TY - JOUR A1 - Wyschkon, Anne A1 - Schulz, Franziska A1 - Gallit, Finja Sunnyi A1 - Poltz, Nadine A1 - Kohn-Henkel, Juliane A1 - Moraske, Svenja A1 - Bondü, Rebecca A1 - von Aster, Michael G. A1 - Esser, Günter T1 - 5-Jahres-Verlauf der LRS T1 - 5-year course of dyslexia BT - Stabilität, Geschlechtseffekte, Schriftsprachniveau und Schulerfolg BT - Persistence, sex effects, performance in reading and spelling, and school-related success JF - Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie N2 - Fragestellung: Untersucht wird der Verlauf von Kindern mit Lese-Rechtschreibstörungen (LRS) über gut 5 Jahre unter Berücksichtigung des Einflusses des Geschlechts der Betroffenen. Außerdem werden Auswirkungen der LRS auf das spätere Schriftsprachniveau und den Schulerfolg überprüft. Methodik: Eingangs wurden 995 Schüler zwischen 6 und 16 Jahren untersucht. Ein Teil dieser Kinder ist nach 43 sowie 63 Monaten nachuntersucht worden. Eine LRS wurde diagnostiziert, wenn für das Lesen bzw. Rechtschreiben das doppelte Diskrepanzkriterium von 1.5 Standardabweichungen zur nonverbalen Intelligenz und dem Mittelwert der Klassenstufe erfüllt war und gleichzeitig keine Minderbegabung vorlag. Ergebnisse: Die LRS weist über einen Zeitraum von 63 Monaten eine hohe Störungspersistenz von knapp 70 % auf. Der 5-Jahres-Verlauf der mittleren Lese- und Rechtschreibleistungen wurde nicht vom Geschlecht beeinflusst. Trotz durchschnittlicher Intelligenz blieben die LRS-Schüler in der Schriftsprache mindestens eine Standardabweichung hinter durchschnittlich und etwa 0.5 Standardabweichungseinheiten hinter unterdurchschnittlich intelligenten Kindern zurück. Der Schulerfolg der LRS-Schüler glich dem unterdurchschnittlich intelligenter Kinder und fiel deutlich schlechter aus als bei durchschnittlich intelligenten Kontrollkindern. Schlussfolgerungen: Eine LRS stellt ein erhebliches Entwicklungsrisiko dar, was frühzeitige Diagnostik- und Therapiemaßnahmen erfordert. Dafür sind reliable und im Hinblick auf die resultierenden Prävalenzraten sinnvolle, allgemein anerkannte Diagnosekriterien essenziell. N2 - Objective: The study examines the 5-year course of children with dyslexia with regard to their sex. Furthermore, the study investigates the impact of dyslexia on the performance in reading and spelling skills and school-related success. Method: A group of 995 6- to 16-year-olds were examined at the initial assessment. Part of the initial sample was then re-examined after 43 and 63 months. The diagnosis of dyslexia was based on the double discrepancy criterion using a standard deviation of 1.5. Though they had no intellectual deficits, the children showed a considerable discrepancy between their reading or writing abilities and (1) their nonverbal intelligence and (2) the mean of their grade norm. Results: Nearly 70 % of those examined had a persisting diagnosis of dyslexia over a period of 63 months. The 5-year course was not influenced by sex. Despite average intelligence, the performance in writing and spelling of children suffering from dyslexia was one standard deviation below a control group without dyslexia with average intelligence and 0.5 standard deviations below a group of children suffering from intellectual deficits. Furthermore, the school-related success of the dyslexics was significantly lower than those of children with average intelligence. Dyslexics showed similar school-related success rates to children suffering from intellectual deficits. Conclusions: Dyslexia represents a considerable developmental risk. The adverse impact of dyslexia on school-related success supports the importance of early diagnostics and intervention. It also underlines the need for reliable and general accepted diagnostic criteria. It is important to define such criteria in light of the prevalence rates. KW - dyslexia KW - discrepancy criterion KW - persistence KW - course KW - school-related success KW - Lese-Rechtschreibstörung KW - Diskreptanzdefinition KW - Stabilität KW - Verlauf KW - Schulerfolg Y1 - 2017 U6 - https://doi.org/10.1024/1422-4917/a000535 SN - 1422-4917 SN - 1664-2880 VL - 46 IS - 2 SP - 107 EP - 122 PB - Hogrefe CY - Bern ER - TY - JOUR A1 - Hohm, Erika A1 - Laucht, Manfred A1 - Zohsel, Katrin A1 - Schmidt, Martin H. A1 - Esser, Günter A1 - Brandeis, Daniel A1 - Banaschewski, Tobias T1 - Resilienz und