Eva Möhler

Universität des Saarlandes | UKS · Child and Adolescent Psychiatry

Maternal history of abuse has been proposed as a risk factor for child maltreatment, but the background of this "cycle of abuse" is as yet poorly understood. As a contribution toward a deeper understanding of this phenomenon, this study analyzed whether emotional availability is altered by maternal experiences of physical or sexual abuse during the...

Studies in recent years and especially since the beginning of the COVID-19 pandemic have shown a significant increase in the problematic use of computer games and social media. Adolescents having difficulties in regulating their unpleasant emotions are especially prone to Problematic Internet Use (PIU), which is why emotion dysregulation has been c...

Introduction No evaluated therapeutic approaches, that can efficiently be established in routine mental healthcare, are currently available for traumatised adolescent refugees in Germany. This study evaluates the efficacy of the Stress-Traumasymptoms-Arousal-Regulation-Treatment (START) programme to reduce trauma-related symptoms and psychological...

Mental health problems in early childhood are common, but there is a lack of psychiatric research on this age group. DC:0-5 is a multiaxial classification system for mental disorders in early childhood, providing a framework for standardizing clinical practice and research. However, research on the validity of DC:0-5 is scarce. The Developmental Ps...

In previous research, we detected that children and adolescents who were diagnosed with ADHD showed deficits in both complex auditory processing of musical stimuli and in musical performance when compared to controls. In this study, we were interested in whether we could detect similar or distinct findings when we use foreign speech perception task...

Background: Identity diffusion plays a central role in the onset of borderline personality disorders. Dialectical Behavioral Therapy for Adolescents (DBT-A) is a treatment program for adolescents with emotional instability and dysregulation. The interest of this study is to examine the potential effects of a standardized and certified DBT-A therap...

Background: Identity diffusion plays a central role in the onset of borderline personality and disorders. The Dialectical Behavioral Therapy for Adolescents (DBT-A) is a treatment program for adolescents with emotional instability and dysregulation. The interest of this study is to examine the influence of a standardized and certified DBT-A therapy...

Background Externalizing behavior problems are related to social maladjustment. Evidence indicates associations between prenatal stress and child behavioral outcomes. It remains unclear how psychological distress vs. biological correlates of stress (cortisol) differentially predict externalizing behavior, and how their effects might differ as a fun...

Background Referrals for child and adolescent acute psychiatric treatment have spiked in the last two years. To provide these adolescents with a fast-acting intervention, a novel treatment approach for acute emotional dysregulation was evaluated in this study. Methods 156 adolescents between the age of 13 and 18 years who were admitted to a psychi...

Early life maltreatment can have severe and long-lasting consequences for the directly affected individual as well as for the next generation. Data from our research including mother-child dyads from Heidelberg and Berlin showed that early life maltreatment is associated with behavioral, hormonal and neural changes including personality traits and...

Background: Given the crucial role of vaccination in managing and halting the COVID-19 pandemic, it is imperative to understand the factors that motivate adolescents to get vaccinated. However, data on this topic are currently limited. This study aimed to characterize the adolescent population willing to receive COVID-19 vaccination in mid-2021 in...

Background Associations between parent and child cortisol levels (“cortisol synchrony”) are often reported and positive synchrony may mark dyadic regulation on a physiological level. Although dyadic behavior during interaction and adolescent borderline personality disorder (BPD) traits are linked with individual and dyadic regulatory capacities, li...

Background: Management and treatment of spinal muscular atrophy (SMA) has changed in recent years due to the introduction of novel transformative and potentially curative therapies resulting in the emergence of new disease phenotypes. Yet, little is known about the uptake and impact of these therapies in real-world clinical practice. The objective...

Seit November 2020 ist mit einer Regelung des G-BA die Umsetzung von Schutzkonzepten für alle Leistungserbringer im Gesundheitssystem verbindlich vorgeschrieben. Es haben sich längst noch nicht alle Kliniken und Praxen in Deutschland auf den Weg gemacht, ein Konzept zu entwickeln, jedoch gibt es bereits einiges an Best-Practice-Beispielen. Es werde...

Background Management and treatment of spinal muscular atrophy (SMA) has changed in recent years due to the introduction of novel transformative and potentially curative therapies resulting in the emergence of new disease phenotypes. Yet, little is known about the uptake and impact of these therapies in real-world clinical practice. The objective o...

The large number of children, adolescents and their families with refugee experience poses an enormous challenge for the care systems. Due to the frequent traumatic experiences, minors with refugee experience are a particularly vulnerable group with respect to psychosocial stress factors and psychopathological disorders. In practice, concepts are n...

