Kirstin Goth

Bio: Kirstin Goth is an academic researcher from University of Basel. The author has contributed to research in topics: Personality & Personality disorders. The author has an hindex of 11, co-authored 28 publications receiving 517 citations. Previous affiliations of Kirstin Goth include Goethe University Frankfurt.

Assessment of identity development and identity diffusion in adolescence - Theoretical basis and psychometric properties of the self-report questionnaire AIDA

Abstract: In the continuing revision of Diagnostic and Statistical Manual (DSM-V) “identity” is integrated as a central diagnostic criterion for personality disorders (self-related personality functioning). According to Kernberg, identity diffusion is one of the core elements of borderline personality organization. As there is no elaborated self-rating inventory to assess identity development in healthy and disturbed adolescents, we developed the AIDA (Assessment of Identity Development in Adolescence) questionnaire to assess this complex dimension, varying from “Identity Integration” to “Identity Diffusion”, in a broad and substructured way and evaluated its psychometric properties in a mixed school and clinical sample. Test construction was deductive, referring to psychodynamic as well as social-cognitive theories, and led to a special item pool, with consideration for clarity and ease of comprehension. Participants were 305 students aged 12–18 attending a public school and 52 adolescent psychiatric inpatients and outpatients with diagnoses of personality disorders (N = 20) or other mental disorders (N = 32). Convergent validity was evaluated by covariations with personality development (JTCI 12–18 R scales), criterion validity by differences in identity development (AIDA scales) between patients and controls. AIDA showed excellent total score (Diffusion: α = .94), scale (Discontinuity: α = .86; Incoherence: α = .92) and subscale (α = .73-.86) reliabilities. High levels of Discontinuity and Incoherence were associated with low levels in Self Directedness, an indicator of maladaptive personality functioning. Both AIDA scales were significantly different between PD-patients and controls with remarkable effect sizes (d) of 2.17 and 1.94 standard deviations. AIDA is a reliable and valid instrument to assess normal and disturbed identity in adolescents. Studies for further validation and for obtaining population norms are in progress and may provide insight in the relevant aspects of identity development in differentiating specific psychopathology and therapeutic focus and outcome.

CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?

Abstract: Background. In children with pediatric bipolar disorder (PBD), a consistent pattern of elevations in hyperactivity, depression/anxiety, and aggression has been identified on the child behavior checklist (CBCL-PBD profile). The aim of the present study was to estimate the prevalence of the CBCL-PBD profile in a child psychiatric sample, and to determine ICD-10 diagnoses in CBCL-PBD patients.

Prevalence of the Child Behavior Checklist-pediatric bipolar disorder phenotype in a German general population sample.

Abstract: Background: In children with pediatric bipolar disorder (PBD), a consistent pattern of elevations in inattention/hyperactivity, depression/anxiety, and aggression has been identified on the Child Behavior Checklist (CBCL-PBD profile). In Germany, no epidemiological study has included PBD to date. Objectives: To estimate the six-month prevalence of the CBCL-PBD profile in Germany in a large normative general population sample, and to examine subjects with CBCL-PBD profile with regard to symptoms assumed to coexist with PBD (e.g., suicidality, decreased need for sleep, and hypersexuality). Methods: We studied a nationwide representative general population sample of 2,856 children and adolescents aged 4–18 years. Results: A total of 21 subjects [0.7% of the sample; 95% confidence interval (CI) = 0.5–1.1] met the criteria for the CBCL-PBD phenotype. CBCL-PBD subjects were more pervasively disturbed than clinical controls (n = 118; 4.1% of total sample; 95% CI = 3.4–4.9), demonstrated in significantly more social problems and delinquent behavior, and showed significantly higher rates of suicidality, decreased need for sleep and hypersexual behavior. Conclusions: The prevalence of CBCL-PBD subjects in the general German population compares to rates of PBD in US and Dutch epidemiological samples. Regardless of whether these subjects are affected by ‘real’ PBD or ‘severe, pervasive ADHD’ with pronounced emotional dysregulation, they constitute a group of seriously disturbed children and adolescents. The high rate of suicidality among CBCL-PBD subjects emphasizes the need for the identification and adequate treatment of children meeting this profile.

Severe Affective and Behavioural Dysregulation Is Associated with Significant Psychosocial Adversity and Impairment.

