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ADHS bei Jugendlichen
(2024)
ADHS galt lange als eine Störung des Kindesalters. Aber bis zu 80 % der Patient:innen sind auch noch als Jugendliche betroffen. Gerade sie brauchen Hilfe bei ihren Problemen!
In der Schule müssen sie öfter die Klasse wiederholen, im sozialen und emotionalen Bereich gibt es Konflikte mit Gleichaltrigen und Eltern. Unbehandelt drohen psychische Störungen, Drogenmissbrauch oder delinquentes Verhalten.
Das vorliegende Lerntraining ist das erste multimodale Behandlungskonzept für Jugendliche im Alter von 12 bis 17 Jahren. Es werden konkrete Probleme und Aufgaben aus Schule und Umwelt behandelt, um daran allgemeine Strategien herzuleiten. Eltern und Lehrer werden intensiv in die Behandlung mit einbezogen.
Battle of plates
(2017)
Objective: Approach-avoidance training (AAT) is a promising approach in obesity treatment. The present study examines whether an AAT is feasible and able to influence approach tendencies in children and adolescents, comparing implicit and explicit training approaches. Design/Setting/Subjects: Fifty-nine overweight children and adolescents (aged 8-16 years; twenty-six boys) participated in an AAT for food cues, learning to reject snack items and approach vegetable items. Reaction times in the AAT and an implicit association rest (IAT) were assessed pre- and post-intervention. Results: A significant increase in the AAT compatibility scores with a large effect (eta(2) = 0.18) was found. No differences between the implicit and explicit training approaches and no change in the IAT scores were observed. Conclusions: Automatic tendencies in children can be trained, too. The implementation of AAT in the treatment of obesity might support the modification of an unhealthy nutrition behaviour pattern. Further data from randomized controlled clinical trials are needed.
Several longitudinal studies and meta-analytic reviews have demonstrated that exposure to violent media is linked to aggression over time. However, evidence on effective interventions to reduce the use of violent media and promote critical viewing skills is limited. The current study examined the efficacy of an intervention designed to reduce the use of media violence and aggression in adolescence, covering a total period of about 12 months. A sample of 683 7th and 8th graders in Germany (50.1% girls) were assigned to two conditions: a 5-week intervention and a no-intervention control group. Measures of exposure to media violence and aggressive behavior were obtained about 3 months prior to the intervention (T1) and about 7 months post-intervention (T2). The intervention group showed a significantly larger decrease in the use of violent media from T1 to T2 than the control group. Participants in the intervention group also scored significantly lower on self-reported aggressive behavior (physical aggression and relational aggression) at T2 than those in the control group, but the effect was limited to those with high levels of initial aggression. This effect was mediated by an intervention-induced decrease in the normative acceptance of aggression. No gender differences in program efficacy were found. The results show that a 5-week school-based intervention can produce changes in the use of media violence, aggressive norms, and behaviors sustained over several months.
In Anlehnung an das Self-Regulated-Strategy-Development-Modell von Harris und Graham (1996) wurde das Selbstregulatorische Aufsatztraining (SAT) zur Förderung der Schreibkompetenz bei Grundschülern der 4. und 5. Klasse entwickelt. SAT integriert die Vermittlung von Schreibstrategien (hier: „Erzählendes Schreiben“) mit Merkmalen selbstgesteuerten Lernens (Zielsetzung, strategisches Planen, Selbstbewertung und Selbstkorrektur). Die Wirksamkeit des Trainings wurde in drei Studien untersucht: 1. Eine Pilotstudie diente der Überprüfung der prinzipiellen Eignung von SAT zur Förderung von Schreibleistungen bei Grundschülern der 5. Klassen (N = 42) und der Optimierung seiner Teilkomponenten und Vorgehensweisen. 2. In der Hauptuntersuchung wurden die Effektivität und Nachhaltigkeit des SAT-Programms bei Schülern der 4. Klasse (N = 154) im Vergleich zu zwei Bedingungen getestet: (a) der isolierten Einübung von Schreibstrategien (Aufsatztraining) und (b) konventionellem Aufsatzunterricht (Unterrichtskontrollgruppe). 3. In einer weiteren Studie wurde die Wirksamkeit des Trainings speziell bei Schülern mit ungünstigen Lernvoraussetzungen überprüft; die Studie diente zudem der Illustration des dabei gewählten Vorgehens am Einzelfall (N = 6). Die ermittelten Befunde sprechen übereinstimmend dafür, dass die Kombination aus strategischem plus selbstregulatorischem Training (SAT) die stärksten und nachhaltigsten Effekte auf die Schreibleistung erzielt. Der Trainingseffekt generalisiert zudem auf die Erinnerungsleistung bei der freien Wiedergabe einer Kurzgeschichte. Schüler mit schwachen Aufsatzleistungen und ungünstigen Lernvoraussetzungen profitieren von dem SAT-Programm in besonderem Maße. In der Diskussion werden Aufgaben für die zukünftige Forschung erörtert. Forschungsbedarf besteht u.a. hinsichtlich (a) einer stärkeren Verknüpfung von Schreibtrainings mit der kognitionspsychologischen Forschung; (b) der Dekomposition und gezielten Überprüfung der einzelnen Trainingskomponenten; (c) der Ausweitung des SAT-Programms auf andere Textgenre; (d) der Integration verfeinerter Revisionsstrategien in das Förderprogramm; und (e) dessen Implementierung in den Regelunterricht.
