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Aribert Rothenberger

Publications and source records attributed to Aribert Rothenberger.

52 records · Page 3Linked to original sources
PubMed2004

Normative data and scale properties of the German parent SDQ.

BACKGROUND AND OBJECTIVES: The Strengths and Difficulties Questionnaire (SDQ) is a short assessment instrument which addresses positive and negative behavioural attributes of children and adolescents and generates scores for clinically relevant aspects. Although this brief questionnaire has been widely used in Germany to gather information from parents, teachers, and older children themselves, normative results obtained with the German version have not yet been reported to the international scientific community. To allow comparisons with SDQ findings in other countries, normative data for the German parent-rated form as well as a community-based evaluation of scale properties are summarised and complemented by results obtained in a number of clinical samples. METHODS: Parent ratings were collected for a community-based sample of 930 children and adolescents aged between 6 and 16 years, in which both genders and all age levels were equally represented. Statistical evaluation of psychometric properties included a factor analysis verifying the proposed scale structure, assessment of scale homogeneities, and determination of age, gender and social class effects. Based on the distributions of SDQ scores observed in this normative sample, recommended bandings identifying normal, borderline, and clinical ranges were defined for each scale. RESULTS: Exact replication of the original scale structure, satisfactory internal reliabilities, and observation of the expected associations with age and gender confirmed the equivalence of the German SDQ parent questionnaire with the English original. Differences between community-based results and clinical groups provided descriptive evidence of a dramatic impact of clinically defined psychiatric status on SDQ scores. CONCLUSIONS: After evaluating parent ratings obtained in a community-based sample, the German SDQ was shown to possess favourable psychometric properties. Thus, the German translation of this popular and versatile instrument seems to be a similarly reliable and useful assessment tool as the original English questionnaire.

Adolescent↗
PubMed2004

Validation of the parent and teacher SDQ in a clinical sample.

OBJECTIVES: This study examines whether the German translation of the Strengths and Difficulties Questionnaire (SDQ) is a reliable and valid screening instrument and whether it is as effective a tool for clinical diagnostics and scientific applications as the CBCL/TRF. METHODS: We examined 543 children and adolescents (147 girls and 396 boys) with ages ranging from 5 to 17 years and correlated the results of the parent and teacher SDQ as well as the CBCL/TRF with clinical diagnoses. Furthermore, the adequacy of the scale structure of the SDQ was tested using confirmatory and exploratory factor analyses. RESULTS: It was demonstrated that the scales of the parent and teacher versions were sufficiently homogeneous (0.72-0.83). Correlations between SDQ scales and corresponding CBCL/TRF scales showed a high degree of congruence, while an exact replication of the original SDQ scale structure could also be achieved. Parent and teacher versions of both questionnaires presented with good validity, not only with regard to the discrimination between child psychiatric patients and a representative community sample, but also in the identification of different categories of disorders within the clinical sample. CONCLUSION: The parent and teacher SDQs proved to be valid and helpful questionnaires for use in the framework of a multi-dimensional behavioural assessment, and appear to be well suited for screening purposes, longitudinal monitoring of therapeutic effects, and scientific research purposes.

Adolescent↗
PubMed2004

Evaluation of the self-reported SDQ in a clinical setting: do self-reports tell us more than ratings by adult informants?

OBJECTIVES: The aim of this study was to evaluate the German self-reported Strengths and Difficulties Questionnaire (SDQ) in a clinical setting. We also investigated whether this additional information gathered directly from older children and adolescents improves the prediction of clinical status when external ratings from their parents and/or teachers are already available. METHODS: SDQ self-reports were collected from 214 in- and outpatients (81 girls and 133 boys) aged 11 to 17 years who were seen at the department of child and adolescent psychiatry of the University of Göttingen. Results obtained with the self-rated questionnaire were compared with the parent and teacher SDQs, corresponding CBCL/YSR scores, and the clinical diagnostic classification. Finally, the additional diagnostic benefits of the self-reports were examined. RESULTS: The scales of the SDQ self-report proved to be sufficiently homogeneous, and acceptable correlations were found with the equivalent parent and teacher ratings. The self-rated version of the SDQ demonstrated good validity with respect to the differentiation between clinically defined cases and non-cases and in detecting various subcategories of psychiatric disorders within the clinic sample. SDQ self-reports significantly contributed to the prediction of diagnostic status, specifically if only parent or teacher ratings were available. CONCLUSIONS: The self-rated version of the SDQ was shown to be a reliable and valid method for the assessment of behavioural problems in children and adolescents. In the absence of adult informant reports from parents and teachers, the diagnostic value of self-ratings was also demonstrated.

