Christian Postert's research while affiliated with Hochschule Bochum and other places

By using the example of hearing loss, an overview is given on genetics, new diagnostic developments and their applications. Owing to novel high-throughput technologies of DNA sequencing, most patients now can get a genetic diagnosis for several reasons, in the routine workup after failed newborn hearing screening but also in cases of hearing loss manifesting later in life.

Adolescent-onset Major Depressive Disorder (MDD) is associated with an increased risk of recurrent depressive episodes, suicidal behaviors, and psychiatric morbidity throughout the lifespan. The objective of the present study was to investigate brain structural and functional changes in adolescent patients with MDD. Furthermore, we aimed to clarify the influence of early-life stress on brain function and structure. The study investigated adolescent patients with severe MDD (n=20, mean age=16.0, range=15–18 years) and a control sample of matched healthy adolescents (n=21, mean age= 16.6, range=15–18 years). Functional MRI data were obtained using a face-matching paradigm to investigate emotion processing. Structural MRI data were analyzed using voxel-based morphometry (VBM). In line with previous studies on adult MDD, adolescent patients showed elevated amygdala activity to negative and reduced amygdala activity to positive emotional stimuli. Furthermore, MDD patients showed smaller hippocampal volumes compared to healthy adolescents. Higher levels of childhood maltreatment were associated with smaller hippocampal volumes in both depressed patients and healthy controls, whereby no associations between amygdala reactivity and childhood maltreatment were found. Our results suggest that hippocampal alterations in youth MDD patients may at least partly be traced back to higher occurrence of early-life adverse experiences. Regarding the strong morphometric impact of childhood maltreatment and its distinctly elevated prevalence in MDD populations, this study provides an alternative explanation for frequently observed limbic structural abnormalities in depressed patients.

From the perspective of attachment theory, insecure attachment can be seen as a key risk factor for the development of anxiety symptoms and anxiety disorders. This systematic review addresses the current state of empirical research on the relationship between attachment status and anxiety symptoms respective anxiety disorders in childhood and adolescence. 21 current international studies published between 2010 and 2014 were included in this systematic review. These studies were heterogeneous in target populations, methods and study design. The majority of studies supported the assumed correlation between insecure attachment and anxiety symptoms or anxiety disorders. These findings are more evident in studies with school-age children than with preschool children or adolescents. Furthermore, the disorganized-disoriented type of attachment seems to be a particular risk factor for the development of anxiety symptoms and anxiety disorders. Results were discussed in relation to attachment theory and with reference to the results of previous relevant reviews.

This study describes the treatment outcomes of preschoolers with severe mental health problems who were treated at the child psychiatric family day hospital for preschool children in Münster, Germany. The eclectic multi-modal treatment combines behavioral and psychodynamic techniques for both parents and children in various settings within an intermittent attendance structure provided by a multi-disciplinary team. This study evaluated 185 children with the Caregiver-Teacher Report Form (C-TRF/1.5-5), which was completed by therapists, and the Child Behavior Checklist (CBCL/1.5-5), which was completed by mothers, at admission and discharge. The mothers' ratings of their children were statistically adjusted for the distortion caused by their own psychopathology. After treatment, the patients showed significant improvement on the C-TRF/CBCL Total Problem score with an average Cohen's d = -0.50 based on therapists' ratings, d = -0.97 for the non-adjusted maternal ratings, and d = -0.68 for the adjusted maternal ratings. We conclude that specialized family day hospitals may successfully treat preschool psychiatric patients.

Psychiatric treatment of children in preschool age (0-6 years) and their parents is an expanding field of research due to its high clinical significance. Specific family psychiatric treatment programs have been developed to meet the demands of this young age group, but are little known. A multiprofessional intermittent treatment approach sensitive to developmental and family context has been established in the Preschool Family Day Hospital for Infants, Toddlers and Preschoolers and their Families at Munster University Hospital, Germany. Group and individual therapeutic interventions for both children and parents, video-based parent-child-interaction therapy, psychiatric and psychotherapeutic treatments of parents and family therapeutic interventions integrating siblings are supporting and enhancing each other in an innovative and integrated family psychiatric program. First results of evaluation studies are reported that show that this treatment is effective.

MULTIPROFESSIONAL INTERMITTENT PSYCHIATRIC TREATMENT OF PSYCHIATICALLY SICK CHILDREN IN PRESCHOOL AGE AND THEIR PARENTS IN A FAMILY DAY CLINIC Psychiatric treatment of children in preschool age (0 to 6 years) and their parentsis an expending field of research due to its high clinical significance. Specific family psychiatric treatment progams have been developed to meet the demands of this young age group, but are little known. A multiprofessional intermittent traetment apprach sensitive to developmental and family context has been established in the Preschool Family Day Hospital for Infants, Toddlers and prescool Children and teir Families at Münster University Hospital, Germany. Group and individual therapeutic interventions for both children and parents, video-based parent-child-interaction therapy, psychiatric and psychtheraputic treatments of parents and family therapeutic interventions integrating siblings are supporting and enhancing each other in an innovativ and integrated family psychiatric program. First results of evaluation studies are reported that show that this treament is effective.

