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 - 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 - Kuhlmann, Anna-Lena A1 - Romer, Georg A1 - Möller, Birgit T1 - „Wenn man sich so besser fühlt …“ JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. Während 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 können. Hierzu wurden Leitfaden-gestützte Interviews mit zehn transidenten Jugendlichen sowie zwölf ihrer Geschwister nach den Regeln der Grounded Theory ausgewertet. In den meisten Fällen 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 für den transidenten Adoleszenten ersetzt. Die transidenten Jugendlichen zeigten sich mit der Reaktion des Geschwisters grundsätzlich zufrieden, obwohl das Maß an Unterstützung unterschiedlich war. Die Zeit des Coming-out und der Transition führte häufig zu einer Verbesserung der Geschwisterbeziehung, mehr Nähe und familiärem Zusammenhalt. Insgesamt zeigte sich, dass die Geschwister bei einer Transidentität im Jugendalter unmittelbar mitbetroffen sind und daher im klinischen Alltag von Anfang an mit einbezogen werden sollten. Durch Berücksichtigung ihrer Situation kann negativen Entwicklungen vorgebeugt und die Geschwisterbeziehung als Ressource nutzbar werden. KW - Adolescent KW - Grief KW - Humans KW - Sibling Relations KW - Siblings/psychology KW - Surveys and Questionnaires KW - Transgender Persons/psychology Y1 - 2020 U6 - http://dx.doi.org/10.13109/prkk.2020.69.6.524 SN - 0032-7034 VL - 69 SP - 524 EP - 540 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 - 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 - 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 - Rutzen, Katharina M. A1 - Nieder, Timo Ole A1 - Schreier, Herbert A1 - Möller, Birgit T1 - Die Versorgung von Kindern und Jugendlichen mit Geschlechtsdysphorie aus der Sicht internationaler Expertise JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - The clinical treatment of children and adolescents with gender dysphoria is still a controversial issue. The aim of this study was to get an overview of the knowledge and experience of international experts and to highlight shared views as well as differences in theoretical convictions and treatment approaches. Half-structured, guide-line based interviews were carried out with international experts in the field. The interviews were analyzed using qualitative content analysis (Mayring, 2010). KW - Adolescent KW - Child KW - Preschool KW - Cooperative Behavior KW - Cross-Cultural Comparison KW - Education KW - Nonprofessional KW - Female KW - Gender Identity KW - Gonadal Steroid Hormones/therapeutic use KW - Humans KW - Interdisciplinary Communication KW - Interview KW - Psychological KW - Male KW - Practice Guidelines as Topic KW - Psychosexual Development KW - Psychotherapy KW - Puberty/drug effects/psychology KW - Sex Counseling KW - Surveys and Questionnaires KW - Transsexualism/diagnosis/psychology/therapy Y1 - 2014 SN - 0032-7034 VL - 63 SP - 449 EP - 464 ER -