Adolescent↗
PubMed2004

[Does a morning dose of Methylphenidate Retard reduce hyperkinetic symptoms in the afternoon?].

OBJECTIVES: In order to treat children with Attention-deficit/Hyperactivity Disorder (ADHD) with a once-a-day stimulant several galenic approaches have been tried. The long acting methylphenidate (MPH, Medikinet-Retard) is a preparation with a two-step dynamic to release MPH (step one: acute; step two: prolonged). The efficacy of Medikinet-Retard, a new long-acting methylphenidate preparation, is analyzed based on the assessment of parents in the afternoon. METHODS: In a multicenter drug treatment study (placebo controlled, randomized, double-blind) 85 children (normal intelligence, age 6 to 16 years, diagnosis of ADHD according to DSM-IV) were investigated over 4 weeks with weekly visits. Forty-three children received Medikinet-Retard and forty-two children placebo. The weekly dose titration depending on body weight and symptomatology allowed a final maximum of 60 mg. The effects on ADHD as perveived by the parents were assessed weekly with a German symptom checklist for ADHD according to DSM-IV and ICD-10 (FBB-HKS). The differences between baseline and last week of treatment were compared statistically between groups. RESULTS: There was a large and statistically significant positive drug effect on ADHD symptomatology. The effect size of these differences was d = 1.2 (total score). Effects were found on inattention, hyperactivity and impulsity on the respective subscales. The efficacy of Medikinet-Retard was evaluated by the parents on an average as good. The rate of responders was four-times higher in the verum-group. The correlations of the changed scores in the parent ratings with the respective change scores in the teacher ratings were in the medium range. CONCLUSION: This is the first study with a German long-acting methylphenidate preparation (Medikinet-Retard). According to data based on parents' assessments, the drug showed very good clinical efficacy and safety in children with ADHD. Its two step galenic release of methylphenidate seems to be appropriate for a once-a-day (morning) stimulant in schoolchildren.

Adolescent↗
PubMed2004

[Therapy of tic-disorders].

BACKGROUND: Within the last decade therapeutic approaches to tic disorders are reflected in many new studies. The advent of novel neuroleptics and the more sophisticated behavioural therapeutic techniques may give new hope to children and adolescents with tic disorders. OBJECTIVE: Hence, the progress in the field should be explored to find out the state of the art. METHOD: A critical review of the empirically based literature and practical experience. RESULTS: Worldwide, drug treatment with clonidine and (from the group of novel antipsychotics) risperidone show the broadest empirical basis while in Europe benzamides have a good empirical clinical background. Behaviour therapy presents more and more helpful empirical data. CONCLUSIONS: Risperidone may become the first-line drug in treatment of tic disorders and behaviour therapy might be increasingly used within a multimodal treatment program.

Antipsychotic Agents↗
PubMed2004

Early administration of tiapride to young rats without long-lasting changes in the development of the dopaminergic system.