Crime scene Internet: Cybergrooming as sexual violence against children and adolescents The use of digital information and communication technologies is an important part of children's and youth’s lives. It has increased once again during the wave of the COVID-19 pandemic. Along with this, cybercrime is also on the rise, including cybergrooming, wh...

Background Temperament might be considered as a risk factor as well as a resilience factor for later externalizing and internalizing disorders. Therefore, this study examines different dimensions of temperament in preschool age with regard to their predictive value for psychopathology later in childhood. Methods A total of 76 patients (63.2% male)...

Background Behavioral inhibition, characterized by shyness, fear and avoidance of novel stimuli, has been linked with internalizing personality traits in childhood, adolescence and early adulthood, and particularly later social anxiety disorder. Little is known about the relevance of potential prenatal precursors and early predictors for the develo...

Evaluations after the first and second waves of the COVID-19 pandemic in Germany showed an increase in mental health problems and a reduction in health-related quality of life (HRQoL). The aim of the study was to assess those aspects after the third wave of COVID-19 in adolescents who decided to receive a vaccination. In students aged 12–17 years r...

Research has established the diagnostic validity of borderline personality disorder (BPD) in adolescence. The roots of BPD often lie in childhood; however, significantly less is known about the presence and correlates of BPD traits in school-age children and whether these are comparable with those observed in adolescents. Trained psychologists admi...

Invitation to submit valuable research on the topic

Background: From March – June 2021, the third wave of the COVID-19 pandemic occurred in Germany. First and second wave evaluations showed an increase in mental health problems and a reduction of quality of life in adolescents. In August 2021, two vaccines against COVID-19 were approved for adolescents aged 12-17 years in Germany. Aim of the study w...

Research has shown that dyslexia and attention deficit (hyperactivity) disorder (AD(H)D) are characterized by specific neuroanatomical and neurofunctional differences in the auditory cortex. These neurofunctional characteristics in children with ADHD, ADD and dyslexia are linked to distinct differences in music perception. Group-specific difference...

Emotional Dysregulation is a frequent challenge in clinical child psychiatric contexts. The Stress-Arousal-Regulation-Treatment for Children aged six to twelve (START-Kids, Dixius u. Möhler, 2021a), was developed as low threshold treatment tool for children with emotional dysregulation. The program is based on principles of dialectic behavioral the...

Zusammenfassung Hintergrund und Ziel Die im Rahmen der COVID-19-Pandemie erlassenen Maßnahmen zum Infektionsschutz führten zu tiefgreifenden Einschränkungen und Veränderungen im sozialen, (vor-)schulischen, familiären und Freizeitbereich. Die vorliegende Studie untersucht das Ausmaß an psychischer Belastung von Kindern, Jugendlichen und ihren Fami...

Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline....

Early life maltreatment (ELM) has an impact on brain functions involved in parenting and is associated with impaired maternal sensitivity. Here, we investigated the influence of ELM on intrinsic neural function and its associations with maternal sensitivity in mothers without a current episode of a mental disorder. Twenty-seven mothers with ELM and...

Background: There are many studies on mother-child-bonding with little theoretical doubt that better bonding may have a positive effect on further social development. However, there is hardly any empirical evidence. In particular, there is a lack prospective longitudinal studies. Methods: As part of a longitudinal study, bonding was assessed in a c...

In April 2020, the European Society for Child and Adolescent Psychiatry (ESCAP) Research Academy and the ESCAP Board launched the first questionnaire of the CovCAP longitudinal survey to estimate the impact of COVID-19 on child and adolescent psychiatry (CAP) services in Europe. In this brief report, we present the main findings from the second que...

The present study investigated dissociation as a predictor of parenting and a potential mediator in the relationship between early life maltreatment (ELM) and impaired parenting. Mothers reporting moderate to severe sexual and/or physical abuse (assessed with the Childhood Trauma Questionnaire) formed the maltreatment group (n = 58; MG) and were co...

Background: The aim of this study was to evaluate the role of early Emotional Dysregulation (ED) at preschool age as a risk factor or predictor of later media use behavior and Gaming Disorder (GD) in school age. Methods: 80 patients (63.7% male; mean age = 4.2, SD = 1.23) who had attended a special outpatient program for preschoolers at measuring p...

Despite an extensive literature on associations between early childhood temperament and behavior problems, most of this evidence is based on general population samples. Hence, relatively little is known about the temperament characteristics of children who have been referred for in- or outpatient treatment of emotional and/or behavioral problems. W...

