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Grow & Treat
About Grow&Treat
Childhood maltreatment is associated with a range of emotional and behavioral problems during childhood and is a risk factor for different mental health problems, which may persist into adulthood. Maltreated children show significantly more externalizing and internalizing symptoms, more discipline problems in school and more symptoms of depression than children without maltreatment experiences. They are often more aggressive against peers, have fewer social skills and are more likely to be socially withdrawn. Moreover, longitudinal studies point to the fact that these symptoms are often persistent across long periods of time. Among the most far-reaching effects of trauma and neglect is the loss of the ability to regulate the intensity of feelings and impulses. The inability to modulate emotions might underlie a range of behaviors such as aggression against others or self-destructive behavior and might interfere with flexible response strategies during the child’s development. Emotional dysregulation might also extend to other social contexts, including peers and difficulties in establishing and maintaining positive peer relationships.
GROW - part
The overall aim of the longitudinal study was to analyze the development of children with preceding experiences of maltreatment placed in foster families and to compare it with children without maltreatment experiences. Therefore the longitudinal part compared the development of children in foster families, receiving different levels of support (see TREAT-part), with children without maltreatment experiences living in their original families.
The sample was traced across an interval of about 12 months. The intervals between pre and post assessment resp. between the post and follow-up assessment were about six months. The initial interval included the intervention phase for the foster care children (for details see TREAT-part).
The main assumptions regarding the longitudinal GROW-Part were (1) that there are large differences at the baseline assessments between children living in foster families in comparison to children without maltreatment experiences living in their family of origin. During the stay in a foster family (2) the differences between the foster care group and the comparison group will be reduced (even more for the group with additional intervention)
Intervention Aims
Usual Care Condition
The parent-focused intervention was only offered to half of the foster families. Because foster children usually receive a number of services from the child welfare system on a routine basis, Usual Care was selected as a control condition. The government has the responsibility to protect children from further harm and therefore the Usual Care condition included all services deemed necessary by the government to follow their responsibility. As a result, the same services were also available to the intervention group. We were interested in evaluating the additional benefit of the intervention to Usual Care in foster families.
Usual Care + foster-parent-based intervention (Taking Care Triple P)
Subsamples of the families participating in the longitudinal study were allocated (by randomization) to an intervention focusing on their primary caregiver, in this case the foster parents. The Taking Care intervention is a prototype (newly designed but not yet fully tested) intervention which – if successful – would become part of the comprehensive parenting support system (Triple P) that promotes positive, caring, and consistent parenting practices, which have been shown to modify risks, and reduce the incidence of maltreatment (Prinz et al., 2009). The intervention has been adapted and tailored to the needs of foster parents by using consumer input in Australia (e. g., from foster parents and agencies, using focus groups) and research evidence.
References
Chandler, C. L. & Sanders, M. R. (2013).Taking Care Triple P - Positive Parenting Program for out-of-home care providers workbook for use with children up to 12 years old (1st Ed.). University of Queensland, Brisbane, Australia.
Chandler, C. L. & Sheffield, J. (2013, February). Does Triple P work with foster carers? Taking Care Triple P: Program design and review of feasibility trial. Poster presented at the Helping Families Change Conference hfcc, Los Angeles, USA.
Prinz, R. J., Sanders, M. R., Shapiro, C. J. et al. (2009). Population-based prevention of child maltreatment: The US Triple P system population trial. Prevention Science, 10, 1-12.
Neurobiological and neurocognitive measures
In addition to psychological variables, neurobiological and immunological indicators were assessed to explore potential associations between psychological and neurobiological or neurocognitive parameters in children with and without maltreatment experiences. This data category was assessed at baseline within the GROW-part. Additionally, some measures were re-assessed once or twice within the TREAT-part (post-intervention and/or follow-up).
Sleep: Questionnaire and actigraphy data
Parents were asked to answer the Children's Sleep Habits Questionnaire (CSHQ; German validation by Schlarb, Schwerdtle, & Hautzinger, 2010). The CSHQ yields a total score and eight subscale scores reflecting key sleep domains such as sleep duration, anxiety around sleep, behavior occurring during sleep and night wakings. In addition, actigraphy data of the child were collected on three consecutive nights.