Abstract: Background: Recently, a highly heritable behavioral phenotype of simultaneous deviance on the Anx-ious/Depressed, Attention Problems, and Aggressive Behavior syndrome scales has been identified onthe Child Behavior Checklist (CBCL–Dysregulation Profile, CBCL-DP). This study aims to investigatepsychosocial adversity and impairment of the CBCL-DP. Methods: A total of 9024 patients aged4–18 years were assessed using the CBCL, and the axes V and VI of ICD-10. Results: ANOVA revealedsignificantdifferencesregardingpsychosocialadversityandimpairmentbetweenpatientswithCBCL-DPphenotype and the clinical control group, patients with attention problems, and patients withattention problems and additional anxious/depressed symptoms as assessed by the CBCL. Patientswith CBCL-DP showed significant psychosocial adversity and impairment. However, in most casespatients with aggressive behavior showed equal psychosocial adversity as patients with CBCL-DP. Conclusions: Findings suggest the CBCL-DP phenotype to be associated with significant psycho-socialadversityandimpairmenteitherasacauseoraneffectofthesyndrome.Cliniciansshouldcarefullyaddresspsychosocialadversityandimpairmentwithparticularattentiontotheadversityandimpairmentof adolescents with CBCL-DP. Keywords: Pediatric dysregulation profile, Child Behavior Checklist,psychosocial adversity, prevalence.Severe affective and behavioral dysregulation,including irritability, aggression, ‘affective storms’,hyperarousal and altered mood remains a chronicproblem in a sizable number of youth and posessubstantial challenges to practitioners. Severe dys-regulation is currently not well characterized inDSM-IV and ICD-10 but is captured by a profile onthe Child Behavior Checklist (Achenbach, 1991), oneof the best-studied, empirically derived parentchecklists to measure general child and adolescentpsychopathology (‘CBCL-dysregulation profile’,CBCL-DP; Biederman et al., 1995; Holtmann, Goth,Wo¨ckel, Poustka, & Bo¨lte, 2008; Hudziak, Althoff,Derks, Faraone, & Boomsma, 2005). The CBCL-DPis characterized by deviance on the Anxious/Depressed, Attention Problems, and AggressiveBehavior syndrome scales and has shown strongassociations with suicidal behavior (Holtmann et al.,2008; Ayer et al., 2009). About 1–2% in epidemio-logical samples, 6–7% in child psychiatric clinicalsamples and 13–20% of children with attention-def-icit/hyperactivity disorder meet criteria for CBCL-DP(Holtmann et al., 2008; Hudziak et al., 2005; Volk& Todd, 2007). The profile is highly heritable, stableacross ages and verified by replication studies (Ayeret al., 2009; Biederman et al., 2009; Hudziak et al.,2005). There is increasing consensus that CBCL-DPappears to be an indicator of disordered self-regu-lation and impaired functioning, rather than beingindicative of any particular diagnosis (Ayer et al.,2009; Meyer et al., 2009).Recent studies have examined the neurobiologyunderlying this behavioral phenotype, and pre-sented, e.g., evidence of genetic (Hudziak et al.,2005; McGough et al., 2008), neurometabolic (Zepf,Wo¨ckel, Poustka, & Holtmann, 2008) and endocri-nologic (Holtmann, Duketis, Goth, Poustka, & Bo¨lte,2010a) characteristics of CBCL-DP.While the CBCL-DP has consistently been shownto be associated with considerable psychosocialimpairment, both cross-sectionally and longitudi-nally (Hazell, Carr, Lewin, & Sly, 2003; Meyer et al.,2009; Biederman et al., 2009), surprisingly littleattention has been paid to environmental correlatesof severe dysregulation.To our knowledge, familial and environmentalassociations with the CBCL-DP have not been

Reliability and validity of the Junior Temperament and Character Inventory

Abstract: The Junior Temperament and Character Inventory (JTCI) was developed to assess the temperament (‘novelty seeking’, ‘harm avoidance’, ‘reward dependence’, ‘persistence’) and character (‘self-directedness’, ‘cooperativeness’, ‘self-transcendence’) dimensions of Cloninger's biosocial model of personality in children and adolescents. The psychometric properties of the JTCI are presented. We used the German version of JTCI in a clinical sample of 188 adolescent psychiatric patients (aged 12 to 18 years) and in a non-referred sample of 706 German adolescents of the same age range. Aspects of reliability and validity are discussed. We subjected the JTCI to confirmatory factor analysis and were able to replicate the temperament and character scales of the original TCI. The internal consistency of the scales was satisfactory with the exception of ‘reward dependence’ and ‘persistence’. Construct validity was supported by good correspondence of JTCI dimensions with related constructs. Psychometric properties of the German version of JTCI are very promising. Results yield strong support for Cloninger's psychobiological theory. Copyright © 2001 Whurr Publishers Ltd.

