Manfred Döpfner

University of Cologne | UOC · Department of Psychiatry and Psychotherapy of Childhood and Adolescence

Objectives To examine how the concept of prevention is applicable to adolescent ADHD, which preventive interventions may be feasible, and which methods can be used to evaluate effectiveness. Method Following a literature search for prevention clinical trials relevant to adolescent ADHD, selected studies are critically reviewed to identify suitable...

BACKGROUND Web-based self-help parent management trainings have widely been implemented in the evidence based treatment of children with behavioral problems. However, little is known about the direct association of caregiver usage and child externalizing symptom changes. OBJECTIVE This study aims to examine the association between the utilization...

Attention-deficit/hyperactivity disorder (ADHD) is one of the most diagnosed neurodevelopmental disorders of childhood. Current studies addressing gender and age differences in ADHD are lacking. The present study aims to fill this research gap by dimensionally evaluating gender and age differences in ADHD symptoms, as measured by a DSM-5-based pare...

Background Web-based self-help interventions for parents of children with ADHD and other externalizing disorders have been proven to be effective. In order to recommend individualized and optimized interventions, a better understanding of the acceptance and utilization of this innovative treatment approach is needed. Previous research has frequentl...

Family inpatient units in child and adolescent mental health (CAMH) services engage all admitted family members in the treatment of children's symptoms. Studies demonstrated improvements in child and family functioning following family inpatient treatment, but evidence regarding predictors of treatment outcome is lacking. We analyzed data of famili...

Kinder mit einer Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) zeigen häufig Probleme in der Selbststeuerung, die zu Lernschwierigkeiten führen können. Zudem leiden Kinder mit einer ADHS nicht selten an einer Lese-Rechtschreibstörung (Dyslexie) oder Rechenstörung (Dyskalkulie). In der Lerntherapie fällt es den Betroffenen jedoch oft schwer,...

Research has pointed to both cross-sectional and longitudinal associations between parental internalizing symptoms and child externalizing symptoms. This study analyzed whether the association is mediated by negative parenting behavior in view of previous reports that both parental internalizing symptoms and child externalizing symptoms are related...

The objective of this study is to quantify the impact of the COVID-19 pandemic on attention deficit hyperactivity disorder (ADHD) medication consumption globally and nationally using pharmaceutical sales data from 2014 to 2021 across 47 countries and regions. A seasonal autoregressive integrated moving average model (SARIMA) was applied to the time...

Background Compared to healthy controls (HCs), adult Tic Disorder (TD) patients exhibit a lower interoceptive accuracy (IAcc) in heartbeat perception. Since the lower IAcc is not evident in children, the age at which tics develop, but in adults only (Pile et al., 2018, https://doi.org/10.1007/s10803-018-3608-8), lower IAcc may reflect a pathologica...

This meta-analysis investigated the effects of computerized cognitive training (CCT) on clinical, neuropsychological and academic outcomes in individuals with attention-deficit/hyperactivity disorder (ADHD). The authors searched PubMed, Ovid, and Web of Science until 19th January 2022 for parallel-arm randomized controlled trials (RCTs) using CCT i...

Background: Randomised controlled trials (RCTs) have provided considerable evidence for the short-term efficacy of cognitive behavioural therapy (CBT) in children and adolescents with depressive and anxiety disorders. However, the effectiveness and long-term stability of treatment effects under routine care conditions remain unproven. Aims: This...

Introduction: Psychotherapy delivered via videoconferencing (teletherapy) was a well-accepted treatment option for children and adolescents during the early phases of the COVID-19 pandemic. Information on the long-term satisfaction with teletherapy in routine clinical practice is missing. Methods: Caregivers (parents) and psychotherapists of n =...

To enhance the understanding of how symptoms of attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders such as oppositional defiant disorder (ODD), conduct disorder (CD), including callous-unemotional (CU) traits, differentially relate to functional impairment (FI). Participants were 474 German school-age children (age: M...