Neurocognition: Emotional Go/Nogo Task
We used a slightly modified version of the Emotional Go/Nogo paradigm as previously described by Tottenham et al. (2011). The task was applied to all children aged 6 years and older in order to assess the associations between emotion discrimination, emotional regulation, cognitive control, neurobiological and psychopathological parameters as well as to evaluate the effects of the intervention. In addition, the same task was applied at baseline to all parents.
Neurobiology: HPA axis function parameters
Children's as well as parent's hair cortisol levels were assessed as a measure of chronic stress during the last 3 months (Stalder & Kirschbaum, 2012).
Immunology:
In order to define immunological parameters, which might be related to stress responses of foster children, secretory immunoglobulin A (sIgA) in the child's saliva was examined as a potential marker of chronic, long-term stress (Tanaka & Naruishi, 2013). In addition, the child's number of infections was assessed via interviews with the parent.
A description of all measures used is listed here
(Liste der eingesetzten Instrumente)
Instrument / Name | Thema / Topic | Beurteiler / Source | Literatur / Literature | Eingesetzt im Teilprojekt / Used in Subproject |
Adverse Events | Erfassung des Auftretens unerwünschter Ereignisse / Recording of adverse events | Selbst- und Fremdbericht (Eltern) / Self and parent report | Entwicklung im Rahmen der GROW&TREAT-Pflegefamilienstudie | Längsschnitt- und Interventionsstudie / Longitudinal and intervention study |
Big Five Inventory - Short Form (BFI-S) | Persönlichkeit / Personality | Selbstbericht / Self report | Gerlitz, J. Y., & Schupp, J. (2005). Zur Erhebung der Big-Five-basierten Persoenlichkeitsmerkmale im SOEP. DIW Research Notes, 4, 2005. | Längsschnittstudie / Longitudinal study |
Child Behaviour Checklist (CBCL) 1,5-5 | Verschiedene Bereiche zu internalisierenden und externalisierenden Verhaltensweisen bei Kindern / Internalising and externalising behaviour problems in children | Fremdbericht (Eltern) / Parent report | Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA Preschool Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families. | Längsschnittstudie / Longitudinal study |
Child Behaviour Checklist (CBCL) 4 - 18 | Verschiedene Bereiche zu internalisierenden und externalisierenden Verhaltensweisen bei Kindern / Internalising and externalising behaviour in children | Fremdbericht (Eltern) / Parent report | Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA Preschool Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families. | Längsschnittstudie / Longitudinal study |
Checkliste / Checklist | Erlebte Misshandlungsformen / Experienced forms of maltreatment | Fremdbericht (Jugendamt) / External report (Youth Welfare Office) | Entwicklung im Rahmen der GROW&TREAT-Pflegefamilienstudie | Längsschnittstudie und Moderator in der Interventionsstudie (kein Outcomemaß) / Longitudinal study and moderator in the intervention study (no outcome measure) |
Checkliste kindliche Beziehungsgesaltung (CkB) / Checklist for childlike relationship formation (CkB) | Negative kindliche Beziehungsgestaltung / Negative child relationship behaviour | Fremdbericht (Eltern) / Parent report | Briegel, W. (2013). Checkliste kindliche Beziehungsgestaltung (CkB). Unveröffentlicht, Leopoldina Krankenhaus | Interventionsstudie / Intervention study |
Children's Sleep Habits Questionnaire (CSHQ) | Screening Instrument zur Erkennung von Schlafstörungen im Kindesalter / Screening instrument for the detection of sleep disorders in childhood | Fremdbericht (Eltern) / Parent report | Owens, J. A., Spirito, A., & McGuinn, M. (2000). The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1043-1052. | Neurobiologische Studie / Neurobiological study |