IntroductionWhile physical activity (PA) can play an important role in the treatment of mental disorders (MD), large proportions of patients with MD do not meet PA recommendations. The aim of this trial was to evaluate whether structured psychological intervention (MoVo-LISA) is effective in helping outpatients with MD to increase their level of PA. As active control group (CG) we modified MoVo-LISA to target healthy diet behavior.MethodsN=83 outpatients with MD (F1-F4) were randomized to the two conditions. PA (self-report and accelerometry), dietary behavior, social-cognitive determinants of health behavior change, psychiatric symptoms and health-related quality of life were assessed at baseline, 1 and 12 weeks after the intervention.ResultsSignificant time*group interaction effects for objectively measured PA, dietary behavior and fruit and vegetable consumption indicated differential effects of the interventions on these outcomes. PA increased in the MoVo-LISA group (IG) from baseline to follow-up while it decreased in CG. IG showed a significant higher level of objectively measured PA at follow-up compared to CG. Dietary behavior and fruit and vegetable consumption significantly increased from baseline to follow-up in CG, but not IG. IG showed a significant increase in some, but not all social cognitive determinants of health behavior change.ConclusionsMoVo-LISA is effective in helping outpatients with MD to increase their level of PA in short- and mid-term. The used intervention strategies are effective for the promotion of healthy diet in patients with MD as well.
Background: Physical fitness is a key aspect of children’s ability to perform activities of daily living, engage in leisure activities, and is associated with important health characteristics. As such, it shows multi-directional associations with weight status as well as executive functions, and varies according to a variety of moderating factors, such as the child’s gender, age, geographical location, and socioeconomic conditions and context. The assessment and monitoring of children’s physical fitness has gained attention in recent decades, as has the question of how to promote physical fitness through the implementation of a variety of programs and interventions. However, these programs and interventions rarely focus on children with deficits in their physical fitness. Due to their deficits, these children are at the highest risk of suffering health impairments compared to their more average fit peers. In efforts to promote physical fitness, schools could offer promising and viable approaches to interventions, as they provide access to large youth populations while providing useful infrastructure. Evidence suggests that school-based physical fitness interventions, particularly those that include supplementary physical education, are useful for promoting and improving physical fitness in children with normal fitness. However, there is little evidence on whether these interventions have similar or even greater effects on children with deficits in their physical fitness. Furthermore, the question arises whether these measures help to sustainably improve the development/trajectories of physical fitness in these children.
The present thesis aims to elucidate the following four objectives: (1) to evaluate the effects of a 14 week intervention with 2 x 45 minutes per week additional remedial physical education on physical fitness and executive function in children with deficits in their physical fitness; (2) to assess moderating effects of body height and body mass on physical fitness components in children with physical fitness deficits; (3) to assess moderating effects of age and skeletal growth on physical fitness in children with physical fitness deficits; and (4) to analyse moderating effects of different physical fitness components on executive function in children with physical fitness deficits.
Methods: Using physical fitness data from the EMOTIKON study, 76 third graders with physical fitness deficits were identified in 11 schools in Brandenburg state that met the requirements for implementing a remedial physical education intervention (i.e., employing specially trained physical education teachers). The fitness intervention was implemented in a cross-over design and schools were randomly assigned to either an intervention-control or control-intervention group. The remedial physical education intervention consisted of a 14 week, 2 x 45 minutes per week remedial physical education curriculum supplemented by a physical exercise homework program. Assessments were conducted at the beginning and end of each intervention and control period, and further assessments were conducted at the beginning and end of each school year until the end of sixth grade. Physical fitness as the primary outcome was assessed using fitness tests implemented in the EMOTIKON study (i.e., lower body muscular strength (standing long jump), speed (20 m sprint), cardiorespiratory fitness (6 min run), agility (star run), upper body muscular strength (ball push test), and balance (one leg balance)). Executive functions as a secondary outcome were assessed using attention and psychomotor processing speed (digit symbol substitution test), mental flexibility and fine motor skills (trail making test), and inhibitory control (Simon task). Anthropometric measures such as body height, body mass, maturity offset, and body composition parameters, as well as socioeconomic information were recorded as potential moderators.