Ressourcen im Verlauf der Entwicklung T1 - Resilience and Resources During Development BT - Von der frühen Kindheit bis zum Erwachsenenalter BT - From Early Childhood to Adulthood JF - Kindheit und Entwicklung N2 - Anhand von Daten der Mannheimer Risikokinderstudie, die sich mit der langfristigen Entwicklung von Kindern mit unterschiedlichen Risikobelastungen beschäftigt, wird gezeigt, wie Schutzfaktoren aufseiten des Kindes und seines familiären Umfelds im Verlauf der Entwicklung wirksam werden und zur Entstehung von Resilienz beitragen können. Eine besondere Rolle kommt dabei positiven frühen Eltern-Kind-Beziehungen zu (sowohl Mutter- als auch Vater-Kind-Interaktionen). Daneben spielen auch Interaktionserfahrungen im Alter von zwei Jahren des Kindes eine bedeutsame Rolle; diese schützen Risikokinder davor, eine ungünstige Entwicklung zu nehmen und tragen dazu bei, dass sich Kinder, die in psychosozialen Hochrisikofamilien aufwachsen, trotz ungünstiger „Startbedingungen“ positiv entwickeln. Neben Merkmalen der sozialen Umwelt nehmen auch sprachliche, sozial-emotionale und internale Kompetenzen des Kindes im Entwicklungsverlauf eine wichtige Rolle ein. Diese Kompetenzen ermöglichen es Risikokindern auch unter widrigen Lebensumständen (psychosoziale Hochrisikofamilien, Aufwachsen in Armutsverhältnissen) erfolgreich zu bestehen. Darüber hinaus zeigt die Arbeit, dass Resilienz ein Persönlichkeitsmerkmal ist, das ab dem frühen Erwachsenenalter eine hohe Stabilität besitzt. Mit diesen Befunden verweist die Arbeit auf die große Bedeutung der Resilienz bei der Vorhersage der langfristigen Entwicklung von Risikokindern. N2 - Resilience refers to the ability to successfully deal with stressful life circumstances and experiences and to cope with them. Based on data from the Mannheim Study of Children at Risk, which follows a sample of children at risk from birth to adulthood, the present paper provides convincing evidence demonstrating how protective factors in the child and his/her family environment operate during the course of development to contribute to the development of resilience. As shown, a major role is assigned to positive early parent–child relationships (both mother– and father–child interactions). Moreover, positive interactive experiences at the child’s age of 2 years play a significant role. These experiences consistently contribute to a positive child development in the face of adversity. In addition to characteristics of the social environment of the child, cognitive, social–emotional, and internal competencies during childhood, youth, and young adulthood play a major role in the development of resilience. These competencies enable children at risk who are growing up in psychosocial high-risk families or in poverty to successfully cope with conditions of high adversity. Moreover, the findings presented here demonstrate that resilience may be conceived as a personal characteristic that exhibits high stability since young adulthood. With these findings, the present study points to the significance of resilience in predicting the long-term outcome of children at risk. KW - protective factors KW - risk factors KW - longitudinal study KW - Mannheim Study of Children at Risk KW - early parent-child relationship KW - Schutzfaktoren KW - Risikofaktoren KW - Längsschnittstudie KW - Mannheimer Risikokinderstudie KW - frühe Eltern-Kind-Beziehung Y1 - 2018 U6 - https://doi.org/10.1026/0942-5403/a000236 SN - 0942-5403 SN - 2190-6246 VL - 26 SP - 230 EP - 239 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Hohm, Erika A1 - Zohsel, Katrin A1 - Schmidt, Martin H. A1 - Esser, Günter A1 - Brandeis, Daniel A1 - Banaschewski, Tobias A1 - Laucht, Manfred T1 - Beeinträchtigter Start ins Leben T1 - Impaired Start into Life BT - Langfristige Auswirkungen der postpartalen Depression und der Einfluss des mütterlichen Interaktionsverhaltens BT - Long-Term Effects of Postpartum Depression and the Role of Maternal Interactional Behavior JF - Kindheit und Entwicklung N2 - Postpartale Depressionen sind häufige und schwerwiegende psychische Erkrankungen mit ungünstigem Einfluss auf die kindliche Entwicklung. Als Haupttransmissionsweg gilt die frühe Mutter-Kind-Interaktion. Über die langfristigen Auswirkungen auf die Kinder im Erwachsenenalter und die Rolle der Interaktion liegen kaum Ergebnisse vor. Im Rahmen der Mannheimer Risikokinderstudie wurden postpartale Depressionen bis zwei Jahre nach der Geburt erfasst. Die kindliche Entwicklung wurde fortlaufend und die Mutter-Kind-Interaktion im Alter von 3 Monaten standardisiert erhoben. 