (Germany) and Zurich (Switzerland) and tested potential correlates of mental stress using quantitative methods. Subsequently, we interviewed clients from both clinics regarding mental stressors and protective factors. There were no quantitative differences in the level of mental stress of clients between Munster and Zurich, whereas health-related quality of life was significantly higher in Munster. Problems in physical well-being and school environment were the strongest correlates of mental stress. This reflects in the interviews, too, in addition to further related factors reported. We conclude that physical well-being and inclusion at school should be addressed with special emphasis in counseling or treatment of adolescents with gender dysphoria to counter the in average high levels of mental stress. Zusammenfassung Das Ausmaß psychischer Auff{\"a}lligkeiten bei Jugendlichen mit Geschlechtsdysphorie wird in vielen Studien als hoch beschrieben, unterscheidet sich jedoch in den Inanspruchnahmepopulationen verschiedener Spezialambulanzen f{\"u}r Jugendliche mit Geschlechtsdysphorie. Bislang hat kein Vergleich innerhalb des deutschsprachigen Raums stattgefunden. In diesem Beitrag werden die Inanspruchnahmestichproben der Spezialzentren in M{\"u}nster und Z{\"u}rich mit quantitativen Methoden verglichen sowie Korrelate von psychischen Auff{\"a}lligkeiten gepr{\"u}ft. Anschließend f{\"u}hrten wir Interviews mit Klient/innen1 der Spezialambulanzen hinsichtlich psychischer Belastungen und Schutzfaktoren durch. Es zeigten sich im quantitativen Vergleich der Zentren keine Unterschiede in den psychischen Auff{\"a}lligkeiten zwischen M{\"u}nster und Z{\"u}rich, w{\"a}hrend sich die gesundheitsbezogene Lebensqualit{\"a}t in M{\"u}nster als signifikant h{\"o}her erwies als in Z{\"u}rich. Als st{\"a}rkste Korrelate psychischer Belastung konnten Probleme im k{\"o}rperlichen Wohlbefinden sowie im schulischen Umfeld identifiziert werden. Dies spiegelte sich auch in den qualitativen Interviews wider, in denen weitere assoziierte Faktoren benannt wurden. Wir schlussfolgern, dass das k{\"o}rperliche Wohlbefinden und die schulische Integration in der Beratung bzw. Behandlung von Jugendlichen mit Geschlechtsdysphorie besonders ber{\"u}cksichtigt werden sollten, um der im Schnitt hohen psychischen Auff{\"a}lligkeiten entgegenzuwirken.},
  subject      = {Adolescent},
  language  = {de}
}
@article{BeckerAuerBarkmannetal.2018,
  author    = {Becker, Inga and Auer, Matthias and Barkmann, Claus and Fuss, Johannes and M{\"o}ller, Birgit and Nieder, Timo O. and Fahrenkrug, Saskia and Hildebrandt, Thomas and Richter-Appelt, Hertha},
  title     = {A Cross-Sectional Multicenter Study of Multidimensional Body Image in Adolescents and Adults with Gender Dysphoria Before and After Transition-Related Medical Interventions},
  series = {Archives of sexual behavior},
  volume    = {47},
  journal   = {Archives of sexual behavior},
  doi       = {10.1007/s10508-018-1278-4},
  pages     = {2335 -- 2347},
  year      = {2018},
  abstract  = {Persistent feelings of gender dysphoria (GD) are accompanied by distress and body dissatisfaction in most clinically referred adolescents and adults. Transition-related medical interventions (e.g., puberty suppression, hormones, or surgery) may alleviate body dissatisfaction. The aim of the present cross-sectional study was to compare multidimensional body image across clinically referred adolescents and adults undergoing different transition-related medical interventions. Two clinical samples of adolescents (n = 82) and adults (n = 120) referred to specialized departments of four different transgender health services in Germany participated in the study. In total, 202 individuals from the female-to-male (FtM individuals) and male-to-female (MtF individuals) spectrum aged 14-74 years were included at different stages of their transition. Four scales assessing multidimensional aspects of body image (measured by the Body Image Assessment Questionnaire, FBeK) were compared across three groups: sample, gender, and medical interventions (while controlling for age and treatment duration). The results indicated less favorable body image scores compared with the norm in both adolescents and adults with GD. Individuals who had undergone transition-related medical interventions presented a significantly better body image on two of the four scales. Differences according to gender and age were also present. These findings suggest that medical interventions, especially gender-affirming hormones and surgery, are generally beneficial to the body image in individuals with GD. However, not all of the less favorable outcomes in multidimensional body image were positively influenced by the treatment conditions and may thus benefit from additional integrative counseling before and during transition.},
  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{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}
}
