TY - JOUR A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Halverscheid, Susanne A1 - Wiegand-Grefe, Silke A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - 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 JF - Journal of psychosomatic research N2 - 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. KW - Adolescent KW - Affective Symptoms/psychology KW - Child KW - Female KW - Humans KW - Male KW - Mental Disorders/psychology KW - Neoplasms/psychology KW - Parent-Child Relations KW - Parents/psychology KW - Quality of Life Y1 - 2014 U6 - http://dx.doi.org/10.1016/j.jpsychores.2013.11.020 VL - 76 SP - 213 EP - 220 ER - TY - JOUR A1 - Möller, Birgit A1 - Barkmann, Claus A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Bergelt, Corinna A1 - Beierlein, Volker A1 - Ernst, Johanna A1 - Brähler, Elmar A1 - Flechtner, Hans-Henning A1 - Herzog, Wolfgang A1 - Klitzing, Kai A1 - Führer, Daniel A1 - Resch, Franz A1 - Romer, Georg T1 - Children of cancer patients: prevalence and predictors of emotional and behavioral problems JF - Cancer N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Child Behavior Disorders/etiology KW - Child of Impaired Parents/psychology KW - Female KW - Humans KW - Male KW - Mental Disorders/etiology KW - Neoplasms/psychology KW - Parents/psychology KW - Prevalence KW - Risk Factors KW - Surveys and Questionnaires KW - Young Adult Y1 - 2014 U6 - http://dx.doi.org/10.1002/cncr.28644 VL - 120 SP - 2361 EP - 2370 ER - TY - JOUR A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Führer, Daniel A1 - Beierlein, Volker A1 - Brähler, Elmar A1 - Resch, Franz A1 - Klitzing, Kai V. A1 - Flechtner, Hans-Henning A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - Coping skills and mental health status in adolescents when a parent has cancer: a multicenter and multi-perspective study JF - Journal of psychosomatic research N2 - OBJECTIVE Parental cancer increases the risk of psychosocial problems in adolescents. We investigated the frequency and efficacy of adolescents' coping strategies and relationships between those strategies and mental health status. Age and gender differences regarding coping and mental health were also investigated. METHODS In total, 214 adolescents from 167 families participated in a cross-sectional, multicenter study. All participants were recruited from standard oncological care. Among the participants, 52% utilized a child-centered intervention program. Adolescents' coping skills were measured using KIDCOPE. Mental health status was rated by adolescents and parents by the SDQ for symptomatology and the KIDSCREEN for well-being. RESULTS We found that 29% of the adolescents showed emotional and behavioral problems. We found gender differences in mental health status but not in coping. Adolescents used a broad spectrum of coping strategies. Active problem-solving, distraction, acceptance, wishful thinking and seeking social support were the most frequently used coping strategies. The utilization of certain coping skills was mediated by their perceived efficacy. Problem-focused or approach-oriented coping strategies generally are associated with better mental health, while avoidance-oriented coping are associated with worse mental health. Emotion-focused coping was associated with both lower and higher mental health. CONCLUSION The strategies used by adolescents to cope with parental cancer are associated with their mental health. Problem-solving and approach-oriented coping strategies should be facilitated by psychological interventions regardless of age and gender. Age and gender differences in adolescents' mental health should be further investigated because these differences are not explained by differences in coping strategies. KW - Adaptation KW - Psychological/classification/physiology KW - Adolescent KW - Adult KW - Age Factors KW - Aged KW - Child KW - Cross-Sectional Studies KW - Female KW - Humans KW - Male KW - Mental Disorders/epidemiology/etiology KW - Middle Aged KW - Neoplasms/psychology KW - Parents KW - Psychiatric Status Rating Scales Y1 - 2013 U6 - http://dx.doi.org/10.1016/j.jpsychores.2012.10.003 VL - 74 SP - 252 EP - 259 ER - TY - JOUR A1 - Inhestern, Laura A1 - Bultmann, Johanna Christine A1 - Beierlein, Volker A1 - Möller, Birgit A1 - Romer, Georg A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Elterliche Sorgen und psychische Belastung bei krebskranken Eltern mit minderjährigen und jungerwachsenen Kindern JF - Psychotherapie, Psychosomatik, medizinische Psychologie N2 - 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 Krebsüberlebenden 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 Krebsüberlebenden 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 unauffällige Werte. Alleinleben, jüngeres Alter des jüngsten Kindes, ein höheres Tumorstadium und das Vorhandensein einer weiteren körperlichen Erkrankung sind mit Sorgen in allen 3 Subskalen des PCQ positiv assoziiert. Ein niedriger Sozialstatus konnte als Kovariate für 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 Unterstützungsangebote für krebskranke Eltern sollten auch spezifische elterliche Sorgen thematisieren. Eltern mit Risikokonstellationen für eine erhöhte Belastung sollten besonders berücksichtigt werden, um bedarfsgerecht Unterstützung anbieten