The Saturated Self: Dilemmas of Identity in Contemporary Life

Abstract: Examines various industries to show how business endows products with evocative meaning. Kramer was one of the most visionary musical thinkers of the second half of the 20th century. In his The Time of Music, he approached the idea of the many different ways that time itself is articulated musically. This book has become influential among composers, theorists, and aestheticians. Now, in his almost completed text written before his untimely death in 2004, he examines the concept of postmodernism in music. Kramer created a series of markers by which we can identify postmodern works. He suggests that the postmodern project actually creates a radically different relationship between the composer and listener. Written with wit, precision, and at times playfully subverting traditional tropes to make a very serious point about this difference, Postmodern Music, Postmodern Listening leads us to a strongly grounded intellectual basis for stylistic description and an intuitive sensibility of what postmodernism in music entails. Postmodern Music, Postmodern Listening is an examination of how musical postmodernism is not just a style or movement, but a fundamental shift in the relationship between composer and listener. The result is a multifaceted and provocative look at a critical turning point in music history, one whose implications we are only just beginning to understand. A timely essay collection on the development and influence of secular expressions of Buddhism in the West and beyond. How do secular values impact Buddhism in the modern world? What versions of Buddhism are being transmitted to the West? Is it possible to know whether an interpretation of the Buddha’s words is correct? In this new essay collection, opposing ideas that often define Buddhist communities—secular versus religious, modern versus traditional, Western versus Eastern—are unpacked and critically examined. These reflections by contemporary scholars and practitioners reveal the dynamic process of reinterpreting and reimagining Buddhism in secular contexts, from the mindfulness movement to Buddhist shrine displays in museums, to whether rebirth is an essential belief. This collection explores a wide range of modern understandings of Buddhism—whether it is considered a religion, philosophy, or lifestyle choice—and questions if secular Buddhism is purely a Western invention, offering a timely contribution to an ever-evolving discussion. Contributors include Bhikkhu Bodhi, Kate Crosby, Gil Fronsdal, Kathleen Gregory, Funie Hsu, Roger R. Jackson, Charles B. Jones, David L. McMahan, Richard K. Payne, Ron Purser, Sarah Shaw, Philippe Turenne, and Pamela D. Winfield. `I judge this book to be something of a triumph. It provides many valuable insights into how social psychologists work within different paradigms and with quite different assumptions.... Throughout, the writing is clear, central issues are constantly reexamined, and sight is never lost of the whole \"task\" of the book... it addresses central issues both adventurously and provocatively. Students who use it are lucky to have such a feast provided, and they are bound to find the material both challenging and stimulating... there is much more about self issues in this text than in any comparable social psychology text. And that, in itself, is a major achievement' Self & Society This accessible, broad-based and a

Behavioral disinhibition: liability for externalizing spectrum disorders and its genetic and environmental relation to response inhibition across adolescence.

Abstract: Behavioral disinhibition has been characterized as a generalized vulnerability to externalizing disorders. Despite increasing evidence for its validity and heritability, the structural stability of behavioral disinhibition across adolescence and the strength and etiology of its relation to executive functions have not been studied. In this multivariate twin study, the authors assessed behavioral disinhibition using measures tapping substance use, conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and novelty seeking at ages 12 and 17. Executive functions were assessed with laboratory-based cognitive tasks at age 17. Results indicated that, at age 12, behavioral disinhibition was dominated by ADHD and conduct problems and was highly heritable. At age 17, the contributions of the 4 components were more balanced, and the proportion of variance attributable to genetic factors was somewhat smaller, with additional variance due to shared environmental influences. At both ages, behavioral disinhibition was more closely related to response inhibition than other executive functions (working memory updating and task-set shifting), and this relationship was primarily genetic in origin. These results highlight the dynamic nature of behavioral disinhibition across adolescence and suggest that response inhibition may be an important mechanism underlying vulnerability to disinhibitory psychopathology.

