Ulrike Lehmkuhl

• Head of Department at Charité Universitätsmedizin Berlin

Purpose Childhood abuse is associated with an increased risk of developing eating disorders (EDs) as well as personality disorders (PDs). However, their interaction is still uncertain, particularly in adolescents. This study investigates the correlations between childhood emotional neglect (CEN), childhood emotional abuse (CEA), and obsessive-compu...

Das Rollenbild und Selbstverständnis junger Männer befindet sich im Wandel: Der eine Teil hängt noch einem traditionellen Bild des starken, unverletzlichen Mannes an, der nicht über seine Gesundheit reflektieren kann und muss. Der andere Teil öffnet die Rolle auch für Emotionen, Empathie, soziale Verantwortung und Selbstkritik und lässt eine sensib...

Sibling relationships wherein at least one sibling suffers from a mental disorder have seldom been studied. The few existing studies found that children with mental disorders reported high levels of disputes within sibling relationships as well as less parental support and admiration. The aim of the present study was to examine the quality of sibli...

Background The current study investigates determinants of treatment evaluation by adolescent outpatients with anorexia nervosa (AN) and the accordance with their parents’ and psychotherapists’ evaluation. Sampling and methods The sample included 50 female adolescent outpatients (mean age: 16.9 ± 1.8) with AN (DSM-IV). They were randomly assigned t...

Background: Early life maltreatment (ELM), borderline personality disorder (BPD), andmajor depressive disorder (MDD) have been associated with empathy deficits in differentdomains. Lack of maternal empathy has also been related to child behavioral problems. As ELM, BPD, and MDD often co-occur, we aimed to identify dissociable effects on empathydue...

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...

Background Magnetic resonance imaging (MRI) of the brain in children and adolescents is a well-established method in both clinical practice and in neuroscientific research. This practice is sometimes viewed critically, as MRI scans might expose minors (e.g. through scan-associated fears) to more than the legally permissible “minimal burden”. While...

The aim of the current paper is to evaluate clinical characteristics of 30 children with early onset anorexia nervosa (EO‐AN; age = 12.2 ± 1.6 years) compared with 30 patients with adolescent onset AN (AO‐AN; age = 15.9 ± 0.7 years) and 60 age‐matched healthy controls. Statistical analyses included one‐way analyses of variance with three planned co...

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...

The importance of the therapeutic alliance in child psychotherapy The therapeutic alliance encompasses more than merely the therapeutic relationship. It also includes the capacity and willingness of the patient to confront his internal difficulties, his conflicts and his resistances. Therapist and patient have to construct a frame in which allows f...

Objective: Cognitive remediation therapy (CRT) is a specialized treatment approach targeting cognitive weaknesses in anorexia nervosa (AN). Regarding follow-up effects of CRT, there are only few studies available; for adolescents, there are no data. Methods: Forty-eight adolescents with AN were assigned to receive either CRT and treatment as usu...

Objective: Whereas the evidence in adolescents is inconsistent, anorexia nervosa (AN) in adults is characterized by weak cognitive flexibility. This study investigates cognitive flexibility in adolescents with AN and its potential associations with symptoms of depression, obsessive compulsive disorder (OCD), and duration of illness. Methods: 69 pat...

Objective: To provide further insight into the presently poorly understood role of familial psychopathology in the development of eating disorders (ED). Method: The present study assesses psychiatric and personality disorders listed on Axis I and II of the DSM-IV in 27 mothers of adolescent patients with anorexia (AN mothers) and 14 bulimia nerv...

When anorexia nervosa (AN) occurs in children below the age of 14 years, it is referred to as early-onset AN (EO-AN). Over the last years, there has been an increased focus on the role of cognitive functioning in the development and maintenance of AN. Adults with AN show inefficiencies in cognitive functions such as flexibility and central coherenc...

BACKGROUND: Cognitive remediation therapy (CRT) is a relatively new therapy for patients with anorexia nervosa (AN). There is an increased demand to include the patient view during the evaluation of treatment programs. So far, there is no structured evaluation of the subjective view of adolescents with AN on CRT available. METHODS: 20 patients with...

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...

