Christine M. Freitag

Christine M. Freitag
Goethe-Universität Frankfurt am Main ·  Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters

MD, PhD (Habilitation)

About

518
Publications
128,299
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27,063
Citations
Citations since 2017
222 Research Items
16292 Citations
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Introduction
Christine M. Freitag is the director of the Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main. Christine does research in child and adolescent psychiatry, namely Genetics, Neurophysiology, Neuropsychology, Diagnostics, and Clinical Trials. She focusses on Autism Spectrum Disorder, Conduct Disorder and Attention-Deficit/Hyperactivity Disorder in her studies. Current Projects are A-FFIP (funded by the DFG); FemNAT-CD (funded by the EU), STIPED - StimAT clinical trial (funded by the EU) and CoCA - PROUD clinical Trial (funded by the EU).
Additional affiliations
December 2008 - present
Goethe-Universität Frankfurt am Main
Position
  • Managing Director
November 2003 - November 2008
Universitätsklinikum des Saarlandes
Position
  • Consultant, Senior Researcher

Publications

Publications (518)
Article
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Evidence of alterations in emotion processing in maltreated youth has been hypothesized to reflect latent vulnerability for psychopathology. However, previous studies have not systematically examined the influence of psychopathology on the results. Here, we examined emotion recognition and learning in youth who differed in terms of presence vs. abs...
Article
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Background Attenuated social attention is a key marker of autism spectrum disorder (ASD). Recent neuroimaging findings also emphasize an altered processing of sensory salience in ASD. The locus coeruleus–norepinephrine system (LC-NE) has been established as a modulator of this sensory salience processing (SSP). We tested the hypothesis that altered...
Article
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BACKGROUND Childhood maltreatment is common in youths with Conduct Disorder (CD) and both CD and maltreatment have been linked to neuroanatomical alterations. Nonetheless, our understanding of the contribution of maltreatment to the neuroanatomical alterations observed in CD remains limited. We tested the applicability of the ‘ecophenotype’ model t...
Article
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Perceptual expectations influence perception, attention and the perceptual decision bias during visuospatial orienting, which is impaired in individuals with Autism Spectrum Disorder (ASD). In this study, we investigated whether during visuospatial orienting, perceptual expectations in ASD differentially influence perception, attention and the perc...
Article
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Empathy is defined as the ability to vicariously experience others’ suffering (vicarious pain) or feeling their joy (vicarious reward). While most neuroimaging studies have focused on vicarious pain and describe similar neural responses during the observed and the personal negative affective involvement, only initial evidence has been reported for...
Article
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Attenuated social attention has been described as a reduced preference for social compared to geometric motion in preschoolers with autism spectrum disorder (ASD). The locus coeruleus-norpinephrine (LC-NE) system modulates sensory reactivity and is a promising underlying mechanism. LC-NE activity is indexed by a stimulus-evoked pupillary response (...
Article
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Youth with attention-deficit/hyperactivity disorder (ADHD) are at increased risk to develop co-morbid depression. Identifying factors that contribute to depression risk may allow early intervention and prevention. Poor emotion regulation, which is common in adolescents, is a candidate risk factor. Impaired cognitive emotion regulation is a fundamen...
Article
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In recent years, findings from genetic and other biological studies are starting to reveal the role of various molecular mechanisms that contribute to the etiology of ASD [...]
Article
Some individuals with autism spectrum disorder (ASD) carry functional mutations rarely observed in the general population. We explored the genes disrupted by these variants from joint analysis of protein-truncating variants (PTVs), missense variants and copy number variants (CNVs) in a cohort of 63,237 individuals. We discovered 72 genes associated...
Article
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The consequences of the current COVID-19 pandemic for mental health remain unclear, especially regarding the effects on suicidal behaviors. To assess changes in the pattern of suicide attempt (SA) admissions and completed suicides (CS) in association with the COVID-19 pandemic. As part of a longitudinal study, SA admissions and CS are systematicall...
Article
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Recently, we have shown that pupil dilation during a recognition memory task can serve as an index of memory retrieval difficulties in autism. At the time of publication, we were unaware of specific data‐analysis methods that can be used to shed further light on the origins of such memory related pupil dilation. Specifically, by distinguishing “ton...
Article
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Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in early childhood [...]