Objective: We aimed to quantify the clinical utility of continuous performance tests (CPTs) for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) compared to a clinical diagnosis in children and adolescents. Method: Four databases (MEDLINE, PsycINFO, EMBASE, and PubMed) were screened until January 2023. Risk of bias of included re...

In den Diagnosesystemen wird der Terminus der Störung des Sozialverhaltens benutzt, um eine heterogene Gruppe von Verhaltensstörungen zu bezeichnen, die durch oppositionelle, aggressive oder dissoziale Störungen des Sozialverhaltens gekennzeichnet ist. Dabei handelt es sich um ein sich wiederholendes Verhaltensmuster, das die Verletzung wichtiger a...

The objective of this study is to gain insight into the inherent structure of anxiety and depressive symptoms by combining the strengths of latent factor analysis and network analysis. The sample comprised 743 children and adolescents aged 4–18 years (M = 11.64, SD = 3.66, 61% males) who sought routine care outpatient psychotherapy. Parents or prim...

The COVID-19 pandemic led ADHD services to modify the clinical practice to reduce in-person contact as much as possible to minimise viral spread. This had far-reaching effects on day-to-day clinical practice as remote assessments were widely adopted. Despite the attenuation of the acute threat from COVID, many clinical services are retaining some r...

For children with externalising disorders, parent training programmes with different theoretical foundations are available. Currently, there is little knowledge concerning which programme should be recommended to a family based on their individual needs (e.g., single parenthood). The personalised advantage index (PAI) indicates the predicted treatm...

Affective dysregulation (AD) is characterized by irritability, severe temper outbursts, anger, and unpredictable mood swings, and is typically classified as a transdiagnostic entity. A reliable and valid measure is needed to adequately identify children at risk of AD. This study sought to validate a parent-rated screening questionnaire, which is pa...

Given the limited effectiveness of conventional treatments for children and adolescents with oppositional defiant disorders and conduct disorders, a supplement to conventional social skills training (SST) is needed. Digital health interventions (DHI) such as computer programs, smartphone applications, or virtual reality are likely to overcome some...

Objective To examine and validate the self-report Questionnaire on the Regulation of Unpleasant Moods in Children (FRUST), which is a modified and shortened version of the Questionnaire for the Assessment of Emotion Regulation in Children and Adolescents (FEEL-KJ). Methods The data comprised child and parent ratings of a community-screened sample...

Background Based on the current state of research regarding the treatment in pediatric obsessive–compulsive disorder (OCD), cognitive behavioral therapy (CBT) (in severe cases with additional pharmacotherapy) is considered as the first-line treatment according to internationally recognized guidelines. Research is mostly based on randomized controll...

Background Children experiencing unfavorable family circumstances have an increased risk of developing externalizing symptoms. The present study examines the direct, indirect and total effects of family adversity, parental psychopathology, and positive and negative parenting practices on symptoms of attention-deficit/hyperactivity disorder (ADHD) a...

Kategoriale und dimensionale Klassifikationsansätze für psychische Störungen unterscheiden sich in wesentlichen Punkten. In der kategorialen Klassifikation werden psychische Störungen als diskrete, klar voneinander und von psychischer Normalität abgrenzbare und unterscheidbare Störungseinheiten beschrieben. Bei der dimensionalen Klassifikation werd...

Das Psychopathologische Befund-System für Kinder und Jugendliche (CASCAP-2) dient der Erfassung der wichtigsten Merkmale psychischer Störungen im Kindes- und Jugendalter. Mithilfe des CASCAP-2 können über 100 psychopathologische Merkmale klinisch beurteilt werden. Die Diagnostikerin bzw. der Diagnostiker nimmt die Einschätzung auf der Basis einer k...

Analyzing COVID-19-related stress in children with affective dysregulation (AD) seems especially interesting, as these children typically show heightened reactivity to potential stressors and an increased use of maladaptive emotion regulation strategies. Children in out-of-home care often show similar characteristics to those with AD. Since COVID-1...