28 Kinder postpartal depressiver und 107 Kinder gesunder Mütter konnten mit 25 Jahren untersucht werden. Beeinträchtigungen der kognitiven und psychischen Entwicklung bei Kindern postpartal depressiver Mütter waren bis ins Erwachsenenalter nachweisbar. Responsives bzw. sensitives mütterliches Verhalten wirkte der negativen Entwicklung entgegen. Dies betont die Bedeutung einer hohen Qualität der Mutter-Kind-Interaktion für die Entwicklung von Risikokindern. N2 - Postpartum depression (PPD) is a common and serious mental health problem with prevalence rates ranging from 13% to 19%, and is associated with an increased risk of adverse child development. PPD is characterized by symptoms common of depression, particularly by impairments of maternity, parenting, and mother-infant interactions. Several reviews suggest an impact on attachment, cognitive, behavioral, and health-related outcome in the offspring. However, the long-term effects of PPD regarding cognitive and mental development into adulthood and the underlying mechanisms, especially the role of maternal interactional behavior, are not yet well understood. In the Mannheim Study of Children at Risk, maternal depression was assessed when the child was 3 months and 2 years old. Development from infancy to young adulthood (25 years) was assessed at regular intervals in 28 children of postnatally depressed mothers and 107 children born to mentally healthy mothers. Cognitive outcome up to age 11 was measured using standardized instruments; in adulthood, school outcome was used approximately. Psychiatric diagnosis as well as symptom scores served as psychological outcome. At age 3 months, mothers and infants were videotaped during a nursing and a playing situation. Videotapes of the 10-min session were recorded and evaluated by trained raters (kappa > .83) using the Category System for Microanalysis of Early Mother Child Interaction (Esser, Scheven, et al., 1989). The cognitive as well as social-emotional outcome of children of mothers suffering from PPD was significantly poorer than in the children of mentally healthy mothers. The adverse effects were more pronounced during childhood. The offspring of postnatally depressed mothers who interacted in a responsive manner with their infant exhibited a better prognosis in contrast to those with mothers interacting less sensitively. This effect was observed with regard to cognitive development and symptoms of externalizing behavior at age 19 years. Regarding internalizing behavior, no impact of maternal behavior was detected. These findings emphasize the importance of high-quality early mother-child interaction in the development of children at risk. Furthermore, convincing arguments are given for very early specialized treatment of impaired mother-child interactions in mothers suffering from PPD. The PPD treatment should always comprise treatment of depression as well as treatment of the disturbed mother-child interaction. KW - postpartum depression KW - development KW - longitudinal study KW - Mannheim Study of Children at Risk KW - mother-child interaction KW - Postpartale+Depression KW - Entwicklung KW - Längsschnittstudie KW - Mannheimer+Risikokinderstudie KW - Mutter-Kind-Interaktion Y1 - 2017 U6 - https://doi.org/10.1026/0942-5403/a000234 SN - 0942-5403 SN - 2190-6246 VL - 26 SP - 210 EP - 220 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Kucian, Karin A1 - Zuber, Isabelle A1 - Kohn, Juliane A1 - Poltz, Nadine A1 - Wyschkon, Anne A1 - Esser, Günter A1 - von Aster, Michael G. T1 - Relation Between Mathematical Performance, Math Anxiety, and Affective Priming in Children With and Without Developmental Dyscalculia JF - Frontiers in psychology N2 - Many children show negative emotions related to mathematics and some even develop mathematics anxiety. The present study focused on the relation between negative emotions and arithmetical performance in children with and without developmental dyscalculia (DD) using an affective priming task. Previous findings suggested that arithmetic performance is influenced if an affective prime precedes the presentation