Results: (1) The evaluation of possible effects of the remedial physical education intervention on physical fitness and executive functions of children with deficits in their physical fitness did not reveal any detectable intervention-related improvements in physical fitness or executive functions. The implemented analysis strategies also showed moderating effects of body mass index (BMI) on performance in 6 min run, star run, and standing long jump, with children with a lower BMI performing better, moderating effects of proximity to Berlin on performance in the 6 min run and standing long jump, better performances being found in children living closer to Berlin, and overall gendered differences in executive function test performance, with boys performing better compared to girls. (2) Analysing moderating effects of body height and body mass on physical fitness performance, better overall physical fitness performance was found for taller children. For body mass, a negative effect was found on performance in the 6 min run (linear), standing long jump (linear), and 20 m sprint (quadratic), with better performance associated with lighter children, and a positive effect of body mass on performance in the ball push test, with heavier children performing better. In addition, the analysis revealed significant interactions between body height and body mass on performance in 6 min run and 20 m sprint, with higher body mass being associated with performance improvements in larger children, while higher body mass was associated with performance declines in smaller children. In addition, the analysis revealed overall age-related improvements in physical fitness and was able to show that children with better overall physical fitness also elicit greater age-related improvements. (3) In the analysis of moderating effects of age and maturity offset on physical fitness performances, two unrotated principal components of z-transformed age and maturity offset values were calculated (i.e., relative growth = (age + maturity offset)/2; growth delay = (age - maturity offset)) to avoid colinearity. Analysing these constructs revealed positive effects of relative growth on performances in star run, 20 m sprint, and standing long jump, with children of higher relative growth performing better. For growth delay, positive effects were found on performances in 6 min run and 20 m sprint, with children having larger growth delays showing better performances. Further, the model revealed gendered differences in 6 min run and 20 m sprint performances with girls performing better than boys. (4) Analysing the effects of physical fitness tests on executive function revealed a positive effect of star run and one leg balance performance and a negative effect of 6 min run performance on reaction speed in the Simon task. However, these effects were not detectable when individual differences were accounted for. Then these effects showed overall positive effects, with better performances being associated with faster reaction speeds. In addition, the analysis revealed a positive correlation between overall reaction speed and effects of the 6 min run, suggesting that children with greater effects of 6 min run had faster overall reaction speeds. Negative correlations were found between star run effects and age effects on Simon task reaction speed, meaning that children with larger star run effects had smaller age effects, and between 6 min run effects and star run effects on Simon task reaction speed, meaning that children with larger 6 min run effects tended to have smaller star run effects on Simon task reaction speed and vice versa.
Conclusions: (1) The lack of detectable intervention-related effects could have been caused by an insufficient intervention period, by the implementation of comprehensive and thus non- specific exercises, or by both. Accordingly, longer intervention periods and/or more specific exercises may have been more beneficial and could have led to detectable improvements in physical fitness and/or executive function. However, it remains unclear whether these interventions can benefit children with deficits in physical fitness, as it is possible that their deficits are not caused by a mere lack of exercise, but rather depend on the socioeconomic conditions of the children and their families and areas. Therefore, further research is needed to assess the moderation of physical fitness in children with physical fitness deficits and, in particular, the links between children’s environment and their physical fitness trajectories. (2) Findings from this work suggest that using BMI as a composite of body height and body mass may not be able to capture the variation associated with these parameters and their interactions. In particular, because of their multidirectional associations, further research would help elucidate how BMI and its subcomponents influence physical fitness and how they vary between children with and without physical fitness deficits. (3) The assessment of growth- related changes indicated negative effects associated with the growth spurt approaching age of peak height velocity, and furthermore showed significant differences in these effects between children. Thus, these effects and possible interindividual differences should be considered in the assessment of the development of physical fitness in children. (4) Furthermore, this work has shown that the associations between physical fitness and executive functions vary between children and may be moderated by children’s socioeconomic conditions and the structure of their daily activities. Further research is needed to explore these associations using approaches that account for individual variance.
