Ulrike Schulze - Academia.edu (original) (raw)

Papers by Ulrike Schulze

Nervenheilkunde, Sep 1, 2022

European Child & Adolescent Psychiatry

Youth with disruptive behavior showing high callous-unemotional (CU) traits and proactive aggress... more Youth with disruptive behavior showing high callous-unemotional (CU) traits and proactive aggression are often assumed to exhibit distinct impairments in emotion recognition from those showing mainly reactive aggression. Yet, reactive and proactive aggression and CU traits may co-occur to varying degrees across individuals. We aimed to investigate emotion recognition in more homogeneous clusters based on these three dimensions. In a sample of 243 youth (149 with disruptive behavior problems and 94 controls) aged 8–18 years, we used model-based clustering on self-report measures of CU traits and reactive and proactive aggression and compared the resulting clusters on emotion recognition (accuracy and response bias) and working memory. In addition to a Low and Low-Moderate symptom cluster, we identified two high CU clusters. The CU-Reactive cluster showed high reactive and low-to-medium proactive aggression; the CU-Mixed cluster showed high reactive and proactive aggression. Both CU c...

Social Psychiatry and Psychiatric Epidemiology

Purpose The service configuration with distinct child and adolescent mental health services (CAMH... more Purpose The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians’ advice to continue treatment at AMHS. Methods Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians’ transition recommendations. Results Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psych...

Psychological Medicine

Background Disruptive behavior disorders (DBD) are heterogeneous at the clinical and the biologic... more Background Disruptive behavior disorders (DBD) are heterogeneous at the clinical and the biological level. Therefore, the aims were to dissect the heterogeneous neurodevelopmental deviations of the affective brain circuitry and provide an integration of these differences across modalities. Methods We combined two novel approaches. First, normative modeling to map deviations from the typical age-related pattern at the level of the individual of (i) activity during emotion matching and (ii) of anatomical images derived from DBD cases (n = 77) and controls (n = 52) aged 8–18 years from the EU-funded Aggressotype and MATRICS consortia. Second, linked independent component analysis to integrate subject-specific deviations from both modalities. Results While cases exhibited on average a higher activity than would be expected for their age during face processing in regions such as the amygdala when compared to controls these positive deviations were widespread at the individual level. A mu...

BMC Pediatrics, 2020

Background Mental health disorders in the child and adolescent population are a pressing public h... more Background Mental health disorders in the child and adolescent population are a pressing public health concern. Despite the high prevalence of psychopathology in this vulnerable population, the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) has many obstacles such as deficiencies in planning, organisational readiness and policy gaps. All these factors contribute to an inadequate and suboptimal transition process. A suite of measures is required that would allow young people to be assessed in a structured and standardised way to determine the on-going need for care and to improve communication across clinicians at CAMHS and AMHS. This will have the potential to reduce the overall health economic burden and could also improve the quality of life for patients travelling across the transition boundary. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Health Care) project aims to address t...

Education for Health, 2017

Background: Gender medicine has gained importance over the past 20 years. Nevertheless, the scien... more Background: Gender medicine has gained importance over the past 20 years. Nevertheless, the scientific findings concerning gender- and sex-specific patient care have not been sufficiently integrated into the education of physicians. It was therefore our aim, against initial resistance in our school, to integrate clinically relevant aspects of gender medicine into the existing medical curriculum. This paper describes the implementation process of a lecture-based interdisciplinary, longitudinal, basic gender curriculum and evaluates students' attitudes in relation to sex and semester level. Methods: The curriculum encompasses 15 lecture sessions scheduled in years 1 through 5 of the medical curriculum at Ulm University, Germany. Prospectively gathered evaluation data of two cross-sectional analyses of this basic curriculum in the first and fifth semesters are analyzed by sex. Results: More than 80% of the students have registered for this new curriculum. Evaluation data show a predominantly positive (75.5%) student response; however, only about half of those surveyed indicated that they had learned new material or judged the content on gender to be relevant to their practice of medicine. Students at a more advanced semester level (88.2% vs. 55.2%) and male participants more than female participants (36.7% vs. 62.4%) showed lower acceptance. Discussion: It was possible to integrate gender issues into the existing medical student curriculum. Despite the overall positive rating, our evaluation data identified the aspects of rejection and resistance in some students, particularly male and more advanced students. Further studies on the development of student attitudes toward gender issues are needed.