Cognitive remediation therapy (CRT) aims to strengthen weak cognitive flexibility and central coherence in adult and adolescent anorexia nervosa (AN). Currently, there are no studies in adolescents with AN that control for learning effects because of re-testing while evaluating CRT. Twenty in- and outpatients with AN aged 12 to 18 years received CR...

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...

Studies have shown impairments in cognitive function among adult patients with anorexia nervosa (AN) and affective disorders (AD). The association between cognitive dysfunctions, AN and AD as well as the specificity for these psychiatric diagnoses remains unclear. Therefore, we examined cognitive flexibility and processing speed in 47 female adoles...

Objective: Evidence-based treatment programs for children with anorexia nervosa (AN) are scarce, while their prognosis is negative and the incidence rate rises. A new therapeutic approach recently received positive attention: cognitive remediation therapy (CRT). This intervention targets inflexibility and the inability to perceive the bigger pictu...

The present study examines the psychometric properties of the German version of the Sibling Relationship Questionnaire (SRQ-deu, self-rating) in 961 children and adolescents aged 8-18 years. Internal consistency was satisfactory to high. Associations with other clinical instruments point in the expected direction and support the external validity o...

Einleitung. Kinder, die unterhalb des 14. Lebensjahres an einer Anorexia nervosa (AN) erkranken, werden als early-onset AN (EO-AN) Patientinnen bezeichnet. Da die späte Kindheit eine sensible Entwicklungsphase darstellt, könnte EO-AN ernsthafte Folgen für die körperliche sowie kognitive Entwicklung haben. In Einklang damit suggerieren einzelne Stud...

Body image disturbance (BID) is a central feature of anorexia nervosa (AN), but evidence for bodily-related disorders also exists for patients with cystic fibrosis (CF), who are frequently underweight. A comparison of BID in patients with AN, CF and controls serves to clarify the specificity of BID for AN. 22 patients with AN, 10 patients with CF,...

Hyperkinetic disorders are among the most prevalent behavioral problems during childhood and adolescence with a prevalence of 4 to 5 %. The diagnosis should be based on standardized tests and should lead to a multimodal treatment plan.

ADHD is associated with decreased ventral-striatal (VS) responsiveness during reward anticipation. However, previous research mostly focused on adults with heterogeneous ADHD subtype and divers drug treatment status while studies in children with ADHD are sparse. Moreover, it remains unclear to what degree ADHD is characterized by a delay of normal...

Until now, no German diagnostic instrument existed for somatoform disorders in children and adolescents. Therefore the Screening for Somatoform Disorders in Children and Adolescents (SOMS-CA) was developed based on the SOMS-2 (Screening for Somatoform Disorders 2) (Rief & Hiller, 2008). This study investigates to what extent the SOMS-CA can differe...

The ChiP-C is a clinically oriented questionnaire for assessing the quality of the child-parent relationship according to the child’s subjective appraisal. The ChiP-C is based on family systems theory and a cumulative vulnerability model. The questionnaire consists of 36 items representing three resource scales, five risk scales, and one additional...

Background: Children of parents with cancer are at risk of developing mental disorders. RESULTS from divorce research also reveal that sibling relationships can protect the mental health of children in difficult times. Objective: Does having a sibling help to cope with an oncological disease of a parent and thus act as a protective factor? Meth...

In this study, we investigated the emotional processing of extremely emaciated body cues in adolescents and young adults with (n = 36) and without (n = 36) anorexia nervosa (AN), introducing a new picture type, which was taken from websites that promote extreme thinness and is targeted specifically at adolescents interested in extreme thinness. A s...

Numerous research centres apply magnetic resonance imaging (MRI) for research purposes in children. In view of this practical research, ethical concerns regarding the strains the study participants are exposed to during the MRI examination are discussed. The study evaluates whether an MRI examination induces negative emotions in children and adoles...

Objective: Adults with anorexia nervosa (AN) show weaknesses in several cognitive functions before and after weight restoration. There is a great demand for standardized examinations of executive functioning in the field of child and adolescent AN. Previous studies exhibited methodological inconsistencies regarding test selection and operationaliz...