Objective Both genetic and environmental factors contribute to the development of ADHD, but associations between risk factors and ADHD symptom severity in affected children remain unclear. This systematic review and meta-analysis synthesizes evidence on the association between familial factors and symptom severity in children with ADHD (PROSPERO CR...

This study analyzes whether the association between parental internalizing symptoms (depression, anxiety, stress) and child symptoms of attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) is mediated by positive and negative parenting behaviors. Cross-sectional data of 420 parents of children (age 6–12 years) with...

Objective: This study examined the quality of therapeutic alliance from different rater perspectives (child, parent, therapist) in cognitive behavioural therapy for children with oppositional defiant disorder (ODD) and conduct disorder (CD), and its association with symptom severity. Further, a panel model with an autoregressive cross-lagged panel...

Objective: Although there is clear evidence-based knowledge regarding state-of-the-art treatment for pediatric obsessive-compulsive disorder (OCD), two main issues remain in clinical practice: (1) Exposure-based cognitive behavioral therapy (CBT) is limited in terms of availability and accessibility or is not adequately provided, and (2) despite la...

The study examined potential mediating effects of therapist behaviors in the per-protocol sample (n = 108) of a randomized controlled trial comparing a behavioral and a nondirective guided self-help intervention for parents of children with externalizing disorders (4–11 years). Additionally, from an exploratory perspective, we analyzed a sequential...

The categorical approach of diagnosing mental disorders entails the problem of frequently occurring comorbidities, suggesting a more parsimonious structure of psychopathology. In this study, we therefore aim to assess how affective dysregulation (AD) is associated with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorde...

The present study sought to refine knowledge about the structure underlying externalizing dimensions. From a “top-down” ICD/DSM-based perspective, externalizing symptoms can be categorized into attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). From a “bottom-up” developmental theory-bas...

Background The COVID-19 pandemic is challenging for health care systems around the world. Teletherapy (psychotherapy conducted via videoconference) for children and adolescents offers a promising opportunity not only to provide treatment during social distancing restrictions but also to reduce treatment barriers that might prevent families from see...

Background Social competence training interventions, especially child-focused ones, have proven to be effective in the treatment of children with conduct disorder. Therapy homework assignments implemented between the therapy sessions are essential for practicing strategies developed during treatment sessions and transferring them to everyday life....

Attention-Deficit Hyperactivity Disorder (ADHD) is a complex and heterogeneous neurodevelopmental condition for which curative treatments are lacking. Whilst pharmacological treatments are generally effective and safe, there is considerable inter-individual variability among patients regarding treatment response, required dose, and tolerability. Ma...

Objective: Highly-controlled, randomized controlled trials have provided considerable evidence for the efficacy of outpatient cognitive-behavioral therapy (CBT) for patients with school absenteeism and anxiety disorders. However, the effectiveness of outpatient CBT under routine-care conditions for youth with school absenteeism remains unproven. Me...

Kategoriale und dimensionale Klassifikationsansätze für psychische Störungen unterscheiden sich in wesentlichen Punkten. In der kategorialen Klassifikation werden psychische Störungen als diskrete, klar voneinander und von psychischer Normalität abgrenzbare und unterscheidbare Störungseinheiten beschrieben. Bei der dimensionalen Klassifikation werd...

The aim of this study was to investigate which factors predict lifetime reports of delinquent behavior in young adults who had received adaptive multimodal treatment of attention-deficit/hyperactivity disorder (ADHD) starting at ages 6–10 years. Participants were reassessed 13–24 years (M = 17.6, SD = 1.8) after they had received individualized ADH...

Objective Computer-assisted child-focused interventions are expected to improve efficiency and personalization of therapist-led treatments for children and adolescents. However, therapist-led, outpatient interventions using computer assistance are lacking for children with oppositional defiant disorder (ODD) or conduct disorder (CD). The present ra...