Neuropsychiatrie de l'Enfance et de l'Adolescence, 2012

European Neuropsychopharmacology, 2013

S617 results should raise awareness on designer drug consumption in adolescents and should be an ... more S617 results should raise awareness on designer drug consumption in adolescents and should be an alarm sign for public health policy makers. References [1] Lundqvist, T., 2005. Cognitive consequences of cannabis use: Comparison with abuse of stimulants and heroin with regard to attention, memory and executive functions.

Klinikmanual Kinder- und Jugendpsychiatrie und -psychotherapie, 2013

Additional file 1: Table S1. Polychoric correlations between items (reasons for seeking inpatient... more Additional file 1: Table S1. Polychoric correlations between items (reasons for seeking inpatient treatment) given by patients. Table S2. Polychoric correlations between items (reasons for seeking inpatient treatment) given by parents. Table S3. Results of regression analyses with BMI-SDS as outcome (n = 360) according to model Ib (see Table 4) supplemented by single reasons for inpatient admission based on reasons (total number = 23). a Given by patients (each row represents a single regression analysis; slight changes for items premorbid BMI-SDS and age not shown). The change in R2 (ΔR2) indicates the improvement of the model compared to model Ib. Nominally (p < 0.05) significant items/reasons are bolded. b Given by parents (each row represents a single regression analysis; slight changes for items premorbid BMI-SDS and age not shown). The change in R2 (ΔR2) indicates the improvement of the model compared to model Ib. Nominally (p < 0.05) significant items/reasons are bolded...

Child and Adolescent Psychiatry and Mental Health, 2021

Background Body mass index (BMI) at hospital admission in patients with anorexia nervosa (AN) rep... more Background Body mass index (BMI) at hospital admission in patients with anorexia nervosa (AN) represents a prognostic marker for mortality, chronicity and future body weight. The current study focused on the associations between BMI standard deviation score (BMI-SDS) at admission and reasons for seeking inpatient treatment. Further interest was given to the relationship between premorbid weight and weight at admission, as well as the effect of both weight at referral and reasons for admission on treatment outcome. Methods Data ascertained in the German Register of Children and Adolescents with AN were analysed to assess the parental and patient overlap for 23 predefined reasons for admission, using factor analyses and regressions models. Results Complete parent-patient data sets were available for 360 patients out of 769. The highest consensus rates between parents and patients were obtained for weight and eating behavior related reasons and hyperactivity. Based on factor analysis, ...

Hauptthema des Kapitels sind Angststorungen und phobische Storungen. Neben Informationen zu Klass... more Hauptthema des Kapitels sind Angststorungen und phobische Storungen. Neben Informationen zu Klassifikation, Epidemiologie, Atiologie, Symptomatik, Diagnostik und Therapieverfahren finden sich auch zahlreiche praktische Tipps und Hilfestellungen fur den Alltag in Praxis und Klinik wieder.

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 2020

Monatsschrift Kinderheilkunde, 2022

Frontiers in Psychiatry, 2022

BackgroundIn mental health, transition refers to the pathway of young people from child and adole... more BackgroundIn mental health, transition refers to the pathway of young people from child and adolescent to adult services. Training of mental health psychiatrists on transition-related topics offers the opportunity to improve clinical practice and experiences of young people reaching the upper age limit of child and adolescent care.MethodsNational psychiatrist's organizations or experts from 21 European countries were surveyed 1/ to describe the status of transition in adult psychiatry (AP) and child and adolescent psychiatry (CAP) postgraduate training in Europe; 2/ to explore the amount of cross-training between both specialties. This survey was a part of the MILESTONE project aiming to study and improve the transition process of young people at the service boundary.ResultsTransition was a mandatory topic in the AP curriculum of 1/19 countries (5%) and in the CAP curriculum of 4/17 countries (24%). Most topics relevant for transition planning were addressed during AP training i...

Background: Child maltreatment can cause significant physical and psychological problems. The pre... more Background: Child maltreatment can cause significant physical and psychological problems. The present study aimed to investigate the prevalence and determinants of child maltreatment in Guangzhou, China, where such issues are often considered a taboo subject. Methods: A school-based survey was conducted in southern China in 2005. 24 high schools were selected using stratified random sampling strategy based on their districts and bandings. The selfadministered validated Chinese version of parent-child Conflict Tactics Scale (CTSPC) was used as the main assessment tool to measure the abusive experiences encountered by students in the previous six months. Results: The response rate of this survey was 99.7%. Among the 6592 responding students, the mean age was 14.68. Prevalence of parental psychological aggression, corporal punishment, severe and very serve physical maltreatment in the past 6 months were 78.3%, 23.2%, 15.1% and 2.8% respectively. The prevalence of sexual abuse is 0.6%. The most commonly cited reasons for maltreatment included 'disobedience to parents', 'poor academic performance', and 'quarrelling between parents'. Age, parental education, places of origins and types of housing were found to be associated with physical maltreatments whereas gender and fathers' education level were associated with sexual abuse. Conclusion: Though largely unspoken, child maltreatment is a common problem in China. Identification of significant determinants in this study can provide valuable information for teachers and health professionals so as to pay special attention to those at-risk children. Background Child maltreatment results in significant medical, social, and economic costs. It has been found to be associated with a number of long-term mental health problems [1,2]. Abused children often have higher lifetime prevalence of suicide ideation and disability than the general

