The prevalence of misophonia in a representative population-based survey in Germany.

PURPOSE: Misophonia is a new disorder, currently defined as significant emotional and physiological distress when exposed to certain sounds. Although there is a growing body of literature on the characteristics of the disorder, the prevalence in the general population is still relatively unknown. This study therefore aims at determining the prevalence and symptom severity of misophonia in a large and representative general population sample in Germany. METHODS: To examine the prevalence of misophonic sounds, misophonic reactions and misophonia severity, a cross-sectional population representative survey in Germany has been conducted. Participants (N = 2.522) were questioned retrospectively about misophonic symptoms using the Amsterdam Misophonie Scale - Revised (AMISOS-R). RESULTS: Overall 33.3% reported to be sensitive to at least one specific misophonic sound. Within the total sample, subthreshold symptoms were reported by 21.3%, mild symptoms were reported by 9.9%, moderate to severe symptoms were reported by 2.1%, and severe to extreme symptoms were reported in 0.1% of participants. CONCLUSION: Based on the diverging presentations and prevalence rates of misophonic sounds, reactions and symptoms according to the severity, it seems worthwhile to conceptualize misophonia as a rather continuous spectrum disorder (subthreshold, mild, moderate to severe), still taking into account that an additional categorical diagnostic approach might be necessary to derive a diagnosis in clinical practice.

Development and validation of the caregiver-report version of the international depression questionnaire (IDQ-CG) and international anxiety questionnaire (IAQ-CG).

The International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ) are self-report measures of ICD-11 single episode depressive disorder (DD) and generalised anxiety disorder (GAD). The present study sought to describe the development and psychometric evaluation of the caregiver-report versions of the IDQ and IAQ for children, referred to as the IDQ-CG and IAQ-CG, respectively. Participants were 639 parents living in Ukraine who provided data on themselves and one child in their household as part of "The Mental Health of Parents and Children in Ukraine Study: 2023 Follow-up" study. The latent structure of the IDQ-CG and IAQ-CG were tested using confirmatory factor analysis (CFA), composite reliability (CR) estimates were estimated, and convergent validity was assessed. Prevalence rates of probable ICD-11 DD and GAD were also estimated. CFA results indicated that the IDQ-CG and IAQ-CG were unidimensional, while the internal reliability of both scales was excellent. Convergent validity was established via associations with external measures of internalizing, externalizing, and attention problems as well as trauma exposure. Factors associated with increased IDQ-CG and IAQ-CG scores included pharmacological support for emotional or behavioural problems, delayed milestone development, being forced to move to another part of Ukraine, serious life disruption due to the war, and having experienced a bereavement. Of the total sample, 1.6% met diagnostic requirements for ICD-11 DD and 5.8% met diagnostic requirements for ICD-11 GAD. This study supports the psychometric properties of the IDQ-CG and IAQ-CG. These measures can be effectively used to identify young people in need of mental health support.

Evaluation of "Cognitive Behavioral Intervention for Trauma in Schools" (CBITS) in child welfare programs in Germany: study protocol of a randomized controlled trial.

BACKGROUND: Children and adolescents growing up in child welfare institutions have been frequently exposed to traumatic events and psychosocial stress and show elevated rates of mental disorders. Yet, there is a lack of empirically supported treatments to provide adequate mental health care for children in care suffering from trauma-related mental disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is an evaluated trauma-focused cognitive-behavioral group intervention, which has proven to be effective in reducing symptoms of PTSD, depression, and anxiety for traumatized children in group settings. The trial will evaluate the effectiveness of the CBITS intervention as an outreach treatment compared with an enhanced treatment-as-usual condition (TAU +) within the German mental health and child welfare system. METHODS: In a randomized controlled trial (RCT) involving N = 90 children and adolescents, we will compare CBITS with TAU + . Participants between 8 and 16 years, reporting at least one traumatic event and moderate posttraumatic stress symptoms (PTSS), will be randomized within their child welfare institution to either one of the conditions using a CATS-2 severity-stratified block randomization. Assessments will take place at baseline, as well as 4 months and 10 months after baseline. The primary outcome is the severity of PTSS after 4 months. Secondary outcomes are depression, anxiety, irritability/anger, quality of life, and global functioning level. DISCUSSION: The results of our trial will provide evidence regarding effective treatment options for traumatized children in care, which represent an understudied population with limited access to mental health care. Additionally, it could serve as a blueprint for implementing trauma-focused outreach group treatments for children in care and increase the accessibility to appropriate treatment. TRIAL REGISTRATION: Clinical Trials.gov NCT06038357 D. September 13, 2023.