of an arithmetic problem. In children with DD specifically, responses to arithmetic operations are supposed to be facilitated by both negative and mathematics-related primes (= negative math priming effect). We investigated mathematical performance, math anxiety, and the domain-general abilities of 172 primary school children (76 with DD and 96 controls). All participants also underwent an affective priming task which consisted of the decision whether a simple arithmetic operation (addition or subtraction) that was preceded by a prime (positive/negative/neutral or mathematics-related) was true or false. Our findings did not reveal a negative math priming effect in children with DD. Furthermore, when considering accuracy levels, gender, or math anxiety, the negative math priming effect could not be replicated. However, children with DD showed more math anxiety when explicitly assessed by a specific math anxiety interview and showed lower mathematical performance compared to controls. Moreover, math anxiety was equally present in boys and girls, even in the earliest stages of schooling, and interfered negatively with performance. In conclusion, mathematics is often associated with negative emotions that can be manifested in specific math anxiety, particularly in children with DD. Importantly, present findings suggest that in the assessed age group, it is more reliable to judge math anxiety and investigate its effects on mathematical performance explicitly by adequate questionnaires than by an affective math priming task. KW - developmental dyscalculia KW - mathematics KW - affective priming KW - calculation KW - arithmetic KW - anxiety KW - gender KW - children Y1 - 2018 U6 - https://doi.org/10.3389/fpsyg.2018.00263 SN - 1664-1078 VL - 9 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Millenet, Sabina A1 - Laucht, Manfred A1 - Hohm, Erika A1 - Jennen-Steinmetz, Christine A1 - Hohmann, Sarah A1 - Schmidt, Martin H. A1 - Esser, Günter A1 - Banaschewski, Tobias A1 - Brandeis, Daniel A1 - Zohsel, Katrin T1 - Sex-specific trajectories of ADHD symptoms from adolescence to young adulthood JF - European child and adolescent psychiatry : offical journal of the European Society for Child and Adolescent Psychiatry N2 - Reports of current ADHD symptoms in adults with a childhood diagnosis of ADHD are often discrepant: While one subgroup reports a particularly high level of current ADHD symptoms, another reports—in contrast—a very low level. The reasons for this difference remain unclear. Although sex might play a moderating role, it has not yet been examined in this regard. In an epidemiological cohort study from birth to young adulthood, childhood ADHD diagnoses were assessed at the ages of 4.5, 8, and 11 years based on parent ratings. Sex-specific development of ADHD symptoms was analyzed from the age of 15 to 25 years via self-reported ADHD symptoms in participants with (n = 47) and without childhood ADHD (n = 289) using a random coefficient regression model. The congruence between parent reports and adolescents’ self-ratings was examined, and the role of childhood ADHD diagnosis, childhood OCC/CD, and childhood internalizing disorder as possible sex-specific predictors of self-reported ADHD symptoms at age 25 years was investigated. With regard to self-reported ADHD symptoms, females with a childhood ADHD diagnosis reported significantly more ADHD symptoms compared to females without childhood ADHD and males with and without ADHD throughout adolescence and young adulthood. In contrast, males with childhood ADHD did not differ from control males either at age 15 or at age 25 years. Only in females did a childhood diagnosis of an externalizing disorder (ADHD and CD/ODD) predict self-reported ADHD symptoms by age 25 years. Our findings suggest that self-reports of young adults with a childhood diagnosis of ADHD are influenced by sex. Specifically, females with childhood ADHD report increased levels of ADHD symptoms upon reaching adulthood. To correctly evaluate symptoms and impairment in this subgroup, other, more objective, sources of information may be advisable, such as neurophysiological measures. KW - ADHD KW - Sex KW - Self-report KW - Longitudinal study Y1 - 2018 U6 - https://doi.org/10.1007/s00787-018-1129-9 SN - 1018-8827 SN - 1435-165X VL - 27 IS - 8 SP - 1067 EP - 1075 PB - Springer