Conflict Tactics Scale Parent-to-Child (CTS-PC) | Erfassung des Ausmaßes verschiedener Arten körperlicher und verbaler Aggression von Eltern gegenüber ihrem Kind / Measuring the extent of different types of physical and verbal aggression by parents towards their child | Selbstbericht (Eltern) / Self report (parents) | Straus, M. A., Hamby, S. L., Finkelhor, D., Moore, D. W. & Runyan, D. (1998). Identification of child maltreatment with the Parent-Child Conflict Tactics Scales: development and psychometric data for a national sample of American parents. Child Abuse & Neglect, 22, 249-270. | Längsschnittstudie / Longitudinal study |
Couple Satisfaction Index (CSI-32) | Partnerschaftszufriedenheit / Couple Satisfaction | Selbstbericht / Self report | Funk, J.L. & Rogge, R.D. (2007). Testing the Ruler With Items Response Theory: Increasing Precision of Measurement for Relationship Satisfaction With the Couples Satisfaction Index. Journal of Family Psychology, 21 (4), 572-583. | Längsschnittstudie / Longitudinal study |
Der Erziehungsfragebogen (EFB) / The Education Questionnaire | Elterliche Verhaltenstendenzen in schwierigen Erziehungssituationen, dysfunktionales Erziehungsverhalten / Parental behaviour tendencies in difficult parenting situations, dysfunctional parenting | Selbstbericht (Eltern) / Self report (parents) | Englische Originalversion: Arnold, D. S., O'Leary, S. G., Wolff, L. S. & Acker, M. M. (1993). The Parenting Scale: A measure of dysfunctional parenting in discipline situations. Psycho-logical Assessment, 5, 137-144. | Interventionsstudie / Intervention study |
Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder DIPS) / Diagnostic interview for mental disorders in childhood and adolescence (Children DIPS) | DSM IV/ICD-10 Diagnosen / DSM IV/ICD-10 Diagnosis | Fremdbericht (Eltern) / Parent report | Unnewehr, Adornetto, Suppiger, Margraf & Schneider, (2009). Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS) (2. akt. u. erw. Aufl.). Heidelberg: Springer. | Interventionsstudie / Intervention study |
Dyadic Parent Child Interaction Coding System (DPICS), 4th ed. | Eltern-Kind-Interaktion / Parent-child interaction | Standardisierte Verhaltensbeobachtung (Eltern und Kind) / Standardized behaviour observation (parents and child) | Eyberg, S.M., Nelson, M.,M., Ginn, N.C., Bhuiyan, N., & Boggs, S.R. (2013). Dyadic Parent-Child Interaction Coding System: Comprehensive Manual for Research and Training (4th ed.). Gainesville, FL: PCIT International. | Interventionsstudie / Intervention study |
Elternstressfragebogen (ESF) / Parental stress questionnaire (ESF) | Elternstress / Parental stress | Selbstbericht / Self report (parents) | Domsch, H., & Lohaus, A. (2010). Elternstressfragebogen. Göttingen: Hogrefe. | Längsschnittstudie / Longitudinal study |
Ergänzungsfragebogen zum Kinder DIPS (ACC) / Supplementary Questionnaire for Children DIPS (ACC) | Kindliche Verhaltensprobleme / Childhood behavioural problems | Fremdbericht (Eltern) / Parent report | Entwicklung im Rahmen der GROW&TREAT-Pflegefamilienstudie | Längsschnittstudie / Longitudinal study |
Erziehungszielfragebogen (EZZF) / Educational goals questionnaire | Erziehungsziele / Educational goals | Selbstbericht (Eltern) / Self report (parents) | 1993; Erziehungsziele von Eltern hochbegabter Kinder. In D.H. Rost (Hrsg.), Lebensumweltanalyse hochbegabter Kinder. Das Marburger Hochbegabtenprojekt (S. 75- 104). Göttingen: Hogrefe. | Längsschnittstudie / Longitudinal study |
Eyberg Elternfragebogen zu kindlichem Verhalten (ECBI) / Eyberg Child Behaviour Inventory (ECBI) | Expansives Verhalten/Verhaltensprobleme / Expansive behaviour/Behaviour problems | Fremdbericht (Eltern) / Parent report | Originalversion: Eyberg, S. M. & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student Behavior Inventory-Revised: Professional Manual. Odessa, FL: Psychological Assessment. | Interventionsstudie / Intervention study |
FAS Screening Fragebogen / Fetal alcohol screening | Alkoholkonsum während der Schwangerschaft / Alcohol consumption during pregnancy | Selbstbericht / Self report | Entwicklung im Rahmen der GROW&TREAT-Pflegefamilienstudie | Neurobiologische Studie / Neurobiological study |
Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität von Kindern und Jugendlichen (KINDL) / Questionnaire for recording the health-related quality of life of children and adolescents | Gesundheitsbezogene Lebensqualität / Health-related quality of life | Selbst- und Fremdbericht (Eltern) / Self and parent report | Ravens-Sieberer, U. & Bullinger, M. (1998a). Assessing health related quality of life in chronically ill children with the German KINDL: first psychometric and content-analytical results. Quality of Life Research, Vol. 4, No 7. | Längsschnittstudie / Longitudinal study |
Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen (Feel-KJ) / Questionnaire for the survey of emotion regulation in children and adolescents | Emotionsregulationsstrategien für Angst, Trauer und Wut / Emotional regulation strategies for fear, grief and anger | Fremdbericht (Eltern) / Parent report | Originalversion: Grob, A. & Smolenski, C. (2009). Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen (2. akt. u. erg. Aufl.). Göttingen: Hogrefe. | Neurobiologische Studie / Neurobiological study |
Fragebogen zur kindlichen Beziehungsgestaltung (FkB) / Questionnaire on childlike relationship formation (FkB) | Positive kindliche Beziehungsgestaltung / Positive childhood relationship formation | Fremdbericht (Eltern) / Parent report | Briegel, W. (2013). Fragebogen zur kindlichen Beziehungsgestaltung (FkB). Unveröffentlicht, Leopoldina | Interventionsstudie / Intervention study |
Haarcortisol Fragebogen / Hair cortisol questionnaire | Mögliche Einflussfaktoren auf die Haarcortisol Auswertung / Possible influencing factors on the hair cortisol evaluation | Selbstbericht / Self report | Entwicklung im Rahmen der GROW&TREAT-Pflegefamilienstudie | Neurobiologische Studie / Neurobiological study |
Hintergrundinterview / Background Interview | Auflistung aller möglichen Eigenschaften, die als Einzelvariablen stehen und mögliche Stör- oder Einflussvariablen abbilden können (Bereiche zu Kindergarten- oder Schulbesuch, Geschwister der Kinder, Partnerschaften der Eltern, Beruf der Eltern, Überblick über mögliche Behinderungen, Erkrankungen, Therapien, Elterntrainings, bei Pflegekindern Kontakthäufigkeit zur HKF und Herausnahmegründe aus Elternsicht sowie intent to continue) Intention of the parents to continue the foster care | Selbstbericht (Eltern) / Self report (parents) | Entwicklung im Rahmen der GROW&TREAT-Pflegefamilienstudie | Längsschnittstudie/ Longitudinal study |
Immundefektfragebogen / Immunodeficiency questionnaire | Körperliche Gesundheit / Physical health | Fremdbericht (Eltern) / Parent report | Entwickelt vom Institut für Immunologie der Uniklinik RWTH Aachen, Prof. Dr. Lothar Rink | Neurobiologische Studie / Neurobiological study |
Inventory of Callous-Unemotional Traits (ICU) | Gefühlslose, hinterlistige und hartherzige Eigenschaften / Callous, unemotional traits | Fremdbericht (Eltern) / Parent report | Essau, C. A. , Sasagawa, S. & Frick, P. J. (2006). Callous-unemotional traits in a community sample of adolescents. Assessment; 13(4), 454–469. | Moderator in der Interventionsstudie (kein Outcomemaß) / Moderator in the intervention study (no outcome measure) |
Parent-Child Play Task and Observation System (PTOS) | Eltern-Kind-Interaktion / Parent-child interaction | Standardisierte Verhaltensbeobachtung (Eltern und Kind) / Standardized observation of behaviour (parents and child) | Rusby, J. C., Sanders, M., Milchak, C., Hulegaard, K., Lange, T., Ware, R. & Metzler, C. W. (2009). Mother-Child Play Task Observation System (Mother-Child PTOS) Manual. Unpublished Manuscript. | Interventionsstudie / Intervention study |
Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSCSA) | Selbstwahrnehmung und wahrgenommene soziale Akzeptanz im Selbstbericht / Self-perception and perceived social acceptance in the self-report | Selbstbericht / Self report | Fantuzzo, J. W., McDermott, P. A., Manz, P. H., Hampton, V. R., & Burdick, N. A. (1996). The Pictorial Scale of Perceived Competence and Social Acceptance: Does It Work with Low‐Income Urban Children? Child Development, 67(3), 1071-1084. | Längsschnittstudie / Longitudinal study |
Preschool Anxiety Scale (PAS) | Angst / Anxiety | Fremdbericht (Eltern) / Parent report | Originalversion: Spence, S. H., Rapee, R., McDonald, C. & Ingram, M. (2001). The structure of anxiety symptoms among preschoolers. Behaviour Research and Therapy, 39, 1293-1316. | Interventionsstudie / Intervention study |
Relationship Problems Questionnaire (RPQ) | Screeninginstrument für Bindungsstörungen / Screening instrument for attachment disorders | Fremdbericht (Eltern) / Parent report | Minnis, H., Macmillan, S., Pritchett, R., Young, D., Wallace, B., Butcher, J., ... & Gillberg, C. (2013). Prevalence of reactive attachment disorder in a deprived population. The British Journal of Psychiatry, 202(5), 342-346. | Längsschnittstudie / Longitudinal study |
Soziale-Erwünschtheits-Skala-17 (SES-17) / Social Desirability Scale-17 | Tendenz zu sozialer Erwünschtheit / Tendency towards social desirability | Selbstbericht (Eltern) / Self report (parents) | Stöber, J. (1999). Die Soziale-Erwünschtheits-Skala-17 (SES-17): Entwicklung und erste Befunde zu Reliabilität und Validität. Diagnostica, 45, 173-177. | Längsschnittstudie / Longitudinal study |
Sozialisationsziele (SZ) / Socialisation goals | Übergeordnete gesellschaftliche Ziele der Eltern für ihre Kinder / Overall social goals of parents for their children | Selbstbericht / Self report | Kärtner, J., Keller, H., Chaudhary, N., Yovsi, R.D. (2012). The Development of Mirror Self-Recognition in Different Socio-Cultural Contexts. Monographs of the Society for Research in Child Development, 77, 1-87. | Längsschnittstudie / Longitudinal study |
Traumaliste aus dem Early Trauma Inventory (ETI) / Traumalist of the Early Trauma Inventory (ETI) | Traumata | Fremdbericht (Eltern) / Parent report | Originalveröffentlichung: Bremner, J.D., Vermetten, E. & Mazure, C.M. (2000). Development and preliminary psychometric properties of an instrument for the measurement of childhood trauma: The Early Trauma Inventory. Depression and Anxiety, 12, 1-12. | Längsschnittstudie / Longitudinal study |
Wechsler Intelligence Scale for Children (WISC-IV), (ehemals /former HAWIK-IV) | Intelligenz / Intelligence | Standardisiertes Verfahren (Kinder) / Standardized procedure (children) | Wechsler, D. (2011). WISC-IV - Wechsler Intelligence Scale for Children (Deutsche Ausgabe) - Fourth Edition.Frankfurt a. M.: Pearson. | Längsschnittstudie / Longitudinal study |
Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) | Intelligenz / Intelligence | Standardisiertes Verfahren (Kinder) / Standardized procedure (children) | Petermann, F. & Lipsius, M. (2009). WPPSI-III - Wechsler Preschool and Primary Scale of Intelligence - Third Edition - deutsche Version. Frankfurt a. M.: Pearson. | Längsschnittstudie / Longitudinal study |
Winkler-Index | Instrument zur Ermittlung eines Indexes für den sozioökonomischen Status der Familie / Instrument for determining an index of the socio-economic status of the family | Selbstbericht (Eltern) / Self report (parents) | Winkler, J. & Stolzenberg, H. (2009). Adjustierung des Sozialen-Schicht-Index für die Anwendung im Kinder- und Jugendgesundheitssurvey (KiGGS) 2003/2006. Wismarer Diskussionspapiere (7). | Längsschnittstudie / Longitudinal study |
Zürcher Kurzfragebogen zum Erziehungsverhalten (ZKE) / Zurich Short Questionnaire on Educational Behaviour (ZKE) | Fragebogen zur Erfassung des Erziehungsverhalten für drei Bereiche / Questionnaire to record parenting behaviour for three areas | Selbstbericht / Self report | Reitzle M., Metzke C.W., Steinhausen H.C. (2001). Eltern und Kinder: Der Zürcher Kurzfragebogen zum Erziehungsverhalten (ZKE). Diagnostica, 47, 196-207.