Objective: Obstetric complications (OCs) are adverse events during pregnancy, birth, or immediately after birth. Evidence on cumulative OC and longitudinal associations with child psychopathology is sparse. Prospective studies testing mediating pathways such as parenting stress are needed. This study aimed to investigate the impact of OC on child...

Background: This review summarizes the state of knowledge of use of new media on the development in early childhood in 6 sections: descriptive utilization data, psychosocial and emotional development, cognition and language, motor development, nutrition and sleep, and influence of parental media consumption. Methods: The review is based on a lit...

Research has shown associations between adverse parenting experiences and (borderline) personality disorder ([B]PD). A biopsychosocial model suggests that child characteristics and the environment interact in the development of symptoms. However, prospective data in this aspect are limited. This study focused on maternal bonding impairment (MBI; 2...

Background: The ‘Stress-Trauma-Symptoms-Regulation-Treatment’ (START) is an innovative manualized short-term treatment program for stabilization and stress resilience in emotionally dysregulated adolescents, based on an approach of stress and management and emotional regulation. The current pilot trial aims to assess the feasibility and effectivene...

Zusammenfassung Der Alltag von Kindern und Jugendlichen ist in den letzten zwei Dekaden einem umfassenden und kontinuierlichen sozialen und kulturellen Wandel ausgesetzt, der durch digitale Technologien und Kommunikationsmöglichkeiten vorangetrieben wird. Dieser Wandel beeinflusst die Art und Weise, wie Kinder aufwachsen, lernen, spielen und intera...

The original version of this article were unfortunately published with an error in "Methods" section. This has been corrected by publishing this correction article.

Background: Early life maltreatment (ELM) has a high risk of transmission across generations, known as "the cycle of abuse." ELM is also an important risk factor for developing mental disorders, and having a mental disorder increases the risk of child abuse. Both the abuse potential in mothers with ELM and in mothers with a history of mental disor...

Obstetric complications (OC) may have implications for later health outcomes. However, there is a lack of research examining the association between OC and behavior problems or quality of life (HRQoL). We aimed to close this gap and further investigate functioning of the hypothalamus-pituitary-adrenal (HPA)-axis as a potential physiological vulnera...

ZUSAMMENFASSUNG Mobbing beinhaltet aggressive Handlungen mit dem Ziel, eine andere Person zu verletzen, zu demütigen oder einzuschüchtern. Die digitale Revolution hat die Möglichkeiten des klassischen Mobbings erweitert. Täter können anonym bleiben, körperliche Überlegenheit ist nicht notwendig, ein größeres Publikum kann erreicht werden, Nachricht...

Early life maltreatment (ELM) has severe and lasting effects on the individual, which might also impact the next generation. On an endocrine level, the hypothalamus–pituitary–adrenal axis has been suggested to play an important role in the interplay between ELM and the development of mental disorders. Several studies have revealed that maternal pos...

Dieses Kapitel befasst sich mit psychischen Störungen post partum, vom „Baby Blues“ über postpartale Depression, Angst- und Zwangsstörung, Psychosen bis hin zu posttraumatischen Belastungsstörungen. Neben Informationen zu Klassifikation, Definition, Epidemiologie, Symptomen und Diagnostik wird auf das weitere Vorgehen und die interdisziplinäre Zusa...

Early Life Stress Stress and daily hassles are a normal part of day-to day-life. The amount of control that is experienced strongly contributes to resilience and coping. Children very frequently do not experience control over the stressors within their lives. Starting from pregnancy, they are subjected - via the maternal endocrine system - to a var...

The study addresses the impact of maternal early life maltreatment (ELM) and maternal history of depression (HoD) on offspring’s mental health. Maternal sensitivity was examined as a potential mediator explaining the relationship between maternal ELM, maternal HoD and child psychopathology. Participants were 194 mothers with and without HoD and/or...

Early life maltreatment (ELM) has long-lasting effects on social interaction. When interacting with their own child, women with ELM often report difficulties in parenting and show reduced maternal sensitivity. Sensitive maternal behavior requires the recognition of the child’s emotional state depicted in its facial emotions. Based on previous studi...

Frühe Gewalterfahrungen können schwerwiegende und lang anhaltende Auswirkungen auf die direkt Betroffenen, aber auch auf die nächste Generation haben. Anhand vorliegender Daten unserer Untersuchungen von Heidelberger und Berliner Mutter-Kind-Dyaden konnten wir zeigen, dass frühe Gewalterfahrungen zu Veränderungen auf behavioraler und neuronaler Ebe...