CY - New York ER - TY - JOUR A1 - Esser, Günter A1 - Schmidt, Martin H. T1 - Die Mannheimer Risikokinderstudie T1 - The Mannheim Study of Children at Risk BT - Idee, Ziele und Design BT - Concept, Aims, and Design JF - Kindheit und Entwicklung N2 - Die Mannheimer Risikokinderstudie untersucht die psychische Entwicklung und ihre Störungen bei Kindern mit unterschiedlich ausgeprägten Risiken mit dem Ziel, Empfehlungen für die Verbesserung der Prävention, Früherkennung und Frühbehandlung von psychischen Störungen bei Kindern abzuleiten. Dazu begleitet sie eine Kohorte von anfangs 384 Kindern in ihrer Entwicklung von der Geburt bis zum Erwachsenenalter. Die Erhebungen fanden in regelmäßigen Abständen statt, beginnend im Alter von 3 Monaten, mit 2 Jahren, 4;6, 8, 11, 15, 19, 22, 23 und 25 Jahren. Geplant ist eine weitere Erhebung mit ca. 30 Jahren. N2 - The Mannheim Study of Children at Risk investigates psychological development and its disorders in children with different risks with the aim of delineating recommendations for improvements of prevention, early identification, and treatment of psychiatric disorders in children. Assessments are conducted at regular intervals, starting at the age of 3 months and then at 2, 4.5, 8, 11, 15, 19, 22, 23, and 25 years. The next assessment is planned for the age of about 30 years. KW - risk research KW - developmental psychopathology Y1 - 2017 U6 - https://doi.org/10.1026/0942-5403/a000232 SN - 0942-5403 SN - 2190-6246 VL - 26 SP - 198 EP - 202 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Meiser, Susanne A1 - Esser, Günter T1 - How dysfunctional are dysfunctional attitudes? BT - a threshold model of dysfunctional attitudes and depressive symptoms in children and adolescents JF - Cognitive Therapy and Research N2 - In order to clarify further the role of Beck’s vulnerability-stress model in the early development of depression, this longitudinal study tested a threshold model of dysfunctional attitudes in children and adolescents. An initially asymptomatic sample of 889 youths aged 9–18 years completed measures of dysfunctional attitudes and depressive symptoms. Twenty months later, participants reported stressful life events and current depressive symptoms. Results support a threshold view of cognitive vulnerability as only dysfunctional attitudes above a certain threshold significantly interacted with life events to predict depressive symptoms. Thus, findings suggest that dysfunctional attitudes must exceed a certain threshold to confer vulnerability to depressive symptomatology in youth. The term “dysfunctional” might therefore only apply to higher levels of the “dysfunctional attitudes” proposed by A. T. Beck. Results also indicate that studies using non-clinical samples may systematically underestimate the effect of dysfunctional attitudes when relying on conventional linear methods. KW - Cognitive vulnerability KW - Depression KW - Children KW - Adolescents KW - Dysfunctional attitudes KW - Threshold models Y1 - 2017 U6 - https://doi.org/10.1007/s10608-017-9842-0 SN - 0147-5916 SN - 1573-2819 VL - 41 SP - 730 EP - 744 PB - Springer CY - New York ER - TY - JOUR A1 - Holz, Nathalie E. A1 - Boecker-Schlier, Regina A1 - Jennen-Steinmetz, Christine A1 - Hohm, Erika A1 - Buchmann, Arlette F. A1 - Blomeyer, Dorothea A1 - Baumeister, Sarah A1 - Plichta, Michael M. A1 - Esser, Günter A1 - Schmidt, Martin A1 - Meyer-Lindenberg, Andreas A1 - Banaschewski, Tobias A1 - Brandeis, Daniel A1 - Laucht, Manfred T1 - Early maternal care may counteract familial liability for psychopathology in the reward circuitry JF - Social Cognitive and Affective Neuroscience N2 - Reward processing is altered in various psychopathologies and has been shown to be susceptible to genetic and environmental influences. Here, we examined whether maternal care may buffer familial risk for psychiatric disorders in terms of reward processing. Functional magnetic resonance imaging during a monetary incentive delay task was acquired in participants of an epidemiological cohort study followed since birth (N = 172, 25 years). Early maternal stimulation was assessed during a standardized nursing/playing setting at the age of 3 months. Parental psychiatric disorders (familial risk) during childhood and the participants’ previous psychopathology were assessed by diagnostic