| Längsschnittstudie / Longitudinal study |
Publications
Chodura, S., Lohaus, A., Symanzik, T., Möller, C., Heinrichs, N. & Konrad, K (2019). Die demographischen Eigenschaften von Pflegefamilien in Deutschland. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 47, 211-227.
Ehrenberg, D., Lohaus, A., Konrad, K. & Heinrichs, N. (2018). Kindesmisshandlung bei Pflegekindern: Eine Studie zur Untersuchung der Häufigkeit und der spezifischen und kumulierten Auswirkungen von Kindesmisshandlung. Zeitschrift für Klinische Psychologie und Psychotherapie, 47, 77-88.
Job, A.-K., Ehrenberg, D., Hilpert, P., Reindl, V., Lohaus, A., Konrad, K. & Heinrichs, N. (2020). Taking Care Triple P for Foster Parents With Young Children in Foster Care: Results of a 1-Year Randomized Trial. Journal of Interpersonal Violence.
Job, A.-K., Lohaus, A., Kerkeroff, D., Nussbeck, F., Konrad, K. & Heinrichs, N. (2019). Dyadic Coping in Foster and Biological Parents and its Relation to Child Psychopathology - Longitudinal Results. European Journal of Health Psychology.
Job, A.K., Lohaus, A., Konrad, K., Scharke, W., Reindl, V. & Heinrichs, N. (2016). Die Rolle von adpativer und maladaptiver Emotionsregulation bei Pflegekindern mit Misshandlungserfahrung. Zeitschrift für Klinische Psychologie und Psychotherapie, 45, 267-278.
Lohaus, A., Chodura, S., Möller, C., Symanzik, T., Ehrenberg, D., Job, A.-K., Reindl, V., Konrad, K., Heinrichs, N. (2017). Children's Mental Health Problems and their Relation to Parental Stress in Foster Mothers and Fathers. Child and Adolescent Psychiatry and Mental Health. 11:43
Lohaus, A., Kerkhoff, D., Chodura, S., Möller, C., Symanzik, T., Rueth, J. E., Ehrenberg, D., Job, A.-K., Reindl, V., Konrad, K. & Heinrichs, N. (2018). Longitudinal Relationships between Foster Children’s Mental Health Problems and Parental Stress in Foster Mothers and Fathers. European Journal of Health Psychology, 25, 33-42. doi:10.1027/2512-8442/a000007
Reindl, V., Job, A. K., Heinrichs, N., Lohaus, A. & Konrad, K. (2017). Multimethodale Erfassung der kindlichen Emotionsregulation. Kindheit & Entwicklung, 26 (3), 166-174.
Symanzik, T., Job, A.-K., Lohaus, A., Konrad, A., Heinrichs, N., Chodura, S., & Reindl, V. (2019). Stability and Change of Attachment Symptoms and Interpersonal Problems in Foster Children. Mental Health & Prevention, 13, 35-42.