Scoping Review: Digital Mental Health Interventions for Children and Adolescents Affected by War.

OBJECTIVE: More than 200 million children and adolescents live in countries affected by violent conflict, are likely to have complex mental health needs, and struggle to access traditional mental health services. Digital mental health interventions have the potential to overcome some of the barriers in accessing mental health support. We performed a scoping review to map existing digital mental health interventions relevant for children and adolescents affected by war, to examine the strength of the evidence base, and to inform the development of future interventions. METHOD: Based on a pre-registered strategy, we systematically searched MEDLINE, Embase, Global Health, APA PsychInfo, and Google Scholar from the creation of each database to September 30, 2022, identifying k = 6,843 studies. Our systematic search was complemented by extensive consultation with experts from the GROW Network. RESULTS: The systematic search identified 6 relevant studies: 1 study evaluating digital mental health interventions for children and adolescents affected by war, and 5 studies for those affected by disasters. Experts identified 35 interventions of possible relevance. The interventions spanned from universal prevention to specialist-guided treatment. Most interventions directly targeted young people and parents or carers/caregivers and were self-guided. A quarter of the interventions were tested through randomized controlled trials. Because most interventions were not culturally or linguistically adapted to relevant contexts, their implementation potential was unclear. CONCLUSION: There is very limited evidence for the use of digital mental health interventions for children and adolescents affected by war at present. The review provides a framework to inform the development of new interventions. DIVERSITY & INCLUSION STATEMENT: We actively worked to promote sex and gender balance in our author group. STUDY PREREGISTRATION INFORMATION: Digital mental health interventions for children and young people affected by war: a scoping review; https://osf.io/; hrny9.

Aktueller Stand der Interkulturellen Öffnung der psychiatrischpsychotherapeutischen Versorgung von Kindern und Jugendlichen aus Sicht von Fachkräften / The Current Status of the Intercultural Opening of the Psychiatric-Psychotherapeutic Care for Children and Adolescents from the Perspective of Professionals.

The Current Status of the Intercultural Opening of the Psychiatric-Psychotherapeutic Care for Children and Adolescents from the Perspective of Professionals Children and adolescents with a migration background have a high demand for psychiatricpsychotherapeutic care in Germany. Nevertheless, they often do not receive the care needed, despite the Intercultural Opening, which aims at adjusting the services to their needs.The aim of the study is to get insights in the current status of the Intercultural Opening of the psychiatric- psychotherapeutic care system by examining the perspectives and needs of the staff working with this vulnerable population. A sample of N = 232 pedagogical and health care professionals completed the online survey. Intercultural competencies, further training needs and challenges in their work were assessed by open and closed questions. Overall, our results demonstrate high intercultural competencies. Pedagogical and health care professionals reported several challenges in their work (e. g. with the language barrier). There was a great demand for specific transcultural trainings. Despite high intercultural competencies of the professionals, there is a clear need for action to improve the Intercultural Opening of the psychiatric-psychotherapeutic care systems. Further transcultural trainings and several structural improvements (e. g. changes in the training curriculum of the professionals, provision of more trained translators) would help to open the care system.

Mental health in Ukraine in 2023.