Preprint
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Theoretical and empirical accounts suggest that adolescence is associated with heightened reward learning and impulsivity. Experimental tasks and computational models that can dissociate reward learning from the tendency to initiate actions impulsively (action initiation bias) are thus critical to characterise the mechanisms that drive developmenta...
Article
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Background Facial expression of emotion is fundamental to human social interactions. Attention to relevant cues in ADHD and ASD patients are believed to underlie difficulties in recognizing emotions. Cognitive vergence eye movements during gaze fixation have a role in attention. Here we evaluate a possible role of cognitive vergence in facial emoti...
Article
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Small average differences in the left-right asymmetry of cerebral cortical thickness have been reported in individuals with autism spectrum disorder (ASD) compared to typically developing controls, affecting widespread cortical regions. The possible impacts of these regional alterations in terms of structural network effects have not previously bee...
Article
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Exercise interventions in mental disorders have evidenced a mood-enhancing effect. However, the association between physical activity and affect in everyday life has not been investigated in adult individuals with ADHD, despite being important features of this disorder. As physical activity and affect are dynamic processes in nature, assessing thos...
Article
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Due to modern technological innovations, aggressive behaviors have expanded into the cyberspace, creating a new matter of public concern: cyberbullying. Antisocial and aggressive behaviors, including bullying are characteristic for children and adolescents diagnosed with conduct disorder (CD), raising the question whether these youths are highly in...
Article
Objective: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition that is associated with significant difficulties in adaptive behavior and variation in clinical outcomes across the life span. Some individuals with ASD improve, whereas others may not change significantly, or regress. Hence, the development of "personalized medic...
Article
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Among youths with conduct disorder, those with callous-unemotional traits are at increased risk for persistent antisocial behaviour. Although callous-unemotional traits have been found to be associated with white-matter brain abnormalities, previous diffusion imaging studies were conducted in small samples, preventing examination of potential sex b...
Article
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Conduct Disorder (CD) is an impairing psychiatric disorder of childhood and adolescence characterized by aggressive and dissocial behavior. Environmental factors such as maternal smoking during pregnancy, socio-economic status, trauma, or early life stress are associated with CD. Although the number of females with CD is rising in Western societies...
Article
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The ability to infer intentions from observed behavior and predict actions based on this inference, known as intention attribution (IA), has been hypothesized to be impaired in individuals with autism spectrum disorder (ASD). The underlying neural processes, however, have not been conclusively determined. The aim of this study was to examine the ne...
Article
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Objective Conduct disorder (CD) involves aggressive and antisocial behavior and is associated with blunted cortisol stress response in male youths. Far less is known about cortisol stress responsivity in female youths with CD or other neuroendocrine responses in both sexes. Although CD is linked to early adversity, the possibility that neuroendocri...
Article
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Conduct disorder (CD) with high levels of callous-unemotional traits (CD/HCU) has been theoretically linked to specific difficulties with fear and sadness recognition, in contrast to CD with low levels of callous-unemotional traits (CD/LCU). However, experimental evidence for this distinction is mixed, and it is unclear whether these difficulties a...
Article
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Interpretation bias and dysfunctional social assumptions are proposed to play a pivotal role in the development and maintenance of social phobia (SP), especially in youth. In this study, we aimed to investigate disorder-specific implicit assumptions of rejection and implicit interpretation bias in youth with severe, chronic SP and healthy controls...
Article
Several non-mental diseases seem to be associated with an increased risk of ADHD and ADHD seems to be associated with increased risk for non-mental diseases. The underlying trajectories leading to such brain-body co-occurrences are often unclear - are there direct causal relationships from one disorder to the other, or does the sharing of genetic a...
Article
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Conduct disorder (CD), a psychiatric disorder characterized by a repetitive pattern of antisocial behaviors, results from a complex interplay between genetic and environmental factors. The clinical presentation of CD varies both according to the individual’s sex and level of callous-unemotional (CU) traits, but it remains unclear how genetic and en...
Article
Objective: Autism spectrum disorder (ASD) is accompanied by highly individualized neuroanatomical deviations that potentially map onto distinct genotypes and clinical phenotypes. This study aimed to link differences in brain anatomy to specific biological pathways to pave the way toward targeted therapeutic interventions. Methods: The authors ex...
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Neurophysiological measures of preparation and attention are often atypical in ADHD. Still, replicated findings that these measures predict which patients improve after Neurofeedback (NF), reveal neurophysiological specificity, and reflect ADHD-severity are limited. Methods We analyzed children’s preparatory (CNV) and attentional (Cue-P3) brain ac...