Adult Outcomes of Childhood Dysregulation: A 14-year Follow-up Study

Abstract: Objective Using a general population sample, the adult outcomes of children who presented with severe problems with self-regulation defined as being concurrently rated highly on attention problems, aggressive behavior, and anxious-depression on the Child Behavior Checklist–Dysregulation Profile (CBCL-DP) were examined. Method Two thousand seventy-six children from 13 birth cohorts 4 to 16 years of age were drawn from Dutch birth registries in 1983. CBCLs were completed by parents at baseline when children from the different cohorts were 4 to 16 years of age and sampled every 2 years for the next 14 years. At year 14 the CBCL and DSM interview data were collected. Logistic regression was used to compare and contrast outcomes for children with and without dysregulation, as measured by the latent-class–defined CBCL-DP. Sex and age were covaried and concurrent DSM diagnoses were included in regression models. Results Presence of childhood CBCL-DP at wave 1 was associated with increased rates of adult anxiety disorders, mood disorders, disruptive behavior disorders, and drug abuse 14 years later. After controlling for co-occurring disorders in adulthood, associations with anxiety and disruptive behavior disorders with the CBCL-DP remained, whereas the others were not significant. Conclusions A child reported to be in the CBCL-DP class is at increased risk for problems with regulating affect, behavior, and cognition in adulthood.

The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis.

Abstract: Background: Recent studies have identified a Child Behavior Checklist profile that characterizes children with severe affective and behavioral dysregulation (CBCL‐dysregulation profile, CBCL‐DP). In two recent longitudinal studies the CBCL‐DP in childhood was associated with heightened rates of comorbid psychiatric disorders, among them bipolar disorder, an increased risk for suicidality, and marked psychosocial impairment at young‐adult follow‐up. This is the first study outside the US that examines the longitudinal course of the CBCL‐DP. Methods: We studied the diagnostic and functional trajectories and the predictive utility of the CBCL‐DP in the Mannheim Study of Children at Risk, an epidemiological cohort study on the outcome of early risk factors from birth into adulthood. A total of 325 young adults (151 males, 174 females) participated in the 19‐year assessment. Results: Young adults with a higher CBCL‐DP score in childhood were at increased risk for substance use disorders, suicidality and poorer overall functioning at age 19, even after adjustment for parental education, family income, impairment and psychiatric disorders at baseline. Childhood dysregulation was not related to bipolar disorder in young adulthood. The CBCL‐DP was neither a precursor of a specific pattern of comorbidity nor of comorbidity in general. Conclusions: Children with high CBCL‐DP values are at risk for later severe, psychiatric symptomatology. The different developmental trajectories suggest that the CBCL‐DP is not simply an early manifestation of a single disease process but might rather be an early developmental risk marker of a persisting deficit of self‐regulation of affect and behavior.

Adult Outcomes of Childhood Dysregulation: A 14-Year Follow-up Study

Abstract: OBJECTIVE Using a general population sample, the adult outcomes of children who presented with severe problems with self-regulation defined as being concurrently rated highly on attention problems, aggressive behavior, and anxious-depression on the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) were examined. METHOD Two thousand seventy-six children from 13 birth cohorts 4 to 16 years of age were drawn from Dutch birth registries in 1983. CBCLs were completed by parents at baseline when children from the different cohorts were 4 to 16 years of age and sampled every 2 years for the next 14 years. At year 14 the CBCL and DSM interview data were collected. Logistic regression was used to compare and contrast outcomes for children with and without dysregulation, as measured by the latent-class-defined CBCL-DP. Sex and age were covaried and concurrent DSM diagnoses were included in regression models. RESULTS Presence of childhood CBCL-DP at wave 1 was associated with increased rates of adult anxiety disorders, mood disorders, disruptive behavior disorders, and drug abuse 14 years later. After controlling for co-occurring disorders in adulthood, associations with anxiety and disruptive behavior disorders with the CBCL-DP remained, whereas the others were not significant. CONCLUSIONS A child reported to be in the CBCL-DP class is at increased risk for problems with regulating affect, behavior, and cognition in adulthood.