Reversal learning deficits following reward and punishment processing are observed across disrupt... more Reversal learning deficits following reward and punishment processing are observed across disruptive behaviors (DB) and attention-deficit/hyperactivity disorder (ADHD), and have been associated with callous-unemotional (CU) traits. However, it remains unknown to what extent these altered reinforcement sensitivities are linked to the co-occurrence of oppositional traits, ADHD symptoms, and CU traits. Reward and punishment sensitivity and perseverative behavior were therefore derived from a probabilistic reversal learning task to investigate reinforcement sensitivity in participants with DB (n=183, ODD=62, CD=10, combined=57, age-range 8-18), ADHD (n=144, age-range 11-28), and controls (n=191, age-range 8-26). The SNAP-IV and Conners rating scales were used to assess oppositional and ADHD traits. The Inventory of CU traits was used to assess CU traits. Decreased reward sensitivity was associated with ADHD symptom severity (p=0.018) if corrected for oppositional symptoms. ADHD symptoma...

Leseprobe ----- Zusammenfassung Dieser Beitrag beleuchtet die Schwierigkeiten und Herausforderung... more Leseprobe ----- Zusammenfassung Dieser Beitrag beleuchtet die Schwierigkeiten und Herausforderungen, mit denen junge Menschen mit psychiatrischen Erkrankungen im Ubergang zwischen den Hilfe- und Versorgungssystemen fur Jugendliche und Erwachsene konfrontiert sind. Diese Lebensphase der Transition ist gekennzeichnet von schlecht strukturierten und wenig ausgereiften Hilfsangeboten und damit einhergehenden negativen Auswirkungen auf den Krankheitsverlauf bis hin zu Behandlungsabbruchen sowie auf die gesellschaftliche Integration und die Teilhabechancen der Betroffenen. Im Anschluss an die Darstellung verschiedener Problembereiche im Ubergang zwischen den Systemen sollen Ansatze einer konstruktiven Veranderung beleuchtet werden. Schlagworter: Emerging Adulthood, psychische Erkrankung, Transition ----- Double challenge: mentally ill young people on their way into adult life Abstract This contribution attempts to provide a synoptic insight into the interplay between growing up and psychi...

Cortex, 2019

Disruptive behavior is associated with societally and personally problematic levels of aggression... more Disruptive behavior is associated with societally and personally problematic levels of aggression and has been linked to abnormal structure and function of fronto-amygdala-striatal regions. Abnormal glutamatergic signalling within this network may play a role in aggression. However, disruptive behavior does not represent a homogeneous construct, but can be fractionated across several dimensions. Of particular interest, callous-unemotional (CU) traits have been shown to modulate the severity, neural and behavioural characterisation, and therapeutic outcomes of disruptive behaviour disorders (DBDs) and aggression. Further, individuals showing disruptive behavior differ to the extent that they engage in subtypes of aggression (i.e., proactive [PA] and reactive aggression [RA]) which may also represent distinct therapeutic targets. Here we investigated how glutamate signalling within the fronto-amygdala-striatal circuitry was altered along these dimensions in youths showing disruptive behavior (n = 140) and typically developing controls (TD, n = 93) within the age-range of 8-18 years. We used proton magnetic resonance spectroscopy (1H-MRS) in the anterior cingulate cortex (ACC), striatum, amygdala and insula and associated glutamate concentrations with continuous measures of aggression and CU-traits using linear mixed-effects models. We found evidence of a dissociation for the different measures and glutamate concentrations. CU traits were associated with increased ACC glutamate ('callousness': b = .19, t (108) = 2.63, p = .01, r = .25; 'uncaring': b = .18, t (108) = 2.59, p = .011, r = .24) while PA was associated with decreased striatal glutamate concentration (b = -.23, t (28) = -3.02, p = .005, r = .50). These findings suggest dissociable correlates of CU traits and PA in DBDs, and indicate that the ACC and striatal glutamate may represent novel pharmacological targets in treating these different aspects.