Affective dysregulation (AD) in children is characterized by persistent irritability and severe temper outbursts. This study developed and evaluated a screening questionnaire for AD in children. The development included the generation of an initial item pool from existing instruments, a Delphi rating of experts, focus groups with experts and parent...

The stability and effectiveness of the Treatment Program for Children with Aggressive Behavior (THAV) in terms of reducing behavioral problems in children with oppositional defiant disorder (ODD) and conduct disorder (CD) were examined at a 10-month follow-up (FU). A total of 76 families and their children (boys aged 6–12 years), who previously par...

Purpose Anger and irritability are common and impairing symptoms in children. The PROMIS Anger scales assess self- and parent-reported irritable and angry mood over the past 7 days. The aim of this study was to evaluate the psychometric properties of the German version of the PROMIS Parent Proxy Short Form v1.0—Anger and to provide normative data....

Zusammenfassung. Der Beitrag gibt eine kurze Übersicht über die Veränderungen in der Klassifikation von Hyperkinetischen Störungen und Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen nach ICD-11 (International Statistical Classification of Diseases and Related Health Problems). Sowohl in der Bezeichnung als auch in der Binnendifferenzierung lehnt...

Objective This systematic review and meta-analysis aimed to (1) determine the accuracies of a broad range of screening tools for ADHD in children and adolescents and (2) compare the diagnostic accuracy of tools between population-based and clinical/high-risk samples, and across reporters. Method MEDLINE, PsycINFO, EMBASE and PubMed were searched u...

Although sleep problems are common in children with ADHD, their extent, preceding risk factors, and the association between neurocognitive performance and neurobiological processes in sleep and ADHD, are still largely unknown. We examined sleep variables in school-aged children with ADHD, addressing their intra-individual variability (IIV) and cons...

Cognitive-behavioral interventions can be difficult to implement in daily routine, which is often essential for generalizing treatment effects to natural settings. Furthermore, there is a lack of adequate care options concerning habit reversal training for children with Tourette’s disorder. The objective of this study is to evaluate therapeutic onl...

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...

To examine the factor structure of autism spectrum disorder (ASD) and the psychometric properties of the German Symptom Checklist for Autism Spectrum Disorders (SCL-ASD). Data were collected from 312 clinical referrals with suspected ASD (2–18 years). Confirmatory factor analyses and analyses of reliability, convergent and divergent validity were p...

Objective This longitudinal study examined early predictors of educational attainment and occupational functioning in adults with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD). Method Participants ( n = 70) of the Cologne Adaptive Multimodal Treatment (CAMT) Study were diagnosed with ADHD and received adaptive multimodal...

ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adver...

ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adver...

Background Progress feedback provides therapists with progress notes on a regular basis through the continuous assessment of participants throughout their treatment (e.g., symptoms, therapeutic alliance). While for adults the evidence base has increased over the years, progress feedback in the therapy of children and adolescents has not been suffic...

Zusammenfassung Hintergrund Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung (ADHS) oder oppositionelle Verhaltensstörung (OPP) gehen mit unruhigem, oppositionellem und aggressivem Verhalten, negativen Interaktionen zwischen Kind und Eltern und langfristig häufig mit belasteten Eltern-Kind-Beziehungen einher. Kognitiv-behaviorale Elterntrainings, di...

Background The aim of this study was to analyze treatment differentiation in a behavioral and a nondirective telephone-assisted self-help intervention for parents of children with externalizing behavior problems, including the development and evaluation of a rating scale. Methods In a randomized controlled trial, 149 parents of children aged 4–11...

Background Depressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but studies examining the effectiveness of CBT in clin...

The trait impulsivity theory suggests that a single, highly heritable externalizing liability factor, expressed as temperamental trait impulsivity, represents the core vulnerability for externalizing disorders. The present study sought to test the application of latent factor models derived from this theory to a clinical sample of children. Partici...

