TY - JOUR A1 - Bultmann, Johanna Christine A1 - Beierlein, Volker A1 - Romer, Georg A1 - Möller, Birgit A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Parental cancer: Health-related quality of life and current psychosocial support needs of cancer survivors and their children JF - International journal of cancer N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Child Health Services KW - Cross-Sectional Studies KW - Female KW - Follow-Up Studies KW - Health Services Needs and Demand KW - Health Status KW - Humans KW - Male KW - Middle Aged KW - Needs Assessment KW - Neoplasms/psychology KW - Parents/psychology KW - Prognosis KW - Psychology KW - Quality of Life KW - Social Support KW - Stress KW - Psychological KW - Surveys and Questionnaires KW - Survivors/psychology Y1 - 2014 U6 - http://dx.doi.org/10.1002/ijc.28905 VL - 135 SP - 2668 EP - 2677 ER - TY - JOUR A1 - Ernst, J. C. A1 - Beierlein, V. A1 - Romer, G. A1 - Möller, B. A1 - Koch, U. A1 - Bergelt, C. T1 - Krebskranke Eltern und ihre minderjährigen Kinder - eine bundesweite Befragung ambulanter psychosozialer Krebsberatungsstellen zu Bedarf und Inanspruchnahme JF - Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) N2 - OBJECTIVES Children of cancer patients have an increased risk for developing emotional problems. While psychosocial cancer counselling services are available all over the country, it is unclear if parents seek for help and if specific approaches for families are offered. METHODS A survey was made of outpatient cancer counselling services in Germany (n=228). The response rate was 56%. Descriptive and content analyses of the data have been used. RESULTS Providers estimate that 55% of their patients are between 18 and 55 years with 18% of them having minor children. However, only 53% do regularly ask their patients if they have minor children. Family- or child-settings are not provided regularly. Over 60% of providers would welcome special courses on this subject. CONCLUSION Although psychosocial care of minor children is mentioned in outpatient psychosocial cancer counselling guidelines, children are not included regularly. A stronger emphasis on this topic in further education has to be made. KW - Adolescent KW - Adult KW - Ambulatory Care KW - Child KW - Preschool KW - Comorbidity KW - Directive Counseling/supply {\&} distribution KW - Female KW - Germany/epidemiology KW - Health Services Accessibility/statistics {\&} numerical data KW - Humans KW - Infant KW - Newborn KW - Male KW - Mental Disorders/epidemiology/rehabilitation KW - Middle Aged KW - Neoplasms/epidemiology/rehabilitation KW - Parents KW - Prevalence KW - Social Support KW - Utilization Review Y1 - 2012 U6 - http://dx.doi.org/10.1055/s-0032-1329953 VL - 74 SP - 742 EP - 746 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 - TY - JOUR A1 - Becker, Inga A1 - Auer, Matthias A1 - Barkmann, Claus A1 - Fuss, Johannes A1 - Möller, Birgit A1 - Nieder, Timo O. A1 - Fahrenkrug, Saskia A1 - Hildebrandt, Thomas A1 - Richter-Appelt, Hertha T1 - A Cross-Sectional Multicenter Study of Multidimensional Body Image in Adolescents and Adults with Gender Dysphoria Before and After Transition-Related Medical Interventions JF - Archives of sexual behavior N2 - 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. KW - Adolescent KW - Adult KW - Aged KW - Body Image/psychology KW - Cross-Sectional Studies KW - Female KW - Gender Dysphoria/psychology/therapy KW - Gender Identity KW - Germany KW - Hormones KW - Humans KW - Male KW - Middle Aged KW - Psychology KW - Sexual Maturation KW - Surveys and Questionnaires KW - Transgender Persons/psychology KW - Transsexualism/psychology/therapy KW - Young Adult Y1 - 2018 