BACKGROUND: The benzamide tiapride, a selective dopamine D2/D3-receptor antagonist, can be used effectively in children to treat tic disorders and stuttering. Tiapride is a clinically safe substance (even during long-term treatment and when given to young children). Unfortunately, its probable effects on general brain development and the maturation of the dopaminergic system have not been investigated. Thus, important information for drug treatment in children is missing. Therefore, this study in rats describes tiapride's effects on several parameters of dopaminergic activity (dopamine transporter, D2 receptor, dopamine, DOPAC, and homovanillic acid in the striatum) seen after tiapride administration (30 mg/kg/day) to prepubertal (from day 25-39) and postpubertal (from day 50-64) rats. METHODS: Three groups of rats (n = 6) received tiapride within their drinking water for 14 days. Two groups were treated before puberty; one of those was killed at day 50, the other at day 90. The group treated after puberty was measured at day 90. A fourth group (n = 6) was treated from day 50 to day 53 and measured under tiapride at day 53. Changes were measured by ligand-binding assays (KD and Bmax values of dopamine transporter by [3H]-GBR binding and D2 receptor by [3H]- spiperone binding) and by HPLC (concentrations of dopamine, DOPAC, and homovanillic acid). RESULTS: The density of dopamine transporters and D2 receptors remained unaffected after early (day 25) and late (day 50) tiapride administration. Only during the treatment period could a significant reduction of D2-receptor binding (displacement of spiperone) and of dopamine and DOPAC levels be stated. CONCLUSIONS: These data suggest that tiapride treatment during postnatal brain development causes no long-lasting changes in the development of the central dopaminergic system and is in line with clinical experience in children.

3,4-Dihydroxyphenylacetic Acid↗
PubMed2004

Is there a specific polysomnographic sleep pattern in children with attention deficit/hyperactivity disorder?

The aim of the study was to characterize the sleep pattern in children with attention deficit/hyperactivity disorder (ADHD). By means of polysomnography (PSG), sleep patterns were studied in 17 unmedicated preadolescent boys rigorously diagnosed with ADHD and 17 control boys precisely matched for age and intelligence. Although ADHD children did not display a general sleep alteration, major PSG data showed a significant increase in the duration of the absolute rapid eye movement (REM) sleep and the number of sleep cycles in ADHD group when compared with controls. In addition, REM sleep latency tended to be shorter in ADHD children. These results suggest that in ADHD children, a forced REM sleep initiation may produce a higher incidence of sleep cycles and may also contribute to an increased duration of the absolute REM sleep. The overall pattern of the findings implies that a forced ultradian cycling appears characteristic for the sleep in ADHD children, which may be related to alterations of brain monoamines and cortical inhibitory control accompanying the ADHD psychopathology.

Activity Cycles↗
PubMed2003

Disturbed sleep in children with Tourette syndrome: a polysomnographic study.

OBJECTIVE: To evaluate objective data on sleep quantity/quality and motor activity during night sleep in children with Tourette syndrome (TS). METHOD: Polysomnography of 17 unmedicated TS children (ages: 7;11-15;5, mean: 11;10 years) without comorbid attention-deficit hyperactivity disorder (ADHD) was compared with 16 age-, sex- and IQ-matched healthy controls. Sleep analyses according to the procedure of Rechtschaffen and Kales were supplemented by counting epochs with short arousal-related movements (<or=15 s), thus allowing to calculate correlations between motor activity and sleep parameters. RESULTS: Children with TS demonstrated changes in sleep parameters, including longer sleep period time, longer sleep latency, reduced sleep efficiency, and prolonged wakefulness after sleep onset. Their sleep profiles showed significantly more time awake and less sleep stage II. However, REM sleep variables, slow-wave sleep, and number of sleep stage changes were unaffected. Movement time was similar in both groups, but epochs with short arousal-related movements were increased in TS. Further analyses showed no significant correlations between sleep parameters and nighttime nontic movements, level of psychopathology or tic severity during daytime. Periodic limb movements during sleep (PLMS) were only seen in one TS patient (low PLMS index of 7.8/h). CONCLUSIONS: Children with TS have disturbed sleep quality with increased arousal phenomena, which both may be intrinsic to the disorder and might trigger tics and other behavioral problems during daytime. This indicates the need for sleep evaluation in patients with TS.

Adolescent↗
PubMed2003

Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental aspects in children and adolescents.