Fragestellung: Standardisierte klinische Interviews gelten als Gold-Standard zur zuverlässigen und präzisen Diagnostik. Wir haben verschiedene Interview-Leitfäden als Ergänzung zum Diagnostik-System für psychische Störungen im Kindes- und Jugendalter (DISYPS) entwickelt. Diese Interview-Leitfäden (DISYPS-ILF) bieten semi-strukturierte Leitfragen zu...

Background Children with intellectual disability (ID) are more likely to develop behavioural and emotional problems. However, specific interventions for the treatment of these problems in children with ID have rarely been evaluated. Parent management training (PMT) has been shown to be effective in reducing behavioural and emotional problems for ot...

Zwangsstörungen gehören mit einer Langzeitprävalenz von 1-3% auch im Kindes- und Jugendalter zu den häufigsten psychischen Störungen. Es liegen zwei Erkrankungsgipfel im Altersbereich von 11-14 Jahren und im jungen Erwachsenenalter mit 20 Jahren vor. 20% der Zwangsstörungen beginnen vor dem Alter von 10 Jahren und 60% vor dem Alter von 25 Jahren. D...

A previous randomised controlled trial demonstrated the effects of a telephone-assisted self-help (TASH) intervention for parents of pharmacologically treated children with attention-deficit/hyperactivity disorder (ADHD) on ADHD symptoms, oppositional symptoms, functional impairment, and negative parenting behaviour (per-protocol analyses). In the...

Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset condition that may continue into adulthood. When assessing adult patients, clinicians usually rely on retrospective reports of childhood symptoms to evaluate the age-of-onset criterion. Since inaccurate symptom recall may impede the diagnosis and treatment of ADHD, knowledge about...

Although guidelines for the assessment and treatment of mental disorders in childhood and adolescence have been available in Germany for several years, there are barely any data on adherence to guidelines in national routine care. Therefore, the study aimed at a nationwide evaluation of guideline adherence (GA) for the assessment and treatment of c...

Background Attention-deficit/hyperactivity disorder (ADHD) and dyscalculia, also called mathematics disorder, frequently co-occur, yet the etiology of this comorbidity is poorly understood. Aims This study investigated whether impairments in the understanding of numbers and magnitudes (basic numerical skills) are a unique risk factor for mathemati...

Background Affective dysregulation (AD) or synonymously "irritability" is a transdiagnostic construct that serves as a diagnostic criterion in various childhood mental disorders. It is characterized by severe or persistent outbursts of anger and aggression. Emotional self-regulation is highly dependent on the ability to process relevant and ignore...

This observational study examined treatment satisfaction (TS) following routine outpatient cognitive-behavioral therapy (CBT) in a large sample of children (n = 795; aged 6 to 10 years). TS was investigated in parent and therapist rating. Means, standard deviations and inter-rater correlations were calculated to investigate TS. Regression analysis...

Hyperkinetische Verhaltensauffälligkeiten zählen zu den häufigsten Störungsbildern im Kindes- und Jugendalter und sind durch eine Beeinträchtigung der Aufmerksamkeit (Aufmerksamkeitsstörung, Ablenkbarkeit), der Impulskontrolle (Impulsivität) und der Aktivität (Hyperaktivität) gekennzeichnet. Meist wird der Begriff der Aufmerksamkeitsdefizit-/Hypera...

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...

Background The current study aimed to investigate using a superiority framework the efficacy of a combined treatment (cognitive-behavioral therapy based on behavioral components derived from classical behavioral therapy modifications and cognitive components mainly derived from rational emotive behavior therapy, plus an attention training component...

Hyperaktive, unaufmerksame und impulsive, aber auch oppositionelle und regel­verletzende Verhaltensweisen können für die betroffenen Kinder und ihre Familien, aber auch für Lehrkräfte und den schulischen Alltag eine starke Belastung darstel-len. Das vorliegende Selbsthilfe-Arbeitsbuch unterstützt Pädagoginnen und Pädagogen beim Umgang mit Verhalten...