BACKGROUND: Very little is known about the mental health of the adult population of Ukraine following Russia's full-scale invasion in February 2022. In this study, we estimated the prevalence of seven mental health disorders, the proportion of adults screening positive for any disorder, and the sociodemographic factors associated with meeting requirements for each and any disorder. METHODS: A non-probability quota sample (N = 2,050) of adults living in Ukraine in September 2023 was collected online. Participants completed self-report questionnaires of the seven mental health disorders. Logistic regression was used to determine the predictors of the different disorders. RESULTS: Prevalence estimates ranged from 1.5% (cannabis use disorder) to 15.2% (generalized anxiety disorder), and 36.3% screened positive for any of the seven disorders. Females were significantly more likely than males (39.0% vs. 33.8%) to screen positive for any disorder. Disruption to life due to Russia's 2014 invasion of Ukraine, greater financial worries, and having fewer positive childhood experiences were consistent risk factors for different mental health disorders and for any or multiple disorders. CONCLUSION: Our findings show that approximately one in three adults living in Ukraine report problems consistent with meeting diagnostic requirements for a mental health disorder 18 months after Russia's full-scale invasion. Ukraine's mental healthcare system has been severely compromised by the loss of infrastructure and human capital due to the war. These findings may help to identify those most vulnerable so that limited resources can be used most effectively.

Traumatic events and posttraumatic stress symptoms in a treatment-seeking sample of Ukrainian children during the war.

BACKGROUND: The Russian invasion of Ukraine resulted in a dramatic increase of children and adolescents being confronted with war and other traumatic experiences, which could result in an increase of trauma-related mental health disorders such as posttraumatic stress disorder (PTSD) in an entire generation. This study aims at reporting the prevalence of traumatic events, PTSD, and Complex PTSD (CPTSD) in children and adolescents seeking for mental health treatment since the Russian invasion. Additionally, the consistency of child and caregiver reported trauma, PTSD and CPTSD will be examined. METHODS: This study is part of the "TF-CBT Ukraine" project in which Ukrainian therapists were trained in assessing their patients via the "Child and Adolescent Trauma Screen" (CATS-2) before initiating trauma-focused treatment, if indicated. Altogether N = 200 Ukrainian children and adolescents (Mage = 12.01, range 4-21; 62.0% female) were included in the study between October 2022 and August 2023. Data were analysed descriptively, via t-tests and bivariate correlations. RESULTS: The children and adolescents reported on average four different traumatic events, most frequently war (n = 123; 68.7%), bullying threats (n = 71; 39.7%) and domestic violence (n = 68; 38.0%). Almost 70% (n = 123) of the participants fulfilled the DSM-5 PTSD criteria, 31% (n = 56) fulfilled the ICD-11 PTSD criteria and 21% (n = 38) the ICD-11 CPTSD criteria. Rates of PTSD were even higher in preschool children (95%). The comparisons of self-and caregiver reports on traumatic events and PTSD/CPTSD severity scores indicated moderate to high correlations between the patients and their caregivers (r = 0.710-0.767). CONCLUSIONS: This study shows that Ukrainian children and adolescents starting treatment report a high number of traumatic events and trauma-related symptoms, which could have a long-lasting negative impact on their social-emotional development and quality of life. The implementation of evidence-based trauma-focused interventions for these children is therefore crucial.

Validation of the Ukrainian caregiver-report version of the Child and Adolescent Trauma Screen (CATS) in children and adolescents in Ukraine.

OBJECTIVE: Emerging research indicates that the ongoing conflict in Ukraine has led to an increased prevalence of war-related posttraumatic stress disorder (PTSD) in children and adolescents. The current study sought to test the psychometric properties of a Ukrainian-translated measure of PTSD for children and adolescents; the Child and Adolescent Trauma Screen (CATS; Sachser et al., 2017). METHOD: Participants were an opportunistic sample of N = 2,004 parents living in Ukraine who provided data on themselves and one target child in their household as part of The Mental Health of Parents and Children in Ukraine Study. The latent structure of the parent-reported CATS was tested using confirmatory factor analysis, composite reliability estimates were estimated, and criterion validity was assessed. RESULTS: The latent structure of the parent-reported CATS was best reflected by a three-factor model and a four-factor model in the preschool and child and adolescent samples, respectively. Estimates of internal reliability were high for both samples. Criterion validity was supported through associations with external measures of internalizing, externalizing, and attention problems. Parent-report child milestone development delays and prior psychological or pharmacological support were associated with higher average scores on the CATS symptom scales. The prevalence of probable PTSD for the preschool sample was 15.4% (n = 77) and the prevalence of probable PTSD for the child and adolescent sample was 14.4% (n = 217). DISCUSSION: This study supports the psychometric properties of the Ukrainian parent-reported CATS which can be used routinely in clinical practice for the caregiver-rated assessment of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Factors affecting the acculturation strategies of unaccompanied refugee minors in Germany.