Specific developmental disorders of speech, language, and motor function in children are associated with a wide range of mental health problems. We examined whether preschool-age psychiatric patients with specific developmental disorders and those without differed in the severity of emotional and behavior problems. In addition, we examined whether the 2 groups differentially benefited from child psychiatric family day hospital treatment. Data from (N = 78) preschool-age boys (27 with a developmental disorder and 51 without) were analyzed. Before and after treatment, child emotional and behavior problems were rated by parents on the German version of the Child Behavior Checklist for Ages 1.5-5 (T. M. Achenbach & L. A. Rescorla, 2000; Arbeitsgruppe Deutsche Child Behavior Checklist, 2002) and by therapists on the German version of the Caregiver-Teacher Report Form for Ages 1.5-5 (T. M. Achenbach & L. A. Rescorla, 2000; Arbeitsgruppe Deutsche Child Behavior Checklist, 2002). Results indicated small-to-moderate differences between groups in the severity of specific emotional and behavior problems, and there were hints that children without developmental disorders benefited more from treatment than those with developmental disorders. However, results depended clearly on the perspective of the informant, with mothers generally perceiving more treatment benefit and less group differences than therapists. Child psychiatric patients with additional developmental disorders differ slightly from children without additional developmental disorders in the severity of emotional and behavior problems. The evaluation of treatment appears to be more strongly influenced by the informant's perspective than by pretreatment group differences. Reasons for informant differences, especially the observed maternal optimism, may include treatment-related changes in maternal mood, increased parenting skills, and improvement of the mother-child interaction.

Background Major depressive disorder is a serious psychiatric illness with a highly variable and heterogeneous clinical course. Due to the lack of consistent data from previous studies, the study of morphometric changes in major depressive disorder is still a major point of research requiring additional studies. The aim of the study presented here was to characterize and quantify regional gray matter abnormalities in a large sample of clinically well-characterized patients with major depressive disorder. Methods For this study one-hundred thirty two patients with major depressive disorder and 132 age- and gender-matched healthy control participants were included, 35 with their first episode and 97 with recurrent depression. To analyse gray matter abnormalities, voxel-based morphometry (VBM8) was employed on T1 weighted MRI data. We performed whole-brain analyses as well as a region-of-interest approach on the hippocampal formation, anterior cingulate cortex and amygdala, correlating the number of depressive episodes. Results Compared to healthy control persons, patients showed a strong gray-matter reduction in the right anterior insula. In addition, region-of-interest analyses revealed significant gray-matter reductions in the hippocampal formation. The observed alterations were more severe in patients with recurrent depressive episodes than in patients with a first episode. The number of depressive episodes was negatively correlated with gray-matter volume in the right hippocampus and right amygdala. Conclusions The anterior insula gray matter structure appears to be strongly affected in major depressive disorder and might play an important role in the neurobiology of depression. The hippocampal and amygdala volume loss cumulating with the number of episodes might be explained either by repeated neurotoxic stress or alternatively by higher relapse rates in patients showing hippocampal atrophy.

Parenting behavior has a significant influence on children’s mental health and may contribute to the development of emotional or behavior problems in children. Differences in parenting behavior have been related to parent personality and to child temperament, although the direction of causality is not yet clear. This review seeks to provide an overview of the relation between child mental health, parenting, parent personality, and child temperament with a special focus on the interaction effects of parent personality on child temperament. Empirical evidence suggested that child and parent characteristics both—additively and interactively—contribute to parenting behavior. There were only a few studies that explicitly considered interaction effects, and most of them focused on negative effects. More research is necessary to investigate the interaction of parent personality and child temperament and the related child outcomes further. Counseling, family therapy, and other parenting-oriented interventions may benefit from individual adaptations to both parental personality and child temperament.

Background The Parent-Infant Relationship Global Assessment Scale (PIR-GAS) signifies a conceptually relevant development in the multi-axial, developmentally sensitive classification system DC:0-3R for preschool children. However, information about the reliability and validity of the PIR-GAS is rare. A review of the available empirical studies suggests that in research, PIR-GAS ratings can be based on a ten-minute videotaped interaction sequence. The qualification of raters may be very heterogeneous across studies. Methods To test whether the use of the PIR-GAS still allows for a reliable assessment of the parent-infant relationship, our study compared a PIR-GAS ratings based on a full-information procedure across multiple settings with ratings based on a ten-minute video by two doctoral candidates of medicine. For each mother-child dyad at a family day hospital (N = 48), we obtained two video ratings and one full-information rating at admission to therapy and at discharge. This pre-post design allowed for a replication of our findings across the two measurement points. We focused on the inter-rater reliability between the video coders, as well as between the video and full-information procedure, including mean differences and correlations between the raters. Additionally, we examined aspects of the validity of video and full-information ratings based on their correlation with measures of child and maternal psychopathology. Results Our results showed that a ten-minute video and full-information PIR-GAS ratings were not interchangeable. Most results at admission could be replicated by the data obtained at discharge. We concluded that a higher degree of standardization of the assessment procedure should increase the reliability of the PIR-GAS, and a more thorough theoretical foundation of the manual should increase its validity.