In recent years, neuroscience has been a particularly prolific discipline stimulating many innovative treatment approaches in medicine. However, when it comes to the brain, new techniques of intervention do not always meet with a positive public response, in spite of promising therapeutic benefits. The reason for this caution clearly is the brain’s special importance as “organ of the mind”. As such it is widely held to be the origin of mankind’s unique position among living beings. Likewise, on the level of (...) the individual human being, the brain is considered the material substrate of those traits that in combination render each person unique. In view of this preeminent significance of the brain, it is understandable that, in general, interventions into the brain are considered a delicate issue and that new techniques of intervention are scrutinised with particular care. However, in doing so it is important not to go to the opposite extreme and shy away from promising new therapeutic approaches for debilitating disorders of the brain. With respect to the new techniques of brain intervention a broad interdisciplinary perspective is required to discern irrational fear from justified concern. Hence, the Europäische Akademie established a project group consisting, on the one hand, of experts from different fields of medicine who have got first-hand experience of applying the techniques at issue and, on the other hand, of philosophers and a legal expert. The task of this team was to review the state of the art with respect to each single technique of intervening in the brain, to indicate future developments, and to address the ethical and legal issues common to all of them. The project’s outcome is the book at hand. (shrink)

With right-wing-extremist and -populist parties and movements on the rise throughout the world, the concept of authoritarianism has proven to be particularly valuable to explain the psychological underpinnings of these tendencies. Even though many scales to measure the different dimensions of authoritarianism exist, no short screening instrument has been tested and validated on a large scale so far. The present study examines the psychometric properties of the screening instrument Authoritarianism – Ultrashort in three representative German samples. Using exploratory and confirmatory (...) factor analysis, the A-US demonstrated acceptable internal consistency. Model fit was good and correlations with related constructs indicated convergent validity in both samples. Construct validity was demonstrated using the original version of the scale. The instrument proved to be invariant across sex, employment status, and education, but not across different age groups. Finally, the analyses showed that differences in the A-US are associated with sociodemographic variables. Potential causes and effects of these findings are discussed. Based on these results, the A-US proved to be a valuable and highly efficient tool to screen for authoritarian tendencies. (shrink)

IntroductionChildhood maltreatment is a developmental risk factor and can negatively influence later psychological functioning, health, and development in the next generation. A comprehensive understanding of the biopsychosocial underpinnings of CM transmission would allow to identify protective factors that could disrupt the intergenerational CM risk cycle. This study examined the consequences of maternal CM and the effects of psychosocial and biological resilience factors on child attachment and stress-regulatory development using a prospective trans-disciplinary approach.MethodsMother-child dyads participated shortly after parturition, after 3 months, (...) and 12 months later. Mothers’ CM experiences were assessed at t0, attachment representation at t1 and psychosocial risk and social support were assessed at t1 and t2. At t2, dyads participated in the Strange Situation Procedure. Children’s attachmen status were classified as organized vs. disorganized, including their level of disorganized behavior, and heart rate and respiratory sinus arrhythmia were recorded as stress response measures of the autonomic nervous system. Maternal caregiving during SSP was assessed using the AMBIANCE scale. Child’s single nucleotide polymorphisms rs2254298 within the oxytocin receptor and rs2740210 of the oxytocin gene were genotyped using DNA isolated from cord blood.ResultsMaternal CM experiences were significantly associated with an unresolved attachment status, higher perceived stress and more psychological symptoms. These negative effects of CM were attenuated by social support. As expected, maternal unresolved attachment and child disorganized attachment were significantly associated. Maternal caregiving did not mediate the relationship between maternal and child attachment but influenced children’s HR and RSA response and disorganized behavior. Moreover, the rs2254298 genotype of the OXTR gene moderated the stress response of children from mothers with CM. Children carrying the rs2740210 risk allele of the OXT gene showed more disorganized behavior independent from maternal CM experiences.ConclusionWe replicated and extended existing CM and attachment models by co-examining maternal attachment, social support, and child genetic susceptibility on child attachment and cardiovascular stress regulation. The findings contribute to an extended understanding of risk and resilience factors and enable professionals to target adequate services to parents and children at risk. (shrink)

Capacity and competence in the field of child and adolescent psychiatry are complex issues, because of the many different influences that are involved in how children and adolescents make treatment decisions within the setting of mental health. This article will examine some of the influences which must be considered, namely: developmental aspects, the paradoxical relationship between the need for autonomy and participation and the capacity of children, family psychiatry, and the duty of care towards children and adolescents. The legal frameworks (...) relevant to consideration of consent and competence will be briefly considered, as well as some studies of children's consent, participation and competence. A case vignette will be used as a focus to consider the complexity of the issue of competence in child and adolescent psychiatry, in the particular mental disorder of anorexia nervosa. (shrink)

Die Schweigepflicht, einer der Grundpfeiler medizinischer Ethik, spielt in der aktuellen Diskussion um die Verbesserung des Kinderschutzes eine zentrale Rolle. Unklare und mehrdeutige gesetzliche Regelungen und Handlungsanweisungen, wie mit Anhaltspunkten für eine Kindeswohlgefährdung umzugehen ist, wenn die Sorgeberechtigten eine weitergehende Hilfe ablehnen, werden als Hindernis für einen wirksamen Kinderschutz betrachtet. Aus der schwer durchschaubaren Rechtslage resultieren für Angehörige der Gesundheitsberufe regelmäßig Handlungsunsicherheiten, die im Einzelfall notwendige Hilfe verzögern oder gar verhindern könnten. Neue Gesetze auf Länderebene haben deshalb im Sinne eines (...) verbesserten Kinderschutzes eine Erhöhung der Rechtssicherheit sowie eine Förderung der Vernetzung der beteiligten Akteure zum Ziel. Wenn auch einigen der Gesetze ein gewisses Klarstellungspotenzial zugebilligt werden kann, ist doch im Augenblick ihr Beitrag zu mehr Rechtssicherheit im Umgang mit Kinderschutzfällen noch als sehr eingeschränkt zu betrachten. Ein Bundesgesetz, welches die Intention hatte, die heterogenen Landesnormen durch eine bundeseinheitliche Regelung zu ersetzen, ist wenigstens in der letzten Legislaturperiode gescheitert. (shrink)