Article
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Abstract. In ICD-11, similar to ICD-10, speech and language disorders are classified as neurodevelopmental disorders, which are part of ICD-11 Chapter 6 (Mental, Behavioural and Neurodevelopmental Disorders). The ICD-10 criteria were not well accepted by many professionals in research and clinic who work with children with speech and language disor...
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Genetic risk factors and their influence on neural development in autism spectrum disorders Abstract. Abstract. Autism spectrum disorders are etiologically based on genetic and specific gene x biologically relevant environmental risk factors. They are diagnosed based on behavioral characteristics, such as impaired social communication and stereot...
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DNA methylation profiles of aggressive behavior may capture lifetime cumulative effects of genetic, stochastic, and environmental influences associated with aggression. Here, we report the first large meta-analysis of epigenome-wide association studies (EWAS) of aggressive behavior ( N = 15,324 participants). In peripheral blood samples of 14,434 p...
Article
BERNHARD, A., J. S. Mayer, N. Fann, and C. M. Freitag. Cortisol response to acute psychosocial stress in ADHD compared to Conduct Disorder and Major Depressive Disorder: A systematic review. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2020. – Heterogeneous alterations of the cortisol stress response in Attention-deficit/hyperactivity Disorder (ADHD) were...
Article
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Background: Both selective mutism (SM) and social anxiety disorder (SAD) are severe pediatric anxiety disorders with the common trait of behavioral inhibition (BI). The underlying pathophysiology of these disorders remains poorly understood, however converging evidence suggests that alterations in several peripheral molecular pathways might be invo...
Article
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Background: Conduct disorder (CD) rarely occurs alone but is typically accompanied by comorbid psychiatric disorders, which complicates the clinical presentation and treatment of affected youths. The aim of this study was to investigate sex differences in comorbidity patterns in CD and to systematically explore the ‘gender paradox’ and ‘delayed-ons...
Preprint
Full-text available
Small average differences in the left-right asymmetry of cerebral cortical thickness have been reported in individuals with autism spectrum disorder (ASD) compared to typically developing controls. Although these alterations affect multiple and widespread cortical regional asymmetries, the extent to which specific structural networks might be affec...
Article
ZUSAMMENFASSUNG In der überarbeiteten Version der Internationalen Klassifikation von Erkrankungen, der ICD-11, wird das Krankheitsbild Autismus-Spektrum-Störung (ASS) neu eingeführt. ASS nach ICD-11 umfasst die ehemaligen Diagnosen frühkindlicher Autismus und Asperger-Syndrom nach ICD-10. Zahlreiche weitere Änderungen sieht die überarbeitete ICD-11...
Chapter
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and interaction as well as stereotypical and repetitive behavior. Transcranial direct current stimulation (tDCS) has been proposed as a new intervention method in ASD with the potential to improve cognitive, motor and social communicati...
Article
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Zusammenfassung. Im Rahmen der Abklärung des Verdachts einer Angststörung kommen in der klinischen Praxis regelmäßig Screeningfragebögen für Eltern zum Einsatz, die teilweise auch unterschiedliche Angststörungen erfassen. Im klinischen Kontext ist die valide Abgrenzung von Angststörungen zu anderen psychischen Störung sowie die differenzialdiagnost...
Article
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Background Autism spectrum disorder (ASD) is characterized by impaired social communication and interaction, and stereotyped, repetitive behaviour and sensory interests. To date, there is no effective medication that can improve social communication and interaction in ASD, and effect sizes of behaviour-based psychotherapy remain in the low to mediu...
Article
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Conduct Disorder (CD) is characterized by severe aggressive and antisocial behavior. The stress hormone system has frequently been investigated as a neurobiological correlate of CD, while other interacting neuroendocrine biomarkers of sex hormone or neuropeptide systems have rarely been studied, especially in females. We examined multiple basal neu...
Article
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Restricted repetitive behaviors (RRBs) are a core feature of autism spectrum disorders (ASD) and further occur in intellectual disability (ID), mental disorders (MD), and in typically developed people (TD). There is a need of a valid and reliable measure to record RRBs as transdiagnostic symptom, which captures RRBs heterogeneity and evaluates seve...
Article
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Background Atypical arousal regulation may explain slower mean reaction times (MRT) in Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) compared to typically developing controls (TD). The Locus Coeruleus–Norepinephrine system (LC-NE) underlies arousal regulation and adapts its activity to the utility of a task. LC-...