Background: Different acculturation strategies might be related to different mental health outcomes and social participation of unaccompanied refugee minors (URMs), but little is known about which factors influence this acculturation process. Therefore, the aim of this investigation was to examine the impact of individual, stress-related, and contextual factors on the acculturation process of URMs in Germany. Methods: A sample of N = 132 URMs living in child and youth welfare service facilities in Germany completed questionnaires about their acculturation orientation, traumatic experiences, daily stressors, asylum stress, and perceived social support between June 2020 and October 2021. This investigation is part of the multi-center randomized control trial BETTER CARE. Data were analyzed descriptively and via multiple hierarchical regression. Results: Integration (43.5%) and Assimilation (37.1%) were the most common acculturation strategies used by URMs. Multiple hierarchical regression models showed that daily stressors (e.g., the lack of money) were associated with a stronger orientation toward the home country, whereas traumatic events were associated with a weaker orientation toward their home country. No significant predictors were found for the orientation toward the host country. Discussion: Overall, URMs in Germany showed favorable acculturation strategies. Nevertheless, daily stressors and traumatic experiences might influence this process. The implications for practitioners and policymakers are discussed with a view to further improving the acculturation process of URMs in Germany.Clinical Trial Registration: German Clinical Trials Register, DRKS00017453 https://drks.de/search/de/trial/DRKS00017453. Registered on December 11, 2019.

Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety-A secondary analysis of the Better Care study.

Background: Unaccompanied young refugees (UYRs) show elevated levels of mental distress such as post-traumatic stress symptoms (PTSS), depression, and anxiety. The individual post-arrival situation in the host country plays an important role in increasing or reducing mental health risks for these vulnerable children and youth. The study aims at examining the impact of pre- and post-migration factors on the mental health of UYRs. Methods: A cross-sectional survey of N = 131 young refugees (81.7% male, M = 16.9 years old) was conducted in 22 children and youth welfare service (CYWS) facilities in Germany. The participants provided information about pre- and post-flight experiences. Standardized measures were used to assess post-traumatic stress symptoms (CATS-2), symptoms of depression (PHQ-9), and anxiety (GAD-7). Daily stressors were assessed with the Daily Stressors Scale for Young Refugees (DSSYR), sociocultural adaptation with the Brief Sociocultural Adaptation Scale (BSAS), satisfaction with social support with the Social Support Questionnaire (SSQ6-G). Results: Our results demonstrated clinical levels of PTSS in 42.0% of the participants, depression in 29.0%, and anxiety in 21.4%. Hierarchical regression analyses revealed that a higher number of traumatic events and social daily stressors predicted higher levels in all three domains of mental health problems. PTSS and anxiety were also predicted by the distress related to the residence status, depressive symptoms were additionally predicted by sociocultural adaptation, less family contact and length of stay. The satisfaction with social support was not a significant predictor in the regression models. Conclusion: Unaccompanied young refugees in CYWS facilities are a highly vulnerable population. As traumatic events, daily stressors and level of contact to family directly impacted UYRs mental health, interventions should be trauma-focused, but also contain modules on how to cope with daily stressors. On the policy and practical level, stakeholders in host countries are called for establishing measures to reduce post-migration stressors and enhance support for UYRs on all levels.

Implementation of an evidence-based trauma-focused treatment for traumatised children and their families during the war in Ukraine: a project description.