interview. With high familial risk, higher maternal stimulation was related to increasing activation in the caudate head, the supplementary motor area, the cingulum and the middle frontal gyrus during reward anticipation, with the opposite pattern found in individuals with no familial risk. In contrast, higher maternal stimulation was associated with decreasing caudate head activity during reward delivery and reduced levels of attention deficit hyperactivity disorder (ADHD) in the high-risk group. Decreased caudate head activity during reward anticipation and increased activity during delivery were linked to ADHD. These findings provide evidence of a long-term association of early maternal stimulation on both adult neurobiological systems of reward underlying externalizing behavior and ADHD during development. KW - maternal care KW - ADHD KW - ventral striatum KW - fMRI KW - resilience KW - aggression Y1 - 2018 U6 - https://doi.org/10.1093/scan/nsy087 SN - 1749-5016 SN - 1749-5024 VL - 13 IS - 11 SP - 1191 EP - 1201 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Meiser, Susanne A1 - Esser, Günter T1 - Interpersonal Stress Generation-A Girl Problem? BT - The Role of Depressive Symptoms, Dysfunctional Attitudes, and Gender in Early Adolescent Stress Generation JF - Journal of early adolescence N2 - To provide further insight into stress generation patterns in boys and girls around puberty, this study investigated longitudinal reciprocal relations between depressive symptoms, dysfunctional attitudes, and stress generation, the process by which individuals contribute to the occurrence of stress in interpersonal contexts (e.g., problematic social interactions) or in noninterpersonal contexts (e.g., achievement problems). A community sample of N = 924 German children and early adolescents (51.8% male) completed depressive symptoms and dysfunctional attitudes measures at T1 and again 20 months later (T2). Stressful life events were reported at T2. Dysfunctional attitudes were unrelated to stress generation. Interpersonal, but not noninterpersonal, dependent stress partially mediated the relationship between initial and later depressive symptoms, with girls being more likely to generate interpersonal stress in response to depressive symptoms. Findings underscore the role of interpersonal stress generation in the early development of depressive symptomatology, and in the gender difference in depression prevalence emerging around puberty. KW - stress generation KW - depression KW - dysfunctional attitudes KW - children and adolescents KW - gender differences Y1 - 2017 U6 - https://doi.org/10.1177/0272431617725197 SN - 0272-4316 SN - 1552-5449 VL - 39 IS - 1 SP - 41 EP - 66 PB - Sage Publ. CY - Thousand Oaks ER - TY - JOUR A1 - Tetzner, Julia A1 - Kliegl, Reinhold A1 - Krahé, Barbara A1 - Busching, Robert A1 - Esser, Günter T1 - Developmental problems in adolescence BT - a person-centered analysis across time and domains JF - Journal of Applied Developmental Psychology N2 - This longitudinal study investigated patterns of developmental problems across depression, aggression, and academic achievement during adolescence, using two measurement points two years apart (N = 1665; age T1: M = 13.14; female = 49.6%). Latent Profile Analyses and Latent Transition Analyses yielded four main findings: A three-type solution provided the best fit to the data: an asymptomatic type (i.e., low problem scores in all three domains), a depressed type (i.e., high scores in depression), an aggressive type (i.e., high scores in aggression). Profile types were invariant over the two data waves but differed between girls and boys, revealing gender specific patterns of comorbidity. Stabilities over time were high for the asymptomatic type and for types that represented problems in one domain, but moderate for comorbid types. Differences in demographic variables (i.e., age, socio-economic status) and individual characteristics (i.e., self-esteem, dysfunctional cognitions, cognitive capabilities) predicted profile type memberships and longitudinal transitions between types. KW - Adolescence KW - Person-centered approach KW - Depression KW - Aggression KW - Academic achievement Y1 - 2017 U6 - https://doi.org/10.1016/j.appdev.2017.08.003 SN - 0193-3973 SN - 1873-7900 VL - 53 SP - 40 EP - 53 PB - Elsevier CY - New York ER -