TY - JOUR A1 - Inhestern, Laura A1 - Bultmann, Johanna C. A1 - Beierlein, Volker A1 - Möller, Birgit A1 - Romer, Georg A1 - Muriel, Anna C. A1 - Moore, Cynthia W. A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Psychometric properties of the Parenting Concerns Questionnaire in cancer survivors with minor and young adult children JF - Psycho-oncology N2 - 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. KW - Adult KW - Adult Children/psychology KW - Anxiety/epidemiology/psychology KW - Child KW - Cross-Sectional Studies KW - Female KW - Germany/epidemiology KW - Humans KW - Male KW - Middle Aged KW - Neoplasms/epidemiology/psychology KW - Parent-Child Relations KW - Parenting KW - Parents/psychology KW - Psychometrics KW - Reproducibility of Results KW - Social Support KW - Surveys and Questionnaires KW - Survivors/psychology KW - Young Adult Y1 - 2016 U6 - http://dx.doi.org/10.1002/pon.4049 VL - 25 SP - 1092 EP - 1098 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 - Understanding parenting concerns in cancer survivors with minor and young-adult children JF - Journal of psychosomatic research N2 - 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. KW - Adolescent KW - Adult KW - Adult Children/psychology KW - Child KW - Preschool KW - Comprehension KW - Cross-Sectional Studies KW - Female KW - Humans KW - Infant KW - Newborn KW - Male KW - Middle Aged KW - Neoplasms/epidemiology/psychology KW - Parent-Child Relations KW - Parenting/psychology KW - Social Support KW - Surveys and Questionnaires KW - Survivors/psychology KW - Young Adult Y1 - 2016 U6 - http://dx.doi.org/10.1016/j.jpsychores.2016.05.008 VL - 87 SP - 1 EP - 6 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 - Bergelt, Corinna A1 - Ernst, Johanna Christine A1 - Beierlein, Volker A1 - Inhestern, Laura A1 - Holes, Sarah A1 - Möller, Birgit A1 - Romer, Georg A1 - Koch, Uwe T1 - Reaktive Veränderungen in Befinden und Verhalten von Kindern bei elterlicher Krebserkrankung--Ergebnisse einer epidemiologischen Patientenbefragung JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Child Behavior Disorders/diagnosis/epidemiology/psychology KW - Child of Impaired Parents/psychology KW - Child Reactive Disorders/diagnosis/epidemiology/psychology KW - Preschool KW - Cross-Sectional Studies KW - Female KW - Germany KW - Health Surveys KW - Humans KW - Infant KW - Male KW - Middle Aged KW - Neoplasms/epidemiology/psychology KW - Personality Assessment KW - Resilience KW - Psychological KW - Young Adult Y1 - 2012 U6 - http://dx.doi.org/10.13109/prkk.2012.61.6.378 SN - 0032-7034 VL - 61 SP - 378 EP - 395 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 - 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 -