Objective: Several studies have revealed impairments in cognitive functions among patients with affective disorders (AD). However, to date there are few neuropsychological studies on cognitive flexibility among adolescent patients with AD, especially on gender differences in AD. Here, we investigate cognitive functions, especially cognitive flexibi...

Objective: Several studies have revealed impairments in cognitive functions among patients with affective disorders (AD). However, to date there are few neuropsychological studies on cognitive flexibility among adolescent patients with AD, especially on gender differences in AD. Here, we investigate cognitive functions, especially cognitive flexib...

The purpose of this study was to develop an instrument (Test for Body Image Distortion in Children and Adolescents, BID-CA) suitable for adolescents to detect and quantify body image distortion. Participants were patients with anorexia nervosa (AN; N=75), healthy age-matched control participants (N=268) and age-matched thin female athletes (N=50) w...

Findings on gender differences in the psychological distress of cancer patients have been inconsistent. The objectives of the current study were to examine whether being a parent differentially modulates anxiety and depression in men and women and to compare whether psychological distress differs in male and female patients with and without childre...

Objectives: Some studies suggest that both early sexual and early physical abuse are non-specific risk factors for the later development of eating disorders (EDs). However, only little is known about the role of emotional abuse in EDs. Methods: The sample included 77 inpatients with Anorexia nervosa (AN-R: n = 50; AN-BP: n = 27), 26 psychiatric...

Despite several modifications and the wide use of the monetary incentive delay paradigm (MID; Knutson et al. in J Neurosci 21(16):RC159, 2001a) for assessing reward processing, evidence concerning its application in children is scarce. A first child-friendly MID modification has been introduced by Gotlib et al. (Arch Gen Psychiatry 67(4): 380-387,...

Eine Aufarbeitung der Geschichte des eigenen Fachgebietes steht fur die Deutsche Kinder- und Jugendpsychiatrie weiterhin aus. Zwar liegen inzwischen eine ganze Reihe von Publikationen, wissenschaftlichen Auswertungen von Krankenakten, Archivalien und Prozessakten vor, dennoch fehlt eine umfassende und systematische Darstellung der uber 30 «Kinderfa...

32 clinical patients (5-15 years) were diagnosed with an OPD-CA interview-manual (Winter, 2004). To investigate practicability of OPD-CA for patients with migration background (N = 14) a comparison with patients without migration background (N = 18) was carried out. There were patients with different ethnical backgrounds. The OPD-CA covers the axes...

Somatoform disorders in children and adolescents are common and can cause significantly reduced wellbeing and quality of life. Considerable subjective impairment leads to a high number of doctors' visits, which along with a reoccurrence of negative findings, often results in a sense of helplessness in the patient and a lack of trust towards the phy...

From a psychosocial point of view, the children of parents who suffer from cancer are regarded as not being sufficiently provided for, as well as being at greater risk for developing a psychiatric illness. Protective factors are marital satisfaction, open communication within the family and a good relationship with their parents. Results stemming f...

Die vorliegende Arbeit stellt die gängigsten klinischen Interviewverfahren zur Diagnosestellung bei Jugendlichen sowie geeignete störungsspezifische Messinstrumente im deutschen Sprachraum vor. Zudem werden Besonderheiten bei der Diagnostik psychischer Störungen bei Jugendlichen erläutert sowie handlungsrelevante Hinweise gegeben. Beurteiler sind m...

Zusammenfassung. Das Eating Disorder Inventory-2 (EDI-2; Paul & Thiel, 2005) ist ein mehrdimensionales psychometrisches Selbstberichtsinstrument zur Erfassung pathologischen Essverhaltens und anderer fur Anorexia nervosa (AN) und Bulimia nervosa (BN) relevanter psychopathologischer Variablen bei Erwachsenen. In der vorliegenden Arbeit wird uber die...

Objective: Previous studies have shown relationships between personality styles and markers of serotonergic functioning, but data on patients with anorexia nervosa (AN) are scarce. Methods: The personality styles and disorder inventory was administered to 47 acute patients with anorexia nervosa (acAN), 27 weight-recovered patients (recAN) and 72...