Article
Human laughter is a powerful means of communicating social intention, ranging from welcoming and friendly to hostile and ridiculing. To be communicated accurately, the recipient must correctly identify the laugher’s underlying social intention. Regular misattribution of the social intention of others has been associated with maladaptive psychosocia...
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Electroencephalography (EEG) represents a widely established method for assessing altered and typically developing brain function. However, systematic studies on EEG data quality, its correlates, and consequences are scarce. To address this research gap, the current study focused on the percentage of artifact-free segments after standard EEG pre-pr...
Article
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Background Despite the increasing interest in cardiac autonomic nervous activity, the normal development is not fully understood. The main aim was to determine the maturation of different cardiac sympathetic‐(SNS) and parasympathetic nervous system (PNS) activity parameters in healthy patients aged 0.5 to 20 years. A second aim was to determine pot...
Article
The risk for major depressive disorder (MDD) is considerably increased in young adults with attention-deficit/hyperactivity disorder (ADHD) but underlying mechanisms are poorly understood. This review explores ADHD-specific neurocognitive impairments as possible underlying mechanisms for ADHD-depression comorbidity. Two systematic literature search...
Article
Objective: Psychoeducational parent training is an economic way to provide care for parents of children newly diagnosed with an autism spectrum disorder (ASD). This study explores pre-post effect sizes of the manualized autism-specific parent training FAUT-E (Frankfurter Autismus-Elterntraining). Method: Two behaviorally trained therapists worked w...
Article
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The Children's Communication Checklist‐2 (CCC‐2) is often applied to assess pragmatic language impairment which is highly prevalent in autism spectrum disorder (ASD) and several mental health conditions. We replicated previous findings on the limited applicability of the CCC‐2 in clinical samples and the inconsistent findings concerning the factor...
Article
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The original article was missing a statement regarding a shared first authorship. The authors Julia M. Geissler and Timo D. Vloet contributed equally to the manuscript.
Chapter
Transcranial direct current stimulation protocols are often applied with a fixed parameter set to all subjects participating in an interventional study. This might lead to considerable effect variation in inhomogeneous subject groups or when transferring stimulation protocols to different age groups. The aim of this study was to evaluate magnitude...
Article
Full-text available
Background: At the group level, youths with conduct disorder (CD) show deficient emotion processing across various tasks compared to typically developing controls (TDC). But little is known about neuropsychological subgroups within the CD population, the clinical correlates of emotion processing deficits [for instance, with regard to the presence o...
Article
Zusammenfassung. In dem Artikel werden die neuen Diagnosekriterien der Autismus-Spektrum-Störung nach ICD-11 der Klassifikation nach ICD-10 sowie nach DSM-5 gegenübergestellt. Es erfolgt eine Bewertung der Änderungen sowie eine Empfehlung hinsichtlich der Klassifikation nach dem multiaxialen Klassifikationsschema. Da die ICD-11 in vielen Aspekten d...
Article
Background Deficits in social communication and interaction are among the core symptoms of Autism Spectrum Disorder (ASD). Intention understanding in particular has been shown to be impaired in ASD. However, only one previous study has explicitly assessed the understanding of communicative intentions in ASD. Thus, the aim of the present study was t...
Article
Full-text available
Reduced responsiveness to emotions is hypothesized to contribute to the development of conduct disorder (CD) in children and adolescents. Accordingly, blunted psychophysiological responses to emotions have been observed in boys with CD, but this has never been tested in girls. Therefore, this study compared psychophysiological responses to sadness...
Article
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ADHD often affects multiple generations in a family. Previous studies suggested that children with ADHD benefit less from therapy if parents are also affected, since ADHD symptoms interfere with treatment implementation. This two-group randomised controlled trial examined whether targeting maternal ADHD boosts the efficacy of parent–child training...
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The original version of this article were unfortunately published with an error in "Methods" section. This has been corrected by publishing this correction article.
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An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Article
Autismus-Spektrum-Störungen sind als tiefgreifende Entwicklungsstörungen chronische Erkrankungen, deren Behandlungsmöglichkeiten vielen PsychotherapeutInnen unbekannt sind. Dieser Beitrag fasst zusammen, auf welche Aspekte der psychosozialen Versorgung von Patienten mit ASS geachtet werden muss und verdeutlicht die zentrale Relevanz von Alter, kogn...