Studies in adults with mental disorders suggest that the experience of early and chronic trauma is associated with changes in reward expectancy and processing. In addition, severe childhood trauma has been shown to contribute to the development of mental disorders in general. Data on effects of early childhood trauma on reward expectancy and processing in middle childhood currently appear insufficient. The present study aims to fill this research gap by examining the effects of developmental trauma disorder on reward expectancy and (...) processing in children aged 8–12 years, testing the hypothesis that children with multiple complex traumas exhibit altered reward processing as a result of prior disappointing reward experiences. One main feature of developmental trauma disorder is early experiences of multiple separation from important and close relationships alongside other experiences of emotional or physical harm. In the sequel children often show affect regulation disorders. To investigate this, we have developed an adapted version of the Monetary Incentive Delay Task, which examines children’s expectation of reward or frustration. In this first study, behavioral data will be collected from N = 40 children using this adapted version of the MID Task. Children in the experimental group will be recruited from youth welfare centers in Frankfurt a.M., Germany. Healthy control subjects will be recruited from after-school-care facilities. A brief trauma screening will be conducted for both groups, experimental and control. If children show signs of trauma, the presence of a developmental trauma disorder will be further delineated by a German translation of the Developmental Trauma Disorder Structured Interview for Children which was translated the first time in German by our research group. We hypothesize that children in the experimental group will be less accurate in performing the Monetary Incentive Delay Task because of their impaired emotion regulation skills due to emotional avoidance following developmental trauma. If the results of our initial behavioral study are promising, the MID task will be used in a future study to elucidate the relationship between trauma developmental disorder, reward expectancy and processing, and neurobiological processes in middle childhood. (shrink)

BackgroundIn many Western countries like Germany, the social integration of children with an immigrant background has become an urgent social tasks. The probability of them living in high-risk environments and being disadvantaged regarding health and education-related variables is still relatively higher. Yet, promoting language acquisition is not the only relevant factor for their social integration, but also the support of earlier developmental processes associated with adequate early parenting in their first months of life. The Emotional Availability Scales measure the quality (...) of caregiver-child-interactions as an indicator of the quality of their relationship and thus of such early parenting, focusing on mutual and emotional aspects of their interaction.MethodThis pilot study examined in a randomized controlled trial the effects of the prevention project First Steps regarding the hypothesis that the Emotional Availability improved to a greater extent in “difficult-to-reach” immigrant mother-child dyads in a psychoanalytically oriented early intervention compared to a usual care intervention offered by paraprofessionals with an immigrant background. A sample of N = 118 immigrant women in Germany from 37 different countries and their children was compared with regard to the parental EA-dimensions sensitivity, structuring, non-intrusiveness and non-hostility and the child dimensions responsiveness to and involvement of the caregiver in the pre-post RCT design.Results and ConclusionDifferent from what was expected, repeated ANOVAs revealed no significant pre-post group differences for the parental dimensions. For the child dimensions the effect of time of measurement was highly significant, which can be interpreted as mostly natural developmental effects. Still, on the level of simple main effects for each intervention, only in the FIRST STEPS groups child responsiveness significantly improved. When controlled for confounding variables, a significant interaction effect for maternal sensitivity in favor of the FIRST STEPS intervention was found. The systematic group differences indicate that the more extensive and professional intervention, focusing on the individual needs of the participants, is more suitable to support the quality of the mother-child-relationship amongst immigrant mother-child dyads than usual care. The results are discussed taking into account the context of the maternal migration process and potential maternal traumatization.Clinical Trial Registration[https://clinicaltrials.gov], identifier [DRKS00004632]. (shrink)

Affektregulierung als wichtiger Bestandteil von Mentalisierung beinhaltet unterschiedliche Teilaspekte, die in der psychoanalytischen Literatur zum Thema Affekt ausführlich beschrieben werden. Der vorliegende Beitrag bespricht eine Affekttheorie aus der französischsprachigen psychoanalytischen Literatur, die die Transformation von heftigen Affektzuständen mittels Signalen und Zeichen zur Symbolisierung in Bildern und Sprache verdeutlicht.Mithilfe phänomenologischer sowie entwicklungspsychologischer Ansätze wird es möglich, zwischen den Theorien Lacans und Greens eine Brücke zu schlagen. Anhand eines kinderanalytischen Prozesses wird illustriert, wie das normale Spannungsverhältnis zwischen Affekt und Sprache aufgrund einer (...) traumatischen Vorgeschichte besonders starken Belastungen ausgesetzt sein kann. Die detaillierte Analyse klinischen Materials aus der Phase der Diagnostik und aus zwei Therapiesitzungen gibt einen Einblick in die Ängste und Kontaktwünsche eines traumatisierten Kindes und veranschaulicht, wie affektregulierende Therapie im Dienste der Symbolisierung aussehen kann. (shrink)