The full-scale invasion of Ukraine by Russia in February 2022 led to an increase of traumatic events and mental health burden in the Ukrainian general population. The (ongoing) traumatisation can have a crucial impact on children and adolescents as they are especially vulnerable for developing trauma-related disorders such as Post Traumatic Stress Disorder (PTSD) or Depression. To date, these children have only very limited access to trauma-focused evidence-based treatments (EBTs) by trained mental health specialists in Ukraine. The fast and effective implementation of these treatments in Ukraine is crucial to improve the psychological wellbeing of this vulnerable population. This letter to the editor describes an ongoing project which implements a trauma-focused EBT called 'Trauma-Focused Cognitive Behavioural Therapy' (TF-CBT) in Ukraine during the war. In collaboration with Ukrainian and international agencies, the project 'TF-CBT Ukraine' was developed and implemented starting in March 2022. The project entails a large training programme for Ukrainian mental health specialists and the implementation of TF-CBT with children and their families in and from Ukraine. All components of the project are scientifically evaluated on a patient and therapist level, cross-sectionally and longitudinally, in a mixed-methods design. All together nine training cohorts with N = 133 Ukrainian therapists started the programme, all monthly case consultations (15 groups) and treatments of patients are still ongoing. Lessons learnt from this first large-scale implementation project on an EBT for children and adolescents impacted by trauma in Ukraine will help inform the field on challenges and also possibilities to expand such efforts. On a broader level, this project could be one small step in the process of helping children overcome the negative effects and experience resilience in the context of a war-torn nation.

The impact of trauma and daily hardships on the mental health of unaccompanied refugee minors detained in Libya.

BACKGROUND: The high trauma load and prevalence of mental distress in unaccompanied refugee minors (URMs) who resettle in Western (European) countries is well documented. However, the lack of studies investigating the potentially most vulnerable population, URMs who are currently on the move in transit countries such as Libya, is alarming. AIMS: To document the mental health of URMs detained in Libya and the possible associations with trauma, flight and daily hardships. METHOD: In total n = 99 (94.9% male; n = 93) URMs participated in this cross-sectional study conducted in four detention centres near the Libyan capital Tripoli. Data were collected via standardised questionnaires in an interview format and analysed using structured equation modelling. RESULTS: Participants reported high rates of trauma, especially within Libya itself. Reports of daily hardships in detention ranged between 40 and 95% for basic needs and between 27 and 80% for social needs. Higher social needs were associated with increased anxiety symptoms (ß = 0.59; P = 0.028) and increased pre-migration (ß = 0.10; P = 0.061) and peri-migration trauma (ß = 0.16; P = 0.017) with symptoms of depression. Similarly, higher levels of pre-migration trauma were associated with higher post-traumatic stress disorder levels (ß = 0.17; P = 0.010). CONCLUSIONS: The rates of daily hardships and traumatic events are higher compared with those recorded for URMs living in asylum centres in Europe. The emotional, social and cognitive development of detained URMs is severely threatened in both the short and long term. This paper outlines some of the most detrimental effects of migration policies on URMs transiting through Libya.

[Misophonia in Childhood and Adolescence: A Narrative Review]. / Misophonie im Kindes- und Jugendalter: Eine narrative Übersichtsarbeit.

Misophonia in Childhood and Adolescence: A Narrative Review Abstract. Misophonia describes a phenomenon in which the affected children and adolescents show a strong negative physiological and emotional reaction when confronted with specific (misophonic) auditory stimuli (most commonly eating or breathing sounds). Several studies with adults yielded prevalence rates between 6 % and 20 % in various (clinical) samples, but the representativeness of samples was largely limited. More than 80 % of the first manifestation of symptoms occurs during childhood and adolescence. Regarding comorbid disorders, studies show great heterogeneity, with estimates ranging from 28-76 % of comorbid mental disorders and approximately 25 % with comorbid physical disorders. The exact etiology is currently not well studied. Initial neurophysiological explanations and imaging studies point to a specific physiological response in misophonia patients. Although many case reports are now available, and diagnostic criteria and measurement tools have been developed, misophonia currently does not represent a distinct neurological, audiological, or psychiatric disorder in the DSM-5 or ICD-11.

The child and Adolescent Trauma Screen 2 (CATS-2) - validation of an instrument to measure DSM-5 and ICD-11 PTSD and complex PTSD in children and adolescents.