U6 - http://dx.doi.org/10.1007/s10508-018-1278-4 VL - 47 SP - 2335 EP - 2347 ER - TY - JOUR A1 - Kühne, Franziska A1 - Krattenmacher, Thomas A1 - Bergelt, Corinna A1 - Beierlein, Volker A1 - Herzog, Wolfgang A1 - V Klitzing, Kai A1 - Weschenfelder-Stachwitz, Heike A1 - Romer, Georg A1 - Möller, Birgit T1 - There is still so much ahead of us - Family functioning in families of palliative cancer patients JF - Families, systems & health : the journal of collaborative family healthcare N2 - 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. KW - Adolescent KW - Adult KW - Aged KW - Analysis of Variance KW - Child KW - Child of Impaired Parents/psychology KW - Cross-Sectional Studies KW - Family Relations KW - Female KW - Germany KW - Humans KW - Male KW - Middle Aged KW - Neoplasms KW - Palliative Care KW - Self Report Y1 - 2013 U6 - http://dx.doi.org/10.1037/a0032274 VL - 31 SP - 181 EP - 193 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, B. A1 - Stegemann, T. A1 - Romer, Georg T1 - Psychosoziale Belastungen bei Kindern körperlich kranker Eltern: Perspektiven der seelischen Gesundheitsvorsorge JF - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz N2 - 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. KW - Adaptation KW - Psychological KW - Adolescent KW - Anxiety Disorders/epidemiology/prevention {\&} control/psychology KW - Child KW - Child of Impaired Parents/psychology KW - Child Reactive Disorders/epidemiology/prevention {\&} control/psychology KW - Preschool KW - Cross-Cultural Comparison KW - Cross-Sectional Studies KW - Depressive Disorder/epidemiology/prevention {\&} control/psychology KW - Developmental Disabilities/epidemiology/prevention {\&} control/psychology KW - Family Relations KW - Family Therapy KW - Female KW - Germany KW - Health Education KW - Health Surveys KW - Humans KW - Infant KW - Newborn KW - Pregnancy KW - Risk Factors KW - Somatoform Disorders/epidemiology/prevention {\&} control/psychology KW - Stress KW - Psychological/complications Y1 - 2008 U6 - http://dx.doi.org/10.1007/s00103-008-0542-5 SN - 1436-9990 VL - 51 SP - 657 EP - 663 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 - Möller, Birgit A1 - Lamparter, Ulrich A1 - Wiegand-Grefe, Silke T1 - Und plötzlich war ich ganz allein: Traumatisierende Erfahrungen einer Jugendlichen während des Hamburger Feuersturms und ihre transgenerationale Weitergabe uber drei Generationen JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Child of Impaired Parents/psychology KW - Orphaned/psychology KW - Preschool KW - Female KW - Humans KW - Intergenerational Relations KW - Interview KW - Psychological KW - Male KW - Maternal Deprivation KW - Middle Aged KW - Object Attachment KW - Refugees/psychology KW - Stress Disorders KW - Post-Traumatic/diagnosis/psychology KW - Survivors/psychology KW - World War II KW - Young Adult Y1 - 2012 U6 - http://dx.doi.org/10.13109/prkk.2012.61.8.623 SN - 0032-7034 VL - 61 SP - 623 EP - 640 ER - TY - JOUR A1 - Möller, Birgit A1 - Nieder, Timo Ole A1 - Preuss, Wilhelm F. A1 - Becker, Inga A1 - Fahrenkrug, Saskia A1 - Wüsthof, Achim A1 - Briken, Peer A1 - Romer, Georg A1 - Richter-Appelt, Hertha T1 - Versorgung von Kindern und Jugendlichen mit Geschlechtsdysphorie im Rahmen einer interdisziplinären Spezialsprechstunde JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. KW - Adolescent KW - Biomedical Research KW - Child KW - Combined Modality Therapy KW - Cooperative Behavior KW - Education KW - Nonprofessional KW - Female KW - Gender Identity 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 - Transsexualism/diagnosis/psychology/therapy KW - Watchful Waiting Y1 - 2014 SN - 0032-7034 VL - 63 SP - 465 EP - 485 ER -