Although premonitory sensory phenomena (PSP) and suppressibility of tics (SPT) are important in Tourette syndrome not only when behavioural therapeutic approaches in children are considered, there is a lack of developmental information on these phenomena. Therefore, a cross-sectional survey of these factors in children and adolescents was carried out. Rates of PSP and SPT were gathered using a questionnaire for the assessment of Tourette syndrome. The 254 outpatients (212 males, 42 females) with Tourette syndrome investigated had an age range of 8 to 19 years, normal intelligence, and diagnosis according to DSM-IV-TR/ICD-10. To test for developmental effects, the total group was stratified into three age groups (8 to 10, 11 to 14, and 15 to 19 years). Data were statistically evaluated using chi2 tests. Of the 254 participants, 37% reported PSP, while 64% were able to suppress their tics. Only a subgroup of 119 patients gave unequivocal answers to both questions and only 60% of these experienced both PSP and SPT. Statistically significant stepwise increases were found at two different age levels. One was around 10 years (PSP 'Yes' or 'No' and SPT), the other around age 14 (PSP 'Yes'). There was no influence of tic duration and age at tic onset on PSP/SPT. The reported data suggest that PSP is experienced rarely in younger children with Tourette syndrome and is not a necessary prerequisite for SPT. Increasing PSP with age merely seems to reflect cognitive development rather than intrinsic aspects of Tourette syndrome. In children under 10 years of age, SPT might require more awareness of tics than in older age groups. Developmental aspects of PSP and SPT should be taken into consideration when studies of cognitive behavioural treatment for children and adolescents with Tourette syndrome are planned.

Adolescent↗
PubMed2003

Association of ADHD and conduct disorder--brain electrical evidence for the existence of a distinct subtype.

BACKGROUND: To evaluate the impact of psychopathological comorbidity with oppositional defiant/conduct disorder (ODD/CD) on brain electrical correlates in children with attention deficit hyperactivity disorder (ADHD) and to study the pathophysiological background of comorbidity of ADHD+ODD/CD. METHOD: Event-related potentials (ERPs) were recorded during a cued continuous performance test (CPT-A-X) in children (aged 8 to 14 years) with ICD-10 diagnoses of either hyperkinetic disorder (HD; n = 15), hyperkinetic conduct disorder (HCD; n = 16), or ODD/CD (n = 15) and normal children (n = 18). HD/HCD diagnoses in all children were fully concordant with the DSM-IV diagnosis of ADHD-combined type. ERP-microstates, i.e., time segments with stable brain electrical map topography were identified by adaptive segmentation. Their characteristic parameters and behavioral measures were further analyzed. RESULTS: Children with HD but not comorbid children showed slower and more variable reaction times compared to control children. Children with HD and ODD/CD-only but not comorbid children displayed reduced P3a amplitudes to cues and certain distractors (distractor-X) linked to attentional orienting. Correspondingly, global field power of the cue-CNV microstate related to anticipation and preparation was reduced in HD but not in HCD. Topographical alterations of the HD occurred already in the cue-P2/N2 microstate. In sum, the comorbid group was less deviant than both the HD-group and the ODD/CD-group. CONCLUSIONS: The findings suggest that HD children (ADHD-combined type without ODD/CD) suffer from a more general deficit (e.g., suboptimal energetical state regulation) including deficits of attentional orienting and response preparation than just a responseinhibitory deficit, backing the hypothesis of an involvement of a dysregulation of the central noradrenergic networks. The results contradict the hypothesis that ADHD+ODD/CD represents an additive co-occurrence of ADHD and ODD/CD and strongly suggest that it represents a separate pathological entity as considered in the ICD-10 classification system, which differs from both HD and ODD/CD-only.

Adolescent↗
PubMed2003

[German version of the Strength and Difficulties Questionnaire (SDQ-German)--overview and evaluation of initial validation and normative results].

The Strengths and Difficulties Questionnaire (SDQ) is a short behavioural screening questionnaire which can be completed in about five minutes by parents and teachers of 4- to 16-year-olds or as self-report by 11- to 16-year-olds. The English original has already been fully evaluated and is widely used in research and clinical practice. The instrument was translated into German in 1997, and several evaluative studies have since been completed. The present paper gives an overview of this novel instrument and summarizes the normative and validation studies to date. A normative study on a field sample of 930 children demonstrated that the distributions of raw scores in the German parent SDQ closely resemble those found in the English version, while a factor analysis of the German data yielded a pattern of loadings which convincingly replicated the original scale structure. Initial validation studies showed that the parent-, teacher-, and self-completed SDQ-Deu correlates well with the considerably longer German versions of the Child Behavior Checklist (CBCL) and respective teacher and self-report derivatives (TRF, YSR). Both parent-rated instruments are equally able to distinguish between a community and a clinic sample, and between subgroups with and without specified categories of disorders within a clinic sample. After discussing possible uses of the SDQ-Deu as well as similarities and differences to other scales, we conclude that the German SDQ is just as useful and valid an instrument for many clinical and research purposes as the English original.