Background: The study examined the psychometric properties of the Child and Adolescent Trauma Screen 2 (CATS-2) as a measure of posttraumatic stress disorder (PTSD) according to DSM-5 and (Complex) PTSD following the ICD-11 criteria in children and adolescents (7-17 years). Methods: Psychometric properties were investigated in an international sample of traumatized children and adolescents (N = 283) and their caregivers (N = 255). We examined the internal consistency (α), convergent and discriminant validity, the factor structure of the CATS-2 total scores, latent classes of PTSD/Complex PTSD (CPTSD) discrimination, as well as the diagnostic utility using ROC-curves. Results: The DSM-5 total score (self: α = .89; caregiver: α = .91), the ICD-11 PTSD total score (self: α = .67; caregiver: α = .79) and the ICD-11 CPTSD total score (self: α = .83; caregiver: α = .87) have proven acceptable to excellent reliability. The latent structure of the 12-item ICD-11 PTSD/CPTSD construct was consistent with prior findings. Latent profile analyses revealed that ICD-11 CPTSD was empirically distinguishable from ICD-11 PTSD using the CATS-2. ROC-analysis using the CAPS-CA-5 as outcome revealed that CATS-2 DSM-5 PTSD scores of ≥21 (screening) to ≥25 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. For the ICD-11 PTSD scale scores of ≥7 (screening) to ≥9 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. Conclusions: The CATS-2 is a brief, reliable and valid measure of DSM-5 PTSD, ICD-11 PTSD and CPTSD symptomatology in traumatized children and adolescents, allowing crosswalk between diagnostic systems using one measure. HIGHLIGHTS: The CATS-2 screens for potentially traumatic events (PTEs) and PTSD symptoms.The CATS-2 captures DSM-5 and ICD-11 criteria for PTSD and CPTSD and enables clinicians and researchers to crosswalk between both diagnostic systems.International validation has proven good psychometric properties and presents cut-off scoresThe CATS-2 is a license-free instrument and is freely accessible.

The impact of daily stressors on unaccompanied young refugees' mental health: A longitudinal study.

Previous research has shown the drastic impact of daily stressors on the mental health of unaccompanied young refugees (UYRs). This longitudinal study contributes to existing literature by distinguishing different kinds of daily stressors and examining their impact over time, in relation to stressful life events, legal status, and contact with family. We recruited N = 189 UYRs from diverse backgrounds in Greece, Italy, and Belgium, and conducted two additional waves of interviews, accompanying them for approximately 2 years on their migratory and settlement trajectories throughout Europe. Data were analyzed via growth curve modeling. Results showed that both material and social stressors have a long-term negative effect on anxiety and depression symptoms, while stressful life events only have a significant effect in the beginning of UYRs' trajectories. Having long-term documents and contact with family alleviate symptoms of depression. We discuss how these findings relate to previous research and what they imply for policy-makers and practitioners in the field. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Traumatic events, daily stressors and posttraumatic stress in unaccompanied young refugees during their flight: a longitudinal cross-country study.

BACKGROUND: Unaccompanied young refugees constitute an especially vulnerable population, reporting high rates of trauma and mental health problems. There is a significant gap in the literature on trauma and posttraumatic stress symptoms (PTSS) in unaccompanied young refugees who are still on the move and live in precarious circumstances such as refugee camps. This study therefore aimed to contribute to this gap by investigating pre- and peri-migration (potentially) traumatic experiences of unaccompanied young refugees; longitudinal trajectories of trauma, daily stressors and PTSS; and the impact of gender, trauma, and daily stressors on PTSS over time. METHODS: This longitudinal, mixed-method, and multi-country study was conducted in various settings (e.g. refugee camps, reception centers) across nine European countries. A heterogeneous sample of N = 187 unaccompanied young refugees (78.4% male) from 29 different countries was assessed via interviews at 3 time-points during a period of 27 months. Data was analyzed via growth curve modelling. RESULTS: Prevalence rates of (potentially) traumatic experiences ranged from 29.5 to 91.9%. Peri-migration traumatization remained stable over time (b = - 0.02; p = 0.371), but the number of reported daily stressors (b = - 0.24; p = 0.001) and PTSS scores significantly decreased over time (b = - 0.98; p = 0.004). Females reported higher PTSS compared with males at baseline (p = 0.002), but gender did not influence the longitudinal trajectory of PTSS. The pre-migration trauma load and daily stressors at baseline did not have a significant effect on PTSS at baseline or on the longitudinal trajectory. CONCLUSIONS: This is the first study to document not only the high numbers of traumatic events for unaccompanied young refugees pre- and peri- migration, but also the continued traumatization during flight, as well as high rates of daily stressors and PTSS. Humanitarian and political assistance is urgently needed to curb the often life-threatening conditions unaccompanied young refugees face during migration.