@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{KrattenmacherKuehneHalverscheidetal.2014,
  author    = {Krattenmacher, Thomas and K{\"u}hne, Franziska and Halverscheid, Susanne and Wiegand-Grefe, Silke and Bergelt, Corinna and Romer, Georg and M{\"o}ller, Birgit},
  title     = {A comparison of the emotional and behavioral problems of children of patients with cancer or a mental disorder and their association with parental quality of life},
  series = {Journal of psychosomatic research},
  volume    = {76},
  journal   = {Journal of psychosomatic research},
  doi       = {10.1016/j.jpsychores.2013.11.020},
  pages     = {213 -- 220},
  year      = {2014},
  abstract  = {OBJECTIVE To compare the emotional and behavioral problems of children of patients suffering from cancer or a mental disorder and their association with parental quality of life. METHODS A total of 223 children from 136 families and their 160 parents were investigated from multiple perspectives in a cross-sectional study. The consistency of different adjustment reports between family members was examined. Through mixed models, the differences between parental HRQoL and the children's symptomatology were studied with regard to the type of parental illness. The prediction of children's adjustment through parental HRQoL was further examined. Additionally, gender and age of the children were considered. RESULTS Half of the children exhibited psychosocial problems. Gender and age differences were independent of the type of parental disease. In families with parental cancer, the reports of children's adjustment were more consistent between family members than in families where a parental mental disorder was present. We found differences in HRQoL between families with mentally ill parents and those with parental cancer patients. Specifically, the healthy partners of mentally ill parents showed worse HRQoL compared with healthy partners of cancer patients. Healthy parents' reduced HRQoL was associated with worse adjustment in their children, regardless of the type of parental illness, but this result was not found for ill parents. CONCLUSION Family members confronted with parental cancer or mental disorders are more burdened compared with those from the normal population, independently of the type of disease. Our results indicate that the type of a parental disease has no direct effect on children's adjustment. However, there are disease-specific effects on parental HRQoL, which are associated with children's adjustment.},
  subject      = {Adolescent},
  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{MoellerBarkmannKrattenmacheretal.2014,
  author    = {M{\"o}ller, Birgit and Barkmann, Claus and Krattenmacher, Thomas and K{\"u}hne, Franziska and Bergelt, Corinna and Beierlein, Volker and Ernst, Johanna and Br{\"a}hler, Elmar and Flechtner, Hans-Henning and Herzog, Wolfgang and Klitzing, Kai and F{\"u}hrer, Daniel and Resch, Franz and Romer, Georg},
  title     = {Children of cancer patients: prevalence and predictors of emotional and behavioral problems},
  series = {Cancer},
  volume    = {120},
  journal   = {Cancer},
  doi       = {10.1002/cncr.28644},
  pages     = {2361 -- 2370},
  year      = {2014},
  abstract  = {BACKGROUND Children of patients with cancer are at increased risk for developing emotional and behavioral problems. This study explored the prevalence and predictors of emotional and behavioral problems in Children of cancer patients in a multisite research project. METHODS A cross-sectional sample of N = 235 families was recruited simultaneously in 5 university medical centers. The participants, including parents (N = 402) and children (N = 324; ages 11-21 years) completed standardized questionnaires. Emotional and behavioral problems in children were measured by the Strengths and Difficulties Questionnaire (SDQ). On the basis of previous research and using a mixed-model approach, child-, parent-, family- and cancer-related variables were examined in addition to socioeconomic status as potential predictors. Descriptive statistics and a multiple random coefficient model were used in the analyses. RESULTS Compared to norms, Children of cancer patients show increased mean levels of emotional and behavioral symptoms. The best predictor of emotional and behavioral problems from the perspectives of the child, the healthy parent, and the ill parent was general family dysfunction. Although family dysfunction was identified as the main predictor, the analysis revealed that the main part of variance was related to the individual child's level. CONCLUSIONS The results indicate that screening for child mental health problems and family dysfunction in oncological and psychosocial treatment units can identify the families most in need of psychosocial support. Psychological services need to be both family-oriented and child-centered and focus on family dysfunction to prevent mental health problems in children.},
  subject      = {Adolescent},
  language  = {en}
}