Stress-Traumasymptoms-Arousal-Regulation-Treatment (START) ist ein niedrigschwelliges und kulturintegratives Stabilisierungskonzept für Kinder und Jugendliche mit starkem Stresserleben, Traumafolgen und schweren emotionalen Belastungen. Besonders geflüchtete Kinder und Jugendliche leiden häufig unter psychischen und körperlichen Symptomen und werde...

Background: Early-life maltreatment has severe consequences for the affected individual, and it has an impact on the next generation. To improve understanding of the intergenerational effects of abuse, we investigated the consequences of early-life maltreatment on maternal sensitivity and associated brain mechanisms during mother-child interaction...

The hypothalamus-pituitary-adrenal axis (HPAA) and its end product, the glucocorticoid cortisol, has been shown to be associated with psychopathology. Determining cortisol concentrations in hair (HCC) allows the investigation of long-term HPAA-activity. There is a significant scarcity of studies investigating the link between HCC and psychopatholog...

Background: Borderline Personality Disorder (BPD) is one of the most frequently diagnosed but also most differently characterized disorders in the field of child and adolescent psychiatry. Although negative side effects of executive dysfunction are often seen in BPD patients, statistical proof of an association between symptoms of executive dysfunc...

A prospective longitudinal study relating obstetric factors to persisting heart rate alterations in infants was performed. 101 mature AGA-infants were examined at two weeks, two months, four months of age. Basic heart rate and short-term heart rate variability were assessed at each appointment. Infants delivered by caesarean section did not differ...

Early life maltreatment (ELM) is associated with different neurobiological alterations. Lower oxytocin and altered grey matter volumes (GMV) in brain regions associated with the central oxytocin system, such as the hypothalamus, amygdala, and nucleus accumbens, have been reported in women with ELM. However, the association between peripheral oxytoc...

Background: There is a well-established link between maternal depression and child mental health. Similar effects have been found for maternal history of early life maltreatment (ELM). However, studies investigating the relationship of children's quality of life and maternal depression are scarce and none have been conducted for the association wi...

We investigated circadian mother-child adrenocortical attunement in the context of a maternal history of childhood abuse (HoA). Mothers were screened after birth using the Childhood Trauma Questionnaire. Women reporting moderate or severe abuse formed the HoA group (n = 37; HoAG) and were compared with a non-maltreated comparison group (n = 45; CG)...

Previous studies have found that a stressful observational context challenges the mother-child relationship, thus highlighting negative interactive behavior. However, the impact of observational context has only been investigated in infants and preschoolers without specifically using the Emotional Availability Scales. Nor have they explored whether...

START - Development of an Intervention for a First Stabilization and Arousal-modulation for Highly Stressed Minor Refugees This article focuses on the development of an intervention called "Stress-Traumasymptoms- Arousal-Regulation-Treatment" (START), through the process of working with refugeed minors in acute stress during the clearing process im...

Die besondere Situation psychisch belasteter und geflüchteter Kinder und Jugendlicher erfordert neue Konzepte in der psychotherapeutischen Versorgung. Geflüchtete Kinder leiden häufig an psychischen und körperlichen Symptomen und sind durch traumatische Erlebnisse nachhaltig belastet. Das strukturierte und manualisierte Kurztherapiemanual „START“ –...

Zusammenfassung. Unbegleitete minderjährige Flüchtlinge sind auf ihrer Flucht meist komplexen traumatischen Ereignissen ausgesetzt, besonders massiv trifft dies auf minderjährige Mädchen zu. An einem Wochenende wurde in der Kinder- und Jugendpsychiatrie ein 16-jähriges Mädchen zur Krisenintervention mit akuter Suizidalität aufgenommen. Das Mädchen...

Die Zahl der Minderjährigen mit Fluchterfahrung, die nach Deutschland kommen, ist seit dem Jahr 2015 stark gestiegen. Viele dieser Kinder und Jugendlichen waren und sind einer Vielzahl von Belastungsfaktoren ausgesetzt. Die Gruppe derer, die diese Jugendlichen betreuen, ist heterogen und reicht von Ehrenamtlichen bis zu Mitarbeitern der Jugendhilfe...

Recent evidence points to the existence of a neurobiological attunement between mother and child, e.g., associations between maternal and child hypothalamic-pituitary-adrenal (HPA) axis functioning. As maternal history of abuse (HoA) has been shown to negatively affect mother-child interaction and HPA-axis functioning, we theorized those experience...