Bullying ist eine Form wiederholten, aggressiven Verhaltens mit ernstzunehmenden Auswirkungen, unter denen Täter und Opfer häufig lange nach Ende des Bullying-Geschehens leiden. Dennoch ist die Therapie von Bullying und den damit einhergehenden Folgen ein bisher in der Forschung vernachlässigtes Thema. Im Rahmen eines systematischen Literaturüberblicks wurde daher untersucht, welche Therapieformen zur Behandlung von Bullying und dessen Folgen bei Opfern und bei Tätern bereits angewendet wurden. Eine systematische Suche in nationalen und internationalen Datenbanken führte zu 31 relevanten Publikationen, in denen 34 therapeutische Interventionen aus über 14 Ländern beschrieben wurden. In zehn Therapiestudien mit kontrolliertem Design zeigte sich, dass Behandlungsangebote, die sich sowohl an die betroffenen Personen als auch an ihr soziales Umfeld richten, besonders effektiv in der Behandlung von Bullying-Folgen sind. Die restlichen 24 Behandlungsansätze wurden keiner kontrollierten Evaluation unterzogen. Insgesamt zwei Drittel aller therapeutischen Interventionen wenden sich an die Gruppe der Opfer. Hier wird im Unterschied zur Behandlung von Tätern verstärkt auf Gruppentherapien zurückgegriffen. Unter der Bandbreite an Ansätzen ist die kognitive Verhaltenstherapie am häufigsten vertreten. Festzustellen bleibt ein Forschungsmangel an evidenzbasierten, gezielten Interventionen zur Behandlung von Bullying und dessen Folgen bei Opfern und Tätern. Unseres Wissens stellt diese Arbeit den ersten systematischen Überblick zu therapeutischen Interventionen bei Bullying für Kinder und Jugendliche dar.
Mobbing an Schulen
(2016)
Das Buch beginnt mit einem ausführlichen Einblick in die Mobbing-Forschung, u. a. zu Merkmalen und Erscheinungsformen von Mobbing. Darüber hinaus werden Ursachen und Folgen von Mobbing, aber auch neue Formen wie das Cyber-Mobbing thematisiert. Im weiteren Verlauf stehen dann das Eingreifen bei und Vorbeugen von Mobbing im Mittelpunkt. Dabei werden etablierte Interventions- und Präventionsprogramme verständlich präsentiert, konkrete Empfehlungen gegeben, wie man in Mobbing-Situationen handeln kann, und Gelingensbedingungen beschrieben, wie es gar nicht erst zu Mobbing kommt. Gespickt mit vielen Fallbeispielen und einer ausführlichen Materialsammlung zum Download wird die Darstellung anschaulich und der praktische Transfer des präsentierten Wissens erleichtert.
Aufgrund verschiedener wissenschaftlicher Erkenntnisse wird jungen Sporttreibenden vom Gebrauch von Nahrungsergänzungsmitteln (NEM) abgeraten. Diese Dissertation verfolgt vor dem Hintergrund der Theorie der Zielsysteme (TDZ) das Ziel der Erstellung anwendungsorientieren Handlungswissens, anhand dessen Interventionsempfehlungen zur Reduzierung des prävalenten NEM-Konsums im Nachwuchssport ableitbar sind. Insgesamt wurden sechs Untersuchungen durchgeführt. Die Versuchsteilnehmenden absolvierten in sämtlichen Studien eine Variante der lexikalischen Entscheidungsaufgabe. Diese Aufgabe diente der Operationalisierung von automatisch aktivier- und abrufbaren nahrungsergänzungsmittelbezogenen Ziel-Mittel-Relationen.
In einer Stichprobe von Sportstudierenden zeigte sich, dass NEM mit dem Ziel Leistung assoziiert sind (Studie 1). Unter Berücksichtigung des NEM-Konsums wurde dieses Ergebnis für Nachwuchsathletinnen und -athleten aus dem Breitensport repliziert (Studie 2). Zusätzlich konnte in beiden Studien die Bedeutung dieser Ziel-Mittel-Relationen für das Verhalten nachgewiesen werden. In den nachfolgenden Untersuchungen wurden spezifische Veränderungsmechanismen der verhaltensleitenden Ziel-Mittel-Relation aus Leistung und NEM zunächst an Sportstudierenden experimentell evaluiert. Durch das Herausstellen der fehlenden leistungssteigernden Wirkung von NEM konnte diese Zielassoziation nicht modifiziert werden (Studie 3). Das Betonen gesundheitsschädigender Konsequenzen (Studie 4) und das Akzentuieren einer gesunden Ernährung (Studie 5) erwiesen sich demgegenüber als geeignet zur Veränderung der Ziel-Mittel-Relation. Das Herausstellen einer gesunden Ernährung führte deskriptiv bei Nachwuchsathletinnen und -athleten ebenfalls zur Modifikation der Zielassoziation (Studie 6). Die inferenzstatistische Bestätigung der Ergebnisse dieser Studie steht aufgrund der geringen Teststärke der Untersuchung noch aus.
Insgesamt verdeutlichen die Ergebnisse, dass die auf Ebene automatischer Kognitionen bestehende und verhaltensleitende Assoziation des Gebrauchs von NEM mit Leistung durch die Akzentuierung gesundheitlicher Perspektiven experimentell verändert werden kann. Abschließend wird die theoretische und praktische Bedeutung des erstellten Handlungswissen für künftige Interventionsempfehlungen zur Reduzierung des Gebrauchs von NEM diskutiert.