[Framework for a Group Intervention Aiming at Coping with out-of-home Placement - Focus Groups in Residential Foster Homes]. / Potenzielle Inhalte und Rahmenbedingungen einer Gruppenintervention für Jugendliche zur Aufarbeitung der eigenen Fremdunterbringung.

Out-of-home placement is a critical life event for affected children and adolescents. We explored the potential content and conditions for a group intervention aiming at coping with this critical life event by the means of three focus groups with n = 13 participants. The participants reported feelings of guilt, uncertainty concerning their future, experiences of loss, and lack of confidence. So far, standardized programs for sharing the participants' out-of-home care experiences had not been established in their child welfare programs. Under certain circumstances, the participants were willing to take part in a group intervention for this purpose. The intervention should aim at the autobiographical integration of the out-of-home placement as well as the promotion of general protection factors. Further qualitative research is needed to adjust the intervention in order to fit the needs of the target population.

Efficacy of exposure in group settings for youth with posttraumatic stress symptoms.

BACKGROUND: Exposure to traumatic experiences is a fundamental part of evidence-based trauma-focused cognitive behavioral treatment (CBT) but in group settings it is discussed controversially among researchers and practitioners. This study aims to examine the individual participants' stress level during group sessions with exposure and disclosure of traumatic events. METHOD: N = 47 traumatized youth (Mage = 17.00, 94% male) participated in a group intervention comprising six 90-min group sessions (exposure in sessions 2-5). It is based on trauma-focused CBT principles. The individual stress level was assessed by the participants and group facilitators at the beginning, during, and at the end of every session. RESULTS: During the sessions including exposure, the stress level of the participants was higher than during sessions without exposure (Z = - 3.79; p ≤ .001). During the exposure sessions, the participants showed significant changes in stress level (d = 0.34-0.87) following an inverse U-shaped trend. CONCLUSION: The results show that exposure is feasible within the scope of a trauma-focused group intervention for youth. The further dissemination of trauma-focused group treatments is an important component in the mental health care of children and youth who are traumatized.

The immediate impact of lockdown measures on mental health and couples' relationships during the COVID-19 pandemic - results of a representative population survey in Germany.

BACKGROUND: Lockdown measures during the COVID-19 pandemic are expected to have negative effects on mental health and relationship quality. However, little is known about the magnitude of these psychological effects on a population level and for vulnerable subgroups. METHODS: A representative sample (N = 2503; 50.2% female; mean age = 49.5) of the German population was assessed face-to-face during the COVID-19 pandemic (February 10-April 25, 2020). They were examined for differences in mental health (BSI-18) and relationship quality (PFB) in a pre-lockdown and lockdown subsamples. After testing and establishing the measurement models in confirmatory factor analyses, we added covariates as predictors of the factors to the regression model to investigate the impact of the lockdown measures. RESULTS: Overall, participants included after the introduction of lockdown measures reported significantly fewer mental health problems than participants included before the lockdown. Predictor analyses revealed that this effect was larger for participants of younger age and those with higher household income. There was no significant difference in relationship quality between pre-lockdown and lockdown. However, relationship quality improved for younger participants after the lockdown measures started, but deteriorated for older participants. CONCLUSIONS: The German population was found to be largely resilient to the immediate effects of lockdown on mental health and relationship quality. Older participants and those with lower socio-economic status might constitute risk groups during times of lockdown. Further studies in countries affected by more drastic lockdown measures and the long-term consequences of the pandemic are needed to inform decision makers about the psychological effects of lockdown.