Maternal bonding has been described as the quality of the affective tie from a mother to her infant. This early bond's mental components and its longitudinal impact on child outcome have been markedly understudied. Although most researchers assume impaired maternal bonding to have a negative impact on child development, there is a lack of prospecti...

Children’s level of inhibitory functioning has been shown to be positively associated with child adjustment over the course of development. Examining a sample of 194 mothers and their five to twelve year old children, we analyzed whether children of mothers with a history of childhood abuse (n = 30), mothers with remitted depression (n = 38), mothe...

One of the most striking characteristics of early life maltreatment (ELM) is the risk of transmission across generations, which could be linked to differences in maternal behavior. Maternal sensitivity includes appropriate and positive affective exchanges between mother and child. Mothers with a history of ELM have been found to show a lower sensit...

Children’s level of inhibitory functioning has been shown to be positively associated with child adjustment over the course of development. Examining a sample of 194 mothers and their five to twelve year old children, we analyzed whether children of mothers with a history of childhood abuse (n = 30), mothers with remitted depression (n = 38), mothe...

The aim of this study was to examine the impact of a maternal history of abuse on mother-infant interaction (emotional availability; EA) in infancy and early toddlerhood. Over an 18-month period, women giving birth to a child in the local obstetric units were screened using the Childhood Trauma Questionnaire. Women who reported moderate or severe s...

Die Entwicklung der kindlichen Persönlichkeit beginnt pränatal und vollzieht sich auf dem Hintergrund eines multifaktoriellen Bedingungsgefüges. Der vorliegende Beitrag analysiert das Temperament als wesentliches konstituierendes Element dieses Gefüges im Lichte der historischen Entwicklung und des aktuellen Forschungsstandes. Eine Synopsis der phy...

Als Vorbemerkung zu diesem Kapitel ist wichtig, dass die Anlagen eines Kindes vom ersten Lebenstag an durch Interaktionen mit seiner Umwelt moduliert werden. Temperament ist nicht diskutabel ohne ein transaktionales Anlage-Umwelt-Modell, welches den wechselseitigen Einfluss von kindlicher Disposition und Umwelt berücksichtigt; z. B. bedeuten gravie...

Research suggested that maternal anxiety disorders might be related to infants' behavioral inhibition. This study investigated whether maternal postpartum anxiety disorder is associated with infant temperament, more precisely, infant distress to novelty, an early predictor of behavioral inhibition. Differences in the latter were analyzed in a Germa...

A behaviorally inhibited temperament in early childhood has been identified as a potential risk factor for anxiety disorders in children and adolescents. The purpose of our investigation was the development and evaluation of the factor structure, reliability and validity of the first retrospective parent report measure to assess behavioral inhibiti...

Prax Kinderpsychol Kinderpsychiatr 61(4):271-285. Summary Maternal intuitive skills can be threatened as a result of severe deprivation or unresolved trauma in her own childhood. A mother's own childhood experience of abuse may be a risk factor for repeated child abuse. In order to assess intuitive parenting skills of abused mothers it was investig...

This study examines the question whether early childhood temperaments of children of mothers suffering from postnatal depression differs from children of non-depressed mothers. Children of clinically depressed mothers were assessed with regard to their temperament on two different dimensions and compared to a control group. The level of cortisol co...

Maternal intuitive skills can be threatened as a result of severe deprivation or unresolved trauma in the own childhood and can even be inaccessible to the mother. A mother's own childhood experience of abuse maybe a risk factor for repeated child abuse. As a follow-up study to assess the emotional availability of abused mothers it was investigated...

Die Psychiatrie des Säuglings- und Kleinkindalters ist ein relativ junges Teilgebiet der Kinder- und Jugendpsychiatrie. Umfassendere Übersichten und Lehrbücher erschienen erst im Verlauf der 80er-Jahre (Call et al. 1983, 1985; Kreisler u. Cramer 1983; Minde u. Minde 1986). »Zero to Three«, die US-amerikanischen Gesellschaft interdisziplinärer Forsc...

Vernachlässigung und Missbrauch hinterlassen Spuren im Gehirn. Diese belastenden Erfahrungen beeinflussen zum einen das Stress-system, zum anderen sind morphologische Veränderungen in einigen Bereichen des Gehirns nachweisbar. Der folgende Beitrag fasst die neuesten Erkenntnisse der Neurobiologie zusammen.