The common single nucleotide polymorphism (SNP) rs9939609 in the fat mass and obesity-associated gene (FTO) is associated with obesity. As genetic variants associated with weight regulation might also be implicated in the etiology of eating disorders, we evaluated whether SNP rs9939609 is associated with bulimia nervosa (BN) and anorexia nervosa (A...

Support For Families with a Parent Diagnosed with Cancer and Children Under the Age of Five - Delineation of a Counselling Concept Parents of infants and young children, who have been diagnosed with cancer wish to protect their child from the emotional strains of their illness. They wonder, what the child can understand about the illness and how it...

A cancer disease in the family is an emotional crisis with psychological distress for the partner. The study observed the psychological distress of female partners of cancer patients with underage children (HADS-D). The results were compared with the psychological distress of the cancer patient as well as a representative comparison group of women...

Both, children of somatically ill parents and children of single-mothers are at risk to develop mental health problems and low QoL. This study investigates the effect on children when their single-mothers are exposed to cancer. In a Cross-sectional design a sample of N=47 children of single-mothers exposed to parental cancer was compared to a sampl...

Our pilot study evaluates the impact of environmental factors, such as nutrition and smoking status, on epigenetic patterns in a disease-associated gene. We measured the effects of malnutrition and cigarette smoking on proopiomelanocortin (POMC) promoter-specific DNA methylation in female patients with and without anorexia nervosa (AN). POMC and it...

The psychological distress of men with underage children, whose female partners have cancer, was examined using the Hospital Anxiety and Depression Scale (HADS). The sample (N=141) was compared with the partners who have cancer and a comparison group of men from the general population (N=154). The male partners of cancer patients were psychological...

The psychological distress of men with underage children, whose female partners have cancer, was examined using the Hospital Anxiety and Depression Scale (HADS). The sample (N=141) was compared with the partners who have cancer and a comparison group of men from the general population (N=154). The male partners of cancer patients were psychological...

Somatoforme Störungen im Kindes- und Jugendalter sind häufig und schränken das Wohlbefinden und die Lebensqualität stark ein. Aufgrund der hohen subjektiven Beeinträchtigung kommt es zu einer Vielzahl von Arztbesuchen, die oft durch wiederholt negative Untersuchungsbefunde ohne therapeutische Konsequenzen zu Hilflosigkeit der Patienten und zu einem...

Parents of infants and young children, who have been diagnosed with cancer wish to protect their child from the emotional strains of their illness. They wonder, what the child can understand about the illness and how it is able to process or assimilate the experience of the illness. In fact, infants and young children are particularly sensitive to...

Zur Erfassung der psychischen Struktur von Kindern und Jugendlichen mit psychiatrischen Störungen im Entwicklungsverlauf existieren wenige Untersuchungen. Die vorgestellte Studie soll die Frage beantworten, inwieweit die Operationalisierte Psychodynamische Diagnostik des Kindes- und Jugendalters (OPD-KJ) Veränderungen der psychischen Struktur erfas...

Most studies on the relationship between childhood trauma and anorexia nervosa (AN) have focused on the role of childhood sexual and physical trauma in adult patients. Little is known about the role of emotional trauma and eating disorders. The aim of the present study was to examine childhood sexual, physical, and emotional traumatization in adole...

Anorexia nervosa (AN) is an eating disorder with somatic complications. The aim of the study was to analyse echocardiographic abnormalities in patients with AN at initial examination and after weight restoration. A total of 173 consecutively admitted adolescents (aged 12-17 years), diagnosed with DSM-IV AN (307.1) were evaluated in a child and adol...

Neural correlates of emotional dysregulation in attention-deficit/hyperactivity disorder (ADHD) and persisting influence of Methylphenidate (MPH) still remain insufficiently understood. Decreased activation in the subgenual cingulate and the ventral striatum were found during the perception of positive and negative affective pictures in drug-naïve...

Competitive sport has been under increasing discussion as a possible favourable factor in the development of eating disorders among children and adolescents. The aim of this study was to determine the frequency of sport-specific eating disorders, in line with the concept of anorexia athletica. This prospective field study included one experimental...