Modern theories of authoritarianism have stressed the importance of threat to the expression of authoritarian attitudes and intolerance. Arguably, authoritarian tendencies may have increased during COVID-19 pandemic, a major threat to life and security. One issue arising when comparing mean scores is that of measurement invariance. Meaningful comparisons are only possible, if latent constructs are similar between groups and/or across time. This prerequisite is rarely ever tested in research on authoritarianism. In this study, we aim to analyze the short scale (...) for authoritarianism KSA-3 by investigating its measurement invariance on two levels and latent mean changes using two German representative samples. Specifically, we look at differences before and during the pandemic. While measurement invariance holds across both levels in all conditions, we find a decrease in latent means in 2020, contrary to expectations and established theories. Moreover, latent means differ with regard to gender, education, and east–west Germany. We conclude that analyses of latent means and measurement invariance instead of mean comparisons with composites should become the standard. Future studies should focus on threat as a moderator between authoritarianism and intolerance, and on possible interactions with context variables. (shrink)

ZusammenfassungDie Schweigepflicht, einer der Grundpfeiler medizinischer Ethik, spielt in der aktuellen Diskussion um die Verbesserung des Kinderschutzes eine zentrale Rolle. Unklare und mehrdeutige gesetzliche Regelungen und Handlungsanweisungen, wie mit Anhaltspunkten für eine Kindeswohlgefährdung umzugehen ist, wenn die Sorgeberechtigten eine weitergehende Hilfe ablehnen, werden als Hindernis für einen wirksamen Kinderschutz betrachtet. Aus der schwer durchschaubaren Rechtslage resultieren für Angehörige der Gesundheitsberufe regelmäßig Handlungsunsicherheiten, die im Einzelfall notwendige Hilfe verzögern oder gar verhindern könnten. Neue Gesetze auf Länderebene haben deshalb im Sinne eines (...) verbesserten Kinderschutzes eine Erhöhung der Rechtssicherheit sowie eine Förderung der Vernetzung der beteiligten Akteure zum Ziel. Wenn auch einigen der Gesetze ein gewisses Klarstellungspotenzial zugebilligt werden kann, ist doch im Augenblick ihr Beitrag zu mehr Rechtssicherheit im Umgang mit Kinderschutzfällen noch als sehr eingeschränkt zu betrachten. Ein Bundesgesetz, welches die Intention hatte, die heterogenen Landesnormen durch eine bundeseinheitliche Regelung zu ersetzen, ist wenigstens in der letzten Legislaturperiode gescheitert. (shrink)

BackgroundBehavioral and physiological regulation in early life is crucial for the understanding of childhood development and adjustment. The autonomic nervous system is a main player in the regulative system and should therefore be modulated by the quality of interactive behavior of the caregiver. We experimentally investigated the ANS response of 18–36-month-old children in response to the quality of maternal behavior during a mother–child-interacting paradigm.MethodEighty mothers and their children came to our laboratory and took part in an experimental paradigm, consisting of (...) three episodes: a resting phase, a structured play phase, and a free play situation between mothers and their child. Children’s and mother’s heart rate, the sympathetic nervous system activity via the pre-ejection period and the left ventricular ejection time, and the parasympathetic nervous system activity via the respiratory sinus arrhythmia were continuously measured by an electrocardiogram. Maternal sensitivity of interactive behavior was assessed by using the Emotional Availability Scales.ResultsChildren of mothers with insensitive behavior had a significantly lower RSA at baseline, showed a lack of RSA withdrawal during structured and free play, and had shorter LVET across all episodes compared to children of sensitive mothers.ConclusionOur findings depict the influence of low-quality maternal interaction on the child’s ANS regulation, in calm and more stressful play situations. The overall higher SNS mode with impaired PNS reactivity may negatively influence child’s ANS homoeostasis, which may result in a long-term impact on mental and physical wellbeing. Further, the maternal sensitivity may function as a buffer for the stress response of their child. These results could serve as a basis for the development of appropriate psychoeducational programs for mothers of low sensitivity in their interaction with the child. (shrink)

The occurrence of the novel severe acute respiratory syndrome coronavirus-2 at the end of 2019 comes along with many challenges. Besides worry for one’s own health and the well-being of the family, all measures applied to limit the spread of the coronavirus affected daily life. School closures, economic shutdown and contact restrictions have led to high levels of stress. The impact on health and families has been widely discussed. However, population-based data are scarce. Here, we have assessed health, quality of (...) life and intrafamilial relations depending on the COVID-19 pandemic. Using a three-step random-route approach, a population-based sample of 2,515 persons was recruited during the second COVID-19 wave in Germany in winter 2020/21. While the majority of participants reported no change in their health status and the relationship with their partner and children, more than half of participants reported a decreased quality of life since the beginning of the pandemic. Female gender, age above 60 years, a low household income, not living with a partner and the experience of childhood adversity were associated with a higher risk for a worsening of health, quality of life and intrafamilial relations. These had already been well-established risk factors ahead of the pandemic. In order to avoid further increase of inequality in our society and more devastating impact of the pandemic on health and intrafamilial relations, low-level support and intervention programs are urgently needed. (shrink)