Adolescent↗
PubMed2003

[Indications for sleep laboratory studies in psychiatrically symptomatic children and adolescents].

Many mental and behavioural disorders during childhood and adolescence are associated with sleep difficulties. A polysomnography is seldom needed but indicated in following cases: In a general view when there is suspected obstructive sleep apnea syndrome (OSAS), excessive daytime sleepiness or suspected nocturnal seizures. Specific mental disorders with indication of polysomnography are: Diagnostic unclear and dangerous parasomnias, emotional disorders in case of differing sleep perception, Attention-deficit Hyperactivity Disorder (ADHD) and Tourette Syndrome with suspected (additional) OSAS, Restless Legs Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD). Further indications are -therapy-resistant insomnia and sleep-wake-rhythm-disorders.

Adolescent↗
PubMed2002

Developmental event-related gamma oscillations: effects of auditory attention.

This study describes maturational changes in topographical patterns, stability, and functional reactivity of auditory gamma band (31-63 Hz) responses (GBRs) as brain electrical correlates relevant for cognitive development during childhood. GBRs of 114 healthy children from 9 to 16 years were elicited in an auditory focused attention task requiring motor responding to targets, and analyzed by means of the wavelet transform (WT). The effects of age and task variables (attended side and stimulus type relevance) were examined for GBR power and phase-locking within 120 ms after stimulation. Similar to the spontaneous gamma band power, the power and phase-synchronization of GBRs did not depend on the age. However, the functional reactivity of GBRs at specific locations changed in the course of development. In 9-12-year-old children, GBRs at frontal locations were larger and better synchronized to target than to nontarget stimulus type, and were larger over the left hemisphere (contralateral to the responding hand), thus manifesting sensitivity to external stimulus features and motor task. In 13-16-year-old adolescents, GBRs at parietal sites were enhanced by active attending to the side of stimulation, thus being associated with a maintenance of attentional focus to stimulus location. The results indicate that (i) specific aspects of task-stimulus processing engage distinct spatially localized gamma networks at functionally relevant areas, and (ii) the neuronal substrates of gamma band networks and the ability to synchronize them in relation to task-specific processes are available in all age groups from 9 to 16 years. However, the mode and efficiency with which gamma networks can be entrained depends on the age. This age-dependent reactivity of GBRs to different task variables may reflect a transition in processing strategies emerging at approximately 12-13 years in relation to the maturation of cognitive and executive brain functions.

Acoustic Stimulation↗
PubMed2002

Multicenter P300 brain mapping of impaired attention to cues in hyperkinetic children.

OBJECTIVE: To measure specific neurophysiological attention deficits in children with hyperkinetic disorders (HD; the ICD-10 diagnosis for severe and pervasive attention-deficit/hyperactivity disorder [ADHD]). METHOD: In a multicenter sample of 148 children with HD and control children aged 8 to 14 years, event-related potential maps were recorded during a cued continuous performance test (A-X/O-X). Maps to cues (requiring attention but no response) and distractors and performance were tested for differences between age- and sex-matched HD and control groups (n = 57 each), as well as between clinics (n = 5). RESULTS: The N1, P3a, and P3b maps revealed reliable attention effects, with larger amplitudes after cues than after distractors, and only minor differences across clinics. Children with HD missed more targets, made more false alarms, and had larger N1 followed by smaller P3b amplitudes after cues than did controls. Cue-P3b amplitude correlated with detecting subsequent targets. Cue-P3b tomography indicated posterior sources that were attenuated in children with HD. CONCLUSIONS: Brain mapping indicates that children with HD attend to cues (preceding potential targets) with increased initial orienting (N1) followed by insufficient resource allocation (P3b). These multiple, condition-specific attention deficits in HD within 300 msec extend previous results on ADHD and underline the importance of high temporal resolution in mapping severe attention deficits.

Adolescent↗