Compared to the high number of studies that investigated executive functions (EF) in children with attention-deficit/hyperactivity disorder (ADHD), a little is known about the EF performance of adults with ADHD. This study compared 37 adults with ADHD (ADHD(total)) and 32 control participants who were equivalent in age, intelligence quotient (IQ),...

Cognitive flexibility and the flexible learning and relearning of stimulus-reward-associations are important for decision-making and goal-directed behavior. Studies on patients with anorexia nervosa (AN) have shown difficulties in cognitive functions associated with malnutrition and extreme underweight. However, to date we find a lack of neuropsych...

An imbalance in appetite-regulating neuropeptides of the central nervous system has been associated with anorexia nervosa (AN), but the mechanisms of action are poorly understood. Agouti-related protein (AGRP), an orexigenic mediator of the hypothalamus, increases food intake and decreases energy expenditure in times of negative energy balance. The...

Dysfunctional reward processing has been proposed as a main deficit in attention-deficit/hyperactivity disorder (ADHD), which could be modulated by treatment with methylphenidate (MPH). We examined differences in reward processing in adulthood (independent of actual ADHD) depending on MPH treatment during childhood. Eleven males with childhood ADHD...

Seit ca. 10 Jahren wird über den Einsatz von Olanzapin bei Anorexia nervosa berichtet, die Datenlage wird als unbefriedigend eingeschätzt (McKnight u. Park, 2010). Es liegen bisher 4 Studien an Erwachsenen vor, bei den übrigen Publikationen handelt es sich um Fallberichte. Davon beziehen sich 7 auf Kinder und Jugendliche mit Patientenzahlen zwische...

60 clinical patients (5-17 years) were diagnosed with an interview-manual of OPD-CA (Winter, 2004). For clinical validity a comparison of patients with internal (N=17) and external disorders (N=19) was shown. References for clinical validity resulted from the comparison of the groups, especially for the axes "conflict" and "prerequisites for treatm...

Die Rolle des Leistungssports in der Genese von Essstörungen wurde in den letzten Jahrzehnten zunehmend kontrovers diskutiert. Insbesondere im Bereich der ästhetischen Sportarten existieren widersprüchliche Befunde. Ziel unserer Studie ist daher die Erfassung essstörungsrelevanter Psychopathologie bei Eiskunstläuferinnen (EKL) auf Bundeskaderniveau...

Recently, a highly heritable behavioral phenotype of simultaneous deviance on the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndrome scales has been identified on the Child Behavior Checklist (CBCL-Dysregulation Profile, CBCL-DP). This study aims to investigate psychosocial adversity and impairment of the CBCL-DP. A total of 90...

The present study aimed to ascertain the occurrence of personality disorders (PD) in adolescent patients with anorexia (AN) and bulimia nervosa (BN) by means of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). 99 female adolescent patients (57 AN - restrictive type, 17 AN - binge-purging type, 25 BN; M(age) = 16.3 +/- 1...

The prohormone preproenkephalin (ppE) and its derived peptides are involved in leukocyte functioning as well as in the regulation of hunger and satiety. Various abnormalities of the immune and endocrine systems have been described in states of malnutrition such as anorexia nervosa (AN). We hypothesized that ppE expression in AN patients may vary de...

The present study examines the psychometric properties of the German version of the Eating Disorder Inventory EDI-2 (1997) in 371 adolescents aged 13 to 18 years. Internal consistency, convergent and divergent validity were examined and a confirmatory factor analysis was conducted. Internal consistency was high for the group of patients and satisfa...

Zusammenfassung. Der EBF-KJ ist ein klinisch ausgerichteter Fragebogen zur Erfassung der Repräsentation der Eltern-Kind-Beziehung aus der Sicht von Kindern und Jugendlichen. Er basiert auf der systemischen Familientheorie und der Familienstresstheorie. Der Fragebogen umfasst 36 Items pro Elternteil, die sich auf drei Ressourcenskalen (Kohäsion, Ide...

Psychiatric Disorders Among Parents of Patients With Anorexia Nervosa and Bulimia Nervosa Family diseases represent a risk factor in the multifactorial etiology model regarding the gen-esis of eating disorders. In German-speaking countries only a few studies give attention to this topic. The aim of this study is to investigate the occurrence freque...