zu können. KW - Adolescent KW - Adult KW - Child KW - Preschool KW - Cost of Illness KW - Cross-Sectional Studies KW - Female KW - Humans KW - Male KW - Middle Aged KW - Neoplasms/psychology KW - Parenting KW - Parents/psychology KW - Social Support KW - Survivors KW - Young Adult Y1 - 2017 U6 - http://dx.doi.org/10.1055/s-0043-110139 VL - 67 SP - 279 EP - 287 ER - TY - JOUR A1 - Kühne, Franziska A1 - Krattenmacher, Thomas A1 - Bergelt, Corinna A1 - Bierbaum, Anna-Lena A1 - Christine Ernst, Johanna A1 - Flechtner, Hans-Henning A1 - Keller, Monika A1 - Klitzing, Kai V. A1 - Romer, Georg A1 - Möller, Birgit T1 - Elternschaft und Krebserkrankung: Dyadische Analyse von psychosozialer Belastung und gesundheitsbezogener Lebensqualität von krebskranken Eltern minderjähriger Kinder JF - Psychotherapie, Psychosomatik, medizinische Psychologie N2 - 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. KW - Adult KW - Child KW - Preschool KW - Cross-Sectional Studies KW - Employment KW - Family KW - Female KW - Humans KW - Infant KW - Linear Models KW - Male KW - Middle Aged KW - Neoplasms/complications/psychology KW - Neuropsychological Tests KW - Palliative Care KW - Parents/psychology KW - Psychiatric Status Rating Scales KW - Quality of Life KW - Stress KW - Psychological/etiology/psychology Y1 - 2013 U6 - http://dx.doi.org/10.1055/s-0033-1341454 VL - 63 SP - 473 EP - 481 ER - TY - JOUR A1 - Möller, Birgit A1 - Schreier, Herbert A1 - Li, Alice A1 - Romer, Georg T1 - Gender identity disorder in children and adolescents JF - Current problems in pediatric and adolescent health care KW - Adolescent KW - Child KW - Preschool KW - Female KW - Gender Identity KW - Homosexuality KW - Humans KW - Male KW - Parent-Child Relations KW - Psychosexual Development KW - Transsexualism Y1 - 2009 U6 - http://dx.doi.org/10.1016/j.cppeds.2009.02.001 VL - 39 SP - 117 EP - 143 ER - TY - JOUR A1 - Kühne, Franziska A1 - Haagen, Miriam A1 - Baldus, Christiane A1 - Diareme, Stavroula A1 - Grether, Andrea A1 - Schmitt, Florence A1 - Stanescu, Dan A1 - Stöckl, Margit A1 - Thastum, Mikael A1 - Möller, Birgit A1 - Romer, Georg T1 - Implementation of preventive mental health services for children of physically ill parents: experiences in seven European countries and health care systems JF - General hospital psychiatry N2 - 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. KW - Adolescent KW - Child KW - Child Health Services KW - Child of Impaired Parents/psychology KW - Preschool KW - Counseling KW - Europe KW - Humans KW - Mental Health Services KW - Patient Satisfaction KW - Pilot Projects KW - Preventive Health Services/organization {\&} administration KW - Program Development KW - Qualitative Research KW - Surveys and Questionnaires Y1 - 2013 U6 - http://dx.doi.org/10.1016/j.genhosppsych.2012.10.005 VL - 35 SP - 147 EP - 153 ER - TY - JOUR A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Führer, Daniel A1 - Ernst, Johanna A1 - Brähler, Elmar A1 - Herzog, Wolfgang A1 - Klitzing, Kai A1 - Flechtner, Hans-Henning A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - Kinder krebskranker Eltern - elterliches Coping, familiäres Funktionsniveau und psychosoziale Anpassung der Kinder JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. KW - Adaptation KW - Psychological KW - Adolescent KW - Adult KW - Child KW - Child of Impaired Parents/psychology KW - Preschool KW - Family Relations KW - Female KW - Germany KW - Humans KW - Male KW - Neoplasms/psychology KW - Parents/psychology KW - Quality of Life/psychology KW - Social Adjustment KW - Surveys and Questionnaires Y1 - 2012 U6 - http://dx.doi.org/10.13109/prkk.2012.61.6.447 SN - 0032-7034 VL - 61 SP - 447 EP - 462 ER - TY - JOUR A1 - Beierlein, Volker A1 - Bultmann, Johanna Christine A1 - Möller, Birgit A1 - Klitzing, Kai A1 - Flechtner, Hans-Henning A1 - Resch, Franz A1 - Herzog, Wolfgang A1 - Brähler, Elmar A1 - Führer, Daniel A1 - Romer, Georg A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD) JF - Journal of psychosomatic research N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Cross-Cultural Comparison KW - Family Relations/psychology KW - Female KW - Germany KW - Humans KW - Male KW - Parents/psychology KW - Psychometrics/statistics {\&} numerical data KW - Reproducibility of Results KW - Statistics as Topic KW - Surveys and Questionnaires Y1 - 2017 U6 - http://dx.doi.org/10.1016/j.jpsychores.2016.11.007 VL - 93 SP - 110 EP - 117 ER - TY - JOUR A1 - Becker, Inga A1 - Gjergji-Lama, Voltisa A1 - Romer, Georg A1 - Möller, Birgit T1 - Merkmale von Kindern und Jugendlichen mit Geschlechtsdysphorie in der Hamburger Spezialsprechstunde JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. KW - Adolescent KW - Age Factors KW - Child KW - Preschool KW - Cooperative Behavior KW - Cross-Sectional Studies KW - Female KW - Gender Identity KW - Germany KW - Gonadal Steroid Hormones/therapeutic use KW - Humans KW - Interdisciplinary Communication KW - Male KW - Outpatient Clinics KW - Hospital KW - Psychotherapy KW - Puberty/drug effects/psychology KW - Referral and Consultation KW - Self Mutilation/epidemiology/psychology KW - Sex Factors KW - Suicidal Ideation KW - Transsexualism/diagnosis/epidemiology/psychology/therapy Y1 - 2014 SN - 0032-7034 VL - 63 SP - 486 EP - 509 ER -