The Effect of Childhood Adversities and Protective Factors on the Development of Child-Psychiatric Disorders and Their Treatment

Abstract

Context: Families with high rates of childhood adversities (CAs) (multi problem families, MPF) have an increasing importance in public health-policy.Objective: The present study addresses the relationship between risk- and protective factors and the severity and treatment-outcome of mental disorders.Setting: Family-therapeutic home-based treatment for MPF. We examined a clinical sample (N = 1031) of children between the age of 4 to 17, and a non-clinical sample of 148 children. We hypothesized that of all children of the clinical group have a predominance of risk factors and a higher number of psychopathological symptoms. Furthermore, we hypothesized that children with a predominance of protective factors benefit stronger from psychotherapy.Main Results: In the clinical sample, most children met the criteria of a psychopathological diagnosis (95.7%, as compared to 21.6% in the non-clinical sample) and showed significant higher rates of CAs and significant less protective factors as compared to the non-clinical sample. The clinical group showed a significant reduction of psychopathological symptoms and benefited equally well from treatment. The number of risk factors was a significant predictor for a child from the non-clinical sample to meet the criteria of a psychopathological diagnosis, while the number of protective factors significantly predicted the absence thereof.Conclusion: Children and adolescents with high scores of CAs show significant associations with child psychiatric symptoms (d = 0.35; including all ICD-diagnosis such as, e.g., Asperger Syndrome, ADHD etc. with a higher rate of genetic etiology). Early life stressors, however, do not trigger an irreversible fate, as psychotherapy with young people with high numbers of risk factors does help to reduce psychopathological symptoms significantly (range of five outcome parameters: d = 0.31–0.72).

Long-Term Effects of Home-Based Family Therapy for Non-responding Adolescents With Psychiatric Disorders. A 3-Year Follow-Up

“…Multi-problem families (MPFs) are families who experience a multitude of complex problems in various areas of life. Their difficulties usually arise on the level of the family system (psycho-social factors) as well as in their environment (low socio-economic status) (Tausendfreund et al, 2016;Bachler et al, 2018). They range from parenting issues, psychiatric problems, troubled relationships, to financial debt, health-, and housing-related issues, as well as repeated contact with social authorities or the criminal justice system (Tausendfreund et al, 2016).…”

“…According to Kessler et al (2010), parental mental illness, child abuse, neglect, and maladaptive functioning of the parents are the strongest predictors of mental disorders, accounting for the occurrence of 29.8% of all disorders in 21 countries. In MPFs, these childhood adversities are highly prevalent, interrelated, and associated with impaired family functioning (Bachler et al, 2018).…”

“…These include "undefined burden" like the loss of productivity or inability to work, and "hidden burden, " e.g., delaying treatment and healing through revolving door effects, and worse social networks (WHO, 2001). However, Bachler et al (2018) showed that childhood adversities do not predestine children to an irreversible fate: The outcome of therapy is more powerful than the influence of adverse factors on the development of child psychiatric symptoms. Enduring effects of the treatment are of high relevance for both the individual and the society.…”

Detecting pattern transitions in psychological time series – A validation study on the Pattern Transition Detection Algorithm (PTDA)

“…With the increasing use of real-time monitoring devices like the Synergetic Navigation System [1], high frequency sampled longitudinal data of psychological processes become available. Fields of research include, for example, psychotherapy processes [2,3], developmental psychology [4,5], unconscious processes [6], treatment outcome [7,8], psychotraumatology [9], sudden gains and losses in psychotherapy [10][11][12], treatment of multi-problem families [13], psychological aspects of immune diseases [14] or epilepsy [15,16], and suicidal crises [17,18]. Real-time monitoring produces time series with daily or even within-day measurements of psychological variables relevant to psychotherapeutic changes like emotions, motivation, insights, and symptom severity.…”

The Patient’s Change: Understanding the Complexity of the Dynamics of Change and its Precursors in Psychotherapy

“…Reviews on the methodology of single-case research in psychodynamic psychotherapy were published by Hilliard (1993) and Fonagy and Moran (1993). Beyond the frame of psychoanalysis, the non linear dynamic systems approach promoted the field of case-related research designs by using non linear methods in order to understand chaotic dynamics and self-organized pattern transitions of cognitive, affective, and interpersonal processes Schiepek et al, 1997Schiepek et al, ,b, 2018. connected both fields by applying the method of dynamic complexity (DC) on the process ratings of patients and therapists in psychodynamic psychotherapies.…”